Full hospitals creating potential danger, analysis says


Dan Poulter Health Minister said the NHS needs to prevent "people who don't need to be in hospital from being there in the first place".

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Hospitals are "full to bursting" in England, creating a potentially dangerous environment for patients, an analysis by experts suggests.

Hospitals should run at about 85% capacity to give them room to cope with surges in demand, and figures show the NHS average hovering around that mark.

But analysts Dr Foster said the figure was skewed by quiet periods and rose higher if they were stripped out.

Ministers denied the NHS is overcrowded and said it could manage demand peaks.

According to the analysis, if only midweek figures are taken into account, the average capacity figure for 2011-12 was 88%.

It rose to 90% if holiday periods, such as the royal wedding and Christmas, were stripped out, Dr Foster said.

The private research group said this was important as the quiet periods were helping to mask the fact that many trusts were now too full for long periods of the year.

Its report, which excluded specialist centres but included 145 hospital trusts, said when hospitals were too busy patient care suffered because systems started breaking down.

Dr Foster co-founder Roger Taylor said: "When that happens, patients are put in whatever bed can be found, orderly management of admission and discharge can become strained, infections are harder to control and mistakes are more likely to happen."


But the analysis argued that if the NHS organised itself better it could relieve the pressure on hospitals.

From its analysis, Dr Foster said 29% of beds were taken up by patients who did not necessarily need to be there.

These included more than 10% who had conditions such as asthma and heart disease, which could be treated in the community, it said.

Another 5% were readmissions within a week or discharge, while 2.5% were for dementia.

'Real strain'

Patients Association chief executive Katherine Murphy said: "These distressing figures reveal bed occupancy rates are at the very limit of what is safe or indeed desirable for patients.

"Our helpline hears day in day out from patients and relatives who are experiencing unacceptably poor care, with nursing staff telling relatives that they simply do not have time to deliver the fundamentals of good care or dignity."

Dr Andrew Goddard, director of the Royal College of Physicians' Medical Workforce Unit, said: "The staggeringly high bed occupancy rates show that hospitals are at bursting point.

"The medical profession now must carefully consider these findings and decide how to improve hospital services to better meet the needs of patients."

Mike Farrar, chief executive of the NHS Confederation, which represents hospitals, said: "The big message at the heart of this report is that hospitals are under real strain and patients will suffer unless we are able to take swift action."

Dr Mike Williams says 'mistakes' are more likely from overworked NHS staff

He added the solution lay in investing in community services to take the strain off hospitals.

Dr Foster's study also included data on death rates. It uses four different measures, including deaths after surgery and among those with low-risk conditions, to help assess which hospitals are falling outside of what would be expected.

A total of 12 trusts - down on last year's more than 20 - were flagged up as performing worse than expected on two of the four measures.

This does not mean services are performing poorly, but instead the findings act as more of a "smoke alarm", suggesting something could be going wrong.

Health Secretary Jeremy Hunt said local managers in those areas should investigate.

On bed occupancy, he said: "The NHS is not overcrowded - on average, there are around 20,000 of its beds available. Of course this goes up and down, but the NHS has practice and experience in managing peaks in demand, particularly in the winter."

But Dr Foster medical guide editor, Alex Kafetz, said that figure was only an average and the number of patients using beds was "not particularly smooth" and more needed to be done to make sure patients who potentially should not be in hospital were cared for at home or at specialised care facilities.

Health minister Dr Dan Poulter agreed this was key, adding: "That is exactly why the government has embarked on a programme of reforming the NHS to make sure more of the budgets and money is held in the community and people can be better looked after and supported in their own homes.

Panorama will be covering more of the Dr Foster report in How Safe is Your Hospital? on Monday, 3 December at 20:30 GMT on BBC One.


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  • rate this

    Comment number 247.

    It's all we have left . . . . . .Looks like it's on the way out too

  • rate this

    Comment number 246.

    Why is this surprising? If you want to save money in the NHS, you need to reduce what you do, either close beds/wards/hospitals, or reduce the number of staff you are paying. Thus we get headlines of "Appalling' NHS care" and "Full hospitals".

    It gets really interesting when the managers won't allow a hospital to close to admissions because it hits their bonuses. See RPH Preston on Fridays.

  • rate this

    Comment number 245.

    If I accept the new payment deal, I will have up to £ 200 less a month and if I accept the new working hours, I have to work all day 3 to 4 times a week with between 36 and 72 patients with laughable 6 to 7 staff and this will be a KILLER for us nursing staff and for patients but before that goes ahead, I rather resign and work as binman or as street sweeper or as domestic x

  • rate this

    Comment number 244.


    If you are going to strip out the quiet periods, then surely you also have to strip out the "busy" periods too - like every Friday night at A&E, and the "winter peak".

    This is a company skewing the figures to suit their case and get themselves some head lines.

    Surely at this time of year we should worry about the peak? Sorry no room at the inn

  • rate this

    Comment number 243.

    Re 213, from http://blogs.channel4.com/factcheck/factcheck-who-really-stands-to-lose-out-under-nhs-pension-changes/9218

    "With consultants, the overall generosity of the pension is 48.5 per cent of final earnings, and the share of that contributed by the taxpayer rises to a “whopping” 40 per cent of salary"

    No wonder we can't afford hospital beds

  • rate this

    Comment number 242.

    If hospitals dealt with those who are genuinely ill, turned away ambulance-loads of drunks brought in on Friday and Saturday nights, and ceased trying to resuscitate so many elderly instead of allowing them to die naturally and with some dignity, there would be plenty of free beds available to cope with emergencies. The NHS needs to get back to basics, not act as a panacea to all and sundry.

  • rate this

    Comment number 241.

    180.Swing Lowe
    "Why didn't we build more hospitals when we were in power for 12 years, but an amusing stick to beat the Torys with, ha ha!"

    Hospitals were built - using Private Finance Initiatives, a daft idea from the the tories that was fully embraced by labour. The hospitals can't hire as many medical staff as they need now, because they have to pay the private companies that built them.

  • rate this

    Comment number 240.

    And our government wants immigrants to come here? Hospitals full, road congested, insufficient housing, too much spent on social security?
    Facts are facts but no doubt that will be seen as racist to the wooden headed, entrenched politicians that have no ability to look at problems and find solutions.

  • rate this

    Comment number 239.

    I work in the NHS and have come across Dr Foster stats in my area. The short answer is that I'd take what they say with a large pinch of salt!

  • rate this

    Comment number 238.

    If you are going to strip out the quiet periods to "get a better picture" of the "average usage", then surely you also have to strip out the "busy" periods too - like every Friday night at A&E, and the "winter peak".

    This is a company skewing the figures to suit their case and get themselves some head lines. Shame on you for falling for it BBC.

  • rate this

    Comment number 237.

    victim of its own success...thats the nhs.......fixing up just about everybody in the world for nothing. give a big heave ho to health tourism...thats a start.

  • rate this

    Comment number 236.

    blah blah blah. the real problem is worthless opinion. This popular idea that we can just guess on a hunch what is wrong with the NHS without needing to figure it out with actual data.

    "It's labours fault", "I'ts tories fault", "It's doctor's fault", "it's patients fault", "it's migrants", "it's cuts", "it's cosmetic surgery", "it's obesity", "it's alcohol"

    yeah. then prove it. with numbers.

  • rate this

    Comment number 235.

    Not a surprise at all. Its money and targets first in everything this Government touches.
    Over crowed hospitals, elderly care failing, the disabled being hit any way possible, the poor being allowed to freeze.
    Just listen to what the charities are reporting.
    After all the Government Ministers can all go private for everything!

  • rate this

    Comment number 234.

    This is proof that we need more hospitals with better facilities/expansion (where possible) with more staff. The population is increasing so the facilities should increase with it. There are many options to gather the money to acheive an expansion. One example is to cut foreign aid particuarly to countries like India. They have a SPACE program for god sake, they dont need money

  • rate this

    Comment number 233.

    If we had National Car Insurance there'd be:
    More negligent drivers;
    More cars taking up room in a limited number of mechanics shops,
    More expensive repairs as a result of the increased demand,
    This is exacerbated by low mechanics numbers being restricted artificially by the mechanics Union (protectionism).

    Ok, now apply this to the NHS, why would the results be any different?

  • rate this

    Comment number 232.

    A friend of mine is a midwife, that is completely snowed under at the local maternity unit

    Another midwife attached to the unit is on an NHS funded scheme to visit pregnant women in their homes to talk about smoking habits. She only visits the unit to do admin

    Maybe the NHS would work more efficiently if trained staff were used where they are most needed, instead of some daft funded schemes

  • rate this

    Comment number 231.

    We are often told that there is a small window of time for getting many genuine emergency patients to hospital. But A&Es, along with many “specialist” hospital services, are being centralised (i.e. closed down). Quite apart from having patients lying around on trolleys, it also means longer (and probably more) ambulance journeys. Is this actually effective use of resources?

  • rate this

    Comment number 230.

    These sort of things happen when you have an open door policy.

  • rate this

    Comment number 229.

    may be first off the records should be checked as many people using the nhs are infact non british residents and should pay for there treatment, secondly this state shows that recent government ideas are total bunkumand hospitals under tier management fail.
    this is just the beguining of the end of the nhs as planned by parliment for ages to save money.

  • Comment number 228.

    This comment was removed because the moderators found it broke the house rules. Explain.


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