King's develops a new hybrid model of care for patients

Dr Akash Deep, Director of our Paediatric Intensive Care Unit, tells us how his team developed a new way of treating patients during the pandemic

King's arch with Golden Jubilee Wing in background

Q: Could you tell us about how you and your colleagues kept services running during the COVID-19 pandemic?
A: Across the UK, and all over the world, COVID-19 has put an unprecedented strain on our health and care services. In the very early stages of the pandemic, it became clear very quickly that we would all need to adapt extremely quickly to new ways of caring for our patients. Being one of the only three liver transplant centres for children in the UK and a trauma centre, we had to ring-fence beds for children on our Paediatric Intensive Care Unit (PICU). While increasing numbers of people with COVID-19 needed emergency treatment at King’s, we also needed to be able to look adults experiencing non-COVID acute illnesses, like heart attacks, brains tumours and other life-threatening conditions. Whilst a number of PICUs across the UK converted themselves to look after adult patients with COVID-19, we at King’s decided to expand our PICU and work with colleagues in adult services to deliver a hybrid model of care to treat critically ill non-COVID adults alongside paediatric patients on the same unit, cared by the same paediatric staff. Cross pollination of staff, education and collaboration were key to keep both services running on the PICU during this difficult time.

Q: What sorts of patients were you able to treat under the hybrid model?
A: During the first and second waves of the pandemic, we cared for 168 critically ill patients, including 59 adults with diverse non-COVID diseases. We were also able to make sure that 17 paediatric liver transplants took place safely. Children with brain tumours and head injuries were also treated as well.

Q: What were the most challenging moments?
A: Caring for adults with non-COVID-19 pathologies meant each bed had a patient with different disease, unlike, COVID-19 patients, who all have the same disease pattern. My colleagues and I cared for patients of all ages, with very different physical, medical and emotional needs. In one bed, for example, you might have a patient recovering from a road traffic accident, and in the next, you could find a baby with a life-threatening neurological condition. Each patient had a different set of very complex needs, and the whole team needed to be resilient as possible to rise to the challenge.

Q: What experiences stood out for you?
A: At every level, the staff I worked with were incredible. This was a completely new way of working for us all, and it was a privilege to see everyone coming together to make sure patients had the care they needed. We started the pandemic as colleagues, and I now consider them my friends.

Q: What will you take away from developing this new way of delivering patient care?
A: Planning is already underway to make sure we can respond to future waves of COVID-19, as well as seasonal peaks. We’ve successfully shown that this model can make sure critically ill patients can still receive the care they need during a pandemic, but perhaps most importantly we’ve learned that this hybrid model would not have worked without everyone’s communication, teamwork and dedication.