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Reaction to report highlighting massive reduction in the number of NHS hospital beds

RCP President, Jane Dacre

“These stark figures from the King’s Fund do not come as a surprise to those working in medicine. Every day the chronic shortage of hospital beds frustrates and delays much of the care we provide as physicians. Length of stay in our hospitals has also reduced, and the number of frail older people has risen, increasing the intensity and pressures on staff.

“We are concerned about the impact this will have on the NHS this winter.

“With overnight general and acute bed occupancy rates averaging 90% and regularly exceeded 95 per cent in winter – we need government support to enable physicians to give patients the service they deserve.”

Dr Taj Hassan, President of the Royal College of Emergency Medicine

“This important report echoes what we have been saying for some time: we do not have enough beds.

“We have fewer acute beds relative to population than almost any other comparable health system, and yet we are still seeking to cut our bed base.

“Continuing on this course puts both patients at risk and the long-term sustainability of the NHS at risk.

“We know that some sustainability and transformation plans (STPs) suggest cutting hospital beds by up to a third. We believe that these STPs will require a radical rethink to their approach – cutting more beds without realistic or viable alternatives is not deliverable in the present environment.

“Admissions are going up each year – a consequence of an ageing and growing population – and we need beds to put people in. We agree that the downward trend in bed numbers must stop.

“At present, we need to an extra 5000 acute care beds to get us back to safe bed occupancy levels of 85%. Last winter the amount of beds occupied regularly exceeded 95%, however we suspect this is higher as the figure is measured at midnight, when fewer patients are likely to be there.

“Work to improve flow is very welcome and it is important to try to find solutions with what we have, but without a drastic increase in the number of beds and additional resources for social care, much of this work will be in vain.”


Dr Chaand Nagpaul, BMA council chair

“This report highlights the scale of widespread cuts to hospital beds. Our own analysis showed that overnight hospital beds in England have decreased by a fifth in a decade.1

“The UK already has the second lowest number of hospital beds per head to comparable European nations, a key factor in explaining the extreme pressure on the NHS. With many cuts coming from so-called ‘transformation plans’, serious questions need to be asked about whether these plans are realistic and evidence-based given it defies logic to cut bed numbers when we already don’t have enough.

“High bed occupancy routinely above the recommended limit of 85 per cent is compromising patient safety and is a symptom of wider pressure and demand on an overstretched and underfunded system. It causes further delays in admissions, operations being cancelled and patients being unfairly and sometimes repeatedly let down.

“Staff across the NHS faced the worst winter on record last year and we don’t want to see a repeat of that again this year. In the short term we need to see bed plans that are workable and focused on the quality of care and patient experiences, rather than financial targets. But in the long term we need politicians to take their heads of out the sand and provide a sustainable solution to the funding and capacity challenges that are overwhelming the health service.”

Niall Dickson, Chief Executive of the NHS Confederation

“All round the world the number of hospital beds has been cut and in many cases that has been the right thing to do. Medical advances and the closure of long stay institutions have changed the way healthcare is delivered. But of course it is possible to go too far – bed occupancy in the NHS in England is currently too high and in some places is not safe. As the report points out last winter we saw occupancy rates of over 95%, well above safe levels.

“So beds should not be cut unless there are alternative services in place, and it is possible we may need some more beds in some places to deal with a growing and ageing population .

“Alongside this though, the big challenge remains how we manage demand so that patients do not end up in hospital when they could be cared for at home or in the community. The NHS is developing new ways of delivering care and there are signs that these can help to reduce levels of hospital admission.”

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