NHS hospital capacity during covid-19: overstretched staff, space, systems, and stuff

Fong, Kevin J; Summers, Charlotte; Cook, Tim M

doi:10.1136/bmj-2023-075613

Cited by 4 publications

(1 citation statement)

References 18 publications

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“…Counting the number of beds alone, it turns out, isn’t especially useful in determining hospital capacity, particularly in intensive care. Kevin Fong and colleagues, in a sobering piece that should be widely shared with anybody sceptical of the pandemic’s impact on health services (doi:10.1136/bmj-2023-075613), describe hospital capacity as a “complex property of a complex sociotechnical system.”1…”

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confidence: 99%

Why hospital capacity is more complex than bed capacity

Abbasi

2024

BMJ

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mentioning

confidence: 99%

Why hospital capacity is more complex than bed capacity

Abbasi

2024

BMJ

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The Impact of Healthcare Pressures on the COVID-19 Hospitalisation Fatality Risk in England

Mellor,

Jones,

Ward

2024

J Epidemiol Glob Health

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Background As the impact of the SARS-CoV-2 pandemic extends into 2023 and beyond, the treatment and outcomes of infected patients continues to evolve. Unlike earlier in the pandemic there are now further infectious disease pressures placed on hospitals, which influence patient care and triage decisions. Methods The manuscript uses individual patient records linked with associated hospital management information of system pressure characteristics to attribute COVID-19 hospitalisation fatality risks (HFR) to patients and hospitals, using generalised additive mixed effects models. Results Between 01 September 2022 and 09 October 2023, the COVID-19 hospitalisation fatality risk in England was estimated as 12.71% (95% confidence interval (CI) 12.53%, 12.88%). Staff absences had an adjusted odds ratio of 1.038 (95% CI 1.017, 1.060) associated with the HFR when accounting for patient and hospital characteristics. Interpretation This observational research presents evidence that a range of local hospital effects can have a meaningful impact on the risk of death from COVID-19 once hospitalised and should be accounted for when reporting estimates. We show that both the patient case mix and hospital pressures impact estimates of patient outcomes.

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A modular approach to forecasting COVID-19 hospital bed occupancy

Tobin,

Walker,

Moss

et al. 2024

Preprint

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Monitoring the number of COVID-19 patients in hospital beds was a critical component of Australia's real-time surveillance strategy for the disease. From 2021-2023, we produced short-term forecasts of bed occupancy to support public health decision making. In this work, we present a model for forecasting the number of ward and intensive care unit (ICU) beds occupied by COVID-19 cases. The model simulates the stochastic progression of COVID-19 patients through the hospital system and is fit to reported occupancy counts using an approximate Bayesian method. We do not directly model infection dynamics - instead taking independently produced forecasts of case incidence as an input - enabling the independent development of our model from that of the underlying case forecast(s). We evaluate the performance of 21-day forecasts of ward and ICU occupancy across Australia's eight states and territories between March and September 2022, when major waves of the Omicron variant of SARS-CoV-2 were occurring throughout the country. Forecasts were on average biased downwards immediately prior to epidemic peaks and biased upwards post-peak. Forecast performance was best in jurisdictions with the largest population sizes. Our forecasts of COVID-19 hospital burden were reported weekly to national decision-making committees to support Australia's public health response.

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NHS hospital capacity during covid-19: overstretched staff, space, systems, and stuff

Abstract: Kevin Fong, Charlotte Summers, and Tim Cook unpick arguments that the NHS was not overwhelmed by covid-19, highlighting its legacy effects on healthcare and lessons for future health crises

Cited by 4 publications

References 18 publications

Why hospital capacity is more complex than bed capacity

Why hospital capacity is more complex than bed capacity

The Impact of Healthcare Pressures on the COVID-19 Hospitalisation Fatality Risk in England

A modular approach to forecasting COVID-19 hospital bed occupancy

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