Auditors warn of intensive care bed shortage

Auditors have warned increasing evidence indicates parts of Scotland lack adequate numbers of intensive care beds.

An audit of more than 46,000 patients admitted to specialist wards for the most severely ill or injured last year found the quality of critical care is high but bed shortages are causing problems.

The intensive care unit (ICU) at Ninewells Hospital in Dundee had the highest percentage of patients discharged early at 7%, more than three times the Scottish average, with most being sent to another ward in the hospital.

The report states: "This figure suggests that the number of physical ICU beds available at Ninewells Hospital is inadequate to meet the demands of the service.

"At times of peak occupancy, ICU bed demand appears to exceed the supply and patients were discharged early to a lower level of care."

Elsewhere, a shortage of general hospital beds means patients fit to leave intensive care cannot be moved.

A quarter of patients in intensive care units audited across Scotland had their discharge delayed by more than four hours and for high dependency units this was 22%.

Forth Valley Royal Hospital intensive care unit had the worst record with more than half of discharges (52%) delayed for more than four hours, with main reason a lack of beds elsewhere in the hospital.

Nearly two thirds (60%) of patients in the surgical level one unit at the Western General Hospital Hospital faced similar waits.

Crosshouse Hospital surgical high dependency unit had the longest average length of stay of its type, at almost six days which is said to be a ongoing issue due to lack of available ward beds.

A total of 19% of patients admitted to intensive care died before being discharged from hospital, a similar figure to 2016.

No unit was found to have a significantly higher mortality rate compared to the rest of Scotland.

The most common diagnosis for intensive care patients in 2017 was bacterial pneumonia, followed by post cardiac arrest and self-inflicted overdose, all similar to recent years.

The percentage of patients in intensive care who developed a healthcare acquired infection remained steady at 2.7%.

Chairman of the audit group, Dr Stephen Cole, said: "This report provides reassurance that the quality of critical care available within Scotland is of a very high standard.

"There is, however increasing evidence that some areas of the country really do lack sufficient numbers of intensive care beds.

"The report this year highlights some real disparity between the provision of critical care across the territorial NHS Boards and I would urge those boards that appear to have lower levels of critical care provision to scrutinise this report in detail and to consider their local investment decisions."