Summary
The UK has fewer acute hospital beds relative to its population than many comparable health systems, and the Covid-19 pandemic has had a significant impact on their availability and use. This article by The King's Fund illustrates long-term trends in hospital beds, using 2019-20 data from before the pandemic as the most recent comparator. However, where data is available for 2020/21, the authors have included this for information and to show the impact of the pandemic.
Content
Key messages
- The total number of NHS hospital beds in England has more than halved over the past 30 years, from around 299,000 in 1987/88 to 141,000 in 2019/20, while the number of patients treated has increased significantly.
- Most other advanced health care systems have also reduced bed numbers in recent years. However, the UK has fewer acute beds relative to its population than many comparable health systems.
- Since 1987/88, the largest percentage reductions in bed numbers have occurred in mental illness and learning disability beds as a result of long-term policies to move these patients out of hospital and provide care in the community.
- The number of hospital beds for general and acute care has fallen by 44 per cent since 1987/88; the bulk of this fall is due to closures of beds for the long-term care of older people. Medical innovation, including an increase in day-case surgery, has also had an impact by reducing the time that many patients spend in hospital.
- Research shows that initiatives to moderate demand for hospital care often struggle to succeed. Progress depends on having sufficient capacity to provide appropriate care outside hospital, yet evidence suggests that intermediate care capacity is currently only enough to meet around half of demand and cuts in funding have led to significant reductions in publicly funded social care.
- Before the Covid-19 pandemic there was widespread evidence of a growing shortage of beds. In 2019/20, overnight general and acute bed occupancy averaged 90.2 per cent, and regularly exceeded 95 per cent in winter, well above safe levels.
- It is not yet clear when and at what level hospital beds will stabilise after the pandemic.
- How hospital beds are used depends on the availability of other services, yet national data does not provide a full picture of NHS bed capacity and requirements.
- As the health and care system emerges from the pandemic, greater clarity from NHS national bodies is needed on their expectations for overall health and care bed capacity over the medium term, and the consequences of these choices.
The King's Fund - NHS hospital bed numbers: past, present, future (5 November 2021)
https://www.kingsfund.org.uk/publications/nhs-hospital-bed-numbers
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