Shortage of intensive care beds – what are the implications?

Posted: 27/01/2014

The Telegraph reported this weekend on a growing shortage of intensive care beds in the NHS. The report reveals some worrying statistics about the number of times that critical beds were unavailable for patients needing urgent surgery – with many Trusts reporting a shortage of such beds on 40 or more occasions since November 2013. The article focuses on the impact of the lack of beds – the main one being that patients who require urgent surgery are having their operations delayed because of a lack of an intensive care bed being available post-operatively.

This is an issue which raises a number of aspects of concern, says Philippa Luscombe, partner in the clinical negligence team at Penningtons Manches LLP: “We have comes across a few cases where urgent surgery has been delayed because of lack of resources. In some cases there has been significant damage caused by that delay which has, in turn, resulted in substantial negligence claims. The figures published by The Telegraph suggest that this problem is on the increase.

“However, we also need to look at the causes of this problem.  One is the wider problem in hospitals of bed blocking. There are still patients in hospitals – mainly the elderly or those with long term illnesses – who should be cared for in the community but we still don’t have sufficient community resources available to do this. The obvious impact of this is in A&E where patients come in without emergency needs but it is not appropriate to send them home. The Telegraph’s figures would tend to suggest that this is having a knock on effect on beds elsewhere.

“We are also concerned that a part of the reason for the intensive care bed crisis is a lack of planning pre-operatively. We have a number of clinical negligence cases ongoing which involve patients suffering operative or immediately post-operative complications and requiring a critical care bed that had not been booked for them. There was a high likelihood that these patients would need high level care post-operatively but the arrangements were not made, resulting in problems when their condition deteriorated post- operatively. Each resulted in an intensive care bed being taken up unexpectedly but also for much longer than would otherwise have been the case. It is not hard to see that this would then have a knock-on effect on patients who need such a bed available for them and are being booked in. We are concerned that inadequate planning and pre operative assessment of patients may be part of the cause of this problem and we need to look at how often this is happening and the procedures for such pre-operative assessments so that the need for beds can be more accurately predicted.”

Philippa concluded: “In many ways this is more worrying than the A&E crisis and, if there is this degree of shortage, there will sadly be a number of people adversely affected by the inability to access the specialist care that they need at the right time”.

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