Reply To: SARS cov2 and Covid 19


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#63454
ET

“The number of beds in the NHS have halved since 1986 despite increase in number of patients treated”

There has been significant underfunding of the NHS for many years and I am not defending that but the bed issue is a bit more nuanced.
Many procedures for which people were admitted are now done as day cases and the resource has been invested in day procedure units. Instead of 3 days in hospital people spend a few hours instead.
Post operative days in hospital have reduced significantly after it was increasingly recognised that getting people up and about and home after surgery is overwhelmingly better for their health in most cases. Much more use of minimally invasive surgery (laparoscopic techniques) added to this trend with less post operative morbidity and people fit to go home earlier. Hospitals can be dangerous places for your health. The above has significantly reduced patient in hospital days and consequently the number of beds needed.
The problem is that there is a 100% bed occupancy policy in use of those in patient beds that are there. Any surge tips that balance. Spill over wards are use to mitigate this somewhat but a decision needs to be made to open them by a hospital manager and staff them with consequent costs. A good argument can be made that savings made in not opening underused beds can be redirected to other aspects of care. Problem is this becaomes unstuck when there is a big surge in patients, like every winter and especially so if the winter surge is higher than usual. It can also happen that one hospital gets overwhelmed on a particular day. This has implications on the safety of care for those patients already admitted. Hence you sometimes get hospitals “closing” and redirecting cases to other local or maybe not so local hospitals. It is a difficult management issue.