More than 1 in 10 patients in England face long delays for a hospital bed after emergency admission

Posted 08/12/2016 By: Amanda Cavanagh

Recent NHS figures have shown that nearly 475,000 patients waited for more than four hours for a bed on a ward in 2015-16 which equates to nearly a five-fold increase since 2010-11.

Hospitals reported using side rooms and corridors to cope with the growing number of ‘trolley waits’. NHS bosses blame a ‘growing demand’ on the system. Doctors are saying that hospitals are now dangerously overcrowded, with three quarters of hospitals reporting bed shortages coming into winter.

Bed occupancy is not meant to exceed 85% so that staff have time to clean beds, keep infections low and ensure patients who need beds can get them quickly. However, 130 out of 179 hospital trusts are reporting rates exceeding this for general hospital beds. Hospital managers report that the problem is causing “deeply worrying” delays for those patients who have already had to wait to be seen in A&E for hours before they are diagnosed with a serious condition which means they require a bed.

Roughly one in five patients who come to A&E and who fall into this category are frail or elderly and patients with chest pains, breathing problems and fractures. Whilst these delays are so called ‘trolley waits’ not all patients find themselves on one. Hospitals end up using all sorts of areas, including side rooms, seats in the A&E department and spare cubicles depending on what is available, to house those waiting for a bed.

Too few beds

Siva Anandaciva, of NHS Providers which represents hospitals, said: “These figures are deeply worrying. We are heading into winter in a more fragile state than I have seen in the past 10 years or so. Even the historically top-performing trusts are being challenged, which shows that this is an issue affecting all parts of health. No-one wants to see people waiting in corridors, side rooms and emergency bays when they should be admitted to a hospital bed. These patients are still under the care of doctors and nurses of course, but it is not ideal for them and we know overcrowding leads to worse outcomes.”

Dr Chris Moulton, of the Royal College of Emergency Medicine, echoed the concerns. “Patients who are delayed like this are still being monitored by staff. But we know that the overcrowding we are seeing is dangerous. It leads to worse outcomes for patients – higher infection rates, patients ending up on the wrong wards and generally a negative experience.”

There are just over 100,000 general beds in England, which represents a fall of 40,000 in the past 20 years. The UK lags behind other European countries and the NHS is struggling to cope. A spokesman for NHS England said “growing demand” was putting pressure on the system – the number of emergency admissions having risen by more than 500,000 in five years to 4.2 million.

But he added it was “a tribute to front-line staff” that the NHS was able to handle so many patients.

Amanda Cavanagh, a member of the medical injury team at Ashtons Legal, comments:

“It is surprising that no one has correlated the lack of beds to the issue of bed blocking. Perhaps if the government were to put money back into community nursing and home carers, this would mean that patients who are well enough to be discharged, but may still require some form of home help/nursing, could go home. At present there is just not the funded support in place to allow them to do so. The patients wait in hospitals, taking up beds that they don’t want to be in, and the hospital don’t want them to stay in, but they have no choice. It’s fabulous that the spokesman for NHS England recognises how well the NHS front line staff cope, but presumably the staff themselves would prefer more beds, avoiding the need to stretch them to the limits every day of every month of every year!”