Patients are being routinely cared for in “temporary” beds that should only be used in emergencies or when there are spikes in demand, according to new research from the British Medical Association (BMA).
The research shows that NHS hospitals in England are facing an “ever-increasing struggle” to cope with patient demand, which means staff are being forced to provide routine care to people on “extra beds”, also known as “escalation beds”.
“Hospital bosses should only increase bed capacity if they have the nursing staff to care for the people in them”
Responding to the findings, nursing leaders warned that hospital bosses should only increase bed capacity if they have the staff to provide the additional care- otherwise patients will be put at risk.
Data from the BMA, which was collected using Freedom of Information (FOI) requests to NHS trusts, showed that beds that should be used for patients who had left operating theatres, were instead being commandeered as escalation beds.
Doctors reported that this could lead to cancelled operations for planned surgery and delays for emergency surgery, as there was no place for these patients to recover.
“NHS managers can’t make good decisions on bed use without certainty around staffing”
The research also found instances where patients had been put on beds in other hospital facilities, despite a lack of room in those areas.
The BMA’s findings are based on two seperate waves of FOI requests, which asked trusts how many escalation beds were in use from March to May this year.
Figures showed there were at least 3,428 escalation beds in operation across all 134 acute trusts in England on 3 March.
On 1 May, there were 1,637 escalation beds still in use according to the 80 trusts who provided data to the BMA. The union noted that 54 trusts failed to respond and so suggested the real figure is likely to be higher.
In addition, the BMA found that there were more escalation beds open on 1 May than there were on 1 January where there were 1,603.
It noted that there were variations across the country, with the East Midlands having the highest number of escalation beds per trust.
“There are also not enough staff to cope with the number of people coming through the hospital’s doors”
In the wake of the findings, Royal College of Nursing chief executive and general secretary, Dame Donna Kinnair, said: ”Hospital bosses should only increase bed capacity if they have the nursing staff to care for the people in them.
“Otherwise, patients are put at risk,” she said. “Full-to-bursting hospitals are not places people want to be treated or work.”
“NHS managers can’t make good decisions on bed use without certainty around staffing,” she added.
“Until that is resolved, we’ll see more chaos on wards,” said Dame Donna. “We need a properly-funded staffing plan backed up by legislation to make ministers accountable for safe and effective staffing.”
BMA consultants committee chair, Dr Rob Harwood, 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.
Dame Donna Kinnair
“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,” he said.
“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,” he added.
“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,” Dr Harwood said.
“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,” he added.
“The BMA has been lobbying for thousands of extra beds to be brought into use with the right levels of staff to support them,” he said.