Beds shortage hits intensive care patients

Critically ill patients are being forced to make dangerous journeys because of a shortage of hospital beds.

An Evening Standard investigation reveals that many hospitals in London do not have even one spare bed for patients requiring intensive care.

At one hospital, doctors had to turn away five patients within 24 hours because their intensive care unit was full. The bed shortage means patients suffering organ failure are being ferried across the capital in search of life-support machines.

The scale of the crisis emerged from the Standard's investigation into the state of intensive care services in London. All major London hospitals have such units - called Intensive Therapy Units (ITU) - for patients suffering from heart, kidney or lung failure, or recovering from major surgery. Typical ITUs have about 10 beds linked to life-support machines.

Hospital managers of all London NHS trusts were asked how many spare beds they usually have, and how many are unoccupied at the moment. Results reveal that six trusts have no free beds, while eight have only one. Many trusts insist on keeping one bed aside for "in-house emergencies".

The situation means doctors are frequently forced to ring round frantically to find beds for patients they cannot admit.

Demand for beds is so intense that patients are sometimes unhooked from life-support machines and rushed elsewhere

to make way for newcomers whose condition is less stable.

Dr Stewart Withington, director of intensive care at the Royal London Hospital, said: "There is not enough capacity to cope with peaks and troughs of demand.

"It only takes minor variations to throw the system out of kilter."

As part of the investigation, hospitals were asked the average occupancy rate for their ITUs. The majority say that at any given time 90 to 95 per cent of beds are full, and for some the average figure is 100 per cent.

Occupancy rates are often calculated by the minute so that if a bed is being cleaned for the next patient, it is classified as "unoccupied" - improving the figures.

Many hospitals admit they have recently been forced to turn away criticallyill patients. West Middlesex Hospital said it had transferred 15 criticallyill patients for nonmedical reasons and a north-east London hospital transferred five patients within 24 hours.

Dr Withington said: "It is difficult transferring critically ill patients and hospitals only do it if there is no choice."

However, Guy's Hospital was criticised by an independent report into the death of cab driver David Cason, 55, whose triple heart bypass was twice delayed because of a lack of intensive-care beds. The report said Guy's could have transferred Mr Cason to a hospital with spare beds.

Health chiefs have invested almost £300 million in extra beds for critically-ill patients since 2000. But much of the money has been spent on high-dependency-unit beds, which do not have life-support machines.

Our study also reveals that all London hospitals need more intensive care nurses - with an average vacancy rate of 20 per cent.