Daily Insight: Bed management blues

It remains a fact that all too often NHS trusts still don’t have speedy enough access to information about who is currently occupying what bed in their hospitals.

This was made starkly clear in the pandemic, which led to NHS England recognising the importance of good bed management systems by including a target for it in last year’s Emergency Care Recovery Plan.

That target was for all trusts to have an appropriate bed management and capacity planning system in place by this month.

However, HSJ can reveal that several trusts have still not got there, including some of the worst performers against the key four-hour accident and emergency waiting time target, such as University Hospitals Plymouth and Hull University Teaching Hospitals Trust.

In recognition of this, NHSE said it would provide national funding for eight of the trusts, with a view to implementation during 2024-25. The amount of money in question has not been disclosed.

Having a good bed management system can make a huge difference to patient flow throughout a trust from entrance to exit.

For the trusts waiting for funding, this boost can’t come fast enough.

Words matter

There was some snickering when Simon Stevens changed the name of NHSE’s “failure regime” to “the success regime”.

But there is some evidence that how support for trusts that are struggling is framed makes a real difference.

The manager tasked with turning around Birmingham’s elective and cancer performance cited the provider support programme as the key thing that got all the right people in the same room and concentrated minds.

Two more large hospital trusts were placed in the Recovery Support Programme earlier this month. The addition of Mid and South Essex Foundation Trust and King’s College Hospital FT takes the total to 22 across England. Three integrated care boards are also in there.

The chief exec of one organisation on the list told HSJ the designation had actually been helpful to the trust, getting extra help with financial planning, important as trusts wrestle with contradictions around being ordered to cut staff whilst maintaining safe services and also roll out new diagnostic centres.

This is not a given with central support. The same manager said being placed in “special measures” at a previous trust had been a devastating experience for the organisation.

Perhaps post-pandemic there is the realisation that, even in organisations that appear to be performing poorly, staff are still working very hard.