09.03.18
Intensive care units forced into closure as staffing worries deepen
Intensive care units are closing beds due to staffing shortages on a weekly basis, figures from the Faculty of Intensive Care Medicine (FICM) have revealed.
In a survey of its members carried out at the end of last month, the faculty found that two out of five units closed beds on weekly basis, with only 14% not needing to close beds at all.
Three out five units do not have a full critical care nursing complement, and the vast majority of those affected felt that bed capacity was inevitably leading to cancelled operations.
Around 80% of units needed to transfer patients due to a lack of beds, and 21% of units did this at least monthly.
NHS England data gives a critical care bed capacity rate of 87%, but a number of respondents expressed doubt that the rate entered for their trust was a true reflection of capacity.
Last year the FICM sent a number of Freedom of Information requests, aiming to gather information on non-medical transfers and bed closures due to the lack of critical care staff, but the faculty says that the data was not reliably collected across England.
It argues that this, combined with the statistics revealed by this short survey, raises "serious questions about how the NHS is modelling critical care demand and supply.”
Dr. Carl Waldmann, dean of FICM, said that the faculty recommends that the Department of Health and Social Care and each health board and trust make modelling of critical care need and resources and “urgent priority.”
He added that whilst the results of the survey are concerning, they are not surprising.
“All the four nation’s NHS bodies take considerable care to formulate escalation plans to protect the safety of critically ill patients during the winter period.
“The concern among the critical care community is that these pressures are now being felt throughout the year,” he explained.
However, he warned that now is the time for further service modelling: “Back in the late 1990s, these pressures on critical care services led to the service almost being brought to its knees during some very difficult winters.
“This in turn led to a government review of critical care in the year 2000 that led to positive changes in investment and configuration that vastly improved patient quality of care and the sustainability of the service.
“That time is upon us again. There has not been any true service modelling since then, yet the service has dramatically changed and demand has escalated as the population ages and medical innovations lead to more people being able to benefit from critical support.”
Waldmann cautioned that without targeted interventions to alleviate system pressures, the strain on intensive care staff will “increase exponentially.”
Top image: Martin Barraud
Have you got a story to tell? Would you like to become an NHE columnist? If so, click here.