Cost of Bristol's unused Nightingale hospital revealed

Viewed as an insurance policy for hospitals across the region, the Nightingale was set up in less than three weeks last April to provide up to 300 intensive care beds. 

But by June it was placed on standby and soon NHS leaders were looking at other uses for the facility. It was used for assessments and treatments of more than 7,000 non-Covid patients before it closed on March 31 this year, and is now being decommissioned. 

The NHS confirmed last year that England’s seven Nightingales cost £220million to set up. Together with the running and decommissioning costs, the final bill will be more than half a billion pounds. 

Figures from North Bristol Trust, which managed Bristol’s Nightingale hospital, now reveal the facility cost £15.6million to set up and around £1million a month to keep running. 

Contracts were awarded in a matter of days – the University of the West of England would host it and Kier would convert Frenchay campus exhibition centre. 

Reflecting on the process in UWE’s Bristol Distinguished Address Series in October, vice chancellor Steve West said he received a call on March 25 last year, Army surveyors came the following day, then on March 27 “things really kicked off”. 

He said: “I was required to make the decision as to whether or not we would hand over the exhibition centre for this purpose and that was probably one of the easiest decisions I’ve ever made. 

“We set sail hoping that it would never, ever have to be used.”

Kier was the main contractor. Operations director David Snell said NHS England had challenged him on March 26 to pull a team together, he gave a presentation and that night was told he had been successful. 

“Mentioning the Nightingale hospital in any correspondence or conversations ensured at that time that we got a high level of commitment, and it couldn’t have been easier to marshal the troops,” said Mr Snell.

The hospital was designed to receive patients who had already been intubated and ventilated at other hospitals across the South West.

Marie-Noelle Orzel, who was the Nightingale’s chief officer, had worked in Iraq and in the Balkans but said setting up Bristol’s coronavirus field hospital was a unique experience. 

“What I think was very different about the Nightingale was the pace,” she said on the Bristol Distinguished Address Series video. “With these projects you usually monitor progress using months and years – we didn’t have that luxury.”

She added: “If you allow the experts to get on with it, they’ll get on with it quickly. 

“That was very different in the Nightingale experience, we really didn’t have the bureaucratic chain, they trusted us as experts.

“We always thought of ourselves as an insurance policy for our wider NHS colleagues.” 

The Nightingale Hospital in Bristol (Image: NHS Nightingale Hospital Bristol, free to use by all partners)

Nightingale hospitals were also set up in London, Birmingham, Manchester, Harrogate, Exeter and Sunderland. 

Tim Whittlestone, the hospital’s chief medical officer and a consultant at Southmead Hospital, said the process of setting up Bristol’s had benefited from “pared down” governance. 

He said: “How did we manage to progress at such pace? I think for me the biggest factor was emotion. We were looking at images nightly on the TV of mass casualties in Italy, we were seeing people being removed from the back doors of intensive care units in New York and taken to mass burial sites, and we had modeling which demonstrated that that we could be facing a similar fate in the United Kingdom. 

“Here at Southmead, we were having conversations in the intensive care community about what would happen when we were full and what would happen when the next 50-year-old came into hospital requiring intubation and ventilation and us not being able to provide that care. There’s nothing more devastating for any clinician than simply not being able to offer care.”

Mr Whittlestone said the government had since listened to local NHS bosses who said the South West needed more intensive care beds, and had promised additional investment. 

Ms Orzel said the hospitals in the Severn network had managed to cope with their capacity but the Nightingale had remained as an insurance policy. 

While on standby it offered day treatment and assessments to patients 7,284 patients from the Bristol Royal Hospital for Children and the Bristol Eye Hospital – but it would have quickly been able to revert back to an intensive care Covid-19 hospital had it been needed. 

A spokesperson for NHS England said: “Identifying the locations of all Nightingale sites was led by NHS England and NHS Improvement (NHS E/I) and the process for the refits followed established procurement guidelines for the NHS. 

“Processes have been put in place to redistribute all the clinical equipment from the Nightingale Hospital Bristol equitably across the Severn Network.

“While on standby, the hospital was used to treat 7,284 patients from the Bristol Eye Hospital and the Bristol Royal Hospital for Children. The last patient was treated at the Nightingale on March 31, 2021.

“NHS E/I are currently reviewing all spend incurred for each of the Nightingale Hospitals.  This work is not yet complete.” 

A Kier spokesperson said: “Kier is one of six principal supply chain partners on the Procure22 framework, a construction procurement framework that is used to develop and deliver healthcare schemes across England.

“We have a proven track record of delivering healthcare schemes through this framework, which was the procurement route for NHS Nightingale Bristol, and we utilised our skills and expertise to quickly mobilise and transform the conference centre at UWE Bristol within 20 days.”

UWE declined to comment.