NHS ‘needs more acute beds’ after decade of reduction

Describing his prediction as “quite a significant gear shift”, Mr Stevens said hospitals’ bed stock was “if anything, overly pressurised” and in need of “increased capacity”.

NHS England figures show the number of acute and general beds has dropped steadily since 2010-11 from 110,00 to 100,500 in the third quarter of 2018-19. The number then grew between January and March 2019 to 103,000. 

There was also a large fall in total overnight NHS beds between 1987 and 2009-10, according to official figures. 

Last year NHS Providers, the lobbying organisation for NHS trusts, warned national chiefs the NHS’ growing bed shortage was “the most pressing issue system leaders must address”.

Mr Stevens said it was his “personal view” that the increase in bed numbers would be needed, but he added the assumption would need to be “stress tested” against local plans drawn up in response to the national long-term plan published earlier this year.

“As local parts of the country are thinking about their likely need for acute hospital beds over the next five years, the base case should not be a significant expectation of reductions in those hospital beds,” he said.

“I think where people can prove they have that opportunity then let’s have that discussion, but the reality is that we’re now at a point where our hospital bed stock – if anything – is overly pressurised and we are…going to need increased capacity in parts of the acute sector, not decreased capacity.”

“We are now at that point where we see the previous trend may not be sustainable.”

The NHS long term plan published in January said: ”We have also been realistic… we have therefore not locked-in an assumption that [planned] increased investment in community and primary care will necessarily reduce the need for hospital beds.”

Reacting to the news Chris Moulton, vice-president of the Royal College of Emergency Medicine, said he was “delighted” and that the NHS has reduced beds “acting on poor advice from experts”.

“RCEM has long argued that we need at least 5,000 extra staffed hospital beds to get occupancy rates back down to a safe level below 85 per cent,” he said.

Nick Scriven, president of the Society of Acute Medicine, said the reduction in NHS beds “is a crisis that has been apparent for the past few years”.

Speaking at the NHS Confederation’s conference in Manchester, Mr Stevens also made clear his pitch to the new incoming prime minister over the need for more capital for the NHS.

“Since 2010 our capital investment per member of staff in the NHS has fallen by 17 per cent,” he said.

“If you think about the fact we have 200 large hospitals then even an extra investment of £1.5bn a year would just replace three of those hospitals annually, meaning that the average life expectancy of one of our new hospitals would be equal to the current age of the NHS itself.”

He said the NHS would have to “make and win” an argument about the “adequacy of capital investment in the NHS”, adding that while it was “perfectly understandable” that there had been “such a substantial squeeze” on capital funding it is not a sustainable position for the next five years.

Other initiatives announced by Mr Stevens included:

• Targets for every NHS organisation over the appointment of BME staff to board-level positions for the next five years;
• A new national clinical director for violence reduction; and
• The fast-tracking of certain cancer treatments to NHS patients.