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Suspending elective care this winter won’t solve the beds problem

NHS England has taken the unprecedented step of suspending non-urgent inpatient care until mid-January in order to cope with winter bed pressures. This relates to a peak in emergency admissions leading to a lack of available beds for patients staying overnight after planned, non-urgent procedures such as joint replacement surgery. This means around 15,000 operations are now being cancelled and rebooked. (Source: BBC News)

The underlying problem is a shortage of beds, meaning that elective surgery is being squeezed out during the winter peak. Hospitals need spare bed capacity to ensure patients are admitted promptly from A&E to the correct wards. And overcrowding must be avoided as it encourages the spread of influenza and vomiting bugs. (Source: Nuffield Trust)

There is a predictable winter peak in NHS bed occupancy, and this has crept upwards every year since 2010. In response, the length of time the average patient spends in hospital has steadily decreased. However, the total number of beds has steadily been cut, and the number of delayed transfers due to lack of available social care has been increasing. As a result the number of cancelled elective operations and the number of A&E trolley rates have both increased year-on-year. (Source: BMA report - PDF)

The NHS now has fewer hospital beds relative to population than almost any comparable health system. 2014 figures showed the NHS has 2.3 acute beds per 1,000 population, compared with 6.1 in Germany and 4.1 in France. Bed occupancy levels are now exceeding 95% in the majority of NHS Trusts during winter, which is well in excess of the safe limit. In this context, Sustainability & Transformation Partnership (STP) plans to close further beds are unrealistic at best. (Source: King's Fund report)

The NHA Party has already voiced concern this month over the escalating NHS crisis. We are gravely concerned that the Conservative government have washed their hands of responsibility for patient care and are instead reducing the NHS to a bare bones, insurance-based service. We support Stephen Hawking, Allyson Pollock and colleagues in their legal campaign to halt NHS England's introduction of Accountable Care Organisations.

Dr Alex Ashman, NHA Party co-leader, said:

"Nobody can blame NHS England for taking steps to prevent loss of life this winter. But cancelling elective surgery just masks the underlying problem: there aren't enough beds to provide a full NHS service this winter. A lack of beds means delayed care; it means longer waits in A&E; it means a higher risk of infections like 'flu and the winter vomiting bug. The idea that STPs are planning to cut beds further is outrageous to say the least.

"The winter illness peak happens every year, and is a surprise to nobody. Hospitals are doing their best to improve efficiency and shorten length of stay, but they cannot run safely at 95% capacity. What is needed is better preventative care, more acute hospital beds, and more community beds to support ongoing care for those who need it. So why has the government pursued a model of care where beds are continually cut without any improvement to public health or social care provision? This all belies the fact that the Conservatives have no appetite for the provision of a universal healthcare system - they are too busy turning it into an insurance-based system."

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The National Health Action (NHA) Party was founded in 2012 to oppose the growing marketisation of the NHS. The NHA Party supports the renationalisation of the NHS, and has publicly backed the 'JR4NHS' legal campaign to stop the introduction of an insurance-based healthcare system in England.

Dr Ashman is a surgical registrar who joined the NHA in 2012 having seen first hand the effects of marketisation and privatisation on the NHS. They have been on the NHA national executive committee since 2013. They were elected to one of the party co-leader roles in December 2016.

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