HEALTHCARE DELIVERY
Warnings over increasing pressures on the NHS
On average, across the whole of last winter, around 95% of the almost 100,000 available beds in England were occupied, even with all the extra escalation beds pressed into service. The situation for 2017 looks even bleaker, according to a leading think tank. As the NHS faces unprecedented pressures, concerns have been raised that hospital- acquired infections will rise and patient safety will be compromised.
The Nuffield Trust has warned that pressure on NHS beds could compromise patient safety. The think tank found that the pressure was so acute that, on any given day last winter, the equivalent of more than five extra hospitals’ worth of beds had to be brought into service to cope with surges in demand.1 On the single busiest day last winter, an extra 4,390 beds had to be opened, equivalent to more than seven extra hospitals in one day. Furthermore, on average, over 95% of beds across English hospitals were occupied every day last winter – despite evidence that once bed occupancy rates exceed 85%-90%, there is an increasing risk of infection.2
Given that
pressures on the health service have not lessened over the last 12 months, Trusts will face similarly high bed occupancy rates this year.
The Winter Insight Briefing explains that high bed occupancy rates are a real problem
for both patients and staff in the NHS: l Firstly, as occupancy levels rise, it gets harder and harder to find beds for emergency patients who need to be admitted from A&E – affecting a hospital’s ability to meet the standard that 95% of patients attending A&E should be treated, admitted or discharged within four hours.
l Secondly, high rates of occupancy lead to problems in maintaining cleanliness and infection control.
l Thirdly, high levels of bed use can make patients’ experience of hospital unpleasant and disruptive, as patients are moved around to accommodate others, or placed on inappropriate wards (elderly patients on obstetrics wards, for example) when there are no free beds on the right ward for them.
l Finally, hospitals need some slack in the system to be able to deal quickly and
efficiently with outbreaks such as flu and norovirus, where numbers affected can rise very quickly.
The report also finds that: l The average number of extra beds brought into service on any given day last winter was 3,466, equivalent to at least five and a half extra hospitals’-worth of beds.
l On the single busiest day last winter, 26 January 2016, the number of extra beds hospitals had to make available to accommodate patients reached its highest level, when 4,390 extra beds were opened – equivalent to bringing onstream an extra seven entire hospitals on that one day.
l The previous day, 25 January 2016, one in seven Trusts reported that all their acute beds were full, and nearly four out of 10 had bed occupancy levels of over 98%. This was after opening nearly 4,200 extra beds that day.
l Throughout that week, nine Trusts were all full every day with 100% of their acute beds – including extra escalation beds brought in temporarily – occupied.
l On 1 February 2016, 72% of all Trusts recorded bed occupancy levels exceeding 95%.
l On average across the whole of last winter, around 95% of the almost 100,000 available beds in England were occupied, even with all the extra escalation beds pressed into service.
Commenting on the findings, Professor John Appleby, chief economist at the Nuffield Trust said: “Our analysis shows just how acute the pressure on beds was last winter, with around 95% of the beds in all hospitals in England occupied every day. With such high levels of bed occupancy linked to higher infection rates and longer waits in A&E, these pressures pose a real threat to the smooth running of
20 I
WWW.CLINICALSERVICESJOURNAL.COM MARCH 2017
© sudok1 - Fotolia.
Page 1 |
Page 2 |
Page 3 |
Page 4 |
Page 5 |
Page 6 |
Page 7 |
Page 8 |
Page 9 |
Page 10 |
Page 11 |
Page 12 |
Page 13 |
Page 14 |
Page 15 |
Page 16 |
Page 17 |
Page 18 |
Page 19 |
Page 20 |
Page 21 |
Page 22 |
Page 23 |
Page 24 |
Page 25 |
Page 26 |
Page 27 |
Page 28 |
Page 29 |
Page 30 |
Page 31 |
Page 32 |
Page 33 |
Page 34 |
Page 35 |
Page 36 |
Page 37 |
Page 38 |
Page 39 |
Page 40 |
Page 41 |
Page 42 |
Page 43 |
Page 44 |
Page 45 |
Page 46 |
Page 47 |
Page 48 |
Page 49 |
Page 50 |
Page 51 |
Page 52 |
Page 53 |
Page 54 |
Page 55 |
Page 56 |
Page 57 |
Page 58 |
Page 59 |
Page 60 |
Page 61 |
Page 62 |
Page 63 |
Page 64 |
Page 65 |
Page 66 |
Page 67 |
Page 68 |
Page 69 |
Page 70 |
Page 71 |
Page 72
