http://news.bbc.co.uk/1/hi/health/8570822.stm

This'll go down like the Titanic...

It'll improve the waiting lists as well

The problem is that when you cut down beds, you increase the turnover of patients to a dangerous point.

Over the Christmas period, there was a huge increase in the number of people being admitted (I know because I was admitting some of them!), moreso than usual. As a result, there was increased pressure on discharging patients. Where a patient was nearing discharge, they were discharged ASAP despite not being ready. Consequently, some patients were coming back in because they deteriorated after returning back home too early.

Reducing the number of beds has the effect as too many people coming in. More people are going to die.


As to managing conditions such as diabetes in an outpatient setting. This is already happening. Patients often come in because they have some blood tests, one of which demonstrates a raised blood sugar. We have to check them out to make sure it's not a diabetic-related emergency, and then start them on medication and send them back to their GP for ongoing management.

Also when I was in hospital a few years ago, the consultants tried to manage the beds in such a way as to get people coming in when there was a bed free. If there are not enough beds then you cannot treat them elsewhere in the system, because you simply do not have the capacity. As for staffing those beds that can be done a lot better. Gerry Robinson found there were so many problems simply because the hospitals were mismanaged.

Also what about unexpected emergencies like a train crash etc, You need a surplus of beds, and wards. You could always draft in staff if necessary. You cannot build a ward and stock it in time.

I take it you mean elective management of patients, rather than emergency admissions? Bringing in patients electively helps reduce emergency admissions. We sometimes had patients with, say, stable angina, coming in for angiograms +/- angioplasty electively as it reduced the likelihood of the patient having a heart attack and requiring a longer stay, reduced likelihood of complications from heart attacks and the subsequent management. This is a better way as you are looking at the longer-term, not just the immediate term.


I agree with the issue of emergencies. Every hospital is meant to have a policy in situ where there is a plan for what to do when there is an emergency. However, we are often unaware of such plans, especially at the junior level.

Yes I was meaning elective wards. Though when I was admitted as an A&E into a renal ward the ward was filled all the time, so it actually impacted on the ability of the consultants to plan elective surgery as well. They had to cancel such procedures because of a lack of a bed. When you consider the cost of getting a surgery team together and then cancelling because of the lack of spare beds for a day or so that is moronic.

Since we're talking about A&E (and I'm sorry to hijack here, I'll start a new thread if needs be), but who decides A&E policy? Is it the PCT?

I find it odd that hospitals can decide to close their A&E departments, surely they have to consider the affect this will have on both the local area and other hospitals?

As for bed capacity, I think it's a telling sign when a man loses his bed simply by popping off to the toilet.