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Covid: How busy are hospitals in England?

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By Ben Butcher
BBC Reality Check

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When asserting the nationwide lockdown, Prime Minister Boris Johnson mentioned the NHS risked being overwhelmed if the measures weren’t taken.

But statistics recommend that the proportion of beds at the moment occupied by sufferers is definitely decrease than standard.

So how can each issues be true?

What is completely different this yr?

Winter is often an extremely busy time for the NHS, coinciding with the height of the flu season.

This is why we regularly see new tales presently of yr about sufferers dealing with lengthy waits for care and ambulances struggling to get sufferers into emergency departments.

But this yr, the system is dealing with the added stress of stopping coronavirus spreading between sufferers whereas anticipating surges in instances.

The adjustments this yr embrace:

  • Less house for beds as a result of want for bigger gaps between them
  • The division of wards into three zones: these for individuals with coronavirus, these awaiting check outcomes and people who have examined unfavourable
  • Increased an infection management – together with cleansing and placing on private protecting tools (PPE) – which takes up workers time
  • Increased essential care beds and sufferers, which require extra intensive staffing

Combined, these elements imply that hospitals have much less capability than standard, that means fewer beds can be found for fewer sufferers.

In complete, NHS hospitals in England have about 7,000 fewer out there beds than standard.

What does the info present?

The knowledge exhibits that hospitals had been at about 87% occupancy in December and early January, nonetheless this determine will increase to simply over 90% in London and the South East.

This signifies that for each 10 hospital beds out there throughout England, roughly 9 had a affected person in them on any given day.

This occupancy charge is definitely noticeably decrease than a standard yr. In a traditional winter, occupancy tends to common between 93% and 95%.

Chart showing hospital occupancy

But NHS England warns towards utilizing direct comparisons as a result of – as talked about – you would not precisely be evaluating like for like in the best way the hospitals are being run.

Effectively, mattress occupancy exhibits what number of beds can be found ought to sufferers want them, however what it would not paint an image of is how a lot work is required to have a tendency to those beds.

And this yr, with elevated an infection management and the motion of workers to intensive areas, that workload has elevated.

Even in early December, NHS Providers, which represents NHS trusts, mentioned that already the pressures felt as dangerous as a traditional yr regardless of fewer sufferers and decrease mattress occupancy.

How a lot additional room is there?

In principle, there are 12,000 free beds in NHS hospitals in England.

But no hospital ever goals to be near 100% occupancy.

Guidance really recommends that an optimum degree is about 85% occupancy. This is to cut back the danger of workers turning into overstretched or being unable to cope with any surprising surges of sufferers for no matter cause.

The coronavirus has meant that hospital bosses have felt the necessity to guarantee much more wiggle room than standard, as a result of the virus tends to unfold rapidly.

The variety of sufferers in hospital in England with the virus has elevated by 8,000 because the begin of December, hitting 22,534 on 1 January, a report excessive.

London's Nightingale hospital

And as soon as the virus is prevalent in a group, it impacts hospital staffing as a few of them must take break day as a result of illness or self-isolation. During the primary wave in April, 6.7% of workers had been absent from work, in contrast with 4% within the earlier yr.

So whereas hospitals are feeling these elevated winter pressures, they want to make sure that they nonetheless have that wiggle room.

Outside the NHS, the federal government can work with non-public hospitals and in addition look in direction of the Nightingale hospitals, however this additionally is likely to be affected by staffing pressures.

Why are operations being cancelled?

To create that wiggle room, there was a giant lower in sufferers coming in for non-urgent operations and outpatient appointments, to make sure that house is there and pressures aren’t elevated.

Even in September 2020, when hospitals had been starting to extend the variety of operations carried out, these had been nonetheless 25% decrease than in earlier years.

This additionally helps clarify why there are additionally fewer sufferers in hospitals this yr, in addition to fewer beds.

The impression of it is a massive backlog and the potential for sure therapies – similar to most cancers care – being delayed.

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