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Hospital beds: innovation, design, research and analysis


  • Kirsty Morrison

Kirsty Morrison is a former Information specialist at The King's Fund.

The hospital bed, both as a physical object and the symbol of a patient requiring treatment, has been a subject for research and investigation throughout the history of The King’s Fund.

The King’s Fund bed

In 1967 The King’s Fund published a new specification for the design of a hospital bedstead after an evaluation of the efficiency of current designs done in conjunction with the Industrial Design (Engineering) Research Unit at London’s Royal College of Art.

The bed redesign project coincided with concerns raised by the then minister of health, Enoch Powell, and the Ministry of Health in 1962 about the need to save money and improve labour efficiency. Standardising the hospital bed was seen as one way to improve nurse productivity and reduce procurement costs.

In 1965, 20 prototype beds were installed for three months at Chase Farm Hospital. Trained observers assessed their use from 6am to 10pm each day, and their observations were collated to establish cost-effectiveness, patient satisfaction and functionality for the frontline staff using them. Some of the amendments and calculations of efficiency can be seen in our 1968 publication, Hospital planning seminars.

As Ghislaine Lawrence states in her thesis on hospital beds by design, one of the key questions at the time was: ‘what mechanical and powered assistance would be necessary if the same quantity of care and attention had to be given with half the present quantity of woman-hours?’

Emergency admissions, waiting times and A&E departments

Almost 50 years after The King’s Fund bed began to be put into use around the world, current news coverage shows that concerns around productivity, staffing, efficiency and costs remain.

Our digital archive highlights the work that the Fund has done throughout the history of the NHS to investigate and analyse these trends. For example, in 1954 a report on hospital bed occupancy covered topics such as:

  • the geographical distribution of beds

  • making more efficient use of what was available

  • demand measurement

  • the integration of teams and working more closely to streamline various processes.

Our 1971 publication, Do we spend enough on health care?, aimed to promote public understanding of standards of care, explain national priorities for expenditure, and investigate how well understood these figures were. It states that: ‘about 12.9% of the population are now aged 65 and over; by 1981 the proportion may rise to 13.8%.’ It also asks a familiar series of questions: ‘do they all need to be there [in hospital wards]? Should we be spending more on better pensions? More day centres? Better housing?’

The strain on A&E departments was considered in one of our Five essays on emergency pathways from 1994:

'In some hospitals waits for beds once patients had been accepted for admission were seen as too long. Views of an acceptable wait varied, with some staff seeing anything over an hour as “unacceptable”, and other hospitals reporting routine waits of several hours. Delays in finding beds for patients meant that they had to wait on trolleys in the A&E department, potentially exacerbating the condition of the patient… and causing distress, as A&E departments were busy, lacked privacy and were difficult environments in which to provide good patient care.'

This work continues right up to the present with our latest analysis of the key questions at the heart of the debate around pressure in A&E.

To find out more about The King’s Fund bed, or to explore more of our work on waiting times and bed occupancy over the years, have a look in our digital archive. Our library team also welcome any queries at [email protected].