Protecting the Health Service and Managing the COVID-19 Pandemic Surge: The Unintended Impact of Service Reconfiguration on the Specialist Rehabilitation Service at a Regional Teaching Hospital

As part of the UK National Health Service (NHS) preparations to manage impact COVID-19 pandemic on hospital services, clinical guidelines that emphasized expansion acute care capacity in managing anticipated surge cases were implemented. Clinical wards reconfigured and routine face-to-face outpatient clinics suspended. Some changes include workforce facilities reorganization. One implemented at Hull University Teaching Hospitals NHS Trust (HUTHT), was relocation Complex Rehabilitation Ward from its 15- bed base Queen’s Centre for Oncology a repurposed 12-bed surgical ward within main Castle Hill Hospital (CHH) building March 2020. Methods: A comparative review admissions outcome measures data (admission diagnosis; referral source; PCAT: Patient Categorization Tool; LOS: Length Stay; Bed occupancy discharge destinations) over 4-month period (March-June 2020) undertaken compared retrospective corresponding 2019) previous year determine delivery specialist rehabilitation patients with complex needs during episode. Results: reduction total number admitted (n=28 2019; n=18 reduced 99% 2019 72% 2020 despite noted following relocation. shorter length stay mean 29 days while an increase patient complexity as demonstrated by PCAT scores observed. The proportion achieving home destination opposed other residential increased, accounting 89% among discharged patients. Conclusion: This some combat 1st wave coronavirus pandemic, specifically inpatient tertiary setting. Though higher had increased complexity, significant observed ward-relocation similar quarter 2019. findings also reflected capacity. there is duration greater achieved destination, this compromise process due constraints new environment. Significant quality therapy programmes delivered longer-term will need be monitored. highlights consideration response planning mass casualty events.