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Hospital bed capacity and usage across secondary healthcare providers in England during the first wave of the COVID-19 pandemic : a descriptive analysis
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Mateen, Bilal A., Wilde, Harrison, Dennis, John M, Duncan, Andrew, Thomas, Nick, McGovern, Andrew, Denaxas, Spiros, Keeling, Matthew James and Vollmer, Sebastian (2021) Hospital bed capacity and usage across secondary healthcare providers in England during the first wave of the COVID-19 pandemic : a descriptive analysis. BMJ Open, 11 (1). e042945. doi:10.1136/bmjopen-2020-042945
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Official URL: http://dx.doi.org/10.1136/bmjopen-2020-042945
Abstract
Objective: In this study, we describe the pattern of bed occupancy across England during the peak of the first wave of the COVID-19 pandemic.
Design: Descriptive survey.
Setting: All non-specialist secondary care providers in England from 27 March27to 5 June 2020.
Participants: Acute (non-specialist) trusts with a type 1 (ie, 24 hours/day, consultant-led) accident and emergency department (n=125), Nightingale (field) hospitals (n=7) and independent sector secondary care providers (n=195).
Main outcome: measures Two thresholds for ‘safe occupancy’ were used: 85% as per the Royal College of Emergency Medicine and 92% as per NHS Improvement.
Results: At peak availability, there were 2711 additional beds compatible with mechanical ventilation across England, reflecting a 53% increase in capacity, and occupancy never exceeded 62%. A consequence of the repurposing of beds meant that at the trough there were 8.7% (8508) fewer general and acute beds across England, but occupancy never exceeded 72%. The closest to full occupancy of general and acute bed (surge) capacity that any trust in England reached was 99.8% . For beds compatible with mechanical ventilation there were 326 trust-days (3.7%) spent above 85% of surge capacity and 154 trust-days (1.8%) spent above 92%. 23 trusts spent a cumulative 81 days at 100% saturation of their surge ventilator bed capacity (median number of days per trust=1, range: 1–17). However, only three sustainability and transformation partnerships (aggregates of geographically co-located trusts) reached 100% saturation of their mechanical ventilation beds.
Conclusions: Throughout the first wave of the pandemic, an adequate supply of all bed types existed at a national level. However, due to an unequal distribution of bed utilisation, many trusts spent a significant period operating above ‘safe-occupancy’ thresholds despite substantial capacity in geographically co-located trusts, a key operational issue to address in preparing for future waves.
| Item Type: | Journal Article | |||||||||||||||||||||
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| Subjects: | R Medicine > RA Public aspects of medicine | |||||||||||||||||||||
| Divisions: | Faculty of Science > Life Sciences (2010- ) Faculty of Science > Mathematics Faculty of Science > Statistics Faculty of Medicine > Warwick Medical School |
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| Library of Congress Subject Headings (LCSH): | COVID-19 (Disease) -- England, COVID-19 Pandemic, 2020- -- England, Hospital beds -- England, Health services accessibility -- England, Hospitals -- England -- Planning. | |||||||||||||||||||||
| Journal or Publication Title: | BMJ Open | |||||||||||||||||||||
| Publisher: | BMJ | |||||||||||||||||||||
| ISSN: | 2044-6055 | |||||||||||||||||||||
| Official Date: | 26 January 2021 | |||||||||||||||||||||
| Dates: |
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| Date of first compliant deposit: | 18 February 2021 | |||||||||||||||||||||
| Volume: | 11 | |||||||||||||||||||||
| Number: | 1 | |||||||||||||||||||||
| Article Number: | e042945 | |||||||||||||||||||||
| DOI: | 10.1136/bmjopen-2020-042945 | |||||||||||||||||||||
| Status: | Peer Reviewed | |||||||||||||||||||||
| Publication Status: | Published | |||||||||||||||||||||
| Access rights to Published version: | Open Access | |||||||||||||||||||||
| RIOXX Funder/Project Grant: |
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