The must-read stories and debate in health policy and leadership.
- Today’s expert insight on integration: The mystery of deaths at home may never be solved
- Today’s social distancing shock: 22 junior doctors under investigation after covid outbreak
The NHS has “significantly less” beds now than last winter and parts of the system “don’t have enough”, an NHS England and Improvement director has admitted.
NHSE/I’s director of elective and emergency care and operations performance made this significant admission last week when he told a webinar there would be circa 2,000 beds fewer open this winter.
Royal College of Emergency Medicine president Katherine Henderson told HSJ the fall was “extremely alarming [and] truly shocking”, while Society for Acute Medicine president Susan Crossland said “for 2,000 less beds to be open this winter than last is unacceptable”.
Covid is of course a decisive factor. NHS Providers estimates between 10 and 30 per cent of beds are effectively wiped out by social distancing and other restrictions.
But this does not excuse a decade in which the NHS’ acute hospital bed base has dropped from around 111,000 in quarter one 2010-11 to around 92,000 in quarter one 2020-21, according to the NHS’ most recent quarterly figures.
During this time royal colleges, think-tanks and NHS lobby groups like NHS Providers and NHS Confederation have all raised concerns about the system’s apparent lack of bed capacity – often pointing to international comparisons.
The most recent international comparison by the OECD said the UK has around 2.5 hospital beds per 1,000 people, well below the OECD average. Japan has the most (13 per 1,000) while other European countries have far more. Germany has 8 and France 5.9 per 1,000.
Of course, more isn’t always best. Sweden, often lauded in health policy circles, has 2.1 hospital beds per 1,000. But Sweden also has a far better resourced primary and community care system, and so it is better placed to deal with more patients outside the acute setting.
To add to the problems of dealing with the pandemic, the board of one major London trust has a serious in-house conflict to deal with.
King’s College Hospital Foundation Trust’s staff-side committee has withdrawn partnership working with its board, with its chair alleging there is an “endemic” culture of “racism, discrimination and bullying”.
The trust insists progress has been made on resuming things again, but it was not long ago that King’s was separately criticised over a top equalities job advert.
While the allegations are serious, it will be about how leaders act from here.