Hospitals across England were dangerously busy over New Year, with as many as nine in 10 running above safe occupancy levels, analysis of official figures by LiverpoolWorld shows.
One leading health think tank said no health service should be running their hospitals as hot as the NHS currently is, warning that evidence shows busy wards can cost lives, while doctors have urged the government to declare a national emergency.
The Royal Liverpool University Hospital hit the headlines over the weekend when a letter sent to the Health Service Journal (HSJ) claimed patients had to be treated in corridors due to overcrowding.
But new figures show that four of the region’s NHS Hospital Trusts are operating above the recommended safe limit for bed occupancy in winter - with one rated as the fourth busiest in the whole of England.
In the seven days to 1 January, 93.2% of general and acute hospital beds were occupied on average each day across acute trusts in England, leaving fewer than 7,000 beds available for new patients across the entire country.
The figures, published as part of the NHS’ weekly winter Situation Reports, show two hospitals were functioning at 100% capacity, one at 99.5% and Southport and Ormskirk Hospital NHS Trust at 99.4%.
The figures are a snapshot of occupancy levels taken at 8am each day. But health experts warn the figures could be even worse than the published data suggests due to the time of day when it is recorded.
An occupancy rate of 85% is generally considered to be the safe limit – one that has been endorsed by the Royal College of Emergency Medicine (RCEM). High bed occupancy rates can lead to bed shortages and make it difficult to find the optimum bed for a patient’s needs, contributing to waiting time backlogs and delays in A&E. There is also evidence it can lead to an increase in hospital acquired infections and other “avoidable adverse events”, according to a review by the National Institute for Clinical Excellence (NICE).
NHS England and NHS Improvement have previously suggested 92% should be considered the recommended safe limit for bed occupancy in winter. Based on the RCEM standard, 120 (87.6%) hospitals were found to be dangerously busy by functioning at 85% occupancy or above in the week to 1 January. Only 17 hospitals were below the 85% standard , while 94 had an occupancy rate of above 92%.
What do the figures show for hospitals in Merseyside?
The general and acute bed occupancy rates in the seven days to 1 January 2023 in Merseyside are:
- Southport and Ormskirk Hospital NHS Trust - 99.4%
- St Helens and Knowsley Teaching Hospitals NHS Trust - 96.3%
- Liverpool University Hospitals NHS Foundation Trust - 93.8%
- Wirral University Teaching Hospital NHS Foundation Trust - 93.4%
- The Clatterbridge Cancer Centre NHS Foundation Trust - 77.7%
- The Walton Centre NHS Foundation Trust - 76.8%
- Liverpool Heart and Chest Hospital NHS Foundation Trust - 59.9%
- Alder Hey Children’s NHS Foundation Trust - 58.1%
- Liverpool Women’s NHS Foundation Trust - 47.6%
‘Pushing the boundaries of what is safe’
Commenting on LiverpoolWorld’s analysis, Nuffield Trust chief executive Nigel Edwards said that “no health system should be running their hospitals this hot”.
“It is almost certain that levels of overcrowding in NHS hospitals in England are even worse than the published data suggests due to the time of day when it is recorded,” he said. “The lack of manoeuvre and available beds is leading to dangerously busy and difficult conditions in accident and emergency departments, waiting rooms and corridors.”
He added that for years before the pandemic the NHS was “forced to push the boundaries of what is effective and safe occupancy rates”, adding that overcrowded hospitals increase risks to patients and link to higher rates of mortality.
“Focusing investment on propping up day-to-day hospital care, while neglecting investment in buildings and equipment as well as important care services outside of hospital will not help to bring these levels of bed occupancy down any time soon,” he said.
Additional figures from the NHS show the strain surging cases of flu and Covid infections are having on the health system. In the last week, the number of flu patients in hospital has surged by 1,626 (47%), while the number of Covid patients has increased by almost 1,200. The NHS said 111 call handlers also answered the second highest number of calls ever in a week with 410,618 calls answered.
The NHS said it had “planned extensively” for winter and recruited hundreds of extra 111 and 999 call handlers and established around the clock system control centres in every area of the country. It has also set up dozens of acute respiratory infection hubs and community falls response services to ease pressure and demand on services. However, NHS national medical director, Professor Sir Stephen Powis, recognised the “enormous pressure” the flu and Covid was having on the healthcare system.