NHS hospital bed numbers: past, present, future
A King's Fund briefing aims to place the debate about hospital beds in a wider context by:
- presenting data on hospital beds for England over a 30-year period and, where possible, data on other categories of beds used in health care
- comparing the NHS’s bed supply with other EU-15 countries
- exploring the drivers underpinning changes observed in hospital bed numbers
- considering whether STPs’ proposed bed reductions are realistic.
Interest in hospital capacity and, more specifically, the number of hospital beds is growing (Bodkin 2017; Royal College of Emergency Medicine 2017). This is, in part, due to mounting evidence that hospitals are struggling: delayed transfers of care are rising, bed-occupancy rates are above recommended levels, and A&E performance remains challenged (Murray et al 2017).
At the same time, the NHS is attempting to change how it delivers care, as set out in the NHS five year forward view (Forward View) (NHS England et al 2014). To do this, 44 geographical ‘footprints’, known as sustainability and transformation partnerships, have been established. These partnerships have been tasked with transforming how services are delivered, in line with the Forward View, as well as delivering financial balance (Alderwick et al 2016).
Changing the role of acute and community hospitals and reducing hospital use is a central theme of sustainability and transformation plans (STPs). This could include reducing hospital capacity; not increasing the number of hospital beds to meet projected increases in demand; and, in some cases, cutting bed numbers from their current level (Ham et al 2017a; Quilter-Pinner 2017; Edwards 2016).