Yesterday, the BBC reported from the Royal Free Hospital in London, highlighting the enormous pressures the NHS is facing this winter.
A&E units are full, patients are being treated in corridors, and many of those occupying hospital beds no longer require acute care but are unable to be discharged due to a lack of community options.
This isn’t an isolated case. Across the country, NHS hospitals are struggling with overcrowding and delayed discharges. Every week, Mildmay Hospital publishes the number of beds we have available - beds that could serve as a lifeline for patients who no longer need the intensive care provided by NHS front-line hospitals. However, our ability to help alleviate the NHS bed crisis depends on NHS funding being approved for these referrals.
The consequences of this are felt not only by the NHS but also by Mildmay Hospital. Our empty beds represent a significant financial challenge, impacting our ability to continue delivering the essential care we’re known for. As the NHS faces growing waiting lists and delayed treatments, it’s frustrating to see available resources, like our beds, underutilised.
The root of the problem lies in the delayed discharge of patients. At its peak in January 2023, over 14,000 patients who were medically fit for discharge were still occupying beds in NHS hospitals. This ‘bed-blocking’ prevents new patients from receiving the care they need and contributes to long NHS waiting times.
Mildmay Hospital could play a crucial role in addressing this issue. If the NHS was willing to fund more referrals to us, we could ease the strain on NHS hospitals by providing care to patients who are ready to leave acute settings. Doing so would not only free up beds for those in urgent need but also help reduce waiting lists.
The current commissioning arrangements also pose significant challenges for Mildmay. NHS contracts make up the majority of our income, so a reduction in patient referrals threatens the sustainability of our charitable work. This isn’t just about Mildmay - it’s about the wider issue of how NHS services are commissioned and funded. The UK has fewer hospital beds per capita compared to other countries, such as Germany, and NHS bed occupancy rates regularly exceed safe levels. Delayed discharges, compounded by issues in social care, only exacerbate the crisis.
For example, a more efficient system might see services like those provided by Mildmay Hospital centrally commissioned for the entire capital, rather than being handled separately by the five London NHS Integrated Care Boards. This fragmented approach not only increases costs but also leaves beds unused while NHS hospitals remain overcrowded.
With the NHS having lost more than half of its hospital beds over the past 30 years, facilities like Mildmay could help alleviate some of the strain if they were utilised more effectively. Our experience in rehabilitating patients and helping them transition back to the community after hospitalisation makes us an ideal partner in easing the pressure on NHS beds.
The solution is within reach. By ensuring that Mildmay Hospital and other not-for-profit healthcare providers are properly funded and utilised, we can make a meaningful contribution to tackling the NHS bed crisis.
We hope that by raising awareness of this issue, we can encourage the NHS and government to work with us to create a more efficient and sustainable system - one that benefits both NHS patients and the wider healthcare community.
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