New patient care test for hospital bed closures

NHS England Chief Executive Simon Stevens will today announce that hospital bed closures arising from proposed major service reconfigurations will in future only be supported where a new test is met that ensures patients will continue to receive high quality care.

From 1 April, local NHS organisations will have to show that significant hospital bed closures subject to the current formal public consultation tests can meet one of three new conditions before NHS England will approve them to go ahead:

  • Demonstrate that sufficient alternative provision, such as increased GP or community services, is being put in place alongside or ahead of bed closures, and that the new workforce will be there to deliver it; and/or
  • Show that specific new treatments or therapies, such as new anti-coagulation drugs used to treat strokes, will reduce specific categories of admissions; or
  • Where a hospital has been using beds less efficiently than the national average, that it has a credible plan to improve performance without affecting patient care (for example in line with the Getting it Right First Time programme)

Speaking at the Nuffield Trust Health Policy Summit, NHS England Chief Executive Simon Stevens is expected to say: “Hospitals are facing contradictory pressures. On the one hand, there’s a huge opportunity to take advantage of new medicines and treatments that increasingly mean you can be looked after without ever needing hospitalisation. So of course there shouldn’t be a reflex reaction opposing each and every change in local hospital services.

“But on the other hand, more older patients inevitably means more emergency admissions, and the pressures on A&E are being compounded by the sharp rise in patients stuck in beds awaiting home care and care home places. So there can no longer be an automatic assumption that it’s OK to slash many thousands of extra hospital beds – unless and until there really are better alternatives in place for patients.

“That’s why before major service changes are given the green light, they’ll now need to prove there are still going to be sufficient hospital beds to provide safe, modern and efficient care locally.”

Hospitals would still have the freedom to flex their number of beds throughout the year, and the responsibility to determine how many beds they can safely staff.

The announcement builds on the four existing tests for reconfiguration put in place in 2010. Under those rules, closures can only go ahead with support from GP commissioners, strengthened public and patient engagement, clear clinical evidence and provided that they are consistent with patient choice.