NHS scheme to reduce hospital pressures ‘stalled’ over lack of beds and staff

A flagship NHS scheme to reduce pressure on hospitals has “stalled” due to a lack of beds and staff shortages, The Independent can reveal.

Hospital wards designed to treat NHS patients within one day are instead being “inappropriately” used as “overflow” areas for busy A&Es, according to research by the Society for Acute Medicine.

These wards, called “same day emergency care units”, were rolled out to all NHS trusts before the pandemic, to help reduce hospital admissions. NHS England promised in 2019 the scheme, once implemented in all trusts, would reduce admissions in English hospitals by 50,000 a year.

However, a study carried out in June, which looked at some of these units, showed just 22 per cent of the patients who attended hospital were assessed and treated within one day, when the national target is for units to see at least 30 per cent.

The Society for Acute Medicine said the units could “play a vital role” in preventing thousands of unnecessary overnight stays but progress is “stalling”. This is due to “significant inconsistencies” in how the 24-hour wards were being used by hospitals and a lack of funding for them.

Patient conditions such as blood clots, skin infections, or fevers in cancer patients could be treated in these wards, preventing them from having to spend a night in hospital.

Despite NHS England making the scheme a priority in 2019, little progress has been made and SAM claims funding made available for urgent care over the last two years has not been directed to this cause.

Speaking with The Independent, Dr Nick Scriven, representing SAM, said the wards are used as overflow for A&E “when bed pressures and staff shortages get too tight.”

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He explained some units are, “just used as normal wards or the staff are taken to fill gaps elsewhere. As hospitals run out of beds they look at somewhere else to put patients and unfortunately the units get hit.

“It’s almost a ‘non-sensical’ loss because you lose that unit until the next day when the patients are gone which means more patients get admitted when they don’t need to be.”

The number of hospital beds in England has been decreasing for decades and by 2019-20, levels were almost half of what they were in 1987, despite the population rising from 47 million to 56 million.

NHS leaders warned this week healthcare services were “at breaking point” as official figures revealed A&E waiting times had hit an all-time-high with more patients than ever waiting over 12 hours in emergency departments.

Ambulance response times for October had also skyrocketed with record delays, which are often driven by ambulances being forced to wait outside of A&E.

A major cause of long emergency care waits are a lack of beds for patients to be admitted to in hospitals. According to an analysis by think thank the Kings Fund the number of hospital beds in England dropped from 153,725 in 2010-11 to 131,795 in 2019-20.

Dr Tim Cooksley from the Society for Acute Medicine, said: “The number of NHS hospital beds has reduced by 11 per cent over the past decade and bed occupancy was around 90 per cent long before the pandemic – both reasons this option to alleviate pressures on hospitals and improve patients’ experiences and access to care is so vital.”

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He said if all the units in the audit had achieved NHS England’s 30 per cent target it would have prevented 350 admissions in one day.

“Over January and February in mid-winter this would equate to more than 20,000 overnight stays being avoided, so we need to ensure these units are both being used appropriately and have the resources needed to make this happen,” he added.

NHS England was approached for comment.


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