Feb 21 2018

Will the NHS struggle to find beds for its patients again this winter?

This is a little blog post about the potential crisis the NHS faces in the 2017/2018 winter. I used freely available data from the NHS website and did a few graphs with Excel. They’ve not come out very well on this blog post, I’ll have to figure out why in the future, but here is my first attempt at some good data journalism. 

 

The crisis that the National Health Service faced last winter was one of the worst in its history. Britain’s news feeds were full of examples of how the nation’s healthcare system was unable to meet demand.

The emergency reached its peak during the first week of January 2017 –  annually the busiest week of the year for the NHS.

One of the key issues the NHS faced was its inability to find beds for its patients resulting in ill people being left in corridors on trollies with no privacy.

During the first quarter of 2017 72% of hospital trusts broke the key 85% bed occupancy guideline. This means the majority of hospitals struggled to find overnight beds for their patients and guarantee the safety of current occupants.

The 85% bed occupancy guideline is in place in order to reduce the chance of an infection spreading and have reserves for emergencies.

Two hospital trusts, Kent and Medway, and, Surrey and Borders, had no spare beds throughout the first quarter.

Almost a year later and the Health Services’ busiest week is nearly here. Is there going to be a repeat of last winter?

One way to answer the question is to look at available statistics for the rest of 2017 and see how the NHS has performed since the winter crisis compared to previous years.

Throughout the second and third quarters of 2017 bed availability was between the high peaks of 2016 and the comparatively lower occupancy rates seen in 2013, 14 and 15. Suggesting the NHS has improved from last year’s lows.

Over time the issue of how many beds are occupied is getting worse. Especially in the busy first quarter. During the Winter of 2016/17, the NHS faced similar occupancy levels as in the previous winter, even though it wasn’t as widely regarded as a crisis by the media at the time.

One thing to note is that for the last four years, NHS England has consistently broken the 85% guideline.

The statistics show during the third quarter of 2017, the NHS managed to maintain an 87.1% occupancy rate which is 1% lower than the same period last year.

Although this does not mean that the NHS has managed to keep more beds free than it did in 2016.  The actual number of available beds during the third quarter of 2017 has decreased by 1.4% from the same period last year, it was 127,614 down from 129,484 in 2016.

However, the England wide statistics hide regional differences. When broken down into the four commissioning regions – North, Midlands, South and London – the statistics show that different regions fare better than others when it comes to having available beds.

For the past four years, the NHS Northern Commissioning Region for the NHS regularly stayed below the 85% bed occupancy guideline and only went above it during the first quarter.

But the London Region hospitals never met the guideline and during the first quarter, it was the only region to go above 90% occupancy.

One of the reasons the NHS is struggling to find beds for all its patients is because of the squeeze on its budget.

Since the Conservatives took power in 2010 the NHS budget has been cut to a 1% after inflation budget increase every year, down from the 4% annual increase the health service saw throughout the previous decade.

Where does this leave the NHS for the coming winter? The statistics show that even though as a percentage the NHS has managed to keep more beds available than the previous year, materially there will be fewer beds available overall and less funding as winter sets in.

There are other aspects to consider besides the internal performance of the NHS. In the autumn budget, Chancellor Richard Hammond pledged £350 million for the NHS specifically for the winter period.

However, the population of England is getting older which adds extra pressure to the NHS as elderly people get ill more often and regularly have more complex illnesses that require more time to treat.

In 2016, the percentage of the population that were over 65 was 18% and this figure has been increasing by an average of 0.21% a year for the past 10 years.

The final point to consider is that during the 2016/17 winter, the NHS did not face any major flu outbreaks. There were 22 consultations about flu out of ever 10,000 people which were similar to the previous three winters and five times lower than the 2009/10 winter flu epidemic.

If the nation faces a flu outbreak during this winter, with fewer beds available than last year’s winter the data suggests the Chancellors extra £350 million will not come close to ensuring the quality of service the people of England expect from their National Health Service.

The data released by the NHS shows that the crisis the health service suffered in 2017 was not a one-off, rather the situation has been building up for years and to avoid similar incidents in the future serious structural changes.

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