DR MARK SIMMONDS

DIVISIONAL DIRECTOR, MEDICINE. CRITICAL CARE CONSULTANT

Nottingham University Hospitals NHS Trust the hospital to cope with the challenges of Covid-19 whilst maintaining ‘normal’ services as much as possible. This involved effectively duplicating many hospital services for Covid-19 and nonCovid-19 patients resulting in the need for two EDs, two admission pathways and a rapidly progressing need for inpatient beds.

I am an intensive care consultant working clinically about 50 per cent of the time, but am also Divisional Director for Medicine at Nottingham University Hosptial NHS Trust (NUH), so Covid-19 was a double whammy for me! NUH is one of the largest hospitals in Europe with up to 1000 emergency attendances per day and 1600 beds spread across two campuses. We serve a population of around 1.2 Million and are the Major Trauma and Neuro centre for the East Midlands.

The response from our staff in this rapidly evolving situation was extraordinary with everyone volunteering to go the extra mile. The sense of camaraderie and collaboration was something I have never witnessed before. I know of many things that we would have done differently in retrospect but I am almightily proud of how Nottingham responded to the Covid-19 crisis. It led to innovations in ICT, systems, processes and patient care in a matter of days that, in normal times would have taken months to implement.

We managed to lead the country in the maintenance of cancer care despite the crisis and, although other waiting lists have suffered, our population is getting the urgent, emergency and cancer care that it needs.

Did you experience lockdown and if so, to what extent? How did that impact your work?

It was odd because I wasn’t massively affected by it in comparison to my wife and kids. I got up, went to work, came home, watched Netflix! Not that much different to normal!!!

What has been the biggest impact on your personal life and why?

The biggest impact on my personal life was not being able to travel with my family. We were meant to be going to Dubai, Malaysia and Florida this year but that turned into Cornwall, a canal boat and Northern Ireland! Which actually were brilliant and much more relaxing than long haul!

When do you see things returning to ‘normal’? Or do you think they never will? Genuinely, we can not sustain this life beyond March next year. Winter is going to be tough, but at some point we are going to have to live with the disease (and its consequences). I am a guinea pig on the Covid-19 vaccine trial and am confident that this will have a profound effect early in the new year.

In my clinical role, I was caring for patients on our Covid-19 ICU who were highly complex and many extremely unwell. The challenges of full PPE and strict isolation affected every aspect of normal ICU work and in this new and tricky disease we learnt a lot as time went on. Covid-19 is not a classic pneumonia so our usual treatments and procedures didn’t always help. Being unable to talk face to face with relatives was particularly difficult as this is usually a substantial part of my role as a consultant: keeping them informed, understanding and realistic about their loved ones’ prognosis and plans. Although our outcomes were good in comparison to other units, our ICU Covid-19 mortality was around 25-30%.

The real challenge though, was my managerial role as Divisional Director for Medicine, which I had only started in February which was impeccable timing! This role is accountable for the work of nine specialities including ED, Geriatrics and Respiratory, all of which were in the forefront of Covid-19 care.

I had previously led our Urgent and Emergency Care Directorate through a very difficult winter but to be honest, the middle of March into April remains a bit of a blur for me. We very rapidly had to redesign virtually every aspect of

The Covid-19 crisis has been a tragedy for many and I believe we will be feeling the negative after effects for many years to come but if you asked me whether our hospital is better now than it was before, I would have to say yes. We have learned more about our capabilities and weaknesses in the last six months that we usually do in five years and made changes (for the better) that we will never go back on.

What was the hardest or most frustrating part of your job?

Concerns about PPE shortages and an ever changing set of guidelines for its use from the government.

How do you think the country coped with the pandemic?

I think we all learned a lot about ourselves, what is important, and how the crazy expectations of modern life may not actually be necessary to live.

Was there anything that could have been done differently?

Honestly, I don’t think there was one right answer. It is too early to tell whether the UK, Swedish, New Zealand or Korean response was right. I think what we can say is that the US response wasn’t.

Are you keen to return to life they way it was before the pandemic, or have you reconsidered a change in your lifestyle or even career as a result of it?

I’ll tell you next year!

What do you miss most about MHS?

The extraordinary teachers. I couldn’t have done any of this without learning from Mr Brownlee, Mr Luke and Mr Hughes and many others, as well as the early leadership training that being Head of House under Mr Williams gave me. Having said that I also can trace many of the skills I have had to use in recent months back to the compassionate leadership and willingness to break the mould that I learnt from Roger McDuff and Aubrey Haigh at Belmont.