First reported 5 Apr 2017•Latest report 17 Apr 2024
Definition
What this concern includes
Includes reports identifying bed availability, winter pressure, demand or comparable capacity constraints as influencing or threatening clinically appropriate hospital admission, continued-care or discharge decisions.
Not included
Excludes general bed shortages or capacity pressures where no effect on a clinically consequential admission, continued-care or discharge decision is identified.
Excludes ordinary delays in admission or discharge where bed-capacity pressure is not the reported cause or influencing condition.
Excludes generic workforce, workload or operational-pressure concerns without a direct connection to hospital admission, continued-care or discharge decision-making.
Excludes failures of the substantive clinical assessment or treatment decision where bed-capacity pressure is not materially involved.
Reports
8
Distinct published reports
Individual concerns
8
A report can raise multiple concerns
Date range
2017–2024
First to latest report issue date
Stated actions
22
Described in published responses
Reports over time
Reports over time
Reports about this concern issued each year.
* 2026 is projected from reports observed to 7 Sep 2026.
Most frequent recipients
Most frequent recipients
Reports about this concern sent to each recipient.
Department of Health and Social Care4
NHS England3
South East Coast Ambulance Service NHS Foundation Trust2
Birmingham and Solihull Mental Health NHS Foundation Trust1
East Kent Hospitals University NHS Foundation Trust1
Greater Manchester Health and Social Care Partnership1
Health Services Safety Investigations Body1
Leeds and York Partnership NHS Foundation Trust1
Lewisham and Greenwich NHS Trust1
NHS Birmingham and Solihull Integrated Care Board1
St George's, Epsom and St Helier Hospital Group1
University Hospital Lewisham1
University Hospitals Sussex NHS Foundation Trust1
NHS trust5
Executive non-departmental public body4
Ministerial department4
Healthcare site1
Health-system partnership1
Integrated care board1
NHS provider group1
Concerns and responses across reports
Only concerns grouped under this recurring concern are included. Select any concern, action or position to view the source wording.
Surrey
Concerns raised1
Failure to protect properly considered discharge planning from bed-space pressure
This report raised 4 other concerns. They are not shown here because they do not form part of this recurring concern.
Responses linked to these concerns
Each statement is shown once, even when linked to more than one concern.
Actions described in response An action is something a respondent says it has done, is doing, or plans to do in response to the concern raised.3
Action
Provide additional acute bed capacity, supported by capital investment, to improve hospital flow and reduce discharge pressure.
Stated by NHS EnglandStated completedThe respondent said that this action was complete when they made their response on 29 April 2024.
Action
Review, update and approve the discharge policy to identify vulnerable patients, involve families and clarify safe-discharge responsibilities and escalation processes.
Stated by Epsom and St Helier University Hospitals NHS TrustStated completedThe respondent said that this action was complete when they made their response on 29 April 2024.
Action
Strengthen discharge escalation pathways and communicate safe-discharge expectations through senior-leadership presentations and staff communications.
Stated by Epsom and St Helier University Hospitals NHS TrustStated completedThe respondent said that this action was complete when they made their response on 29 April 2024.
Cornwall and Isles of Scilly
Concerns raised1
Unavailability of hospital beds for informal admission
This report raised 8 other concerns. They are not shown here because they do not form part of this recurring concern.
Responses linked to these concerns
Each statement is shown once, even when linked to more than one concern.
Respondent positions A position is what a respondent says about the concern when they do not describe a specific action.3
Position
The ICB considers its commissioned mental health bed capacity appropriate because it matches the national median per 100,000 population.
Stated by Department of Health and Social CareDisputes the concernThe respondent disagreed with part of the concern or the basis for it.
Position
The ICB relies on alternative solutions to mitigate the impact of closed mental health beds.
Stated by Department of Health and Social CareExisting arrangements considered sufficientThe respondent said that existing arrangements were sufficient, so no further action was needed.
Position
Closed acute and rehabilitation beds cannot be reinstated because of environmental issues being challenged through the provider’s contract.
Stated by Department of Health and Social CareUnable to actThe respondent said that a constraint prevented them from taking the relevant action.
Birmingham and Solihull
Concerns raised1
Unsafe exceptional process for creating psychiatric bed capacity through discharge of current patients
This report raised 1 other concern. They are not shown here because they do not form part of this recurring concern.
Responses linked to these concerns
Each statement is shown once, even when linked to more than one concern.
Actions described in response An action is something a respondent says it has done, is doing, or plans to do in response to the concern raised.2
Action
Work with local authorities to improve inpatient social-care support and enable faster, safer discharges.
Stated by Birmingham and Solihull Mental Health NHS Foundation TrustStated in progressThe respondent said that this action was in progress when they made their response on 29 November 2023.
Action
Operate a clinical oversight group with acute wards to support appropriate discharges and escalate delays caused by non-clinical issues.
Stated by Birmingham and Solihull Mental Health NHS Foundation TrustStated completedThe respondent said that this action was complete when they made their response on 29 November 2023.
This report raised 13 other concerns. They are not shown here because they do not form part of this recurring concern.
Responses linked to these concerns
Each statement is shown once, even when linked to more than one concern.
Respondent positions A position is what a respondent says about the concern when they do not describe a specific action.1
Position
Rescinding detention did not discharge the patient or affect bed availability; discharge decisions are clinically based and not driven by resource pressures.
Stated by Leeds and York Partnership NHS Foundation TrustDisputes the concernThe respondent disagreed with part of the concern or the basis for it.
Inner South London
Concerns raised1
Failure to ensure that ITU admission criteria are not driven by capacity constraints
This report raised 2 other concerns. They are not shown here because they do not form part of this recurring concern.
Responses linked to these concerns
Each statement is shown once, even when linked to more than one concern.
Actions described in response An action is something a respondent says it has done, is doing, or plans to do in response to the concern raised.2
Action
Apply nationally derived critical-care admission criteria, with urgent intensive-care review within 60 minutes and admission or ward-management advice.
Stated by Lewisham and Greenwich NHS TrustStated completedThe respondent said that this action was complete when they made their response on 22 July 2021.
Action
Use the SELACCN and SPRINT support agreement to facilitate transfer to the nearest available critical-care bed when local capacity is unavailable.
Stated by Lewisham and Greenwich NHS TrustStated completedThe respondent said that this action was complete when they made their response on 22 July 2021.
Respondent positions A position is what a respondent says about the concern when they do not describe a specific action.2
Position
Admission decisions are not refused or driven by critical-care bed shortages when lower-level care is clinically inappropriate.
Stated by Lewisham and Greenwich NHS TrustDisputes the concernThe respondent disagreed with part of the concern or the basis for it.
Position
Critical-care capacity constraints are addressed through immediate specialist support, safe interim care, and transfer arrangements to available local critical-care beds.
Stated by Lewisham and Greenwich NHS TrustExisting arrangements considered sufficientThe respondent said that existing arrangements were sufficient, so no further action was needed.
Manchester South
Concerns raised1
Lack of acute hospital bed capacity
This report raised 2 other concerns. They are not shown here because they do not form part of this recurring concern.
Responses linked to these concerns
Each statement is shown once, even when linked to more than one concern.
Actions described in response An action is something a respondent says it has done, is doing, or plans to do in response to the concern raised.10
Action
Continue rolling out Urgent Treatment Centres to provide a consistent urgent-care service.
Stated by Department of Health and Social CareStated in progressThe respondent said that this action was in progress when they made their response on 23 November 2020.
Action
Continue Same Day Emergency Care initiatives to reduce non-elective hospital admissions.
Stated by Department of Health and Social CareStated in progressThe respondent said that this action was in progress when they made their response on 23 November 2020.
Action
Maintain Nightingale Hospitals, their surge capacity and NHS use of independent-sector hospital capacity.
Stated by Department of Health and Social CareStated completedThe respondent said that this action was complete when they made their response on 23 November 2020.
Action
Expand NHS 111 to provide urgent-care advice and direct patients to appropriate services more quickly.
Stated by Department of Health and Social CareStated plannedThe respondent said that this action was planned when they made their response on 23 November 2020.
Action
Implement agreed principles requiring direct specialty acceptance, specialty assessment of stable patients, and expanded Same Day Emergency Care across Greater Manchester.
Stated by NHS Greater Manchester Integrated Care BoardStated in progressThe respondent said that this action was in progress when they made their response on 23 November 2020.
Action
Implement NHS 111 First so patients are directed to call 111 before attending an Emergency Department.
Stated by NHS Greater Manchester Integrated Care BoardStated completedThe respondent said that this action was complete when they made their response on 23 November 2020.
Action
Implement pre-Emergency Department triage and streaming to direct patients to the most appropriate service.
Stated by NHS Greater Manchester Integrated Care BoardStated completedThe respondent said that this action was complete when they made their response on 23 November 2020.
Action
Adopt and implement Greater Manchester Discharge to Assess guidance, including standard referral, rapid triage, discharge medication, testing, PPE and next-day follow-up processes.
Stated by NHS Greater Manchester Integrated Care BoardStated completedThe respondent said that this action was complete when they made their response on 23 November 2020.
Action
Create additional community discharge capacity, including reablement support, domiciliary care and community beds.
Stated by NHS Greater Manchester Integrated Care BoardStated completedThe respondent said that this action was complete when they made their response on 23 November 2020.
Action
Review community-based capacity to ensure discharge pathways have the correct types of capacity.
Stated by NHS Greater Manchester Integrated Care BoardStated in progressThe respondent said that this action was in progress when they made their response on 23 November 2020.
North East Kent
Concerns raised1
Pressure on staff to avoid hospital admission
This report raised 2 other concerns. They are not shown here because they do not form part of this recurring concern.
Responses linked to these concerns
Each statement is shown once, even when linked to more than one concern.
No linked response statements
No respondent-stated action or position is linked to these concerns in the published data.
Brighton and Hove
Concerns raised1
Lack of hospital bed availability delaying patient admission
This report raised 1 other concern. They are not shown here because they do not form part of this recurring concern.
Responses linked to these concerns
Each statement is shown once, even when linked to more than one concern.
Actions described in response An action is something a respondent says it has done, is doing, or plans to do in response to the concern raised.5
Action
Develop a £31 million capital scheme expanding the emergency floor, Urgent Care Centre, Emergency Department GP input and ambulatory emergency care at Royal Sussex County Hospital.
Stated by University Hospitals Sussex NHS Foundation TrustStated in progressThe respondent said that this action was in progress when they made their response on 28 July 2017.
Action
Review service provision at Princess Royal Hospital to relieve pressure on Royal Sussex County Hospital bed capacity.
Stated by University Hospitals Sussex NHS Foundation TrustStatus unclearThe respondent did not make the status of this action clear when they made their response on 28 July 2017.
Action
Implement the SAFER care bundle to improve patient flow and support earlier discharge.
Stated by University Hospitals Sussex NHS Foundation TrustStatus unclearThe respondent did not make the status of this action clear when they made their response on 28 July 2017.
Action
Expand Newhaven Downs Community Hospital to create additional discharge capacity.
Stated by University Hospitals Sussex NHS Foundation TrustStatus unclearThe respondent did not make the status of this action clear when they made their response on 28 July 2017.
Action
Extend the Hospital at Home scheme to provide additional nursing and medical support after discharge.
Stated by University Hospitals Sussex NHS Foundation TrustStatus unclearThe respondent did not make the status of this action clear when they made their response on 28 July 2017.
Respondent positions A position is what a respondent says about the concern when they do not describe a specific action.1
Position
Existing system-partner arrangements are considered sufficient to prioritise the problem and sustain improvement, although the problem is not yet resolved.
Stated by South East Coast Ambulance Service NHS Foundation TrustExisting arrangements considered sufficientThe respondent said that existing arrangements were sufficient, so no further action was needed.
Pin
Get email alerts
Request correction
Includes reports identifying bed availability, winter pressure, demand or comparable capacity constraints as influencing or threatening clinically appropriate hospital admission, continued-care or discharge decisions.
