‘Serious concerns’ over new bed occupancy target ahead of winter

Leading clinicians have raised serious patient safety and efficiency concerns about a new 92 per cent bed occupancy benchmark for trusts.

The Royal College of Surgeons and the Royal College of Emergency Medics raised concerns following NHS England and NHS Improvement publishing guidance last month.

The Review of Winter 2016-17 set out several recommendations for the coming winter. It said: “Occupancy levels should be more actively monitored and actions taken to ensure that they remain below 92 per cent, to allow patient flow to be maintained to deliver A&E performance.”

RCEM president Taj Hassan told HSJ: “It is extremely concerning that one recommendation seems to revise the safe level of bed occupancy up to 92 per cent. [The college] would have serious concerns about this as a metric of safety and we would be interested in understanding the evidence base behind this thesis.

“Our strong view is that the evidence base all points to 85 per cent as being the safer [and more efficient] level that all systems should be aiming for.”

An RCS spokeswoman said: “Patient safety can be assured at higher levels [but] health experts agree, as a measure of average performance, levels should ideally be around 85 per cent for optimum efficiency.”

However, the colleges welcomed the national focus on bring down bed occupancy. “At present, hospital overnight bed occupancy is around the 94.5 per cent mark, so bringing it down to 92 per cent would be a step in the right direction,” the RCS spokeswoman said.

But they also argued NHS England’s official statistics significantly underestimate current bed occupancy rates – a view support by Nuffield Trust research last year. The think tank’s report said: “Occupancy at midnight is well below the peak number of beds needed on every day of the week. This highlights the serious limitations of a midnight census [used by NHS England] as a basis for understanding the real demand for beds.”

Article from HSJ, 4 August 2017