NHS at breaking point, according to British Medical Association

The NHS is at “breaking point” with a decline in the number of hospital beds leading to delays and cancelled operations, the British Medical Association (BMA) has warned.

Analysis by the BMA found the number of overnight beds in English hospitals fell by a fifth between 2006-07 and 2015-16. The report found that in the first week of January this year, almost three-quarters of trusts had a bed occupancy rate of 95% on at least one day.

According to the analysis, in 2000 there were an average of 3.8 beds per 1,000 people, but this had dropped to 2.4 beds by 2015. The report said that in November 2016 14.8% of patients spent more than four hours waiting for a hospital bed, having been seen in an A&E department.

“The data demonstrates the increasing pressures on the system. It provides evidence of the underlying cracks within the NHS, such as funding constraints, changes and increases in demand, disjointed care and workforce pressures,” the BMA report said.

It noted that pressures on mental health services were particularly acute, with a 44% decrease in the number of mental health beds since 2000-01.

The document was seized on by opposition politicians, with Labour saying it was a “wake-up call [that] Theresa May must not ignore” and the Liberal Democrats warning the situation was becoming “intolerable”.

The BMA’s chairman, Mark Porter, said: “The UK already has the second lowest number of hospital beds per head in Europe and these figures paint an even bleaker picture of an NHS that is at breaking point.

“High bed occupancy is a symptom of wider pressure and demand on an overstretched and underfunded system. It causes delays in admissions, operations being cancelled and patients being unfairly and sometimes repeatedly let down.

“The delays that vulnerable patients are facing, particularly those with mental health issues, have almost become the norm and this is unacceptable. Failures within the social care system are also having a considerable knock-on effect on an already stretched and underfunded NHS.

“When social care isn’t available, patients experience delays in moving from hospital to appropriate social care settings, which damages patient care and places a significant strain on the NHS.

“In the short term we need to see bed plans that are workable and focused on the quality of care and patient experiences, rather than financial targets. But in the long term we need politicians to take their heads out of the sand and provide a sustainable solution to the funding and capacity challenges that are overwhelming the health service.”

Jonathan Ashworth, shadow health secretary, said: “Thanks to Tory mishandling of our NHS, patient numbers in hospitals are now routinely above the levels recommended for safety. The shameful reality is this overcrowding puts patients at risk and blows apart ministers’ claims to be prioritising safety.

“The number of overnight hospital beds has decreased by over a fifth and combined with Tory neglect and underfunding this has left nine out of 10 hospitals dangerously overcrowded this winter.

“Almost all hospitals have been running over the safe 85% mark for bed occupancy while 60 hospital trusts are over 95% this winter. The response from ministers is to blame others and bury their heads in the sand.

“This government’s mismanagement is failing our NHS and failing patients. The prime minister must wake up to this crisis and ensure that the NHS and social care have the funding and support needed in the budget next month.”

Norman Lamb, the Lib Dem spokesman and former health minister, said: “Chronic bed shortages should be the exception not the rule. The situation is getting intolerable, with more cancelled operations, longer delays and those with mental health issues being systematically let down.

“Ultimately we could reduce the need for hospital beds by improving preventive care. But cutting both preventive services and beds leads to disaster. That is what we are now witnessing.”

An NHS Improvement spokeswoman said: “The NHS has been under real pressure this winter, as it copes with a surge in demand for emergency services the knock-on effects are felt throughout our hospitals.

“Our hospitals are extremely busy but we are working tirelessly alongside providers to help them manage and to support more efficient use of the number of beds available.”

The BMA’s report is published before the NHS Improvement’s figures for the third quarter of 2016-17, which are expected to show the parlous state of trusts’ finances.

NHS Improvement’s chief, Jim Mackey, has acknowledged trusts will miss the £580m deficit “control target” and forecasters have predicted the combined black hole in their finances could reach nearly £1bn by the end of the year.

The Department of Health disputed the BMA’s analysis, insisting figures from before 2010-11 could not be compared with those afterwards; the earlier figures included NHS-provided residential care beds and were compiled on an annual basis, while the more recent figures were published quarterly and only included beds under the care of consultants.

A spokesman said: “This analysis is inaccurate, the figures come from two different time periods when the way of counting beds was different, and so they aren’t comparable.

“Our hospitals are busier than ever but thanks to the hard work of staff, our performances are still amongst the best in the world. We have backed the NHS’s own plan for the future with an extra £10bn by 2020.”