RCEM Acute Insight Series: Beds in the NHS (May 2022)

Summary

Since 2010/11, the NHS has lost almost 25,000 beds across the UK. The evolving nature of healthcare provision means that the role of hospital admission has changed, but hospital beds still represent an essential part of healthcare, and the number available to the NHS should be carefully considered. A broad consensus has developed in recent years that the reduction in beds has happened too quickly. The outcome is that the NHS is now under-bedded. This has important consequences; patients must now endure long waits to be admitted with emergency department staff providing care normally provided in wards even as they continue to care for new arrivals; ambulance handover delays increase and there are delays to calls for an ambulance; planned operations are cancelled.

Reducing long stays in emergency departments requires adequate staffing, space, efficient processes, and sufficient inpatient bed capacity. This report from the Royal College of Emergency Medicine (RCEM) focuses on inpatient bed capacity. While the unit of measurement is a bed, it must be remembered that a bed requires medical, nursing and other staff to safely function.

Content

RCEM’s recommendations

• An additional 4,500 beds across the United Kingdom be made available between now and next Winter, and approximately 8,500 more over the next five years.
• The allocation of additional beds should be made available based on a local assessment of population needs and not worsen health inequalities.
• Hospitals should define thresholds for occupancy, and justify if they exceed 85% (sometimes this is appropriate, but more often, not) • Any new hospital buildings should increase the proportion of side rooms in order to restrict the number of beds made unavailable through infection and reduce nosocomial infections.
• There needs to an increase in Mental Health bed capacity. Assessment areas for short term, resource intensive assessment of people suffering a mental health crisis would improve care and patient experience.