Hospitals "dangerously full" during winter crisis, says thinktank

Hospitals were dangerously full during the recent onset of the winter crisis and breached an edict from NHS bosses to keep one in seven beds free, a new King’s Fund analysis reveals.

England’s 153 acute hospital trusts were told by the health service regulator on 9 December to run at no more than 85% bed occupancy between 19 December and 16 January, the internationally recognised level that hospitals are meant to stick to in order to minimise the risk of potentially deadly infections and to maintain the capacity to deal with emergencies.

Hospitals only managed to meet the target for three days over that period and were running at far higher levels of bed occupancy, often exceeding 95%, the King’s Fund found. Occupancy only dipped below 90% on four days since mid-December, it added.

“Bed occupancy rates above 85% increase the chances of bed shortages and the risk of infection. The fact that hospitals have missed the 85% objective by such a significant amount is further evidence of the huge pressure facing hospitals,” said Richard Murray, the thinktank’s director of policy who undertook the analysis.

The NHS entered the winter period with bed occupancy rates already high by historic standards, given that they were at 87.5% in the normally “quiet” second quarter of 2016/17. “The NHS did indeed achieve occupancy rates below 85%, but only on 23–25 December, when bed occupancy often falls as hospitals discharge as many patients as they can for Christmas, ”said Murray’s analysis.

“However, whatever spare capacity the NHS managed to create was quickly eaten up. As a consequence, it should come as no surprise that early January was an exceptionally difficult time as occupancy rates rose quickly above the 95% mark, although they do appear to have eased somewhat since then.”

Hospitals were operating at close to capacity even though flu, the winter vomiting bug norovirus and extreme, snowy weather, which oridnally might make it more difficult for hospitals to cope, did not cause significant problems. But the fact that unprecedented numbers of trusts were forced to declare an alert in the early weeks of January underlined that hospitals have come under unprecedented strain in recent weeks, Murray said.

His analysis, posted on the King’s Fund website, adds: “So with the relative (to date) absence of flu, norovirus and snow drifts, where does the explanation lie? Almost certainly in the clash between the steady, year-on-year increase in demand for NHS services and the ongoing need to constrain expenditure and capacity in healthcare as a result of funding pressures. Cuts in social care have added to this mix by pushing up delayed transfers of care, and may also have contributed to rising numbers of older, frail people arriving at hospital needing admission.”

Between now and the end of this winter, Murray warned: “We need to hope that no unpleasant shocks occur in terms of winter bugs or weather, because on current reckoning the NHS has precious little in the way of excess capacity to absorb them.”

Meanwhile, overcrowding has led two hospitals in Cumbria to breach NHS-wide rules that say male and female patients should not be treated on the same ward.

The North-West Evening Mail reported: “The trust in charge of Barrow’s Furness general hospital recorded 18 breaches of NHS standards on mixed sex wards in December. Of these, eight took place at FGH while the remaining 10 were at FGH’s sister hospital, the Royal Lancaster infirmary.

“Hospital bosses have confirmed the incidents were the result of an acute beds shortage at both sites which prevented patients on critical care wards from being transferred to a medical ward as they recovered.

“Critical care wards can accommodate both male and female patients, but a number were forced to remain in critical care beds for longer than necessary because there were no other places available for them in the hospital.”

The boss of the hospital trust featured in the ongoing BBC series Hospital has unexpectedly resigned after less than three years in the job. Dr Tracey Batten quit on Thursday as chief executive of Imperial College healthcare NHS trust, which runs five hospitals in central and west London. They include St Mary’s, where much of the filming for the series has taken place. The show has won widespread acclaim for its vivid portrayal of the acute pressures facing the NHS.

Hospitals "dangerously full" during winter crisis, says thinktank