The number of hospital beds in England has fallen by almost 3,000 since ministers promised 5,000 before winter, prompting warnings that patients are being “warehoused” in emergency departments.

Kat Lay www.thetimes.co.uk 

Nurses are run ragged dealing with the equivalent of a full ward of patients waiting in casualty departments due to a lack of beds , and patients are receiving “less good care, in the wrong place”, the UK’s top A&E doctor said.

Emergency medicine leaders have said they feel let down by a lack of progress since the prime minister and health secretary joined NHS chiefs in January to announce a “recovery plan” for urgent and emergency care, promising “5,000 more staffed, sustainable beds in 2023-24”.

Analysis of NHS England data by the Royal College of Emergency Medicine (RCEM) showed that between January and September, bed numbers in major acute hospitals fell from 100,046 to 97,332.

Announcing the target at the start of the year Rishi Sunak said: “Our plan will cut long waiting times by increasing the number of ambulances, staff and beds — stopping the bottlenecks outside A&E and making sure patients are seen and discharged quickly.”

NHS England said the baseline for its promise was the 94,500 core hospital beds it had planned to have available last winter, before pressures led to the opening of extra escalation beds across the country. It is still aiming to have 99,500 core beds by winter.

Adrian Boyle, president of the RCEM, said a lack of beds meant “patients who need to be admitted end up stuck in the emergency department”.

He said: “Most emergency departments are lodging or warehousing the equivalent of three quarters and a full medical ward inside the emergency department, while trying to look after all the new arrivals.”

He said emergency department nurses were not trained to provide the kind of inpatient and continuing care that those patients needed. He said: “People are getting less good care, in the wrong place.”

Boyle said the college was disappointed with the lack of progress, which he feared was driven by financial concerns and budget deficits in many areas.

It was unconscionable that hospitals where patients are being warehoused were closing beds, he said. “We feel we supported the urgent and emergency care recovery plan in good faith — and we feel let down.”

Officials said core beds are always lower in September than over winter and increase as pressures rise.

The number of core beds reported last month was 95,171, with a further 2,161 “escalation beds” — a total of 97,332, 93 per cent, of which were occupied. Last September there were 96,668 core beds, with 94 per cent full.

While the NHS can increase the number of beds quite quickly when needed, this often resulted in “providing not very good care in less than ideal clinical areas”, Boyle said. “The fact that people have had six months to build that capacity but appear not to have [done so] is cause for concern.”

The college had suggested 5,000 beds would not be enough to reduce capacity down to a safe, 85 per cent, operating level. It wants political parties to commit themselves to increasing the number of hospital beds in manifestos for the next election.

Siva Anandaciva, chief analyst at the King’s Fund, said: “The UK has fewer hospital beds per person than many comparable countries and this is a key reason for why the NHS comes under serious pressure every year and waiting times for patients reach eye-watering levels.”

A lack of beds has ripple effects through the rest of the system, he said, meaning A&E departments filled up with patients who needed admission and ambulances could not transfer patients into A&E and get back on the road.

He warned: “Hospitals can only open more physical or virtual beds if they have the clinically trained staff to run them. And due to a combination of staffing shortages that are only now being slowly reversed and industrial action on an unprecedented scale, the NHS is heading into winter with bed occupancy levels that are far higher than they should be to ensure timely care for patients.” The NHS has hit a target of opening 10,000 beds on virtual wards before winter. Virtual wards allow patients to be treated at home using technology such as apps and wearables to let clinical staff monitor the patient’s recovery.

An NHS spokeswoman said: “We know that the NHS is already under considerable pressure as we head into winter with continuing high demand for services and the impact of industrial action, but thanks to the hard work of staff and the measures outlined in our urgent and emergency care recovery plan there are hundreds more hospital beds open now compared to this time last year.

“Our focus has been on ensuring the NHS is more resilient coming into winter with more beds available on a regular basis, and work continues towards delivering our recovery plan commitment of 99,500 core beds to help manage pressures, boost capacity and to provide the best quality care for patients.”