National emergency beds pledge

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A national emergency bed system to help doctors find intensive-care vacancies anywhere in England will be fully in place by 1 December, the Health minister, Gerald Malone, announced yesterday.

The system will create "a one-stop shop" to allow doctors through one phone call to find the nearest intensive-care bed when their own hospital is full or their unit does not provide the appropriate care.

The service will extend nationally a bed register covering 100 units in the South-east which was set up in 1995 after Malcolm Murray, 45, died of serious head injuries he received in a road accident in Orpington, south London. The junior doctor on duty at Queen Mary Hospital, Sidcup, where Mr Murray was taken, was unable to find an intensive-care bed anywhere in the London area, despite many phone calls, and the patient eventually died after being flown 200 miles by air-rescue helicopter to Leeds General Infirmary.

"Clinicians will no longer have to waste valuable time in telephoning other units to find a suitable bed," Mr Malone said yesterday. Now they will be able to go to a central database, which will keep track of vacant beds by telephoning the 234 hospitals which have them three times a day for an update on availability. The system will cover all 2,600 adult and children's intensive-care beds in England - although Scotland and Wales have yet to decide whether to join in.

Where the nearest bed may be over a national border - in the case of Bristol and Cardiff, for example, or Carlisle, and the Scottish hospitals, good local links already existed, Mr Malone argued. The Scots and Welsh were free to join the system later, he said.

The move follows a series of scandals, of which Mr Murray's case was merely the most extreme, where doctors have faced serious difficulties in locating vacant beds. "This will save time, prevent needless delay, help doctors make the best decisions for patients, and improve care," Mr Malone said.

"It is sometimes essential to move patients, but these transfers need to be kept to a minimum. They must be swift, safe and sensitive."

With each intensive-care bed costing pounds 750,000 a year to run, they were an expensive resource which would always be limited, he said. "We must make sure we make the very best use of them." The system would be fully up and running before the winter months, when demand for beds and intensive care facilities usually peaks.

The move was welcomed by the Royal College of Physicians which said that as well as saving "precious time" it would also provide a clear picture of the demand for intensive care, "something we have called for in the past".

Mr Malone said that he was always reluctant to say there were no problems in the National Health Service, but since the system in the South-east had been introduced, providing services from general intensive care to neurosciences and paediatric cover, there had been no recurrence of the problem Mr Murray's case revealed.

The system will link the London-based service with a register already running in the North-west, while bringing in the rest of the country at total set-up cost of pounds 200,000 and an annual running cost of pounds 100,000 a year - a sum described as "excellent value" by Mr Malone, given the cost of each bed. The NHS Executive will fund it for the first 18 months after which health authorities, which will be required to take part, will have to meet the running costs.

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