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Patients are being routinely cared for in ‘temporary’ beds as hospitals are ‘full-to-bursting’

The NHS needs 10,000 extra beds to guarantee safe care all year round.

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Hospitals in England are struggling to cope with the rising demand.

Research by the British Medical Association (BNA) has revealed that patients are being routinely cared for in ‘temporary’ beds as hospitals in England struggle to cope with rising demand.

The data, obtained by Freedom of Information (FIO) Requests reveals how hospitals are now routinely caring for patients in beds that should be used only in emergencies or when there are spikes in demand, such as during the winter months.

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Doctors report that beds which should be for patients who have left operating theatres are being commandeered as escalation beds and this can lead to cancelled operations for planned surgery and delays for emergency surgery, as there is no place for these patients to recover.

The findings come as NHS chief executive Simon Stevens acknowledges that hospitals would need to increase bed capacity to deal with demand, after years of reductions. The BMA has previously said that the NHS needs 10,000 extra beds to guarantee safe care all year round.

Beds in corridors.

Dr Rob Harwood, BMA consultants committee chair, 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.

Full-to-bursting.

Responding to the news, 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. 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. Until that is resolved, we’ll see more chaos on wards. We need a properly-funded staffing plan backed up by legislation to make Ministers accountable for safe and effective staffing.”

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Workforce

Patient safety in danger unless nurse numbers increased, warns RCN

The college is encouraging people to speak out about the impact of England’s nurse shortage.

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Hospital Admissions Unit

There have only been an extra 9,894 nurses recruited to NHS hospitals since 2013.

The shortage of nursing staff in England is putting patient safety in danger, the Royal College of Nursing (RCN) warns today as it use the first World Patient Safety Day to launch a new campaign.

The campaign encourages the people to speak out about the potentially devastating impact of the nursing shortage.

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There are an estimated 40,000 unfilled nursing vacancies in England alone.

It calls for legislation to be brought forward in England to help address the nursing workforce crisis. Earlier this year, nurses and support workers in Scotland secured new legislation on safe staffing levels after a nurse staffing law was introduced in Wales in 2016.

There are not enough nurses.

A new analysis by the RCN shows that for every one extra nurse NHS acute Trusts in England have managed to recruit in the five years since 2013/14, there were 157 extra admissions to hospital as emergencies or for planned treatment.

Last year the number of extra admissions for every additional nurse taken on increased to 217.  The analysis shows that the extra 9,894 nurses recruited to NHS hospitals since 2013/14 is dwarfed by the additional 1,557,074 admissions over the same period.

Public carried out to mark the campaign launch reveals that 71 per cent of the public think there are not enough nurses to provide safe care to patients and 67 per cent of the public in England wrongly think the Government has a legal responsibility to ensure there are sufficient nursing staff.

The 2013 Francis Report on failings of care Stafford Hospital concluded that the main factor responsible was a significant shortage of nurses at the hospital.

Issuing a stark warning

Dame Donna Kinnair, RCN Chief Executive and General Secretary, said: “Today we’re issuing a stark warning that patient safety is being endangered by nursing shortages.  Staffing shortfalls are never simply numbers on a spreadsheet – they affect real patients in real communities.

“We’re calling on the public in England to fight for nurses and sign our petition calling on the Westminster Government to invest in the future workforce and make clear who is accountable in law for safe patient care. 

“Our polling shows almost two-thirds of people already fear there aren’t enough nurses to provide safe care – and they want recruiting more nurses to be the top priority for any extra funding for the NHS in England. 

“Nurses are the single most trusted professional group in the whole country, with 96% of the public placing them at the top of a list of occupations including doctors, teachers, the police and scientists.  Nursing staff are asking for your support in calling time on this crisis.”

‘Too much pressure’.

Responding to the RCN’s campaign on safe and effective staffing for patient care; Andrea Sutcliffe CBE, Chief Executive and Registrar at the Nursing and Midwifery Council (NMC), said: “Every time we, or someone we love, needs care, we trust nurses and midwives with the right skills and knowledge to be there to meet our needs.

“The RCN analysis echoes some of the NMC’s own findings. Our survey of nurses and midwives leaving the register revealed that almost a third of respondents cited too much pressure leading to stress and/or poor mental health as a top reason for leaving. And our research with the public tells us they fear these most trusted professionals are held back by the pressures of today’s health and care system.

“You only have to look at some of the stories we are sharing in our Always Caring, Always Nursing campaign to see the difference these dedicated professionals can make in people’s lives.

“Additional resources to support nurses and midwives is a wise investment now and for the future.”

You can sign a petition to support the campaign. 

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Emergency Medicine

People living in deprived areas visit A&E twice as much as the affluent

Nearly 25 million people attended A&E in 2018-19.

Laura Townsend

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Busy A&E waiting room

Over a quarter of all A&E attendances are by the 20% of the population living in the most deprived areas.

Accident & Emergency (A&E) attendances for those living in most deprived areas are around double that of those living in the least deprived, official figures have revealed.

NHS Digital’s data on Hospital Accident & Emergency Activity in 2018-19 show that the bottom 10% account for the largest number of A&E attendances of any group, with just over 3 million attendances in 2018-19. In contrast, the top 10% only accounted for around 1.5 million A&E attendances.

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Expanding these figures further shows that 27% of all A&E attendances are by the 20% of the population living in the most deprived areas.

A recent study suggested that socioeconomic such as poor housing quality, unemployment, self-care difficulties, depression, and proximity increased a person’s likelihood of attending an A&E service.

The report includes data from all types of Accident and Emergency departments ranging from major A&E departments, single specialty, consultant-led emergency departments to Minor Injury Units and Walk-in Centres.

An overall increase in attendances.

Looking at all arrival times, 1.5% of all attendances in 2018-19 spent more than 12 hours in A&E, compared with 1.6% the previous year.

The data also shows a 4% increase in attendances to A&E from 23.8 million in 2017-18 to 24.8 million in 2018-19 and a 21% increase from 20.5 million in 2009-10. Since 2009-10, the average growth in A&E attendances per year is 2%.

An NHS spokesperson said; “Over a busy summer, NHS staff have continued to deliver more care than ever before for those who need it, with 37,000 more people receiving A&E treatment within four hours this August compared with last August.”

“July also saw the highest ever number of people in a month benefiting from fast NHS cancer checks, other routine tests and rapid treatment for serious mental health problems, while an extra 1,600 people started planned treatment every day compared to last year, showing that every part of the health service is playing its part in meeting the rising demand for care.”

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