NHS hospital bed numbers per 1,000 population  – Scotland better resourced than England and Wales according to new RCEM briefing

By stewartb

The Royal College of Emergency Medicine (RCEM) has provided summary data on NHS hospital bed capacity – ‘RCEM Explains: – Hospital beds across the UK’ – dated May 2023.

See https://res.cloudinary.com/studio-republic/images/v1684400862/RCEM-Explains-Hospital-beds-across-the-UK-May-2023/RCEM-Explains-Hospital-beds-across-the-UK-May-2023.pdf?_i=AA

On yet another objective measure, NHS Scotland performs favourably when compared to equivalents in England and Wales. This is not to ignore the challenges and deficiencies presently in NHS Scotland. But it most certainly is to counter the relentless gaslighting tactics of the political opposition in the Holyrood Parliament: it most certainly is to counter the negativity amplified day after day, notably by BBC Scotland, without context and without perspective. And it provides yet another example of how the chaos/alarmist narratives about NHS Scotland that are peddled by the leadership of the Labour Party in Scotland are exposed for their hypocrisy as the comparative performance of the health service in Wales where Labour has long been in power is revealed.

Background

From the introduction to the RCEM’s document: ’Last year the Royal College of Emergency Medicine (RCEM) published a report examining Beds in the NHS and the impact of full hospitals on the provision of safe and timely care. This briefing outlines the developments in UK bed numbers since the report’s publication and calls for an increase in the number of staffed hospital beds required to #ResuscitateEmergencyCare and improve patient safety.’

Key findings

‘From 2011 to 2019, the UK experienced a loss of 11,980 acute beds. This includes 9000 in England, 1,500 in Scotland, 1,100 in Wales and 380 in Northern Ireland’.

The RCEM states: ‘Compared to OECD EU nations, the UK is the second least-bedded per-1000 population. This has been a deliberate policy decision due to advances in medical treatment, meaning patients don’t have to stay in hospital as long and a shift towards providing care outside of the hospital.’

The graph below, from the RCEM, provides noteworthy context. It reveals that NHS Scotland has consistently maintained the highest level of beds per 1,000 people of any UK nation.

On occupancy levels – which intuitively may reflect national responses to general demand and investment in contingency to cope with peaks in demand – we learn from the RCEM that:

• In England: ‘Hospital occupancy has remained above 94% for six consecutive months’
• In Scotland: in quarter ending September 2022, ‘occupancy was on average 89% across all Scottish Health Boards’
• In Wales: ‘Across 2022, the level of hospital occupancy was on average 93% and most recently was 95.5%’.

The RCEM notes: ‘Evidence suggests that hospitals tend to operate most effectively when their occupancy levels do not exceed 85%, allowing for extra capacity to handle sudden increases in demand.’

The RCEM’s briefing states:

• ‘Across the UK, an additional 9,728 beds are required to achieve optimum occupancy levels. This includes: 8,527 in England, 448 in Scotland, 582 in Wales, and 171 in Northern Ireland.

The RCEM tabulates its assessment of the number of additional beds required to achieve appropriate hospital occupancy levels:

Using these RCEM’s data, the percentage increase in staffed bed numbers required in England amounts to 8.2% of currently available beds; in Wales the required increase is 9.0% whereas the shortfall in Scotland is just 3.3%!

End note

I came across this briefing on NHS beds in a statement the RCEM released on 22 May on the UK Labour Party’s new ‘mission for health’ policies (see https://rcem.ac.uk/rcem-responds-to-labours-mission-for-health/ ).

Arguably, the short statement is polite but hardly enthusiastic: ‘While we are pleased to see a focus on prevention with the provision of greater community-based intervention, this doesn’t eliminate the need for increased bed capacity within hospitals ..’

And it goes on ‘The health care system has to be treated holistically – with adequate resourcing provided in the community, in Emergency Departments, elsewhere in hospitals, and in social care so that the whole system can work effectively. Our members and colleagues need to have the resources they need to do their jobs, ensuring patients receive the best end-to-end care possible.’

I note from elsewhere that one ‘big’ new policy aim of the Labour Party announced recently is to decrease deaths in the UK from heart disease over the next ten years (https://www.bbc.co.uk/news/uk-politics-65665696 ). By how many? And the same BBC article notes: ‘health experts believe there needs to be a big increase in NHS funding to achieve what Labour says it wants to, and costings are largely missing from its plan.’ For context, the graph below is from the British Heart Foundation (https://www.bhf.org.uk/what-we-do/our-research/heart-and-circulatory-diseases-in-numbers/death-rates-over-time ). Perhaps Labour needs to be more specific about its new ten year target: perhaps it should offer more information on how attribution specifically to its proposed new interventions of any further reduction on this falling trend might be evaluated!