LETTER: Resources for intensive care units
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Your support makes all the difference.Sir: The present crisis in the provision of intensive care services in the NHS should come as no surprise ("Intensive care units lose 20 per cent of beds", 7 February). It is a worsening of a serious situation that has been known about for severa l years.
In 1988, the Association of Anaesthetists of Great Britain and Ireland published the results of an extensive survey of intensive care units in the UK. The number of nursing staff was inadequate in 32 per cent of units. Few units had enough consultant medical cover, and almost one in five had a bed occupancy of more than 80 per cent.
It has been recognised for over 20 years that many patients require a level of care that is midway between intensive care and an acute hospital ward - that is, they need high dependency care. Only 23 per cent of hospitals had a high dependency unit as well as an intensive care unit. The result was that high dependency patients were often admitted to intensive care units.
This is not only an inappropriate use of expensive resources but also prevents or delays the admission of other patients to intensive care units.
The association put forward recommendations about the nursing and medical staffing levels required to deliver safe and effective intensive care, as well as about the rationalisation of intensive care services within Health Regions. It also published detailed proposals about the setting up and running of high dependency units in hospitals.
It is now clear that no progress has been made by Health Authorities and NHS Trusts in any of these areas.
Yours faithfully, John Searle Consultant Anaesthetist Royal Devon and Exeter Healthcare NHS Trust Exeter 8 February
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