NHS hospitals under pressure: trends in acute activity up to 2022

We look at trends in admissions and bed use over the last few years.

The way we use hospital beds is constantly changing, with demand on hospitals being influenced by a growing, ageing population with increasing chronic health problems, and changes in the technology used to diagnose and treat patients. NHS hospitals under pressure: trends in acute activity up to 2022 looks at how the NHS has met these pressures in the recent past, to give an indication of how it might fare in the future.

We have reviewed trends in acute hospital activity for the period 2006/07 to 2012/13 using hospital episode statistics data, and forecast what demand may be to 2021/22 based on recent trends and demographic pressure. We then consider what the implications of this would be for hospitals.

Our analysis shows that if admission rates continue to rise, the NHS will need an additional 6.2 million ‘bed days’ by 2022 – which equates to 22 hospitals with 800 beds each.

To date, attempts to reduce the numbers of people admitted to hospital through better preventive care have not been very successful on a large scale. Concentrating on ensuring patients can be discharged quickly and do not stay in hospital for long periods may be a more certain strategy. In fact, our analysis shows that significant reductions in lengths of stay can be achieved this way.

“The pressures on hospitals are immense, and this analysis suggests that demographic change looks set to be the most significant driver of pressures on the NHS in the future. But even if building several more hospitals were affordable, this wouldn't be the right answer - we should look closely at alternative solutions first. History shows we can manage rising admissions by carefully reducing the time people spend in hospital. This requires excellent and co-ordinated care in the community. But this too costs money."

Nigel Edwards, Chief Executive, Nuffield Trust.

This is the latest output from our ongoing research programme on efficiency and productivity in the NHS. To find out more about our work in this area, visit the dedicated project page.

Suggested citation

Smith P, McKeon A, Blunt I and Edwards N (2014) NHS hospitals under pressure: trends in acute activity up to 2022. Nuffield Trust.