Revealed: Hospital made ‘lunacy’ bed cuts before severe winter problems

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The Dudley Group FT reduced its core bed numbers by almost 40 ahead of “most difficult winter”
Royal College of Emergency Medicine vice president called the provider’s actions “tantamount to lunacy”
Trust says changes were made to “give us the maximum number of beds in medicine”, and more assessment space

A trust reduced its “core bed base” by nearly 40 in the run up to last winter, when its emergency department endured severe problems and intervention by inspectors, it has emerged.

The Dudley Group Foundation Trust confirmed to HSJ its “core bed base” dropped from 679 in June 2017 to 637 in December. However, a trust spokeswoman added that during winter, 44 escalation beds were available.

The figures show the core bed base remained below 640 until June this year, when it was increased to 669.

Royal College of Emergency Medicine vice president Chris Moulton told HSJ: “In terms of poor flow and long [accident and emergency] waits, A&E overcrowding closing beds is tantamount to lunacy.”

The trust’s emergency department saw major care quality concerns during winter 2017-18 and since. The Care Quality Commission rated its emergency services as “inadequate” based on an inspection in December, and has served it with enforcement action notices about ED safety in January, February and June and August 2018.

Two frontline staff members, who asked to remain anonymous, told HSJ they believed the beds cut had hit emergency performance during winter.

One told HSJ: “There have been a number of reorganisations at the front door, which have reduced the number of acute medical beds to put patients into. This seems to coincide with a drop in our performance in four hour waiting times in ED.

“Last year was the most difficult winter that we have ever had. We need to make sure we are better prepared this year.

“I don’t think that we always delivered the standard of care that we would have wanted to. Our patients had to wait too long, sometimes in corridors…

“We all did our utmost to keep patients safe, but it’s just not sustainable all the time.”

The trust told HSJ: “Bed numbers during this period were remodelled to give us the maximum number of beds in medicine, where our greatest need is during winter. We converted a 25 bedded space to assessment spaces. This provides rapid medical assessment and ambulance triage. These are both trolley facilities and, therefore, not included in the bed base.”

The trust also highlighted the availability of escalation beds.