Laura Ruxton, Director & head of healthcare at Dunwoodie Architects, gives an interesting insight into the availability of hospital beds in the UK during Covid 19
During the current Covid 19 pandemic we have witnessed how the NHS has coped with the enormous number of patients admitted to hospital due to the virus. As an Architect who has worked in all areas of the healthcare sector for 15 years in the UK & abroad, I thought it might be an appropriate time to look into hospital and critical care bed numbers given our experience and previous involvement delivering acute and critical care bed wards.
This is by no means an analysis of the care provide by the NHS but a reflection on how the amazing staff at the NHS have dealt with this unprecedented pandemic given the reduction in hospital beds in recent years. Hospital beds play an important role in delivering acute health care services.
They are part of a wider network of key components to deliver healthcare, due mainly to the fact that beds rely on staff and associated equipment to deliver care. For this reason, when we hear about available beds this refers to beds that are fully staffed funded and available for use by patients. According to data published by the Kings Fund in March 2020 the number of NHS beds has been falling by 53 per cent between 1988 and 2020, a major contributor to this figure was the number of overnight acute beds which fell by 44 per cent from around 181,00 to 101,000. However, the number of critical beds has increased in recent years from 5,400 in 2011/2012 to 5,900 in 2019/2020. There are many factors that have contributed to this trend. Three broad categories are; national policy, underlying patient demand and local circumstances and, most significantly, the evolution of medical care such as anaesthetic and surgical techniques, pain control and changes to how recovery is managed, reducing the amount of time patients stay in hospital during treatment or after a procedure. Critical care units have been at the front line in the response to Covid-19 and the NHS has taken unprecedented action to increase critical care capacity to cope with the Covid-19 pandemic. However, the UK has the fewest hospital beds per 1,000 inhabitants of any other comparable health system in Europe, which was certainly a big surprise to me. When you look at these figures you start wondering if this is what contributed to the length and frequency of the lockdowns we experienced, particularly when the risk of critical services being overwhelmed was cited as a major factor behind repeated regional and national lockdowns in England. A 2017 survey of nurses working in critical care services found an 8 per cent vacancy rate in the critical care nursing workforce, with higher vacancy rates in North, Central and East London, the South East Coast and the South West. An increasing number of units were seeking to recruit registered nurses from overseas to fill vacancies. Nationally, 9.9 per cent of the critical care nursing workforce was made up of staff from EU countries with a further 16.6 per cent recruited from outside the European Union. With the above figures in mind, and considering that the deadline for EU nationals to settle in the UK was 30th June 2021, the potential impact this will have on the NHS workforce could be significant. We are now faced with a situation where bed numbers have been falling for years and to compound this problem nurses are essentially being discouraged from applying for positions as they will have to go through such a gruelling process to stay in the country. Healthcare should be provided in a healing, welcoming and caring environment but is above all provided by dedicated individuals from around the world that come together under the fantastic NHS umbrella to provide us with first class care as demonstrated by their incredible response throughout this pandemic. We have a lot to thank them for.
