Doctors warn further cuts to hospital beds could have an ‘adverse effect’ on care

Further cuts in the number of beds in Scotland’s hospitals could have an “adverse effect” on the care provided, a doctors’ organisation has warned.

Professor Derek Bell, the president of the Royal College of Physicians of Edinburgh, spoke out after official figures showed a further drop in the number of acute specialist beds.

A reduction of 2% in 2017-18 took this down to 13,426, 4% lower than the total five years ago.

Seven out 10 (70%) of beds were for medical specialities, with 30% for those undergoing surgery.

“The number of hospital beds has been reducing for many years,” the NHS report said.

It added that this was the result of medical advances leading to shorter stays in hospital for patients, alongside the shift to treating more people in the community.

But Professor Bell cautioned that further reductions in bed could impact on care.

He said: “We note a small decrease of staffed, acute hospital beds in the past year – part of an ongoing trend in Scotland, where we’ve seen a 4% reduction when compared with 2012-13.

“NHS boards must remain cautious about the impact that fewer acute inpatient beds may have on patients.

“From the figures on unscheduled and elective care, we believe that any further reduction in bed compliment may have an adverse effect.”

In addition to this he warned bed blocking – where patients remain in hospital despite being well enough to leave because they are waiting for care packages to be put in place – could “further reduce acute bed optimisation”.

A Scottish Government spokeswoman said the reduction was down to factors such as hospital stays becoming shorter, and more people being cared for at “home or in a homely setting”.

But Scottish Conservative health spokesman Miles Briggs stated: “This continual reduction in hospital beds has huge knock-on effects for patients in the NHS.”

Around one in eight people across Scotland – some 693,000 residents – were admitted to hospital in 2017-18.

And while most (69%) of this group were only admitted once over the year, there were 91,000 people who needed hospital care three or more times.

Last year’s figures also showed around one in three people aged 75 and over were admitted to hospital at least once – compared to around one in 12 of those aged 25 to 44.

Scotland’s ageing population – with the number of people aged 65 and over set to increase by 19% between 2016 and 2026 – means this “demographic shift in the population will have significant implications for the future demand on hospital services”.

Meanwhile about 8,000 people who live outside of Scotland were admitted to a Scottish hospital in 2017-18, with this accounting for 0.7% of all admissions.

The Scottish Government spokeswoman said: “Over the last five years, we have seen a steady decline in length of stay in hospital.

“This is encouraging because it reflects improved clinical practice, and we know it is better for people to be discharged in a timely manner so they can return home.

“There are also signs that the growth in emergency admissions is slowing year on year, with the latest figures showing a growth of around 3,000 compared to 17,000 four years ago.

“The change to the number of available beds reflects a number of factors. Our vision is for more people to be at home or in a homely setting if they do not need to be in hospital.

“To achieve this, health and care partnerships are developing innovative ways of developing intermediate care, with around 700 intermediate care beds available across Scotland.

“The number of beds should vary throughout the year to reflect demand. That is why we have introduced the six essential actions which include a focus on hospital capacity and patient flow.”

Mr Briggs stated: “While the shift to community care is right for some patients the balance between acute and community settings must be carefully managed.

“The SNP has caused significant capacity issues within our NHS which, in turn, leads to patients waiting on trolleys and in A&E for far too long.

“It is clear that this reduction in acute hospital beds is reducing flexibility on our wards, leading to delays which could well increase as winter approaches.

“The SNP has planned badly, and this mismanagement is, once again, hurting the most vulnerable patients the most.”

Scottish Labour health spokesman Anas Sarwar also blasted the Scottish Government saying: “Scotland’s NHS is being mismanaged by the SNP government.

“Our health service has 1,400 fewer beds than it did a decade ago.

“This comes amid the SNP’s broken promise to end delayed discharge and the skyrocketing number of vacant nursing posts, causing a capacity crisis in hospital wards.”

Meanwhile Liberal Democrat health spokesman Alex Cole-Hamilton said that people would be “rightly concerned that acute bed capacity continues to be drained”.

The MSP stated: “We know one in 13 beds in Scotland are occupied by patients on delayed discharge – people who have been declared ready to leave hospital but lack the community care they need.

“The social care system and mental health services are dangerously depleted and all too often hospitals are left to pick up the pieces.

“Models of care are changing but hospitals need to be able to meet demand. Ministers need to take a fresh look at NHS bed numbers and ensure they are giving staff the resources and funding they need.”

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