High bed occupancy rates increasing inefficiency

In a letter to The Sunday Times with the Royal College of Surgeons, we have raised the issue of how a lack of available beds is creating inefficiencies on wards. The letter comments on the delays to patient care that are being caused by operations being cancelled and the inefficiency this is causing in terms of staff time.

In the letter, NHS Providers and the Royal College of Surgeons call on NHS England and NHS Improvement to undertake a review of what can be done to reduce the pressures on beds experienced this winter.

Signed by Chris Hopson, chief executive of NHS Providers, and Clare Marx, president of the Royal College of Surgeons, the letter says: “Because of bed shortages, staff, including surgeons, are now sometimes left kicking their heels, waiting for beds to become available so they can operate. Too often, managers, nurses and doctors waste time trying to find somewhere to look after patients. This is frustrating for staff, who just want to care for patients — rising numbers of whom suffer the anxiety of having their planned operations cancelled on the day.”

Because of bed shortages, staff, including surgeons, are now sometimes left kicking their heels, waiting for beds to become available so they can operate

Commenting on the need for a review of how the NHS manages winter pressures, Chris Hopson and Clare Marx said:

“The review should consider how effectively the cancellation of routine operations has worked in freeing up capacity for the extra demand we have seen. This may have been necessary to cope with short-term pressures, but it has undoubtedly caused delays and distress for patients waiting for operations, and it has disrupted funding for trusts, which are paid to carry out this work, at a time when resources are already very stretched.”

The letter was published in The Sunday Times on 12 February 2017. A copy of the letter is included below:

NHS gridlock ties surgeons’ hands

Compared with most European countries’ health services, the NHS is underfunded. It has been assumed this is helping to drive productivity, but now, at times, it is clear that it is creating more inefficiency.

Pressure is spread across the system, affecting hospitals, ambulance services, mental health and community trusts. Hospital bed occupancy rates are unacceptably high. In the interests of safety they should not exceed 85%, but overnight inpatient beds are now routinely at around 89% occupancy.

This is partly because there is not enough social care capacity to look after our frail older patients in the community, so increasingly they cannot be discharged from hospital.

Because of bed shortages, staff including surgeons are now sometimes left kicking their heels, waiting for beds to become available so they can operate. Too often managers, nurses and doctors waste time trying to find somewhere to look after patients.

This is frustrating for staff, who just want to care for patients — rising numbers of whom suffer the anxiety of having their planned operations cancelled on the day. At a time when the NHS is being told to make the most of its resources, this is a shocking waste.

NHS England and NHS Improvement should undertake a review of what we can do to reduce the pressures we’ve seen this winter.

There must be a national debate about how much we are prepared to spend on health and care, and what kind of NHS we want to pass on to future generations. Our patients and our health service staff deserve better.

Chris Hopson, Chief Executive, NHS Providers

Clare Marx, President, Royal College of Surgeons of England

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