Critical Care at UCLH

I stood in the Critical Care Unit (CCU) at University College London Hospital (UCLH) today, for Governor purposes by the grace of God, talking efficiency-savings and cuts with one of the brilliant staff there. In the midst of our talking it suddenly occurred to me that the acronyms we were bandying about would have completely passed me by 6 months ago. What a time it’s been!

This afternoon I spent some time with one of the brilliant nurses in the CCU in the UCLH tower. I went to discuss the ‘Prevention and Management of Pain’ benchmarking exercise with the staff lead but will save that for next time. While I was there, she kindly took me around her area of work and explained some of the key aspects of their work and the challenges ahead.

The CCU, with a full 35 beds, is one of the largest units of its type in the country and provides care for around 2,500 patients a year. Critical care is a incredibly specialised area of work, where staff are trained to react quickly to problems as they arise and use state-of-the-art equipment to look after the very ill. This unit have a lot to be proud of as national intensive care audits have shown the survival rates to be some of the highest in the country.

Our CCU incorporates an adult intensive care, high dependency care, the Post-Anaesthesia Care Unit, a critical care outreach team and the critical care follow-up clinic. Critical care deals with a wide range of problems but typically patients have problems with one or more of their organ systems (e.g. lungs or heart).

The work and care being put into the patients is tremendous (thank God for the NHS) but the hard part for me was seeing loved ones gathered round the very sick as I passed the bays and isolation rooms. I can’t begin to imagine the heartache and awfulness of seeing someone you care about so very unwell. I am thankful for the work of the chaplaincy team and psychologists to support families and friends through these times.

As I understand it, no matter how many parts of the NHS become privatised, critical care units will almost certainly remain in the public domain because of the high cost of care. While private companies/hospitals will happily take on the simpler cases (easy money), any serious problems that arise with the patient will then lead to necessary transport out to a hospital with an A&E, critical care unit or similar.

I am reminded of a something a fellow hospital governor, and much more prolific blogger than myself, said in a post about specifically choosing NHS services over anything else. By always supporting and choosing your local NHS hospital services, those elements of the hospital that make a surplus (Richard explains that well in his post) help to support those crucial services the hospital provides that don’t, typically A&Es, CCUs, and similar difficult and complex areas of care. As Richard puts it “Literally, if you have you hip operation paid by the NHS at a private hospital, there will not be the money to treat sick kids.”

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