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NHS needs 10,000 more beds to meet winter demand

Analysis predicts NHS set for worse winter pressures

Adrian O'Dowd

Thursday, 06 December 2018

The NHS in England needs as many as 10,000 more beds to meet anticipated demand this winter, according to a new analysis released today.

The British Medical Association (BMA) analysis suggests emergency departments in England are set for their worst winter on record, meaning around 10,000 additional hospital beds will be needed to ensure safe care for patients.

The new figures build on a previous BMA analysis released last month of NHS England data from the past seven years.

This warned of rising pressure on emergency care departments, with the most recent winter showing record levels of admissions. It said 200,000 more patients were left stranded on hospital trolleys in emergency care departments than in the same period in 2011.

For the latest analysis, the BMA analysed bed occupancy rates and trends from previous winters to produce a likely picture for January to March 2019 and predictions on how many beds the NHS in England needs.

It found that last winter, bed occupancy in general and acute beds peaked at 95.1% in February 2018, despite guidance from the National Audit Office suggesting occupancy should not exceed 85% to avoid impacting on quality of care. NHS Improvement has said that above 92%, the deterioration in emergency care standards begins to accelerate.

The BMA said that high bed occupancy led to issues across all hospital departments and was often a decisive factor in decisions to cancel planned operations and could also delay patients moving from the emergency department to a ward.

The analysis says that to bring bed occupancy down to the recommended minimum safe limit of 92%, the NHS in England this winter will need to continue using 5,000 temporary escalation beds opened at the peak of the winter pressures last year and will need an additional 5,000 general and acute beds.

Without extra resources, the BMA said it believed approximately 238,000 patients would spend more than four hours waiting to be admitted to hospital – 12,000 higher than the record from the previous winter.

In addition, if conditions deteriorated more dramatically, 305,000 patients could endure long waits on trolleys.

The percentage of patients seen, admitted or discharged within four hours of visiting an emergency department would reach record lows, warned the trade union, with compliance falling to somewhere between 84.3% and 82.5%. The government target is 95%.

Dr Rob Harwood, BMA consultant committee chair, said: “The NHS is facing an all year crisis that is leaving patients in an intolerable situation.

“This winter could be the worst on record for frontline emergency care departments, with a BMA analysis suggesting hundreds of thousands of patients will be left either waiting to see a doctor for an assessment or stranded in cramped corridors on a hospital trolley waiting for a hospital bed to become available.

“A key part of this problem is the lack of available beds within the NHS system. Last winter saw incredibly high levels of bed occupancy, well above recommended limits, and despite thousands of escalation beds being put into action temporarily.

“At this level patients will struggle to get the attention and care they need. While there is a commitment for the NHS 10-Year plan funding to come on stream next April, there is a pressing need to tackle shortages in hospital capacity and improve care for patients in the community.”

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