One leading health think tank said no health service should be running their hospitals as hot as the NHS currently is, warning that evidence shows busy wards can cost lives, while doctors have urged the government to declare a national emergency.
In the seven days to 1 January, 93.2% of general and acute hospital beds were occupied on average each day across acute trusts, leaving fewer than 7,000 beds available for new patients across the entire country.
The figures, published as part of the NHS’ weekly winter Situation Reports, show two hospitals were functioning at 100% capacity. The figures are a snapshot of occupancy levels taken at 8am each day. But health experts warn the figures could be even worse than the published data suggests due to the time of day when it is recorded.
An occupancy rate of 85% is generally considered to be the safe limit – one that has been endorsed by the Royal College of Emergency Medicine (RCEM). High bed occupancy rates can lead to bed shortages and make it difficult to find the optimum bed for a patient’s needs, contributing to waiting time backlogs and delays in A&E. There is also evidence it can lead to an increase in hospital acquired infections and other “avoidable adverse events”, according to a review by the National Institute for Clinical Excellence (NICE).
NHS England and NHS Improvement have previously suggested 92% should be considered the recommended safe limit for bed occupancy in winter. Based on the RCEM standard, 120 (87.6%) hospitals were found to be dangerously busy by functioning at 85% occupancy or above in the week to 1 January. Only 17 hospitals were below the 85% standard , while 94 had an occupancy rate of above 92%. You can find out how full your local hospital was by using the searchable table further down this article.
The figures come as the NHS faces one of its most challenging winters yet, with doctors warning that the entire health and social care system is overstretched. Health secretary, Steve Barclay, blamed high levels of flu, Covid and fears of Strep-A for the ongoing crisis.
Earlier this week Saffron Cordery, interim chief executive of NHS Providers, credited staff shortages, lack of investment, a worn-out workforce and a backlog of operations as contributing to the pressure, as well as rise of Covid and flu cases. The government has been urged to declare a national major incident.
‘Pushing the boundaries of what is safe’
Commenting on NationalWorld’s analysis, Nuffield Trust chief executive Nigel Edwards said that “no health system should be running their hospitals this hot”.
“It is almost certain that levels of overcrowding in NHS hospitals in England are even worse than the published data suggests due to the time of day when it is recorded,” he said. “The lack of manoeuvre and available beds is leading to dangerously busy and difficult conditions in accident and emergency departments, waiting rooms and corridors.”
He added that for years before the pandemic the NHS was “forced to push the boundaries of what is effective and safe occupancy rates”, adding that overcrowded hospitals increase risks to patients and link to higher rates of mortality.
“Focusing investment on propping up day-to-day hospital care, while neglecting investment in buildings and equipment as well as important care services outside of hospital will not help to bring these levels of bed occupancy down any time soon,” he said.
Dr Ellen Welch, co-chair at the Doctors’ Association UK, also called on investment for the whole health and social care sector. She said: “The entire NHS is overstretched, from GP services who are consulting with record numbers of patients, the ambulance service, our hospitals and the social care sector. The whole system is interlinked and investment is needed in all parts.”
Additional figures from the NHS show the strain surging cases of flu and Covid infections are having on the health system. In the last week, the number of flu patients in hospital has surged by 1,626 (47%), while the number of Covid patients has increased by almost 1,200. The NHS said 111 call handlers also answered the second highest number of calls ever in a week with 410,618 calls answered.
The NHS said it had “planned extensively” for winter and recruited hundreds of extra 111 and 999 call handlers and established around the clock system control centres in every area of the country. It has also set up dozens of acute respiratory infection hubs and community falls response services to ease pressure and demand on services. However, NHS national medical director, Professor Sir Stephen Powis, recognised the “enormous pressure” the flu and Covid was having on the healthcare system.
He said: “It remains vital that people make the most of services like 111 online and as ever, only use 999 in an emergency, and it’s also crucial that those who are eligible come forward for flu and covid vaccines as soon as possible.”
How does my local hospital compare?
Bed occupancy rates vary across England’s hospitals. Both George Eliot Hospital NHS Trust in the Midlands and Wrightington, Wigan and Leigh NHS Foundation Trust in the North West were found to be at full occupancy last week, while Moorfields Eye Hospital NHS Foundation Trust, Queen Victoria Hospital NHS Foundation Trust and Liverpool Women’s NHS Foundation Trust were the only trusts to fall below 50% occupancy. You can find out how busy your local hospital was last week using the searchable table below. Click here if you can’t see the table.
You can also find out which hospitals have the highest bed occupancy rate in England here.
What is the government doing to help the NHS?
A Department of Health and Social Care spokesperson said: “We recognise the pressures the NHS is facing following the impact of the pandemic and are working tirelessly to ensure people get the care they need, backed by up to £14.1 billion additional funding for health and social care over the next two years.
“This includes investing an additional £500 million to speed up the safe discharge of patients from hospital, creating the equivalent of 7,000 more beds nationally and establishing 24/7 data driven system control centres in every local area to manage demand and capacity.”
The spokesperson added that there are “record numbers” of nurses and doctors working in the NHS.