Hospitals hit unsafe occupancy and divert ambulances in first week of winter

Winter strain on the NHS in England is showing, with hospitals hitting “unsafe” occupancy levels and many ambulance crews being diverted from busy sites, figures show.

NHS England statistics—the first weekly report of this so far mild winter—showed that nearly 95% of beds were occupied and eight emergency departments had diverted ambulance crews elsewhere.1 To deliver safe care, occupancy rates should not exceed 85%.

Siva Anandaciva, chief analyst at the health think tank the King’s Fund, said, “These figures show little slack in a system which is operating consistently in the red zone.

“Hospital bed occupancy levels are already higher than recommended levels, the point at which hospitals are so full that good patient care is put at risk.”

Ambulance crews are expected to hand over patients to emergency departments within 15 minutes of arrival, but 11% of cases took more than 30 minutes, the figures show.

The NHS 111 service, which patients are being advised to use more to avoid going to hospital if necessary, is under increased pressure. The service received 340 600 calls in the week to 9 December, 11% up on the 306 800 in the equivalent week last year.

An NHS England spokesperson said, “NHS staff continue to work hard to deal with increased demand across the board, seeing 1000 more people within four hours in A&E every day in November compared with last year.

“A growing proportion of people are getting same day emergency care, which prevents the need for an overnight stay, and hospitals have freed up an additional 742 beds, by working closely with councils to help more people return home with the right care in place.”

Anandaciva said, “‘Sustained funding squeezes and staff shortages are piling pressure onto hospitals. The upcoming NHS long term plan must set out how the NHS will deliver the access to care that patients and the public need.”

Last week an analysis by the BMA showed that the NHS needed up to 10 000 more hospital beds to meet anticipated pressure this winter.2 Helen Fidler, deputy chair of the BMA’s Consultants Committee, said that the latest figures “set alarm bells ringing for the government and health chiefs.”

She said, “We are at the very beginning of winter and yet hospitals in England are already feeling the pressure, with demand reaching a record high for November as more patients attend and are admitted to A&E. Despite the milder weather, the number of patients waiting in hospital corridors on trolleys this year has already exceeded the total in 2017—with the situation only set to get worse in the coming month.

“On top of this, November saw the number of patients discharged, admitted, or transferred within four hours fall to 87.6%, a record low for the month.”

She said that there was an urgent need for the government to tackle understaffing and under-resourcing in the NHS in England “so that patients get the care they need this winter.”