NHS Hospital Access in England

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A 2005 study by the Imperial College London’s Carol Propper revealed disparities in England hospital access, based on patient population. The study found that, although most people could reach several NHS trusts within an hour, areas including North Yorkshire, East Anglia and Cornwall had fewer options due to lower bed numbers and long travel times. This created an additional barrier to patients needing elective care, with lengthy wait times endemic to the system.

Fast forward to 2025, and the NHS still cannot reliably provide good availability out of hospital. All who know what they are talking about have said that hospitalbed occupancy rates have consistently exceeded safe levels and have cited reports that 95% of hospital beds were already occupied by December 2024. This high occupancy has contributed to a rise in “corridor care,” where patients are treated outside of traditional spaces when there are no beds available.

These challenges are due to several factors:​

• Decreasing Beds: Between 2010 and 2020, the numbers of available beds in the NHS decreased, compounding pressure on hospital resources.
• Staffing shortages: The NHS is currently working with more than 107,900 vacancies, 31,800 of which are in nursing, which has an impact on the ability of staff to deliver services to patients. ​
• Growing Need: An aging population and the aftereffects of the COVID-19 pandemic have increased demand for hospital services, further straining resources.

To help with this, there are a number of measures the NHS has put in place to improve access to hospitals:​

• Expansion of Patient Choice: Patients now will have multiple providers to choose from for their care, including in the independent sector. It is part an initiative to reduce waiting times by providing alternatives to traditional NHS hospitals. ​
• Through technology: The NHS App and website have been refreshed so patients know waiting times, miles & quality ratings to help people make informed choices about care.
• Working with private providers: To help reduce pressure on NHS hospitals, NHS patients have been treated at private hospitals under agreed terms. But tensions have arisen over cost, with private hospitals threatening to withdraw services in a way that could make it difficult for some patients to access care. ​

Yet, great challenges remain despite these efforts. The Institute for Fiscal Studies has cast doubt on whether the targets to return to a maximum 18-week wait for planned hospital treatment before the next election will be met. By January 2025, 6.25 million people were on waiting lists for 7.43 million planned treatments or appointments.

The picture of access to NHS hospitals in England has changed over the past two decades but much of the fundamental background remains the same. Sustained action and innovation in addressing bed shortages, staff shortages, and growing demand are needed.