NHS Fife: Reduced hospital bed capacity partially to blame for longer A&E wait times

Surge capacity is the NHS’ ability to respond to a sudden increase in patient care demands, and NHS Fife Board members were told on Tuesday that the closure of surge capacity beds had a knock on effect for A&E wait times in September.

A board report explained that additional bed capacity on Ward 9 was closed at the beginning of the month which then increased pressure on front door areas of the hospital.

The number of A&E patients waiting more than eight hours almost doubled from August to 543 in September and the number waiting more than 12 hours nearly tripled to 76 in September.

The number of wait-time breaches attributed to patients waiting for a bed jumped from 402 in August to 771 in September – which is the highest that figures has been since March, and accounted for 37 per cent of breaches.

The reduced bed capacity was at least partly to blame for September’s figures.

Acting Chair Alistair Morris said the situation demonstrates the importance of balance within NHS Fife services.

“It’s a difficult story to tell the public and it’s difficult to tell the Cabinet Secretary as well,” he said. “The immediate knock on effect [of the surge ward being closed] was A&E waiting times. It’s a demonstration of us needing to get that balance right.”

Claire Dobson, Director of Acute Services, further explained: “Our additional bed capacity was closed for a period in September, which enabled us to deploy the staff working in these in other areas of our hospital to support the staff working there. These beds have since reopened and we expect this capacity to be required throughout the winter months and into spring. It can sometimes be necessary to flex our bed capacity to meet the demand for inpatient care.”

She continued: “Decisions around capacity are usually complex and the dependencies between areas means there is very often a knock-on effect in other parts of the hospital, including our A&E.”

NHS Fife previously made a goal to reduce its surge capacity at Victoria Hospital where possible to reduce costs while still providing a safe service.

In March, the NHS Fife Board agreed to make £15 million of cost savings measures. Surge capacity was one of the areas earmarked as part of the savings program.

The goal was to reduce surge capacity Victoria Hospital where possible to reduce costs while still providing a safe service. However, Ms Dobson said money did not play a primary role in the decision to close additional capacity beds in September.

“Ensuring the safety of patients is our primary focus,” she said. “While we are of course mindful of the effect creating additional bed capacity has on our resources, any decisions around our bed capacity are made with the sole purpose of supporting our staff to provide the very best possible care for patients.”

It’s not the first time NHS Fife has flexed its ability to close or create additional bed capacity at the Victoria Hospital.

Ms Dobson said: “Traditionally, we would be required to create additional bed capacity over the winter months and reduce that capacity in spring. However, the increased demand we have seen throughout the COVID pandemic and since means that our additional capacity has been required through much of the year. “

She continued: “The demand for inpatient care throughout this year has required us to maintain additional capacity for longer periods.”

The additional bed capacity is now reopened and operating ahead of what NHS Fife expects to be a very busy and challenging winter season.