FACILITIES MANAGEMENT The peak period
March and April were the peak times for the NHS in the UK, and from our experience as a team, it felt that London was hard hit. The work we had done to refurbish and extend wards was focused on coping with the increased number of beds needed for admissions with the virus. The majority of these beds needed access to oxygen to help the patients’ treatment – but that presented its own set of specific problems. The ventilators critical to the survival of COVID-19 patients in intensive care require a reliable flow of oxygen. NHS England Medical director, Stephen Powis, said that oxygen is ‘the key supportive treatment to those with lung infection or disease with COVID-19’, when answering a question about another London hospital issuing a patient safety notice about the risk of running out of oxygen. The Medical Oxygen plant at QEH was under pressure supplying oxygen around the hospital, and so we had to take action to ensure that the pipework did not freeze over. In the very short term, one of our team was stationed outside 24/7 to continually run warm water over the pipes. Welcome to the world of medical gas FM.
Working hard to deliver sustainable improvements We then worked hard to deliver sustainable improvements. Warren Hubbard, VINCI Facilities Sector director for Healthcare, explains: “No hospital has ever been designed to have a ventilator at every single bed space; never have hospitals needed it – until now. As patient numbers increased, bed spaces became less and less, with more and more people needing a ventilator connected to the oxygen system; the systems began to show the strain. We had to focus on what the oxygen system could cope with, and share the information with the clinical teams”
We worked with colleagues at our Coventry Hospital contract and our VINCI Technical Engineering team to share our joint understanding of the hospital infrastructures and the complex oxygen ‘flow rate’ calculations. This was critical. While the UK media was fixated on the procurement and manufacture of the ventilators, we focused on providing the right information about oxygen flow rate capacity to minimise the risk of the ventilators failing. Once we did that, we could then help clinical teams increase the bed capacity in a safe and sustainable way.
Getting Medical Oxygen to where it was needed
“Establishing those facts allowed the team to make sure they had the oxygen where and when it was needed,” explained Warren Hubbard. “There are many variables in the calculations – from pipe
As a business, VINCI Facilities teams work at 11 hospitals across the UK.
Like other FM teams in healthcare, VINCI’s frontline staff are used to adapting to and responding to the day-to-day needs of clinical teams and support workers across the hospitals the business supports.
sizing through to physical types of ventilators – but the critical factor comes down to patient flow rates. The original hospital designs did not allow for a scenario where COVID-19 patients needed such consistent high flow rates of oxygen with a ventilator at every bed space. What our teams did was determine a new calculation method that was rolled out across all of the hospitals VINCI Facilities supports, and that was quickly taken up across the NHS.”
This type of solution delivery is what we enjoy doing. After all, FM professionals are problem-solvers. However, COVID-19 was unique. Despite this, as part of the business continuity plan, it was important for our teams to continue as usual – which normally means keeping off the wards as much as physically possible, and allowing the clinical teams to deliver their vital, skilled care to patients. However, increasingly, during the peak of the crisis, it began to feel that the usual lines of behaviours were being blurred. We were all in this together.
Changes in behaviour
We could see changes creeping into our own behaviours. Our team ethic is strong – reinforced by culture, a VINCI Facilities way of doing things. So, when we had extra engineers transfer to the healthcare team from other contracts, they fitted in well. We also brought in some of our apprentices – many of them in their late teens or early twenties. Things seemed fine, but amidst the extra workload and shift patterns we were also very aware of the challenges and sorrow the virus brought with it on and off the ward. There were some experiences that none of us had seen before, and duties performed that had never been previously required – particularly by the younger members of the group. We began to notice that although the team was pulling together, these experiences were affecting the team members’ mental health and wellbeing.
A time of uncertainty
I wanted to ensure that the team knew that although it was a time of uncertainty, we were all in this together, and that we all felt the same. We opened up – I shared my own feelings and those of the management team. I explained that what they were feeling was exactly the same as us, and that I wanted us to all keep talking to each other, keep checking in with one another. If they felt that they wanted to speak with a certain supervisor, manager, or myself, then all they had to do was ask. Then, to boost morale, we had coffee mornings and Pizza Fridays. One afternoon we thought it would be a laugh to do a fancy-dress Friday. It went down brilliantly; the team really took to the idea, and week on week they came back bigger and better. It bound us together, and also brought a smile to the face of NHS staff and patients at the hospital. We even had senior members of the Estates team of Lewisham and Greenwich NHS Trust join in, which was fantastic.
October 2020 Health Estate Journal 35
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