Following the pandemic, hospital bed occupancy is increasing and there is a huge shortage of beds. Our healthcare expert Andy James shares his thoughts on how bed tracking could help the NHS tackle the beds shortage crisis.
There are many challenges facing the NHS right now, but the one that is most raised in our conversations with hospitals and healthcare providers is bed occupancy and shortages. There has been a steady decline in the overall hospital bed stock in NHS England since 2010/11, reducing by 8.3% over ten years.[1] In addition to this, almost 25,000 NHS beds have been lost in the last decade.[2] In a perfect storm of a pandemic, funding cuts, staff shortages and an ageing population, the problem is reaching breaking point in many Trusts.
There isn’t one easy fix to the problem – policymakers need to address a whole host of factors. However, an important part of the answer is digitalisation and the adoption of technology, such as bed tracking, to enable more efficient bed management and improve bed utilisation.
85% bed occupancy is the level generally considered to be the limit, beyond which safety is at risk. According to the British Medical Association, since 2010, the average bed occupancy has surpassed 85%, with an average of 90.2% in England going into the pandemic in 2019/20.[3] It may be assumed that the peak of the pandemic would have seen the highest bed occupancy rates in recent years. However, the long-term impact of COVID-19 on the NHS is now starting to rear its head. One NHS Trust we’ve spoken with admitted 200-300 patients per day during the height of COVID-19. Now, it’s hitting 400 daily admissions. Bed capacity was a major concern before COVID-19, but the strain of a pandemic that has affected all areas of healthcare and service provision is exacerbating the problem. While A&E admissions fell during the height of the pandemic, demand has since steadily risen and, in Q3 2022, attendances at major A&E departments were 12% higher than they were ten years ago, while those at minor departments were 18% higher.[4] There are many reasons why more and more people are attending A&E, but wider pressures on the NHS, such as the GP shortage crisis, are playing a huge part, with many desperate people being forced to A&E as they can’t get an appointment with their GP.
Against a background of rising demand, the NHS is dealing with chronic staff shortages. In September 2022, NHS England and NHS Improvement reported a vacancy rate among doctors of more than 7% and a vacancy rate among nurses of almost 12%. Less than six months earlier, in May 2022, these figures stood at less than 6% and at 10% respectively.[5] Rising hospital admissions and staff shortages also contribute to the growing number of NHS employees experiencing burnout. Burnout leads to more sickness absence and more staff thinking about leaving the NHS[6], which further exacerbates the issue. In addition to this, more than 10,000 NHS employees have been absent from work for 12 weeks or more since the start of the pandemic due to illness from long COVID.[7] This workforce shortage directly impacts patient flow – the movement of patients through the hospital process (i.e., admission, assessment, treatment and discharge) – leading to poor bed utilisation with many patients occupying beds when they’re fit for discharge.
The issues don’t just lie within hospitals. A lack of capacity in social and community care, due to funding cuts and staff shortages, also makes it harder to discharge patients. Thousands of patients (an average 13,600 across NHS England[8]) who are medically fit for discharge are occupying beds that could be used for patients who need them because the community and social care provision isn’t there to support them when they leave hospital. Compounding the issue, the health of these patients can often worsen while they wait to be discharged, repeating the cycle, and resulting in even longer hospital stays.
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As we’ve already emphasised, there is no quick fix to this problem, and it must be taken seriously and addressed by the government to prevent the crisis from worsening. But NHS Trusts and hospitals can make their own smaller changes that have a bigger impact by adopting digital solutions and digitalising some of their operational processes. Many of the Trusts we have spoken to recently don’t have a robust, digital bed tracking and bed management system in place. This is surprising considering the beds shortage issues the NHS has been facing for over a decade.
A bed tracking solution, such as X-Tracking™, integrated with a bed management system can be transformative for hospitals, providing real-time data and visibility on the location and status of hospital beds around the clock. A system like X-Tracking™ replaces clipboards and spreadsheets and, using RFID technology, collects and records the information as and when it happens. This data is then fed into bed management software, enabling hospitals to have full sight of every single bed and related equipment (such as cot sides), where its located, whether its in use and when it is due for planned cleaning or maintenance.
Efficient bed tracking and management helps prevent beds from going missing, reduces the time spent by staff looking for appropriate beds and ensures beds are cleaned and maintained efficiently, which improves infection control. This increases bed utilisation and improves patient flow, subsequently reducing patient wait times and the number of cancelled treatments, such as elective surgery.
For example, there are many different types of hospital beds, some of which are specialist and required for certain patients. This includes bariatric beds, which are designed to accommodate larger patients, and Hi-Lo beds, which are height adjustable, enabling healthcare staff to choose the correct height for lifting or assisting patients. If a patient is at risk of falling out of bed, they would require a Hi-Lo bed as it can be lowered to the floor, safeguarding them from falling out and harming themselves. Specialist beds are expensive, with many hospitals opting to rent them rather than purchasing their own, and therefore often have lower stock numbers. This means, without a real-time bed tracking solution, NHS staff could spend hours, or even days, trying to locate an appropriate bed for a patient, risking the development of bed sores, which would extend the patient’s stay and cause delays to other patients in the system. RFID bed tracking is a simple, but effective, digital solution that has the scope to transform the patient pathway.
The technology isn’t limited to supporting healthcare professionals and patients – it also helps to save costs. Bed tracking data provides procurement teams with the figures they need to more effectively plan and resource hospital beds, meaning money is only spent when it should be, on equipment that is required.
The Health Foundation predicts that due to increasing demand over the next decade, 23,000-39,000 extra beds could be needed in 2030/31 to maintain pre-pandemic standards of care. The build cost is estimated to be between £17bn and £29bn.[9] Not to mention the planning and time required to deliver such a huge construction programme. Solely expanding hospitals and purchasing more beds clearly isn’t the answer.
The outlook may sound grim, but the technology exists to help alleviate the bed occupancy and shortage problem relatively quickly. Implementing a bed tracking and bed management system now will support NHS Trusts and hospitals into the future, putting them in a better position to manage the effects of the beds shortage crisis and, ultimately, helping them to improve patient care and safety.
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