New National Approval Requirements for the Closure of Beds Expected

The Chief Executive of NHS England, Simon Stevens, has outlined new national approval requirements for the closure of beds in the NHS.

In a speech at a Nuffield Trust summit, Stevens announced that there will be three additional tests in order for any consultation involving the removal of hospital beds to be approved.

The announcement is considered particularly important, as it proceeds next week’s budget.

NHS England has sought additional funds for social care and capital spending, but recent comments from the political hierarchy have seemed to suggest that no such monies will be forthcoming.

There has also been considerable controversy regarding the sustainability and transformation plans of the NHS, with many asserting that they are playing a significant role in diminishing services within the system.

NHS England announced that the new plans must meet the following conditions:

– Demonstrate 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.

– Show that specific new treatments or therapies, such as new anti-coagulation drugs used to treat strokes, will reduce specific categories of admissions.

– 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).

The new test will be introduced alongside four existing national test reconfigurations, already instigated back at the beginning of the decade.

These require any alterations to be supported by GP commissioners, while also demonstrating that they strengthen public and patient engagement, offer clear clinical evidence and are entirely consistent with patient choice.

However, a statement on the matter emphasised that “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.”

Speaking at the Nuffield Trust event, Stevens outlined some of the crisis facing the existing NHS system.

“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.”

Stevens also suggested that the greying population will be critical in the coming years, and that an evolution of the NHS is necessary to deal with this demographic reality.

“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.”

Unison’s head of health Christina McAnea welcomed the statement of Stevens, and suggested that it will go some way to ensuring that a satisfactory number of beds are made available to patients.

“This announcement will reassure patients that hospital beds will be available when they need them. But it’s important the NHS has the right staff to provide a high quality service, at a time when the health service faces immense pressure.”


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