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Core bed numbers fall in seven systems, despite NHSE plan
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Core bed numbers fall in seven systems, despite NHSE plan
By Matt Discombe18 December 2023
- Number of core beds drops at seven ICSs
- NHS England had planned for 2,300 additional beds
- NHS Confed concerned about bed occupancy amid upcoming strikes
The number of ‘core’ acute beds has fallen in seven health systems since the summer, according to official sitrep data.
A further four integrated care systems have only reported a handful of extra beds.
In the summer, NHS England set out plans to increase the core number of general and acute beds to 99,000 by December, an increase of around 2,300 on the number at that stage.
Weekly data published by NHSE data suggests the national total had reached around 98,300 at December 10.
The systems which have since seen reductions in core bed numbers, according to the official data, were; Buckinghamshire, Oxfordshire and Berkshire West; Lincolnshire; Leicester, Leicestershire and Rutland; Frimley; Somerset; and Devon.
Trusts frequently open “escalation beds” to cope in periods of high pressure, although these can often be in inappropriate areas such as corridors, and can be more expensive if relying on temporary staff at short notice.
NHSE’s plan aimed to address “high levels of bed occupancy”, yet all seven of the systems which reported reduced core bed numbers reported occupancy levels above 92 per cent in the week to December 10. A safe level of occupancy is deemed by the Royal College of Emergency Medicine and others as 85 per cent.
| Integrated care system | Core beds - Week to Dec 10 | Change since August |
|---|---|---|
| Buckinghamshire, Oxfordshire And Berkshire West ICS | 1,960 | -1.7% |
| Lincolnshire ICS | 972 | -1.6% |
| Leicester, Leicestershire And Rutland ICS | 1,617 | -1.3% |
| Frimley ICS | 1,203 | -1.1% |
| Somerset ICS | 996 | -0.9% |
| Devon ICS | 2,451 | -0.4% |
| Hertfordshire And West Essex ICS | 1,631 | -0.1% |
| Greater Manchester ICS | 5,945 | 0.1% |
| Bristol, North Somerset And South Gloucestershire ICS | 1,848 | 0.1% |
| Norfolk And Waveney ICS | 1,883 | 0.1% |
| Cornwall And The Isles Of Scilly ICS | 642 | 0.1% |
| Mid And South Essex ICS | 1,731 | 0.5% |
| Bedfordshire, Luton And Milton Keynes ICS | 1,502 | 0.7% |
| Herefordshire And Worcestershire ICS | 1,077 | 1.0% |
| Lancashire And South Cumbria ICS | 2,965 | 1.1% |
| West Yorkshire ICS | 4,357 | 1.4% |
| Coventry And Warwickshire ICS | 1,721 | 1.5% |
| North Central London ICS* | 2,896 | 1.5% |
| Cheshire And Merseyside ICS | 5,771 | 1.5% |
| North East London ICS | 2,885 | 1.6% |
| North West London ICS | 3,143 | 1.6% |
| Black Country ICS | 2,639 | 1.7% |
| Sussex ICS | 2,506 | 1.7% |
| Gloucestershire ICS | 862 | 1.7% |
| South West London ICS | 2,493 | 1.8% |
| Birmingham And Solihull ICS | 2,846 | 1.8% |
| Hampshire And Isle Of Wight ICS | 3,113 | 1.8% |
| Humber And North Yorkshire ICS | 2,935 | 2.0% |
| Shropshire, Telford And Wrekin ICS | 921 | 2.0% |
| South East London ICS | 3,061 | 2.2% |
| Bath And North East Somerset, Swindon And Wiltshire ICS | 1,500 | 2.2% |
| Nottingham And Nottinghamshire ICS | 2,320 | 2.4% |
| Dorset ICS | 1,373 | 2.5% |
| Cambridgeshire And Peterborough ICS | 2,119 | 2.6% |
| North East And North Cumbria ICS | 6,650 | 2.6% |
| Northamptonshire ICS | 1,218 | 2.9% |
| Derby And Derbyshire ICS | 1,925 | 3.0% |
| Staffordshire And Stoke-On-Trent ICS | 1,338 | 3.4% |
| South Yorkshire ICS | 3,250 | 4.1% |
| Suffolk And North East Essex ICS | 1,583 | 5.6% |
| Kent And Medway ICS | 2,834 | 6.0% |
| Surrey Heartlands ICS | 1,606 | 6.2% |
*North Central London ICS corrected data due to reporting error
Rory Deighton, director of the acute network at the NHS Confederation said it is “sensible” that ICSs organise care differently due to the varying needs of their populations. But he said the confederation was “concerned” that bed occupancy remains “very high” despite more beds being open than last year, with delayed discharge “remaining a major challenge”.
He added: “The upcoming junior doctors strikes will exacerbate this and pile yet more strain onto a system that is already running very hot. Leaders are also concerned that the unfunded cost of industrial action, combined with pressure to balance system budgets, means most systems have little room to invest in more beds over the winter.”
NHS England said it is “still on track to have 99,000 core beds in place” by the end of December and the additional core beds had been targeted at hospitals with major accident and emergency departments.
This has been achieved “despite increased demand compared to last year, ten months of industrial action, and a steady rise in the number of patients hospitalised with winter viruses,” NHSE added.
Some systems queried the data, saying they were planning to open more beds this winter. Leicester, Leicestershire and Rutland ICS said there had not been a reduction in the total bed base across the system, including escalation beds.
Buckinghamshire, Oxfordshire and Berkshire ICS said figures on ‘available’ core beds fluctuates when some beds are closed due to infection control measures, adding: “Our winter plan includes the option to open up to 95 escalation beds in January 2024 across our three acute trusts. These beds will be opened as required.”
Surrey Heartlands, an ICS which saw a sizeable increase in core beds, said it did not recognise the numbers.
Source
HSJ analysis of NHSE data
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