Accelerated discharge of patients in the event of a major incident: observational study of a teaching hospital.
BACKGROUND
Since October 2002 in the UK Primary Care Trusts (PCTs) have had statutory responsibility for having and maintaining a Major Incident plan and since 2005 they have been obliged to co-operate with other responders to an incident. We aimed to establish the number of beds in our Trust which could be freed up over set periods of time in the event of a major incident and the nature and quantity of support which might be required from PCTs in order to achieve this.


METHODS
Repeated survey over 12 days in 3 months of hospital bed occupancy by type of condition and discharge capacity in an 855-bed UK tertiary teaching hospital also providing secondary care services. Outcome measures were bed spaces which could be generated, timescale over which this could happen and level and type of PCT support which would be required to achieve this.


RESULTS
Mean beds available were 78 immediately, a further 69 in 1-4 hours and a further 155 in 4-12 hours, generating a total of 302 beds (36% of hospital capacity) within 12 hours of an incident. This would require support from a PCT of 150,000 population of 10 nursing care beds, 20 therapy-supported intermediate care beds, and 25 care packages in patients' own homes.


CONCLUSIONS
In order to fulfill the requirements of the Civil Contingencies Act 2004, PCTs should plan to have surge capacity in the order of 30 residential placements and 25 community support packages per 150,000 population to support Acute Trusts in the event of a major incident.
Challen
Kirsty
K
Emergency Department, South Manchester University Hospitals Trust, Manchester M23 9LT, UK. kirsty.challen@smtr.nhs.uk
Walter
Darren
D
D001509:Bed Occupancy / Q000706:statistics & numerical data*; D004189:Disaster Planning / Q000458:organization & administration* / Q000592:standards; D006746:Hospital Bed Capacity, 500 and over; D006779:Hospitals, Public / Q000458:organization & administration / Q000706:statistics & numerical data*; D006785:Hospitals, University / Q000458:organization & administration / Q000706:statistics & numerical data*; D006801:Humans; D020380:Needs Assessment; D019370:Observation; D010351:Patient Discharge / Q000706:statistics & numerical data*; D010360:Patient Transfer / Q000458:organization & administration / Q000706:statistics & numerical data*; D011320:Primary Health Care / Q000458:organization & administration / Q000706:statistics & numerical data; D013997:Time Factors; D006113:United Kingdom / Q000453:epidemiology; D014947:Wounds and Injuries / Q000453:epidemiology* / Q000628:therapy