A 'herculean' effort by staff has prevented operations from being cancelled at Norfolk's crumbling hospital - despite the loss of four of its operating theatres.
Four of the seven theatres at the Queen Elizabeth Hospital in King's Lynn were closed two weeks ago after work to shore up their ceilings was brought forward.
The roof of the entire hospital is being supported to prevent it collapsing, as concrete planks which are still in place more than a decade after their expected working lifespan begin to sag and fail. More than 2,500 props are now in place.
While staff wait anxiously to hear if the government will agree to fund an £862m rebuild, the latest setback has seen many working extra hours to ensure patients' operations can go ahead as planned.
Laura Skaife-Knight, the 500-bed QEH's deputy chief executive, said: "We've got staff working evenings and weekends.
"We're not just talking doctors and nurses, it's porters, cleaners and receptionists. They're pulling out all the stops, quite literally."
Bread and butter elective surgery such as hip and knee replacements, some gynaecological procedures and ENT - ear, nose and throat - operations have been transferred to the Sandringham Unit, a former private hospital which the QEH bought two years ago, which stands on part of its site.
Some patients have also been moved to the newly-opened endoscopy unit near the hospital's main entrance.
"We're running every day at pretty much 100pc bed occupancy," said Mrs Skaife-Knight. "We've got the challenges of a rolling RAAC (reinforced autoclaved aerated concrete roof plank) programme.
"We're planning for winter, but there's no real distinction between the seasons for us now, we're in winter mode all-year round.
"We're seeing sustained and unprecedented pressure on emergency care, we've got the backlog from Covid.
"When you band all of those things together it's like having a massive jigsaw puzzle to do every day, we're having to constantly move things around."
Kerry Broome, the hospital's deputy chief operating officer, oversees elective care as planned operations are known.
She said despite losing the theatres - for work which is expected to take eight months - staff had managed to prevent the hospital losing capacity.
"The teams are really pulling together," she added. "They're thinking out of the box.
"It's not just about patients and staff. It's equipment, it's does the theatre need a hoist? It's what's the airflow like?"
The QEH has already met the government's post-pandemic target of no-one waiting more than 104 weeks for non-urgent surgery.
The next target of 78 weeks comes into force at the end of March.
"We are expecting to hit that 78 weeks by March 31," said Ms Broome. "Thanks to the herculean efforts of our staff."
Those who need an operation more urgently will have it performed in far less time. The loss of the operating theatres may mean a brief delay for some.
"Our aim is not to cancel anyone's operation but there may be some inconvenience," she said.
"If we had a patient we had booked in for a Tuesday, we may have had to juggle a number of patients' days around, say to a Friday."
As the QEH waits for health secretary Therese Coffey's visit later this month, to see the state of what is believed to be Britain's most dilapidated hospital for herself, Mrs Skaife-Knight said it's capacity had long been outgrown. One of the highest demands is on the A&E unit.
"We need a new emergency care centre, designed for what we need now, not 40 years ago," she added.
Staff would add probably add operating theatres which do not have to be abandoned because the roof is threatening to cave in on them and patients to the wish-list.
The QEH was not included in a list of 32 new builds announced by then Prime Minister Boris Johnson two years ago. It now hopes to be one of eight further schemes expected to be announced later this year.
Plans for a new hospital 38pc larger than the current one on what is currently the car park have been drawn up.
Mrs Skaife-Knight, Mrs Broome and other senior staff are quietly confident it will come to fruition, having made a compelling case.
With the current QEH predicated to become unsafe to use after 2030, there is no credible alternative to a new hospital.
Before she was elected Tory leader and became Prime Minister, South-West Norfolk MP Liz Truss said she would ensure the new hospitals programme launched by her predecessor would continue and she was aware of the QEH's crumbling roof. Afterwards, she said the decision was down to Ms Coffey.
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