Bespoke ophthalmic hub installed at Royal Preston Hospital

The use of an innovative and bespoke ophthalmic hub at a hospital in the North-West has been flexed during COVID-19 to meet the needs of the hospital and its patients.

When it was first created by Vanguard Healthcare Solutions, working with Lancashire Teaching Hospitals NHS Foundation Trust, the ophthalmic hub at Royal Preston Hospital was required to add additional capacity for procedures such as cataract surgery.

The hub was created by using two Vanguard two laminar flow theatres. When it opened, one unit was used for general anaesthesia ophthalmology procedures while the other saw teams carry out local anaesthetic ophthalmic procedures such as cataracts.

The theatres are connected by a bespoke-designed modular building which houses consulting rooms, waiting room and reception as well as a two-bed ward area and other facilities such as a kitchen - creating a “one-stop” facility for eye surgery at the Preston site.

Before COVID-19 struck, both theatres were working daily, helping to reduce waiting lists for conditions such as glaucoma, ocular plastics, cancers of the eye and cataracts. In the theatre being used for local anaesthetic work, the team, had carried out more than 100 cataract procedures in just two weeks.

All work on the unit halted as a result of COVID-19 and the cancellation of all elective surgery.

However, its location away from the main hospital site, and as a self-contained environment, made it ideal for use for emergency surgeries and smaller plastic surgeries during the early stages of the pandemic.

During the first weeks and months of COVID-19, with elective surgery lists halted, the unit was used for emergency ophthalmology procedures including emergency vitrectomies for detached retinas as well as plastics trauma and cancer surgeries. It was also used for smaller local anaesthetic plastics cases.

The lists were full every day and the Vanguard team increased its staffing numbers from five to eight to account both for the new procedures the team had to follow when working to stay COVID-secure, and to allow for PPE changes, without slowing lists down.

Staff were also sometimes used to supplement the Trust’s staffing teams on the main theatres within the hospital.

Designed and built by Vanguard, the mobile theatres each provide an anaesthetic room, operating theatre, two bed first-stage recovery area, staff changing room and utility areas. They sit either side of the specially-constructed reception, ward and recovery facility.

Vanguard laminar flow theatre facilities offer HEPA-filtered environmental air that conforms to Grade A EUGMP, with up to 600 air changes per hour passing over the patient, and 25 fresh air changes.

Dr Shveta Bansal, Consultant Ophthalmologist at Lancashire Teaching Hospitals NHS Foundation Trust and Clinical Lead for the project, said:

“Having the Vanguard unit as a standalone facility separate from the hospital was a huge asset during the early stages of COVID-19. The hub had been extremely busy prior to the pandemic, and remained busy and extremely effective throughout, supporting us to continue surgery outside of the main hospital theatres.

“We also installed a portcabin in between theatres, which has helped with patient flow in that we can admit and review pre-operatively and post-operatively in the same location. This has really helped to boost patient experience as it has meant that patients can be admitted on a pathway separate to the main admission area, keeping elective work going. We want to thank Vanguard for their support and expertise in getting the hub up and running.”

The hub is now performing a range of ophthalmic procedures each day.

Simon Squirrell, Vanguard National Sales Manager said: “COVID-19 has brought extensive challenge to our colleagues right across the NHS. We have been honoured to have been able to contribute to their efforts to maintain care for patients in whichever ways we possibly can. At Preston, our teams worked tirelessly to support their colleagues at the hospital to continue to deliver essential patient care.”