- Bed occupancy hits record high, as overall bed numbers across NHS continue to decline
- Royal College of Surgeons says data is “exceptionally worrying”
- Acute bed numbers have however risen slightly overall on last year
Acute bed occupancy hit a record high in the final quarter of 2016-17, while a long-term reduction in the number of acute beds may be slowing.
NHS England bed occupancy data for January to March 2017 reveals 91.4 per cent of overnight hospital general and acute beds were full during the period compared to 91 per cent in the same period the previous financial year. When records began in 2000-01 overnight acute bed occupancy averaged 84.7 per cent (see table 1).
Two trusts, Princess Alexandra Hospital and Weston Area Health recorded acute bed occupancy of 100 per cent, while a further 38 trusts recorded acute bed occupancy as over 95 per cent (see table 2).
Some 150 of the 179 trusts with acute beds recorded acute bed occupancy of 85 per cent or more – the target which clinicians and health experts use as the benchmark over which patient safety is put at risk.
There was huge pressure on emergency care in parts of winter - particularly the very end of 2016 and the early part of 2017 - with very long waits already reported.
The Royal College of Surgeons said today’s figures were “exceptionally worrying” and that ”reductions in hospital bed numbers over recent years may have gone too far”. NHS Providers said the situation was “unsustainable” and the system “must act quickly, to prepare for next winter.”
The number of acute beds inched up to 103,666 from 103,422 beds in the same quarter in 2015-16 – which may be welcome news for system leaders who announced new restrictions on bed closures for hospitals in March. This contrasts with a clear downward trend in most previous years.
Total beds across the whole system continued the downward trend, although the reduction was less than some previous. There were on average 131,561 beds open across the system for Q4 2016-17, compared to 131,060 for the same period the previous financial year. This however is significantly less than the 142,319 available for the same period in 2010-11 (see table).
Royal College of Surgeons president Clare Marx said: “These numbers are exceptionally worrying and suggest that reductions in hospital bed numbers over recent years may have gone too far. We are running short of space in hospitals.
She added: “The next government should set out a plan to protect beds for planned surgery, especially during next year’s busy winter period. NHS England recently announced a new patient care test for hospital bed closures and we hope this will ensure that bad decisions are avoided and patients continue to receive high quality and timely care in the most appropriate place.”
NHS England chief executive Simon Stevens announced new restrictions on hospital bed closures in March. Mr Stevens said any hospital bed closures plans must:
- Demonstrate sufficient alternative provision, such as increased GP or community services, is being put in place alongside or ahead of bed closures, and that the new workforce will be there to deliver”, and/or
- Show that specific new treatments or therapies, such as new anti-coagulation drugs used to treat strokes, will reduce specific categories of admissions” and/or
- Where a hospital has been using beds less efficiently than the national average, that it has a credible plan to improve performance without affecting patient care (for example in line with the Getting it Right First Time programme
Table 1: Overall bed Q4 bed statistics for England
|Year||Period||Total number of beds||Total general and acute beds||Total mental Illness beds||Total bed occupancy (%)||General and acute occupancy (%)||Mental Illness beds (%)|
Table 2: Hospital trust level statistics data
|Org Name||Total beds||Total occupancy||General & Acute occupancy|
|WESTON AREA HEALTH NHS TRUST||265||100.0%||100.0%|
|THE PRINCESS ALEXANDRA HOSPITAL NHS TRUST||502||93.5%||100.0%|
|UNIVERSITY HOSPITALS BRISTOL NHS FOUNDATION TRUST||796||96.3%||99.8%|
|KETTERING GENERAL HOSPITAL NHS FOUNDATION TRUST||674||97.0%||99.4%|
|MEDWAY NHS FOUNDATION TRUST||534||95.8%||99.3%|
|MILTON KEYNES UNIVERSITY HOSPITAL NHS FOUNDATION TRUST||491||95.0%||99.0%|
|BASILDON AND THURROCK UNIVERSITY HOSPITALS NHS FOUNDATION TRUST||691||95.9%||99.0%|
|BUCKINGHAMSHIRE HEALTHCARE NHS TRUST||770||96.3%||98.7%|
|MID ESSEX HOSPITAL SERVICES NHS TRUST||567||93.5%||98.5%|
|KING’S COLLEGE HOSPITAL NHS FOUNDATION TRUST||1,368||95.6%||98.2%|
|OXFORD HEALTH NHS FOUNDATION TRUST||547||93.7%||98.2%|
|CHELSEA AND WESTMINSTER HOSPITAL NHS FOUNDATION TRUST||918||93.7%||98.0%|
|UNIVERSITY HOSPITALS COVENTRY AND WARWICKSHIRE NHS TRUST||1,188||93.0%||97.9%|
|WESTERN SUSSEX HOSPITALS NHS FOUNDATION TRUST||1,016||95.2%||97.9%|
|BEDFORD HOSPITAL NHS TRUST||408||96.9%||97.6%|
|IPSWICH HOSPITAL NHS TRUST||632||95.3%||97.3%|
|LANCASHIRE TEACHING HOSPITALS NHS FOUNDATION TRUST||877||94.6%||97.2%|
|DARTFORD AND GRAVESHAM NHS TRUST||563||96.0%||97.1%|
|NORTH BRISTOL NHS TRUST||959||95.5%||97.1%|
|KINGSTON HOSPITAL NHS FOUNDATION TRUST||474||95.6%||97.0%|
|NORTHAMPTONSHIRE HEALTHCARE NHS FOUNDATION TRUST||305||95.7%||96.9%|
|ROYAL UNITED HOSPITALS BATH NHS FOUNDATION TRUST||666||97.0%||96.9%|
|CORNWALL PARTNERSHIP NHS FOUNDATION TRUST||299||89.0%||96.7%|
|UNIVERSITY HOSPITALS BIRMINGHAM NHS FOUNDATION TRUST||1,076||96.4%||96.4%|
|SANDWELL AND WEST BIRMINGHAM HOSPITALS NHS TRUST||730||94.1%||96.4%|
|THE ROYAL BOURNEMOUTH AND CHRISTCHURCH HOSPITALS NHS FOUNDATION TRUST||575||95.9%||96.3%|
|BRIGHTON AND SUSSEX UNIVERSITY HOSPITALS NHS TRUST||889||94.7%||96.2%|
|PORTSMOUTH HOSPITALS NHS TRUST||1,058||95.1%||96.2%|
|BARTS HEALTH NHS TRUST||1,906||92.7%||96.1%|
|GREAT WESTERN HOSPITALS NHS FOUNDATION TRUST||529||94.5%||96.1%|
|ST HELENS AND KNOWSLEY HOSPITAL SERVICES NHS TRUST||718||95.4%||96.1%|
|CROYDON HEALTH SERVICES NHS TRUST||550||92.8%||95.9%|
|FRIMLEY HEALTH NHS FOUNDATION TRUST||1,390||95.1%||95.9%|
|UNIVERSITY HOSPITAL SOUTHAMPTON NHS FOUNDATION TRUST||1,163||93.4%||95.8%|
|LEEDS TEACHING HOSPITALS NHS TRUST||1,822||92.0%||95.8%|
|YORK TEACHING HOSPITAL NHS FOUNDATION TRUST||1,064||94.1%||95.6%|
|HEART OF ENGLAND NHS FOUNDATION TRUST||1,467||94.2%||95.5%|
|BARNSLEY HOSPITAL NHS FOUNDATION TRUST||398||89.1%||95.5%|
|COUNTESS OF CHESTER HOSPITAL NHS FOUNDATION TRUST||576||89.2%||95.3%|
|SHEFFIELD TEACHING HOSPITALS NHS FOUNDATION TRUST||1,653||94.2%||95.2%|
An NHS England spokesman said: “These figures show that NHS hospitals had 582 more general and acute beds open than a year ago, with occupancy rates as reported by trusts themselves similar to last year.
“Over the coming year hospitals need the biggest single contribution to reducing occupancy rates to come from lowering the number of older people stuck in hospital waiting for community health, home care or a care home place.”
NHS Providers chief executive Chris Hopson said: “The situation is unsustainable. We have to ensure the NHS has the capacity to deal with growing demand. And we must act quickly, to prepare for next winter.”
“These figures reflect the extraordinary pressures NHS trusts faced during the winter. It is important to note these totals expressed as an average do not convey the full extent of the challenges in particular places at particular times, where some services were close to being overwhelmed.
“We know the quality of care, including patient safety, can be compromised when bed occupancy rises above 85 per cent. This puts staff under intolerable pressure. There is an increased risk of infection. And crucially, it means hospitals have less capacity to cope with unpredictable events.”
This story was updated at 3:30pm on 25 May to include statements released by NHS England and NHS Providers after the piece was originally published this morning.