Full hospitals 'a risk to patient safety'
New guide says rising number of emergency admissions makes it tougher to provide a safe service
3rd December 2012 - Hospitals in England are "full to bursting" and the situation is putting patients at risk, say health experts.
An analysis by the private research group Dr Foster says the rising number of emergency admissions is to blame and that many of the patients currently in hospital would be better off being cared for elsewhere.
The 2012 Hospital Guide says many hospitals are working at between 95% and 100% capacity which leaves little room for error. Under those circumstances patients are put in whatever bed can be found, infections are more likely and mistakes are easier to make.
Nowhere else to go
Roger Taylor, Dr Foster's co-founder writes: "The answer is not in more hospital beds, but in the fact that many of the people currently in hospital beds would be better off somewhere else." The guide says one of the biggest problems is the influx of frail, elderly patients who are admitted to hospital because there is nowhere else to go.
For instance, last year, 54,915 people were admitted as an emergency to an acute hospital because they had dementia. Another 151,449 had urinary tract infections which led to a stay in hospital. "Our hospitals are becoming refuges for those who have been let down by the wider health system," says Roger Taylor.
The guide says that the number of days in hospital spent by the over 75s who have underlying illnesses has grown by 15% in the past five years.
Dr Foster says the number of people in hospital who would be better off being cared for elsewhere in the health system varies between regions of England. They account for 25% in South Central to 31% in Yorkshire and The Humber, the North West and Wales. It means that:
- 11.9% of beds are occupied by people with a condition that should not require hospitalisation if it had been managed better elsewhere in the health system
- 5.6% of beds are occupied by patients who have been readmitted as an emergency within a week of being discharged from hospital
- 2.5% of beds are occupied by people with dementia
- 2.1% of patients are in hospital because of failings in scheduling day case surgery efficiently
Bed occupancy is running at 88% on average across the NHS. It peaked in February and was at its lowest during holiday periods. During the royal wedding the national occupancy rate was 79% and capacity was at 81% over the August bank holiday. However, because of winter pressures the average occupancy was running at over 95% in 68 NHS Trusts.
Letting down the elderly
Experts say that the current system is working against the interests of older people as well as clogging up the NHS. They say that because of a lack of care in the wider community, many elderly people are being needlessly admitted because of falls, malnutrition, dementia, depression and other long-term conditions.
Michelle Mitchell, director general at Age UK, writes in the report: "Left with nowhere else to go, older people frequently arrive at hospital, not necessarily inappropriately, but often avoidably."