What is bed blocking and why does it matter?

'Bed Blocking' is an unpleasant term used to describe the situation when hospital beds are occupied by 'patients' that don't really need them. In most cases, these are individuals that are medically well enough to be discharged home, however, their discharge is delayed. This means that those beds are essentially 'blocked' causing delays to the treatment of other patients. Sadly this is not a new problem for the NHS, but one that has been going on for sometime.

See the clip below from 2018.

What delays discharge home?

There are many factors that may delay an individual's discharge home.

• Incomplete discharge paperwork - before going home, all medical records have to be updated, GPs informed of treatment given and planned, prescriptions written
• Waiting for medication - before going home, the individual may need to be issued with medication for their ongoing treatment, and advised how to take and use it safely
• Lack of transport - the individual may need specialist transport to take them home safely
• Waiting for the local authority to plan social care - the individual may need to move into a residential or nursing home in the community, or may need domiciliary care to live safely at home

What all these factors have in common, is that the root cause of the delay is usually either a lack of resources, such as staff or equipment, or increased demand on the service. What we are currently seeing, is a combination of the two.

Other types of bed blocking

Sometimes, beds are blocked within the hospital. For example, patients that have been assessed in A&E or an Acute Admissions Unit, but cannot be moved to the specialist department within the hospital they require, because the hospital ward they need is full. This means that A&E can get very crowded, with patients waiting on beds in corridors, or even in ambulances queueing outside.

This can happen with Intensive Care beds too. Hospitals prefer not to have a full Intensive Care Unit (ICU) because individuals involved in serious accidents, or those having complex surgeries, may need that one to one care at very short notice.

What problems arise due to bed blocking?

The obvious issues are overcrowding in A&Es and ambulances queuing outside, patients unable to attend for more routine treatments and surgeries and slower waiting times for discharge home. But there are additional impacts you may not be aware of.

Deconditioning

Deconditioning is a process that occurs during and after a period of bed rest, particularly damaging for the elderly and the chronically unwell or physically disabled. It causes a functional loss in mobility as muscle mass and strength decline, can cause problems with continence, can effect thinking and cognitive abilities and ultimately affect activities of daily living and independence.

What is the current situation?

This morning, the BBC reported that 'the government says there are currently about 13,000 medically fit patients occupying beds in England.' In response to this, it is expected that the Health Secretary, Steve Barclay, will this afternoon announce an extra £250 million for the NHS to 'buy thousands of beds in care homes and upgrade hospitals amid a winter crisis'. It is not entirely clear how this will work, but the intention is for the NHS to have social care beds available as necessary to move medically fit patients to more expediently. The BBC also reports that a number of additional methods will be trialled as part of this initiative, such as the use of dementia hubs and new rehabilitative care schemes.

You can read more here: NHS to buy care beds to make space in hospitals

Road to Recovery: Hospital

Watch this insightful episode of the BBC documentary Hospital

'In March 2020, as the country entered lockdown, Hospital revealed the frontline of medicine at the Royal Free London. Now, two years on, we revisit the trust as it implements its recovery programme and does its part to tackle the longest waiting lists in the NHS’s history.

Filmed during the first months of 2022, we follow the emotional journeys of the patients starting to receive their long-awaited surgeries and the staff who treat them as the trust grapples with the challenge of recovering from the impact of the last two years.'

Click to watch now