Does our NHS have enough beds?

hospital beds

We know there is a crisis in our NHS.

If there wasn’t a crisis why has all elective surgery been cancelled throughout January?

We know patient demand of our NHS is increasing.

UK population increase

62.77 million in 2010

66 million in 2017

and, of course, don’t forget the baby boomers are getting older and needing more health and social care.

But do we know if our NHS has enough beds to meet the increased demands generated by more potential patients plus the additional pressures of winter.

Clearly not, or the government wouldn’t have needed to demand all the cancellations to try and cope.

The question is simple:

ARE THERE ENOUGH HOSPITAL BEDS?

Finding the facts is is not quite so simple.

You can try The King’s Fund which will tell you there’s 142,000 hospital beds in England.

And the report says that

the UK currently has fewer acute beds relative to its population than almost any other comparable health system.

And that

the number of general and acute beds has fallen by 43 per cent since 1987/8, the bulk of this fall due to closures of beds for the long-term care of older people. 

Hmmm! We can all see what a good idea that was!

The report warns that:

Today there are signs of a growing shortage of beds.

In 2016/17, overnight general and acute bed occupancy averaged 90.3 per cent, and regularly exceeded 95 per cent in winter, well above the level many consider safe.

In this context, proposals put forward in some sustainability and transformation plans to deliver significant reductions in the number of beds are unrealistic.

That’s worrying, isn’t it?

Don’t forget that there is a sustainability and transformation plan for your area so the decisions to cut beds are being made at local level.

So nothing to do with the government who can abnegate any responsibility and blame it on your local decision makers. Except your local decision makers are completely controlled by the amount of funding the government allocates and a requirement to make their books balance.

Of course it’s government decisions that will determine how many beds are available in your local area. The government just want to keep well  away from the blame when things go wrong and we end up with an NHS in crisis.

After extensive internet research I’ve found an interesting NHS website which records Bed Availability and Occupancy Data – Overnight.

The report is a quarterly collection from all NHS organisations that operate beds, open overnight or day only. It collects the total number of available bed days and the total number of occupied bed days.

Now I’m no statistician but I’ve got ‘O’ level Maths and I can read spreadsheets. The NHS data makes interesting reading and you can check it out for yourself and see if you agree with my interpretation. No Fake News here!

In July – September 2017 (the latest period for which data is available)  there were

100.465,553 beds,

That’s a daily average during the three month period of 1,092,016 beds distributed between 210 hospital trusts and hospital foundation trusts.

The Hospital Trust in my local area serves a population of 800,000 residents. After more searching, I’ve found a Care Quality Commission report showing that the five hospitals in the trust have a total of 1170 beds between them.

1170 beds for 800,000 potential patients.

That doesn’t seem very many, does it?

When I had an emergency admission from A&E last year I was admitted onto a ward at 9.30pm when the previous occupant of the bed had been discharged and the bed made ready. Subsequently on transfer to the regional hospital my admission was after midnight waiting for a bed to become available. And that was in the late Spring without any crisis going on. And whatever will happen if there is an epidemic of some awful contagious disease?

Anyway, I digress.

Back to the national bed occupancy data.

Have the number of available beds increased or decreased in the last few years?

Remember we know the number of potential patients has increased.

So, I’m going to lose the detail and concentrate on the millions.

2017

100,465,533

100 million beds for a three month period across 210 areas

2016

103, 248,802

103 million beds for a three month period across 210 areas.

2015

104 million

2014

104 million

2013

104 million

2012

104 million

2011

104 million

2010

110 million

2009

121 million

2008

122 million

You can check out all these figures and see if I’m reading the data correctly but it seems to me there are 22 million fewer beds now in a three month period than there were almost 10 years ago.

Err?

Potential patients INCREASE

Beds to put them in DECREASE

RESULT

Waiting in ambulances

Waiting in corridors

Waiting on waiting lists.

I shall resist the temptation to make party political points; just remind you we had a General Election in 2010 and again in 2015.

If you decide to read the data for yourself you will see that the reporting framework was changed in 2010 when specific reporting of geriatric beds was dropped.

I don’t think this alters the overall picture of more patients and fewer beds. But geriatric beds? Beds specifically for elderly, sick patients who can’t return to their own homes.

Do we even have dedicated geriatric wards any more? Anywhere?

Oh no, we have care in the community, don’t we. And we all know how successful that is at facilitating the discharge of the very elderly, ready to go home but can’t manage alone patients.

But don’t worry! There may be substantially fewer beds than there were 10 years ago but we now have a Secretary of State for Health and Social Care to get it all sorted out.

And who’s that? Only Jeremy Hunt the Secretary of State for Health currently presiding over the worst NHS crisis EVER!

Thanks for reading my blog today.

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