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Fears for quality of nursing care on ‘overwhelmed’ wards this winter

Pressures on hospital beds is so severe that the equivalent of seven extra hospitals had to be opened on the busiest day last winter, according to a new analysis by the Nuffield Trust.

Pressures on hospital beds is so severe that the equivalent of seven extra hospitals had to be opened on the busiest day last winter, according to a new analysis by the Nuffield Trust.


An average of 3,466 extra beds were needed on any given day last winter

The analysis of bed availability and occupancy also highlights the risks of infection from high bed fill rates.

On average, more than 95% beds were occupied in England hospitals every day last winter – there is an increased threat of infection when occupancy rates exceed
85-90%.

The average number of extra beds brought into service on any given day last winter was 3,466, which is the equivalent of at least five-and-a-half hospitals’ worth.

But on the single busiest day, Tuesday 26 January 2016, an additional 4,390 beds were opened – the same as opening seven extra hospitals.

‘Worrying’ gauge of pressure

RCN professional lead for acute, emergency and critical care Anna Crossley said winter had become an increasingly busy and difficult time for the NHS, even without a major illness outbreak.

‘This report is a helpful, if worrying, gauge for the realities of hospitals under pressure,’ she said.

‘Patients suffer if they have to wait a long time on trolleys, or get moved around a hospital at night.

‘Treating more patients with fewer staff can also mean that where wards are overwhelmed, they are over-reliant on agency or support staff – meaning that consistent skilled nursing care is lost.’

Ms Crossley said the chronic underfunding in social and community services meant many people were being kept in hospital when they are medically fit for discharge.

‘A serious discussion is needed about how we ensure that the right number of beds, nurses and other resources in hospitals and the community are there when needed, so that we are not so reliant on treating sick patients in any available space,’ she said.

Worse than last winter

Nuffield Trust chief economist John Appleby said: ‘The NHS is going into this winter in an even worse position than it was a year ago – with record deficits, worse performance against the A&E target, far more trolley waits, record delayed discharges from hospital, and fewer people getting the help they need with social care.  

‘When you add into that mix the sort of intense pressure on beds we’ve demonstrated hospitals experienced last winter, patients’ care is bound to suffer.’

Dr Mark Holland, president of the Society for Acute Medicine, said: ‘This is bad for the patients in those beds and for the system as a whole as we cannot admit routine cases.

‘The strain on social services will be even greater as we struggle to clear the backlog.’

An NHS England spokesman said: 'This report looking back to last year points to the steps the NHS takes each winter to maximise bed availability, and plans are well in hand for this winter too.'

The report comes as the British Heart Foundation warned cold spells caused nearly 6,000 extra deaths from heart attacks and strokes last winter.

It said a three-day cold spell doubles the risk of heart attack and stroke compared with shorter cold snaps, with drinkers and smokers most affected.


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