INPATIENT ACCOMMODATION


The pros and cons of single patient rooms examined


Three senior personnel at London-headquartered public service consultants, The PSC, Smriti Singh, David Chappell, and Sesha Nicholson-Lailey, discuss the implications of the New Hospital Programme (NHP)’s announcement that all new hospitals in England must include 100% single patient rooms. They explore such rooms’ history, their potential benefits and challenges, and the importance of involving clinicians in the planning stage, and discuss developing new ways of working, and leveraging digital solutions, ‘to fully realise single patient rooms’ benefits, and mitigate their challenges’.


The case for and against the mass adoption of single patient rooms has long been discussed in healthcare. Despite this debate, the shift to single patient rooms has long been on the NHS’s agenda,1


and


on the agenda of the Conservative Party, for over a decade.2


In spite of the political


position, Trusts in England have, until now, been allowed to decide the number of single patient rooms in new-builds. As a result, uptake has varied, and while other parts of the UK have opened a number of hospitals with all single patient rooms,3 England currently only has two. The first hospital in England to provide only single patient rooms, in Tunbridge Wells, and the second, the Royal Liverpool Hospital, opened their doors in 2011,4 2022, respectively.5,6


and October


Threat from airborne infection Following the COVID-19 pandemic, the view in England has changed. The pandemic meant that NHS health leaders had to consider the threat from airborne infection at a serious level and scale. In October 2021, NHS England and NHS Improvement’s National Medical director, Stephen Powis, signalled that single patient rooms should be the ‘default’ for inpatients in English hospitals.7


Following


this, leaders of the NHP announced at the December 2022 NHP Industry Day that all new hospitals in England would have 100% single patient rooms.8 Despite this change in policy on single


patient rooms, there is an incomplete picture of their impact, with the significance and evidence of their benefits still hotly debated across the sector. Speaking at the NHP Industry Day, the programme’s leaders said that there was no ‘empirical scientific evidence’ to justify the announcement.8 While evidence in the UK is limited,


a literature review of US studies, where single patient rooms are a regulatory requirement, found that the advantages seem to outweigh the potential disadvantages.9


Figure 1: In 2011, the new Tunbridge Wells Hospital in Kent became England’s first NHS hospital to have 100% single patient rooms.


potential benefits and challenges of single patient rooms are for hospitals in the UK.


Benefits Studies show that single patient rooms bring a number of benefits, to both patients, and healthcare providers and systems.


Patient outcomes and experience In addition to the widely accepted improvements to patient experience, single patient rooms’ increased protection and privacy supports better doctor- patient communication, which in turn translates to patients feeling informed about their care, and confident in discussing their needs.10 Single patient rooms are also quieter than open wards. As a result, patients report less stress over patient interactions, and a greater ability to rest and sleep without being disturbed,11


which in


turn have been linked to better patient outcomes.12


We will consider what the One study found that single


patient rooms resulted in decreased risk of delirium in elderly patients, a disorder


that has been linked to higher noise levels in hospitals.13 A 2022 study found that single patient


rooms significantly reduced the number of intrahospital transfers,14


which have


been linked to increased risk of hospital acquired infections,15 outcomes.16


These improvements to


patient outcomes, coupled with surveys of patients frequently showing that they prefer single patient rooms – for reasons including increased dignity and privacy, and easier visitation by family and friends,11 form a clear picture of improvements for patients in single room settings.


Provider and system performance The physical separation enabled by single patient rooms and reduced patient transfers improves infection control, which could reduce length of stay and hospital costs.17


Studies have shown that single


patient rooms do reduce infections,18 although the impact on stay length (and consequently costs) is less clear.19 Another important aspect of single


patient rooms is the flexibility they offer to March 2023 Health Estate Journal 31 and adverse patient


N Chadwick CC BY-SA 2.0


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