How safe is your hospital?
As new analysis finds that hard-pressed hospitals are facing difficulties in coping
with surges in demand, experts have predicted the potential for greater danger to patients and possibly a rise in medical negligence claims
To deal with busy periods, hospitals should run at around 85% capacity
, a statistic largely borne out by the NHS average.
However, according to the private research group Dr Foster, the actual number is clouded by periods where demand is lower, rising when such times are disregarded.
According to the analysis, if only figures from the middle of the week are considered, the capacity figure for 2011-12 is around 88%
. But if holidays and events such as the royal wedding were removed, the number would rise to 90%
Dr Foster said this was significant, since the quiet periods were helping to conceal the fact that many NHS hospitals are now too full for long periods
of the year.
The report said that patient care is compromised
when systems start breaking down in very busy periods. "Patients are put in whatever bed can be found
, orderly management of admission and discharge can become strained, infections are harder to control and mistakes are more likely to happen
," said the analyst's co-founder Roger Taylor.
Dr Foster's report argues that if the NHS better organised itself it could relieve the pressure on hospitals
, adding that 29% of beds were occupied by patients who did not necessarily need them
Over 10% of these related to conditions which could be treated in the community
, such as asthma and heart disease. A further 5% were readmissions within 1 week of discharge, with 2.5% for dementia.
Death rates were also analysed by Dr Foster, which used 4 different measures, including deaths after surgery and among low-risk patients, to help determine which hospitals are failing expectations
12 trusts, 8 fewer than last year, were identified as performing worse than expected on 2 of the 4 measures.
The Health Secretary, Jeremy Hunt, insisted that the NHS "is not overcrowded"
but that local managers should investigate.
"On average, there are around 20,000 of [NHS] beds available
," Mr Hunt said. "This goes up and down, but the NHS has practice and experience in managing peaks in demand, particularly in the winter."
However, Dr Foster noted that the government statistic is an average and that the volume of patients using beds was "not particularly smooth". More needed to be done to ensure patients who should not be in hospital were cared for at home or at specialised centres
Neil Fearn, head of medical negligence at Simpson Millar LLP, said: "Bursting bed occupancies and stressed, overworked staff are clearly contributing to more mistakes
in medical care. This in turn is likely to lead to an increased number of claims for medical negligence
and, potentially, an even greater strain on NHS resources. It's a vicious circle."
There is a panorama programme due to air today (3 Dec) concerning these issues and entitled "How safe is your hospital".