Figures show that over a ten year period (1997-98 to 2007-08) the total number of NHS beds in Wales fell by nearly two thousand. Yet, the percentage bed occupancy in that time increased from 78.7% to 82.8%. Now, doctors are growing increasingly concerned about the safety of patients.
Dr Stefan Coghlan, Chairman of the BMA's Welsh Consultants Committee believes the NHS is being pushed to breaking point. He says "More patients are being treated and despite managerial efforts to reduce the time that patients spend in hospital, the average length of stays, is actually increasing, but the number of beds available for them, is shrinking. This is putting an intolerable strain on staff and causing a great deal of stress and confusion to patients. We certainly wouldn't be able to cope in a crisis. It is just unsustainable.
"The situation has been getting worse during the first few months of this year. A worrying combination of unprecedented emergency admissions, more planned surgery to meet access 2009 targets and so called efficiency savings with pressure to balance the books by the end of the financial year has resulted in unacceptable bed pressures. NHS managers have been having crisis meetings on a daily basis about where to put patients. We seem to be getting to a point where it's a case of 'any bed will do'.
Dr Coghlan goes onto highlight the problem of patients being moved around wards as beds become free. He says "hot-bedding appears to be more widespread in hospitals, with three or more patients having been in the same bed, on the same day. This constant swapping can cause real confusion and distress, particularly for more elderly patients, who end up not knowing where on earth they are. This makes it very difficult for families visiting, to locate their loved ones, even for doctors to find their own patients. It may not be the best use of a consultant's time, trying to track down patients and we have heard instances of patients being forgotten about, as they are moved from ward to ward.
And it is the most vulnerable that this impacts upon. The elderly, infirm patients who are most affected by being moved, are also the patients most likely to be moved from wards, to accommodate new admissions. Moving elderly patients can precipitate acute confused states and general deterioration in their health.
We have real concerns that specialist teams are being dispersed, and that soft targets such as the abolition of mixed sex awards, so important to patients, are being jeopardised by the continued closure of beds.
Over-crowding and moving people around hospital wards can increase the risk of contracting and passing on infections, such as C.difficile. Last month, the Welsh Conservatives obtained figures showing that in 2007-08, more than 3000 people aged over 65 contracted the C.difficile infection.
Dr Coghlan points to NHS Trust finances as a reason for the decline in bed numbers, "There are extra financial pressures on managers at the moment to balance their books before the planned NHS reorganisation becomes fully operational in October. And one of the easiest ways of making efficiency savings is to cut bed numbers, regardless of the dire consequences this can have for patient care.
"The BMA is calling for a change in bed occupancy policy, with less emphasis on dwindling bed numbers, at a time when we have a growing ageing population, who need more long-term treatment in hospitals. Patients, in particular elderly ones, are being put in danger and this must not be allowed to continue. We also feel it would be beneficial to change the way statistics are collated and reported so that they better reflect what is going on in acute hospital beds."