Worrying new figures from the NHS show many of its hospitals are creaking under the strain, with more than one-in-10 patients in England enduring a long wait for a bed following an emergency admission.
The figures revealed almost 475,000 patients waited more than four hours for a bed on a hospital ward in 2015/16, almost five times the number of 2010/11. More than 1,400 of them endured delays of more than 12 hours.
Corridors, side rooms, waiting rooms and day rooms were all used as makeshift holding areas, some patients able to sit and others left on hospital trolleys. The problem is worse in some parts of the country than others and is simply a matter of demand for hospital beds outstripping supply.
Under NHS guidelines there is supposed to be a 15% safety net for hospital bed occupancy. In other words, occupancy should not exceed 85%, giving hospital staff time to clean and turnaround beds and ensuring a bed can be found quickly for a patient in an emergency. In reality though, occupancy rates often exceed 100%, with no beds immediately available for patients who need them.
A big part of the problem is not with more patients coming into hospital, but with delays in discharging those who are medically able to leave. The UK has a growing ageing population, but often when an older person has been treated in hospital their discharge is delayed because there is inadequate care for them at home.
Improvements in social care – provided at home by professional carers or perhaps in ‘halfway houses’ where patients can recuperate after a hospital stay – could speed up discharges and free up hospital beds. So it isn’t only a case of providing more beds in hospitals, but of putting measures in place outside hospitals which will reduce the length of time those beds are occupied.
Doctors have warned that many NHS hospitals are now dangerously overcrowded, with three-quarters routinely reporting bed shortages. The situation traditionally worsens through the winter months.
It all means that if you need to be admitted to hospital in ahurry, you could face a lengthy wait until a bed is found for you. People going to hospital A&E departments with conditions that require them to be hospitalised could face two waits – first to be seen in A&E and again while a bed is found on a ward. This happens to around one-in-five people who come to A&E, including frail and elderly patients with chest pains, breathing problems and fractures.
As well as the problem of ‘bed blocking’ by patients unable to be discharged due to inadequate social care, the NHS has seen a significant fall in its number of available beds. In England there are estimated to be just over 100,000 beds, down by around 40,000 in the past 20 years.
Dr Chris Moulton, of the Royal College of Emergency Medicine, said: “We simply don't have enough. If you compare us to other European countries, we are really short and the demands being placed on the health service means we are now struggling to cope.”
Looking across Europe, Germany has the most hospital beds available, at just over 8 per 1,000 head of population. By contrast the UK has only 2.7 beds per 1,000 people, with only Sweden scoring lower at 2.5.
NHS England concedes that growing demand is putting more pressure on hospital beds, with the number of emergency admissions up by more than half-a-million over the past five years. It says efforts are under way to both increase the number of hospital beds available and to reduce the length of time they are occupied by increasing the availability of social care for patients medically fit to be discharged.
With winter here, one piece of sound practical advice from the NHS is to consult a pharmacist as soon as you think you might be falling ill. Acting quickly and receiving the right treatment early on could stop a range of relatively minor winter ailments developing into more serious conditions which could require a stay in hospital.
For more good advice from the NHS on staying well this winter, click here.