Guernsey Press

Staff maintaining high standard of care despite the challenges

DESPITE problems with overcrowding, lack of natural light and ageing facilities, the Princess Elizabeth Hospital’s Intensive Care Unit has produced results well above the norm.

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Lead Consultant for Critical Care David McColl. (Picture By Peter Frankland. 31435656)

A new ICU with more space, better privacy, more windows and – crucially – more capacity, is currently under construction and about a year away from completion.

However, the existing facility is performing well, according to the lead consultant for critical care, Dr David McColl.

‘We measure how unwell our patients are when they come in using a physiological scoring system – a statistical scoring system – and from that we can derive an expected mortality rate,’ he said.

‘One of the key metrics that we use to judge the quality of the provision is the number of actual patients who don’t survive, versus the number who would be expected statistically not to survive. What we see across the last five years is that in each year, our mortality rate has been less than half what would be expected, according to the severity of illness of the population that we’re treating.’

These results have come despite the current ICU having had to treat anything up to 11 patients at any one time, despite being set up for just seven.

Medical director Dr Peter Rabey attributes this success to a number of factors.

‘I think we have an excellent team of consultant intensivists,’ he said.

‘They’re a small team who work with each other all the time, so they’re constantly communicating. There are no junior doctors involved, so it’s purely consultant-based decisions, and I think that does help.’

He also praised the 50-strong team of nursing staff, but was keen to ensure all staff were recognised for their roles in maintaining the unit’s high standards.

‘The unsung heroes behind the doctors and nurses are the backup team of physiotherapists and pharmacology support and all the other people involved,’ he said.

‘It’s the whole package that makes the outcome so good, and we’re really proud of the whole lot.’

The ICU treated between 550 and 600 patients per year over the last five years but this figure is expected to increase.

‘The patients that we treat are getting older and they’re getting sicker,’ said Dr McColl.

‘They’re spending longer in intensive care and then needing more input and more support and that means that our bed occupancy and the number of beds that are occupied on any given day is increasing.’

In 2021, bed occupancy was 86.5%, but due to the significant fluctuations that are typical in ICUs, this is considered ‘way too high’, Dr McColl said.

‘We’re looking after critical care patients in parts of the hospital that are not designed for that. So the new unit will enable us to bring all of our critical care patients together and not have to look after them in disparate parts of the hospital.’