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At the heart of general practice since 1960

NHS cuts beds by 10% as work moves to GPs

By Nigel Praities

NHS hospitals have cut acute beds by 10% in just three years as managers pile pressure on GPs to manage complex cases in the community, figures released to MPs reveal.

The number of overnight beds in acute wards across England fell from an average of 2.19 per thousand people in 2004/05 to 1.98 in 2007/08.

The sharp fall, revealed by health minister Ben Bradshaw in response to a parliamentary question, contrasts with the situation over the previous five years, when bed availability stayed constant.

And there has been no accompanying shift in funding from secondary to primary care, despite promises from the Department of Health.

Financial information from the National Audit Office shows the value of healthcare services commissioned by PCTs since has risen by 11% for secondary care, but only 6% for primary care, since 2005.

Mr Bradshaw said the decrease in hospital beds was a result of dealing with patients more efficiently and more people being treated in primary care settings.

‘Experts all agree this is the best way to deliver healthcare. Advances in medical technology and shorter stays for routine operations mean fewer beds are needed — this is part of a long-term downward trend in the average length of stay in hospital.

‘But where the NHS needs more beds, there are more beds,' he said.

But Dr Paddy Glackin, secretary of Camden and Islington LMC, accused PCTs of cutting costs and leaving GPs to pick up the pieces.

‘It's a rolling door. Every single day GPs have to see patient who have been hurtled out of hospital too quickly.

‘Every single Friday the local hospital is on an emergency beds system and we are fighting to get our patients accepted. We are under pressure continually to manage patients at home'.

Dr Jonathan Fielden, chair of the BMA consultants' committee, said funding cuts meant specialists were relying on already stretched GPs to pick up the slack.

‘While we have hospitals with this limited capacity – as we saw this winter – we will have more delays in getting patients in and we will be much more reliant on our GP colleagues to look after patients a bit longer and take them that little bit earlier,' he said.

Pulse reported in October last year there had been a rise in emergency readmissions as hospitals sought to decrease bed-days and follow-up appointments and shift work to GPs.

Fall in hospital capacity

Average daily number of acute beds in wards open overnight per 1,000 of population*, per year

1999/00
2.19

2000/01
2.19

2001/02
2.19

2002/03
2.19

2003/04
2.20

2004/05
2.19

2005/06
2.14

2006/07
2.05

2007/08
1.98


Source: Department of Health

Hospital beds have been cut as burden falls on GPs Hospital beds have been cut as burden falls on GPs

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