Thanks to medical advances (leading to shorter lengths of stay in hospital) and a shift in policy towards providing treatment and care outside hospital, the number of hospital beds in England has been falling for several decades.
Over the past 30 years the number of available hospital beds in England has more than halved. Most hospital beds are for acute patients and although the number of these beds has declined significantly, more marked decreases have occurred in the number of beds for people with learning disabilities, people with mental health problems and for the long-term care of older people. Alternatively, numbers of day-only beds, for patients undertaking same-day procedures, have increased in number by over 520 per cent since 1987/88.
In recent years, there has been an increase in the intensity of hospital bed use, reflecting the increased levels of activity in hospitals. Occupancy rates for overnight acute beds have increased from 87.1 per cent in 2010/11 to 90.4 per cent in 2016/17. This has an impact on how quickly patients can be admitted into hospital (because there are fewer beds free) and is a significant factor in the deterioration in performance against the four-hour standard for admitting or discharging patients from A&E seen in recent quarters.
Optimum occupancy rates for hospital beds depend on the type of services they offer and may vary between organisations. However, the National Audit Office has noted that hospitals with average bed-occupancy levels above 85 per cent can expect to have regular bed shortages, periodic bed crises and increased numbers of health care-acquired infections.
- Notes on the data
- NHS England collects quarterly information on overnight bed availability based on a snapshot midnight census. This midnight snapshot may underestimate the pressures on bed availability during the working day.
- The number of beds presented for each year is the unweighted average across the four quarters of the year.
- The methodology used to count the number of NHS beds was changed in 2010/11. Data is not directly comparable before and after this financial year. Before 2010/11, beds were counted on ward type, but since 2010/11 they have been counted using the specialty of the consultant. This means that some types of beds – such as intermediate care beds and community mental health beds – are not counted in the new methodology. Changing the methodology resulted in the number of reported beds reducing by 10 per cent between 2009/10 and 2010/11.
- Following a revalidation of mental health beds in 2015/16, which confirmed these beds were not consultant-led, there was a significant (around 10 per cent) reduction in the number included in the data.
- Some NHS patients are treated by non-NHS providers. Hospital beds used for these procedures are excluded from the data above.