Cardiff and Vale UHB celebrates anniversary of Protected Elective Surgical Unit

Cardiff and Vale University Health Board (UHB) is marking the one-year anniversary of the Protected Elective Surgical Unit (PESU) or “Green Zones”.  

Developed in response to the COVID-19 pandemic in the first half of 2020, the Green Zones are dedicated units in the University Hospital of Wales, University Hospital Llandough, and with outsourced providers, specially designed and operated to minimise the risk of patients catching COVID-19 in hospital while keeping essential surgical services running. 

To do this the Health Board needed to create separate, self-contained, surgical areas capable of delivering the full range of surgical services to the highest standard in units appropriately staffed for each patient’s needs with predictable bed access. 

It was a multidisciplinary team effort, led by clinicians but with huge input from colleagues across the system including the Capital, Estates and Facilities, and Infection Control teams.  

Separate entrances were created with separate changing rooms and staff were timetabled to be restricted to the unit for the day. Rules were designed in relation to PPE and the movement in and out of the units. A locked door system was even designed for deliveries onto the units.  

Patients who were preparing for surgery were also asked to self-isolate for two weeks prior to their procedure and take a COVID-19 test 72 hours before being admitted to hospital.  

Since the launch of the Green Zones a year ago, staff at Cardiff and Vale UHB have carried out over 10,000 surgical procedures across the full range of surgical disciplines and associated complexity and No patients have been infected with COVID-19 while an inpatient in PESU. 

Although the main aim of the Green Zones was to prevent COVID-19 infection the unit has also recorded no C. difficile or MRSA infections in patients managed in PESU to date. 

Clare Wade, Director of Nursing for the Surgery Clinical Board at Cardiff and Vale UHB, said, “We are so proud of our teams and what we have achieved here. We believe this has significant cost and health quality benefits to us and we would like to be able to share and spread this across the wider NHS in Wales and health systems beyond. We believe based on our experience of creating three units in three different sites, that this model can be adopted in any hospital in Wales or the UK, where emergency patient flow competes with complex planned care, with a minimal amount of resource and enabling works.” 

Prof Stuart Walker, Executive Medical Director at Cardiff and Vale UHB, said, “The system-wide collaboration which we have seen on this project has been inspiring and I believe the results speak for themselves. The teams involved in this programme of work have set the standard for how surgery should be done and I anticipate that the learning we have gained from PESU will be embedded in the way we do things long into the future.” 

Ruth Walker, Executive Nurse Director at Cardiff and Vale UHB, said, “I would like to thank everyone involved in this programme of work for their efforts but especially the staff working in the Green Zones for their diligence, sacrifice and hard work over the past year. Following the regulations involved in working on the Green Zone and not leaving the unit for the entirety of your shift is incredibly difficult and the results we have achieved in minimising the risk of infection to patients are a testament to the people who staff the units and the extra distance they have gone this year to provide the best possible care.”