Total time in English accident and emergency departments is related to bed occupancy.

S imulation modelling has suggested high bed occupancy in hospitals is associated with a greater risk of prolonged waits for admission in the accident and emergency (A&E) department. The NHS Plan has introduced two standards for waits in A&E. Firstly, the wait for admission from the time of a decision to admit (trolley wait); which is the wait that appears to be related to average bed occupancy within acute trusts. This is logical, as one would expect admissions to have to wait if beds are not readily available at all times. The second standard in the NHS Plan relating to A&E is the total time in A&E measured from the arrival of the patient to their discharge from hospital or admission to a ward, this applies to all patients whether they are admitted or not. Therefore the vast majority will be patients who are discharged home. It would be expected that most of these patients would not be affected by the average bed occupancy in the trust unless the backlog of patients awaiting admission cause processes in the A&E department to slow down for the whole range of patients being seen. The objective of this study was to discover if total time spent in A&E departments is related to a trust’s bed occupancy.