Market News

 December 11, 2017
Call for more hospital beds to cope with winter breathing difficulties

 Hospitals need to provide more beds in the winter months to deal with the rising numbers of adults and children who struggle to breathe, according to a report that warns this is a major cause of the crisis in accident and emergency departments.

The report from the British Lung Foundation says more and more people are ending up in an already hard-pressed A&Es because of the increase in breathing problems caused by air pollution, an ageing population and the long-term effects of heavy smoking.

In the last seven years, lung disease admissions to hospitals in England and Wales have risen at over three times the rate of all other conditions, says the report. They are at their worst in the winter, often complicated by seasonal flu.

The foundation is calling for hospitals to be better prepared for this predictable surge in the number of cases. Only 10% of hospital trusts who responded to an FOI request had plans in place to make more beds available for respiratory patients, it says.

"Year after year we are seeing an influx of patients admitted to A&E with respiratory conditions," said Dr Penny Woods, the chief executive of the foundation.

"Despite this our analysis reveals that many hospitals are woefully unprepared. This is at a great cost to patients who suffer as a result. Taking a more seasonal approach to supporting people with lung disease will reduce needless attendances and admissions and ultimately improve patient care and outcomes."

More people go to A&E in the summer, but mostly with injuries that do not require a stay in hospital. Those who arrive struggling for breath in the winter when the cold causes a tightening of the chest, making them feel as if they are drowning, are more likely to need a bed.

Flu can cause serious complications for people who already have breathing problems, but the numbers of people needing medical help rises whether or not there is a bad flu season.

In 2015-16, more than 676,000 adults and children arrived at A&E with respiratory conditions and 41% needed to be admitted to hospital. The most common problems are pneumonia, lower respiratory tract infections, chronic obstructive pulmonary disease (COPD) and bronchiolitis in children under five.

"Lung disease has always had a much larger impact on the health service than most people think. The third most common cause of death, lung disease costs the NHS and patients around £9.9bn each year," writes Woods in a foreword to the report.

"Sadly, it's working its way up the NHS agenda for the worst reasons. Unlike other major disease areas, our lung disease mortality rate hasn't improved in over a decade. We now have the fourth highest in Europe."

The report recommends more effort to prevent illness, including ensuring people get a flu jab and are followed up when they leave hospital. It says that more beds need to be made available in the winter months. And it calls for political action.

"Government and NHS England need to take on board measures to tackle this seasonable and predictable crisis and support a Taskforce for Lung Health. This will improve all aspects of care for the 12 million people with lung disease," said Woods.

NHS England said the report highlights why it is urging people with acute respiratory conditions, such as lung complaints, to get their flu jab and to keep warm in the cold weather.

In winter, respiratory hospital admissions double from 1,000 to 2,000 a day. Around one-third of excess winter deaths are due to respiratory illnesses. For every one-degree drop in temperature below five degrees, there is a 10% rise in elderly people presenting with breathing problems.

"The NHS has robust plans in place this winter to manage expected increased pressures, such as surges in demand from the frail and elderly and those with long-term conditions, and will always have beds available for the sickest patients," said a spokesman.

Dozens of NHS hospitals had to issue black alerts last winter, unable to cope with the demand for beds. NHS England is under great pressure to prevent another meltdown and has ordered NHS Trusts to ensure no patients are kept waiting on trolleys in corridors or in the back of an ambulance.

Emergency doctors have warned that trying to deliver to performance targets will be "nigh-on impossible" in departments with too few beds that are underfunded and under-staffed. NHS Trust chief executives have warned that some hospitals are already running on as high as 99% bed occupancy, when 85% is considered the safe limit.