What bed is that, then? (part 2)
Entering the world of the bed manager...
In episode #1 of this series we learned some lingo and I produced a couple of interesting slides that revealed any bed, any time, any place, anywhere with anybody in it for any reason has been counted by NHS number crunchers, presumably in an attempt to bump positive test numbers to support draconian government policies. In this episode we are going to look at bed availability and occupancy with another splash of that numerical hindsight…
Bed availability
Let’s get that kettle on and get straight in…
Here we have official quarterly figures for 2010/Q2 to 2021/Q41 right from the horse’s mouth. The blue series represents overnight beds for all allocations combined, and thus include general & acute, learning disabilities, maternity, and mental illness. I’ve split out the general and acute (G&A) series because these beds are what normal folk typically encounter when they take in a bunch of grapes and some flowers.
What should strike us here is that these precious beds have been in steady decline for many years at a time when the national population has been increasing and ageing. In truth the NHS was in deep crisis before the pandemic came along, and has been getting deeper into crisis every year. When the pandemic hit the government decided to build some shiny new Nightingale units and spend rather large sums of money on advertising whilst reducing overnight bed availability across NHS England at the stroke of a pen. Go figure the logic. Bed availability has now almost recovered to the usual level of deep crisis.
Removing beds like this will put pressure on remaining beds, waiting lists and staff and this is how the illusion of busy hospitals because-of-COVID can be generated when not much was going on2. What we need to blame here is the ministerial fountain pen and not some ‘novel’ virus.
What the virus did next…
For most people a busy hospital can mean only one thing - beds full to bursting with nursing staff stressed to the eyeballs and beyond. With overnight beds closed to make way for fat Nightingale contracts we may expect the pressure to have squeezed occupancy rates to beyond 90%. Not so….
We are now looking at occupancy rates for 2010/Q2 to 2021/Q4 for both day and night beds for all disciplines. It should be clear that occupancy is generally a pretty stable beast running at 85% - 90% regardless of bed type right up until 2020/Q1. During the first wave of the pandemic overnight bed occupancy curiously dropped to 65%, with day bed occupancy dropping to 50%. This doesn’t make sense in terms of a raging deadly virus that is filling hospital beds but it does make sense in terms of folk too scared to go to hospital.
With overnight bed availability around 8% down and occupancy around 20% down just how busy can our hospitals have been given the combined loss in throughput amounts to around 26%? Well, for the staff working in these hospitals life could have been totally and utterly hectic despite patient throughput being suppressed because we haven’t yet considered staff absences due to symptomatic COVID and staff absences due to a positive test. For the next episode I hope to collar a wedge of staff absence data…
Kettle on!
NHS bed crunchers usually define Q1 as being Apr - Jun but in this slide I have reverted back to Q1 as being Jan - Mar so folk don’t get as confused as I was!
Hardcore folk in-the-know would have figured this after seeing a dozen or more (clean) ambulances lined up outside various emergency departments with coned areas, police and media crews splashed across the main news every night. Those drivers and paramedics literally had nothing to do except pose for the camera and have a cuppa.