Friday, April 03, 2009

Overnight NHS hospital beds fall 10% in just three years

DESPITE a growing population

The number of overnight beds in NHS hospitals has plummeted by almost 10 per cent in just three years. Experts say the falls have exacerbated overcrowding on wards, which is putting patients at increased risk of infection. And the pressure to discharge elderly patients quickly because of the low number of beds was endangering their health, they warned.

The official figures show the number of beds remained virtually constant over the early years of Labour control, but began to fall in 2005 - the year of the financial crisis which engulfed the NHS and forced the closure of dozens of wards and the cutting of hundreds of jobs.

There were 198 overnight beds per 100,000 people in 2007/08. This is down from 219 per 100,000 in 2004/05, the year before the financial crisis, and 222 when Labour came to power.

Ministers say fewer overnight beds are needed because medical advances mean people are no longer kept in hospital for as long. But patients groups claim beds and sometimes entire wards are being shut for cost reasons, while doctors warned the NHS will be unable to cope in times of crisis such as a big flu outbreak. There are also concerns that low numbers of beds lead to high occupancy rates - putting people at risk of catching superbugs because there is not enough time to clean wards properly.

The pressure to free up dwindling numbers of beds has also led to fears that elderly people are being discharged too early, putting them at risk. Last year nearly 150,000 people over the age of 75 had to be re-admitted as emergency admissions within 28 days.

Liberal Democrat health spokesman Norman Lamb said: 'The loss of beds is putting hospitals under an impossible strain, with many seeing increases in emergency admissions. 'It is complete mismanagement to cut the number of NHS beds when the number of emergency readmissions and the number of cancelled operations are on the rise. 'Hospitals across the country are full to overflowing, and staff are being put under impossible pressure thanks to this Government's mistakes.'

Conservative health spokesman Andrew Lansley said the bed cuts would also make it harder for the Government to meet repeated pledges to eradicate mixed-sex wards. 'It is madness to cut beds when wards are overcrowded, when there aren’t enough isolation rooms to control hospital infections and patients are still placed in mixed sex accommodation,' he said. 'Labour’s complacent assumption that there would not be any more winter crises is now having disastrous consequences for patients. 'In 2000 Labour said that bed numbers needed to increase, but these figures demonstrate again how badly they have failed. The Government needs to explain why our hospitals have so many fewer beds than hospitals in other European countries.'

Michael Summers of the Patients Association said: 'In an ageing population we need a proper number of beds available, but what we are seeing is beds being cut to save money, leaving patients to suffer - as we saw in Mid Staffordshire. 'It can be no accident that the number of beds began to fall after the time of hospital deficits. 'Overcrowding in wards makes them more difficult to clean and encourages the spread of infections. It means the NHS will be less likely to be able to cope if there is a big outbreak of flu or something like that. 'And elderly people could end up being discharged earlier than is good for them, which is counter-productive. These bed cuts are silly, short term decisions by managers.'

A survey out earlier this year showed that the UK had far fewer beds than almost any other country in Europe, with less than half the number per head of population than Germany. The study in the Lancet found that overcrowding in hospitals was linked to superbug outbreaks, and 71 per cent of hospitals had occupancy rates of more than 82 per cent - a recognised safe level. Around a quarter of trusts exceeded 90 per cent.

The new figures, revealed in a parliamentary answer and published in Pulse magazine, show that in only one part of the country has the numbers of beds stayed constant over the past year. This was the South Central region, covering Oxfordshire, Hampshire and neighbouring counties, where there are 164 beds per 100,000 people - one of the lowest rates in the country.

There were wide regional variations, with people in deprived areas like the North East having two thirds more beds per head of population than those in East Anglia - 245 to 151 per 100,000. Across the country, the rate was 222 per person in 1997/98, when Labour took office. It remained constant until 2004/05, when a financial crisis hit the NHS and dozens of hospitals were forced to make cuts to jobs and close wards to save money. From then on, the numbers started to fall.

Answering the parliamentary question, health minister Ben Bradshaw said the fall in the number of hospital overnight beds was the result of dealing with patients more efficiently and releasing them more quickly. 'Experts all agree this is the best way to deliver healthcare,' he said. 'Advances in medical technology and shorter stays for routine operations mean fewer beds are needed. This is part of a long-term downward trend in the average length of stay in hospital. 'But where the NHS needs more beds, there are more beds.' There were 47 per cent more day beds, he said.

However, Dr Jonathan Fielden, chair of the British Medical Association's consultants' committee, said funding cuts meant specialists were relying on already stretched GPs to pick up the slack. 'While we have hospitals with this limited capacity - as we saw this winter - we will have more delays in getting patients in and we will be much more reliant on our GP colleagues to look after patients a bit longer and take them that little bit earlier.'

Dr Paddy Glackin, a GP in north London, said primary care trusts were cutting costs and leaving GPs to pick up the pieces. 'It's a rolling door. Every day, GPs have to see patients who have been hurtled out of hospital too quickly. Every single Friday one local hospital is on an emergency beds system and we are fighting to get our patients accepted. We are under pressure continually to manage patients at home.'

Richard Hoey, deputy editor of Pulse, said: 'Moving patients out of hospital more quickly is great if it's genuinely justified on medical grounds, but it's certainly not acceptable just as a way of saving money. 'The Government must also ensure that if patients are increasingly managed in primary care, rather than in hospital, that there is a concurrent shift in resources. At the moment, hospitals continue to soak up too much of NHS funding.'


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