• 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

YearPeriodTotal number of bedsTotal general and acute bedsTotal mental Illness bedsTotal bed occupancy (%)General and acute occupancy (%)Mental Illness beds (%)
2010/11 Q4 142,319 108,890 23,607 86.6% 88.7% 86.6%
2011/12 Q4 140,454 107,449 23,121 86.9% 89.0% 87.2%
2012/13 Q4 138,178 106,374 22,268 87.6% 89.8% 88.6%
2013/14 Q4 136,811 105,581 21,731 87.5% 89.6% 88.6%
2014/15 Q4 136,946 106,250 21,374 88.5% 90.7% 89.5%
2015/16 Q4 131,561 103,422 19,086 89.0% 91.2% 89.6%
2016/17 Q4 131,060 103,666 18,422 89.0% 91.4% 89.4%

Source: NHS England 

Table 2: Hospital trust level statistics data

Org NameTotal bedsTotal occupancyGeneral & 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%

Source: NHS England 

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.