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High bed occupancy rates threaten patient safety

BBC found 90% of hospital trusts had mean occupancy rates above recommended 85% level

Louise Prime

Wednesday, 08 February 2017

Hospital bed occupancy rates way above the recommended level are threatening patient safety, doctors’ leaders and hospital trusts have warned. They are calling for an urgent review of winter pressures and a long-term strategy to address the NHS’s "fundamental funding challenges".

A BBC investigation has reported that this winter nine out of every ten NHS hospitals in England recorded mean bed occupancy levels about the acknowledged ‘safe’ threshold of 85%. NHS Providers, which represents NHS acute, ambulance, community and mental health services, said the ‘worrying’ high bed occupancy figures have become routine in the NHS – but this "does not mean they are acceptable".

The BBC analysed NHS England data to reveal that between the start of December 2016 and 22nd January this year, 137 out of 152 hospital trusts (90.1%) had mean bed occupancy rates above the recommended 85% level; and 66 trusts (43.4%) had mean occupancy rates above 95%. NHS Providers cited strong evidence that patient safety is comprised when levels exceed 85%, as the risk of infection rises. In addition, it said, they leave hospitals less able to respond to flu outbreaks and other unexpected demands, and to delayed operations which is distressing for patients and carers.

NHS Providers chief executive Chris Hopson said: "High bed occupancy rates have become routine in the NHS. But that does not mean they are acceptable. They are an important indicator of unsustainable pressures on the whole health service, which have reached unprecedented levels in recent weeks. This impacts on the quality of care for patients, but is also demoralising for frontline staff who have responded heroically to the surge in demand. That is why we have called for an urgent review of winter pressures, to establish what needs to be done to ensure safe and timely services for patients year-round."

The BMA said hospitals are now experiencing crisis year-round, not just in winter. It accused the government of seeming "unwilling or unable to address" the wider pressure and demand on services of which high bed occupancy is a symptom.

BMA chair Dr Mark Porter said yesterday: "Failures within the social care system are also having a considerable knock-on effect on an already stretched and underfunded NHS. When social care isn’t available, patients experience delays in moving from hospital to appropriate social care settings which damages patient care and places a significant financial strain on the NHS.

"The UK already has the second lowest number of hospital beds per head in Europe per capita. We need to carefully monitor the number of beds available but most importantly we need the government to produce a long term strategy for the NHS that addresses the fundamental funding challenges that are overwhelming the health service."

One of the factors behind high hospital bed occupancy rates is the lack of appropriate social care available for patients medically fit for discharge. It was widely reported yesterday that Mrs Iris Sibley was unable to be discharged from Bristol Royal Infirmary for six months, long after she could have left hospital, because of the lack of a suitable nursing home place.

In a joint statement, University Hospitals Bristol NHS Foundation Trust, South Gloucestershire CCG and Bristol Community Health said a rising elderly population with increasingly complex health needs means that NHS and social care are struggling to meet growing demand; local authorities are under pressure and struggling to provide the care required to keep elderly and vulnerable people living independently at home; and nursing home placement supply is limited. They said: "We are working together to shift more resources into community health and social care in order to support people when they are ready to leave hospital and to help avoid the crises and injuries that can lead to emergency hospital admissions in the first place."

How would qualify the communication between primary and secondary care services? (See OnMedica News 20/04)

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