Providing intensive care

BMJ 1996; 313 doi: https://doi.org/10.1136/bmj.313.7049.111a (Published 13 July 1996) Cite this as: BMJ 1996;313:111

Criticisms of situation in Birmingham are unsubstantiated

  1. Jonathan Michael,
  2. Ralph Hibbert,
  3. Jeremy Plewes
  1. Medical director Clinical director, anaesthetics and intensive therapy unit directorate Clinical director, trauma, accident and emergency, and burns and plastics directorate University Hospital Birmingham NHS Trust, Birmingham B29 6JF

    EDITOR,—D F Bowden and D P Burke make inaccurate and unsubstantiated allegations about the organisation of intensive care beds in University Hospital Birmingham NHS Trust.1 We are disappointed that they did not have the courtesy to check their facts before criticising a third party.

    University Hospital Birmingham NHS Trust comprises two hospitals (Queen Elizabeth Hospital and Selly Oak Hospital) some 2.4 km apart. Across the trust there are 46 critical care beds: Queen Elizabeth Hospital has 34 (general intensive therapy unit, 10; liver intensive therapy unit, 6; cardiac intensive therapy unit, 6; and neurocritical care, 6 intensive therapy unit beds and 6 high dependency unit beds) and Selly Oak Hospital has 12 (general intensive therapy unit, 7; and trauma intensive therapy unit, 5). These beds are largely run by a trustwide anaesthetics and intensive care directorate, although the specialist units relate to their specific directorates. We pride ourselves on the collaboration between our departments, which allows maximum flexible use of critical care beds by patients who require them. We need to support patients whose specific treatment requires back up from an intensive therapy unit, such as those having cardiac surgery, liver and cardiac transplantation, or vascular surgery and neurosurgery, in addition to patients who require intensive care, including those with burns, major trauma, and severe medical illness. There is no professional or managerial block to flexible use of these beds.

    Bowden and Burke are wrong in almost all of their comments. We have a major investment in critical care facilities, and these facilities are used flexibly and fully. Like other large acute trusts we sometimes face pressure on intensive therapy unit beds, which prevents us from accepting all patients who would benefit from critical care. We are concentrating on the development of high dependency beds to complement our existing pool of intensive care beds. An increase in critical care beds may require additional resources as well as the optimum use of existing facilities.


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