Of course there should be more beds in ICU and we should spend money on this.

[wahwah]

When their private operations cock up, they'll need to get back to the NHS. See here

"When their private operations cock up, they'll need to get back to the NHS" who are you talking about? the article just says not enough beds in general, i don't understand your point.

They are short of beds everywhere. Mostly we are short of medical, ICU, and stepdown beds. When patients are determined to be medically stable and fit for discharge they are often on the wards for a further 6 weeks waiting for a placement somewhere for care. These people are unable to care for themselves for various reasons and probably always will be due to old age and chronic problems. This is the case even after we cured their pneumonia with IV antibiotics.

In addition to this they are closing beds, getting rid of staff Nurses and refusing to hire more staff nurses to cover the ones who are leaving. Then they are saying that they are closing beds due to "lack of staff". That lack of staff is intentional, make no mistake about it.

I recently got out of the NHS it is a mess. These politicians (both labour and conservative should be jailed). The rot started under labour and the conservatwats will continue with the pain. They are privatising it. The only money to be made is off of elective surgery patients so those beds are being kept.

True statement about the private hospitals though. They do not have the critical care facilities and back up to deal with an emergency.

I just thought that it was interesting that at a time when the Tories are slashing and burning the NHS, this report comes out. Not that we don't need the beds, it's just that it's pretty much the only health provision I know of that the rich can't buy their way out of as private companies won't provide it. Stands to reason that it might be one area that doesn't get reduced funding, but we'll see, I'm sure.

Logically I would have thought ICU beds will be the last type of beds to be cut because, while losing ward beds is dreadful it is less likely to lead to immediate deaths than using ICU beds. People who need an ICU bed need it straight away, people waiting for (for example) an elective hip replacement can wait another month. (of course there is a knock on with getting people off the ICU and onto a ward but still)

Doesn't matter the income of the person who needs either type of bed. It doesn't always have to be a great conspiracy.

Yes but if patients have better care further down the line then surely they're less likely to end up in ICU.My dd ended up in SCBU due to crap care.

Personally I would have thought more money further down the line would pay off so I am suspicious.

Having said that I'm not a medical person so willing to stand corrected by those working in the NHS.

You guys are right. It is illogical. And poor care on the wards (poor RN staffing) sends people to ICU. It is called Failure to Rescue and the term is worth a google.

The wards now are taking much sicker people than they did 10 years ago. The patients we see on the wards now would have been in ICU in the 1990's. This is due to an aging, sicker population with multiple chronic diseases and advances in medicine.

It is illogical. But so is everything they seem to be doing. Closing all sorts of beds when we don't already have enough, recruitment freezes for Registered Nurses etc etc. This is causing RNs who do and don't have jobs to leave the country because the Nurse patient ratios are so bad. Management won't replace the leavers and the new graduate nurses cannot find jobs. This will cause more patients to get shit care and need ICU.

I don't know what the hell they are doing. But I can say that started under Labour and the conservatives are just accelerating it.

wahwah - the Tories have been inpower for 5 months. This situation has been escalating for at least 14 years. Go figure.

I think the BBC piece missed the focus of Rubenfelds work in order to get a good headline.

Rubenfeld has long written on the need for better evidence based practice in ICu and this paper seems to be a continuation of this.

Definitions of ICU beds differ across countries but it's worth noting that the Commonwealth fund found far smaller differences in the area of acute medicine:

beds per 1000

UK 2.6
Germany 5.7

You could also make the argument that if increasing the number of beds naturally makes us have a less efficient system.

It's possible that Germany has too many than is appropriate, as they do with MRI and other imaging devices.