How can the UK's National Health Service transform critical care to ensure resilience during the COVID-19 pandemic?

The Challenge 

Amidst the challenges of the COVID-19 pandemic, the NHS was faced with an unprecedented crisis. With unpredictable surges in critically ill patients threatening to overwhelm individual ICUs, healthcare leaders required a novel strategy for managing the most unwell patients.

The Approach

I developed a large-scale research program with the NHS, across multiple ICUs. The concentrated effort was aimed at scrutinizing and refining critical care operations to bolster health system resilience. 

I engaged with a diverse range of stakeholders, utlizing ethnographic methods to understand the lived experiences and challenges of those working in ICU. Data collection encompassed:

The Key Insight 

The immersive review of ICU’s role within the NHS’s response to the pandemic revealed an urgent need for process improvements within hospitals. 

Despite being a national health services, hospitals and their ICUs were designed to act independently and autonomously. This undermined their collective ability to respond to a pandemic, while existing practices and outdated policies limited capacity transfers. These factors threatened equitable patient access to care during patient surges.

The Outcomes


Successful design & launch of a patient service for transporting critically ill patients between ICUs, leading to a balanced and efficient provision of care across geographies with negligible additional HCP and capital spend.


Implementation of transformative changes, leading to operational improvements within hospitals and ICUs, enabling the service to better handle unpredictable patient surges.


Co-creation of new national healthcare policies, via active engagement with UK policymakers; leaving an enduring footprint on the UK's healthcare landscape.

Client Feedback

It is clear that McKenzie undertakes his work with the aim of generating a positive impact on healthcare, and society more broadly.

Throughout the process McKenzie worked closely with our organisation to ensure the accuracy of his work, while simultaneously disseminating key findings to support our ongoing decision-making, policies, and practices. The output generated has always been of the highest quality.

Despite the challenging conditions of COVID-19, McKenzie's approach was both insightful and optimistic. His presence was a constructive force and his commitment to improving healthcare for patients and healthcare professionals is clear.

— Peter Wilson, Specialised Commissioning Medical Director, NHS England, Oct 12, 2022

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