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Bed pressure on English NHS hospital hits historic high, report reveals

Bed pressure in English hospitals led to the equivalent of more than five extra hospitals’-worth of beds being brought into service to cope with surges in demand last winter.

On the single busiest day, 4,390 beds had to be opened, equivalent to more than seven extra hospitals in one day, finds a report by the Nuffield Trust.

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.

Given that pressures on the health service have worsened over the last 12 months, trusts face similarly high bed occupancy rates this winter.

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 hospitals and, ultimately, to patient safety, the report concludes.

It says that 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.

Furthermore, high rates of occupancy lead to problems in maintaining cleanliness and infection control.

The report also says 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.

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.

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 hospitals and, ultimately, to patient safety.

“What’s more, the NHS is going into this winter in an even worse position than it was a year ago, with record deficits, worse performance against the A&E target, far more trolley waits, record delayed discharges from hospital, and fewer people getting the help they need with social care. When you add into that mix the sort of intense pressure on beds we’ve demonstrated hospitals experienced last winter, patients’ care is bound to suffer”.

The average number of extra beds brought into service on any given day last winter was 3,466, equivalent to at least five and half extra hospitals’-worth of beds.

On Monday 25th January, 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.

Throughout that week, nine trusts were all full every day with 100% of their acute beds – including extra escalation beds brought in temporarily – occupied.

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