Single rooms should be ‘default’ in hospitals, says Powis

Stephen Powis told the Commons health and social care committee the need to move towards individual rooms was a key consideration in determining the NHS’s capital budget which is being negotiated with ministers.

Professor Powis and Amanda Pritchard, making her first appearance at the committee since becoming NHSE/I chief executive, also warned ministers against cutting Health Education England’s budget in the spending review.

On the need for single rooms to be the “default”, Professor Powis said: “Personally, I feel coming out of the pandemic one of the things we need to think really hard about is the number of single beds that we have.

“I think that we need to move in our hospitals much more to single rooms being the default for privacy and dignity, for infection control and for flow issues… That’s something we need to think hard about as we build the hospitals of the future.”

Discussions about building and expanding hospitals as part of the government’s new hospital programme have included consideration of many more single rooms, but this is thought to be the first time NHSE/I has publicly said they should be the default.

Professor Powis’s decision to highlight the matter also follows NHSE/I’s previous chief Simon Stevens’ decision in 2019 to argue the NHS needed to increase its bed base following years of declining bed numbers.

While the NHS has received increases to its revenue settlement, capital funding, which could help boost the bed base, has been in short supply for years.

On the spending review, both Professor Powis and Ms Pritchard agreed with committee chair Jeremy Hunt’s assertion that it was vital that HEE’s budget was not cut as ministers search out savings in the spending review.

Professor Powis said: “It’s absolutely critical [that HEE gets a settlement that allows it to increase staff supply]. The training and supply of future clinicians is really critical.”

Government last month announced revenue budgets for the next three years for the NHS and the Department of Health and Social Care. However, that for Health Education England — which pays for education and training — has not yet been announced, and is expected in the government spending review next month. The spending review should also confirm capital budgets. 

Pressed on what the funding settlement meant for improving the elective waiting list, Mr Pritchard said it provided “very welcome certainty” for the next three years and “allows us to commit to nine million additional checks and treatments and tests over that period”. NHSE has agreed to aim to deliver around 30 per cent more elective activity by 2024-25, compared to pre-pandemic levels.

But Ms Pritchard said the “uncertainty” around how many patients who had not come to the NHS during the pandemic would return, and how severe the winter ahead would be meant it was “very difficult” to predict how much progress the service would make on cutting the waiting list.

She added: “We know that we’ve got a really secure place from which to build and where we can absolutely now deliver a significant improvement in our elective activity [but] how that will translate into the backlog, it would be very difficult to say at this stage.”

The need to ratchet up elective activity was highlighted by official NHSE/I figures published last week revealing that there 5.7 million people on the waiting list at the end of August, a record high. Of those, some 9,754 people had been waiting more than two years.

Ms Pritchard also said the national covid vaccine booking service would shortly be opened to 12-15-year-olds — who have until now had to receive vaccines through schools — in order to “make the most of half term”. Their uptake has been relatively slow so far.

And she reiterated the view of NHSE and government that the “NHS was not overwhelmed” during the pandemic, despite huge pressure on services and staff, very long waits, and widespread cancellations.