Matt Morgan: Treating a VIP patient

When the UK prime minister returned to Downing Street just two weeks after leaving hospital, some people questioned whether he had really needed to be treated in the intensive care unit (ICU) in the first place.

Without speculating on Boris Johnson’s individual case or the amazing work of the staff who treated him at St Thomas’ Hospital, the uncomfortable truth is that most hospitals have “VIP policies” to admit presidents, politicians, or even celebrities to isolation rooms in the ICU, even when they may not medically need it. However, this is designed to protect not the “high value” individuals themselves but rather the care system and other patients around them. And, bizarrely, this policy may cause unintended harm to the VIPs having so called special treatment.

For a hospital to best care for patients it needs a tangled web of people, equipment, departments, and systems to function together. As soon as—for example—a president or a Love Island celebrity arrives on a ward, the delicate interplay between these components can quickly go wrong. The car parks become crowded with journalists, whispered corridor conversations between health workers are overheard, medical record security can become compromised, and open access to wards has to be restricted.

Cumulatively, such lapses in hospital protocol can have a negative impact on the care of patients who are far removed from the VIP. Admitting people to an already restricted and controlled area of the hospital, such as the ICU, can help mitigate harms to others.