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Overspill beds in use for routine care

Patient sitting next to hospital bed 20687

Thousands of beds designated for expected high demand are having to be used for routine care, a BMA investigation of hospitals in England has revealed.

Pressure on NHS trusts has meant that many hospitals are having to resort to using their escalation beds – which are supposed to be reserved for emergencies and periods of high demand such as wintertime, on a daily basis.

Data was released following a series of Freedom of Information requests by the BMA which asked acute trusts in England how many core and escalation beds they had open and occupied from 3 March this year onwards.

The results showed 3,428 escalation beds in use across all 134 trusts at the end of winter, with 1,637 of these still in use by 1 May in 80 of the trusts.

Doctors have reported to the BMA how beds intended for post-operative patients to recover in are being ‘commandeered’ as escalation beds, leading to delays in elective and even emergency surgery.


Critical sign

Responding to the findings, BMA consultants committee chair Rob Harwood said that trusts having to depend on beds reserved for emergencies was a damning indication of how severe service demands on the NHS had become.

He said: ‘The use of escalation beds is a sign that trusts are at a critical stage and are unable to cope with demand with their current bed stock. Some hospitals are forced to designate their theatre recovery beds as “escalation”, resulting in elective surgical operations being cancelled as there is no space for those patients who need immediate care after their surgery.

‘I have heard of other cases where beds in day procedure units – surgical units for patients who can have their operation and return home on the same day – are used as escalation spaces for admitting patients for longer ward-style care, meaning healthcare staff cannot continue with routine day care surgical cases.

‘Most worryingly, the intense pressure on beds can result in patients being placed on beds in corridors or in bits of other facilities, sometimes cramping treatment areas and causing unacceptable stress to the patient and their families. It is obvious in these circumstances that there are also not enough staff to cope with the number of people coming through the hospital’s doors.

‘It cannot be right that the NHS is having to use these measures almost permanently, especially when the BMA, other leading healthcare bodies and patient groups have offered solutions. The BMA has been lobbying for thousands of extra beds to be brought into use with the right levels of staff to support them.’


Set for debate

Other findings from the BMA’s investigation include:

  • Nine out of 10 English hospital trusts were still using these beds on 1 May 2019
  • More escalation beds were in use on 1 May than on 1 January
  • The highest use of escalation beds per trust was in the East Midlands, while London used the most escalation beds as a proportion of total beds.

The BMA has previously said that an extra 10,000 beds need to be found if the health service is to be able to guarantee year-round safe care, with the issue of NHS pressures set to be an important topic of debate at the association’s upcoming annual representative meeting in Belfast.

Read the investigation’s findings


More on this issue: Thousands of ‘escalation’ beds needed year-round

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