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Setting up an emergency medical task force to manage the demands of COVID-19: experiences of a London teaching hospital
  1. Pramit Khetrapal1,2,
  2. Sophie Skarbek3,
  3. Louis Tapper3,
  4. Claire Mason3,
  5. Sarah Davis3,
  6. Daisy Henderson3,
  7. Ben Riley3,
  8. Liam Price3,
  9. Charlotte Cumby3,
  10. Caroline Kennedy3,
  11. Hannah Woodcock3,
  12. Neel Jain3,
  13. Shier Ziser3,
  14. Timothy Yates3,
  15. Jay Mehta3,
  16. Alex Amphlett3,
  17. Deirdre Dinneen4,
  18. Umaira Aziz3,
  19. Vanisha Parekh3,
  20. Bimbi Fernando3,
  21. Paul Dilworth3,
  22. Amir Jehangir5,
  23. John Connolly3,
  24. Rupert Negus3,
  25. Nick Murch3,6,
  26. Aoife Molloy3,
  27. Christopher Hui3,7,
  28. Aine Burns8
  1. 1Division of Surgery, University College London, London, UK
  2. 2Department of Urology, Royal Free Hospital, London, UK
  3. 3Royal Free London NHS Foundation Trust, London, UK
  4. 4Kheiron Medical Technologies, London, UK
  5. 5Department of Acute Medicine, Royal Free Hampstead NHS Trust, London, UK
  6. 6Nightingale Hospital, London, UK
  7. 7Shenzhen Hospital, Shenzhen, Hong Kong
  8. 8PME Department, University College London Centre for Nephrology, London, UK
  1. Correspondence to Dr Pramit Khetrapal, Division of Surgery, University College London, London W1W 7TY, UK; p.khetrapal{at}ucl.ac.uk

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Introduction

The WHO declared COVID-19 a pandemic on 12 March 2020.1 Within 2 weeks of the first identified case in the UK, the number of confirmed cases had increased from 20 to 1500.2 3 By 12 May 2020, the UK had the fourth highest number of cases in the world, and the second highest number of deaths due to COVID-19 infection, with 225 000 positive cases and over 32 000 deaths. London had the highest incidence in the UK with 25 980 confirmed cases,4 which was especially concerning given the population density in the capital.5 6 Hospitals in London, therefore, saw an exponential rise in patients presenting with COVID-19 pneumonitis, necessitating the formation of new wards and an urgent need to support those responsible for them in General Medicine and Intensive Care.

The arrival of COVID-19 caused huge disruption to the regular workflow of hospitals throughout the UK.7–9 Most specialties cancelled elective activities in mid-March 2020, and the Royal Colleges suspended training10 to permit redeployment of trainees. Doctors were transferred from both medical and surgical disciplines to maximise the total workforce pool.11 For many, this was a very stressful time, faced with demanding work outside their chosen specialty, placed on schedules at very short notice with no annual-leave permitted and with no clear endpoint.12 Research posts and placements integral to individuals’ training were suspended.

The Royal Free Hospital is a major university teaching hospital, and hosts the only high-level isolation containment unit in London. It provides healthcare services to a wide catchment population in excess of one million people. Additionally, it is a tertiary referral centre for centralised services such as cancer immunology, rheumatology, liver and kidney disease, transplantation, complex vascular surgery and other specialist disciplines. In anticipation of the added pressures from the COVID-19 outbreak, many …

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Footnotes

  • PK and SS are joint first authors.

  • Twitter @p_khetrapal

  • Contributors PPK, CH and AB wrote the first draft of the manuscript. All authors contributed to critical revision of the manuscript for important intellectual content, gave final approval and are accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. CK and CC contributed to revision of English language.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.