Hospitals strive to keep their bed occupancy rates below 85% so that they can handle unexpected admission rises and avoid an NHS hospital bed shortage. The Nuffield Trust published an analysis revealing that bed occupancy in English NHS hospitals last winter exceeded 95% on a daily basis.

The NHS hospital bed shortage did signal cut backs on elective surgery over the holiday period to keep more beds free for emergency admissions. This message has been strengthened this year, says the BBC, as NHS England has written to hospitals to encourage routine surgery to be postponed until the Christmas and New Year period is over.

Shortage of hospital beds has led to delayed treatment for emergency admissions, as well as an increased infection rate. Controlling these infections is more difficult when hospitals are too full as it is harder to keep everything clean.

The Nuffield analysis revealed that on the busiest day last year, over 4,300 extra beds were opened; the equivalent of over seven extra hospitals. A major factor in this over occupancy was the delay in ongoing care, which meant that those well enough to leave could not do so because their aftercare was not set up.

During one day in January this year, more than 4000 emergency beds had to be opened. On the same day, one in seven Trusts reported that they didn’t have a spare bed, and four out of ten hospital Trusts had over 98% of hospital beds in use.

Professor John Appleby, chief economist at the Nuffield Trust warned that patient safety could be at risk this year too because ‘the NHS is going into this winter in an even worse position than it was a year ago, with record deficits, worse performance against the A&E target, far more trolley waits, record delayed discharges from hospital, and fewer people getting the help they need with social care.’

An NHS England spokesman replied that “This report looking back to last year points to the steps the NHS takes each winter to maximise bed availability, and plans are well in hand for this winter too.”

Chris Hopson of NHS Providers, representing Trusts, said Trusts were caught between a rock and a hard place – “the rock of coping with ever rising emergency demand and the hard place of meeting the referral to treatment elective surgery target and financial control totals where elective income is key…Trusts chief executives tell us it’s increasingly difficult to deliver both.”