Hospital bed cutbacks have gone too far, NHS England boss says

Shutting beds has left hospitals unable to cope with the growing number of patients needing care and needs to stop, the head of the NHS has admitted.

In a surprise U-turn, Simon Stevens, chief executive of NHS England, said the policy had gone too far and that hospital beds had become “overly pressurised” as a result of years of closures.

The number of beds in NHS hospitals and other facilities has fallen from 144,455 in April to June 2010 to 129,992 in January to March 2018 – a cut of 14,463 or 10% of the total.

Stevens said he wants hospitals to increase their supply of acute and general medical beds.

Their numbers have fallen by 7,547, from 110,568 to 103,021, since 2010 despite warnings from staff and NHS groups such as NHS Providers, the Society for Acute Medicine and the British Medical Association that bed reductions were unwise given the increased pressure caused by the ageing and growing population.

Stevens told a conference of health service senior managers: “My personal view is as parts of the country are thinking about acute hospital beds for next five years, the base case should not be expectation of reductions in those hospital beds. Our hospital bed stock is overly pressurised.”

Despite plans to significantly expand health services outside hospitals “in many areas the NHS is going to need more bed capacity to deal with demand”, Stevens said. The new approach represented “quite a significant gear-shift”, he conceded.

However, boosting bed capacity could prove difficult because that would require more nurses at a time when they are the biggest of the heath service’s many workforce problems, he added. NHS England is already short of 40,000 nurses.

Labour welcomed the end of a “shortsighted” policy that had left hospitals struggling. Jonathan Ashworth, shadow health and social care secretary, said: “Cutting hospital beds so rapidly has been shortsighted, contributing to hospitals becoming so overstretched that dozens of patients are left stranded on trolleys in hospital corridors.”

Stevens also said that the NHS needed at least £4bn a year in extra funding on top of the £20.5bn already agreed in order to build new facilities, buy equipment such as scanners, improve antiquated IT systems and tackle a growing backlog of urgent maintenance work.

Ministers cannot continue diverting money from the service’s capital budget to pay for its day-to-day running costs, as the health secretary has in the past six years, Stevens said. “We need to introduce a new regime for capital funding. The squeeze on capital funding isn’t sustainable over the next five years,” he said.

The end of the private finance initiative made additional capital funding from government essential, he added.

Related: NHS needs extra £8bn or long-term plan will fail, say hospital bosses

Stevens’s plea to whoever is the next chancellor comes at a time when hospital bosses are expressing increasing disquiet that continuous cuts to capital funding have left some premises in a dangerous state and unable to upgrade IT systems.

Lord Prior, NHS England’s chair, recently urged ministers to agree to give the NHS £30bn to £50bn more in capital funding over the next decade. “If we were to come up to the OECD average – the average, not a demanding place to be – we would need between £3bn and £5bn per year extra on capital.”

The NHS spends “half the share of [gross national product] on [healthcare] capital that other European countries do. The result is we have far too few MRI and far too few CT scanners”, Prior said, in comments reported by the Health Service Journal.

He added that “43% of NHS buildings are over 30 years old and 18% predate the founding of the NHS in 1948”.