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NHS bed occupancy figures queried

A health minister has said he does not recognise figures on bed occupancy used in an influential report to show NHS hospitals are dangerously full.

Patient safety is being risked because hospitals are “full to bursting”, with many regularly breaching the 85 per cent limit put in place to protect patients, according to the Dr Foster hospital guide.

The report said that in 2011-2012 occupancy was running at 88 per cent in midweek, while averaging 90 per cent for 11 of the 12 months, excluding quiet periods such as Christmas.

But Earl Howe has said that the Department of Health is “struggling to reconcile” its figures with those used in the report.

At question time in the House of Lords, Labour’s Lord Turnberg, a former chairman of the Royal College of Physicians, said the report showed clearly “the stress our hospitals are operating under”.

He added: “With bed occupancy of 95 per cent to 100 per cent for much of the year for many of the hospitals, there are too often no beds available, staff are rushed off their feet, patients are not cared for properly, infection rates rise and mistakes occur.”

But Lord Howe said data from his department showed “the average bed occupancy rate for all beds open overnight had remained stable between 84 per cent and 87 per cent since 2000” and that showed hospitals were “making efficient use of beds”.

He added: “We are struggling to reconcile the Dr Foster bed occupancy figures with those that we have. Dr Foster has stated that bed occupancy is at a dangerous level - over 90 per cent for 48 weeks of the year.

“We’re looking closely at their analysis and methodology, but we can’t agree with their conclusions at the moment.”

He said the Department of Health monitored the position on a daily basis during winter.

Labour shadow health minister Lord Hunt of Kings Heath hit out at NHS underspends, which Lord Howe said amounted to 1.7 per cent in 2010-11 and 1.3 per cent in 2011-12.

Lord Hunt said the underspend over two years was £3bn and he added: “This government promised to protect the NHS and cut the deficit. In fact, it is cutting the NHS and the deficit is rising.

“How can the government justify handing back so much money to the Treasury when large parts of the NHS are under great financial pressure at the moment?”

Lord Howe said the deficit was not rising and the government was putting an extra £12.5bn into the NHS over the course of the spending review, which runs from 2010 to 2015.

He said expenditure in the NHS stemmed from around 400 organisations whose accounts had to be consolidated and in total not exceed the spending limit.

“Given those circumstances, it is sensible to plan for a modest underspend to mitigate against unexpected cost pressures,” he said.

And he added later: “NHS underspends are not lost to the NHS, they can be carried forward.”

Readers' comments (12)

  • So instead of doing anything about it the usual will happen - a bun fight about data. I have not seen a bed occupancy below 95% in our Trust for quite some time

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  • keeping bed occupancy below 85% is reliant on community services and patients having facilities at home to get them out, so until those are addressed hospital beds will always be bursting at the seams.

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  • Of course what is also being missed is that bed occupancy is up because beds that had been closed due to cost savings are being reopened to cope with the pressure and then of course the staffing levels are not sufficent to cope with increased capacity. Therefore additional staff are bought it at premium rates and the costs escalate to higher than they were before the cost savings were made.

    Demand is exceeding what is expected, whilst at the same time hospitals are expected to make 5% savings.

    It doesn't take a genius to work out that you cannot do more activity with less resource. I agree that you may be able to do a bit more activity with the same resource, but you cannot do more for less.

    Each Provider organsiation is expected to make 5% efficiency savings each year, - How does that compare with no cuts in the NHS??????????

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  • Oh god who do we believe!!!

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  • Our hospital occupancy rates never get under 95% unless we also inlcude "ringfenced" beds into the mix as well... if we were to count daycase beds, beds at the non-acute elective site, maternity beds, ITU beds and paediatric beds into our 'empty' beds figures then I am sure our bed occupancy rate would reduce dramatically. But that would be figure massaging on a criminal scale.

    If you are a 95 year old woman brought in to A&E in the middle of the night after a fall at home and you need to be accomodated and cared for on an acute elderly care ward then it really doesn't matter that we have 5 beds free at that point on our maternity ward. The thing about "beds" is that unless they are appropriately resourced and designated clinically for your particular care needs then they may as well be at your local Travel Lodge as in an acute hospital!

    If anyone can show me a hospital with a bed occupancy of 85% across the acute medical and surgical bed base then I will glady dine out on my own hat!

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  • Spike Humphrey

    What I observe is pressure to cut the numbers of hospital beds all over the country. The underlying assumption seems to be that the Supply of beds somehow drives the Demand for them. While I can understand this principle may apply at the margin, as a strategy for managing our health service costs it is patent nonsense. And it leads to exactly the inefficiencies and cost over-runs referred to by Anon 1.29.

    As is now becoming customary, the response from the Government Minister seems entirely complacent, and out of touch with the reality.

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  • So there we have it.....95% is the real world and 85% in the other world ! I wonder where these people get their data from or do they make it up ? Cynical I am, but I face the truth !

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  • Agree with 2.03PM- 95% as a minimum. We must stop telling fairytales - we can't even agree the basic facts

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  • I am sure there are many hospitals where the occupancy rate is above 90% and a fair number where it is over 95%. I suggest the HSJ look to run a comparison between the DoH figures hospital by hospital against Dr Foster's and then readers can state which they believe is more accurate based on their actual experience working in those places.

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  • It is not just a bed that patients need. medical and ancillary staff are quite important. So bed occupancy rates are obviously not the whole story. However simple queuing theory will tell you that to be able to admit patients as the need arises spare capacity has to be present. Failure to so provide leads to a vicious spiral of poor staff utilisation and bad medical decisions. This is just the beginning. Ministers are thinking they are playing with a toy gun when it is actually a lethal weapon.

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  • Denial or bean counting - the widest defence against reality

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  • Anon 2:03 has made the point - it's not as simple as 'empty beds'. Weekends & overnight, patients are shuttled from A&E/assessment into 'any empty bed' just to alleviate the pressure - but this leads to massive inefficiency in terms of doctors ward rounds involving extra 'off ward' patients, patients being in the wrong care setting, and the constant 'juggling of beds' as porters and nursing staff move patients around the hospital site just to ensure the patient eventually ends up in the right unit.

    I've experienced this so many times as a patient - usually 2 to 3 days of 'warehousing' before getting to the correct ward and treatment commencing.
    As someone already said - our drive for constant unrealistic efficiency is actually making the service more inefficient, but it's being masked by poor KPIs.

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