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Number of beds lost due to norovirus this winter highest for five years, warns RCN

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The number of beds lost due to suspected cases of norovirus over the winter reached the highest level for five years and is “unsustainable”, according to the Royal College of Nursing.

Almost 75,000 beds in the NHS hospitals in England had to be taken out of service over the course of this winter because of suspected cases of norovirus, said the college.

“It’s important to note that not just patients but also nursing staff often fall victim to norovirus outbreaks”

Rose Gallagher

The average number of beds closed each week this winter was 5,722, which is 32% higher than the average of the previous four winters, it said, based on its analysis of available data (see document attached below).

It added that on the single worst-affected day, over 1,200 beds had to be taken out of service – equivalent to around two entire hospitals being closed.

With fewer beds available, hospitals then find it harder to admit new patients, which contributes to trusts being unable to meet the government’s four-hour accident and emergency target, warned the college.

The RCN’s analysed the number of beds reported lost because of norovirus and diarrhoea and vomiting-like symptoms each week this winter, comparing them with the previous four winters.

These figures are one of a range of indicators that NHS England publishes weekly from early December to the end of February or beginning of March each winter.

“With so many beds being lost to the illness this winter, bed stocks are reaching unsustainably low levels”

Janet Davies

The analysis found this winter had seen the highest number of beds closed because of suspected norovirus or diarrhoea and vomiting for five years, with 74,390 closed over the course of the winter.

It has also seen the highest weekly average number of beds closed for the last five years, with 5,722 beds closed on average each week, compared with an average of 4,345 each week for the previous four winters. The daily average this winter was 817 beds closed.

In addition, the weekly and daily averages of beds closed this winter were both 17% higher than the daily and weekly averages for the winter of 2016-17, and 32% higher than the average across the previous four.

The single worst-affected week this winter was the week ending 10 December, when 7,862 beds had to be closed. The following week, ending 17 December, was not far behind, with 7,500 beds lost.

Norovirus and diarrhoea and vomiting-like symptoms

Norwalk Caspid

Source: Prasad, B.V., Hardy, M.E., Dokland, T., Bella, J., Rossmann, M.G., Estes, M.K.

X-ray crystallographic structure of the Norwalk virus capsid

The figures show the single day with the highest loss of beds this winter was Sunday 10 December 2017, when 1,271 had to be closed, equivalent to having to lose two entire hospitals’-worth.

The RCN noted that the number of beds closed because of norovirus and diarrhoea and vomiting had appeared to be falling in January and the first week of February,

But in the last three weeks, the number has been steadily increasing again, with last week’s total of 6,643 beds lost the third highest this winter.

NHS England is due to publish its final Weekly Winter Operational Update for the winter today, comprising data on indicators considered to particularly affect the NHS in winter.

Rose Gallagher, the RCN’s professional lead for infection prevention and control, said: “It’s important to note that not just patients but also nursing staff often fall victim to norovirus outbreaks – which then exacerbates existing staffing problems, as affected staff shouldn’t report for duty until they’ve been symptom-free for 48 hours.

“If they return to work too early, staff risk unknowingly passing on the illness, as they remain infectious,” she said. “Norovirus presents a big challenge to nursing staff in winter, and we can all play our part in trying to reduce it.”

Also commenting on the findings, RCN chief executive and general secretary Janet Davies said: “Nursing staff work extremely hard to prevent the norovirus infection spreading.

“But with so many beds being lost to the illness this winter, bed stocks are reaching unsustainably low levels,” she said. “The loss of even a few hundred beds a day can have severe consequences.

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Janet Davies

The reduction in beds “then makes it much harder for A&E departments to get patients admitted to wards quickly as emergencies,” noted Ms Davies.

She also highlighted that bed occupancy rates had been extremely high this winter, averaging 94%, which was around 10% higher than recommended levels.

“Part of the reason experts recommend that no more than 85% of the beds are occupied at any one time is to prevent infections such as norovirus spreading,” she said.

“What this shows is that, despite the intense focus on the A&E four-hour target in coverage of winter pressures on the NHS, there are actually many different factors at play,” she added.

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  • Putting the drunks and drug addicts into drunk-tanks will reduce about 15% of the AE admissions

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  • They are still human beings no matter what their addiction is

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