§ Mr. BurstowTo ask the Secretary of State for Health (1) if he will set out the definitions of(a) critical care, (b) intensive care, (c) high dependency, (d) intermediate care, (e) continuing care and (f) acute care beds; and if he will provide the numbers of beds and associated staff in each case as at 1 December 1999 and 1 December 2000 for each relevant NHS region, health authority and NHS trust; [141498]
(2) how many extra (a) critical care beds and (b) acute care beds there were in each London NHS trust on (i) 1 December and (ii) December 1999; how many extra staff are required to make each bed fully operational; how many staff were in post, broken down by professional group, on (a) 1 December and (b) 1 December 1999; and what the vacancy level was in each case. [141508]
§ Mr. Denham[holding answer 13 December 2000]: The definitions of critical care, intensive care, high dependency and acute care beds, as used in central returns to the Department, have been placed in the Library. Intermediate care beds are not currently identified separately in central returns. The working definition of an intermediate care bed for future monitoring purposes is included. Continuing care is defined by the service provided.
A special bed census, set up to inform the winter planning process, counted the number of available beds in the following categories—critical care (which includes both intensive care and high dependency) and general and acute. A table showing the number of critical care and general and acute beds on 1 December 1999 and 1 December 2000 for each National Health Service region and health authority will be placed in the Library. More detailed information on in-patient bed numbers by ward type and numbers of NHS residential care beds are published annually in "Bed availability and occupancy, England"; and on adult critical care beds in "Intensive care and high dependency provision, England". Both publications are in the Library.
It is not possible to distinguish staff by bed category. The workforce censuses are collected as at 30 September of each year and copies of the 1999 census detailed results—"Department of Health NHS Hospital and Community Health Services Non-Medical Workforce Census England: 30 September 1999" and "Department of Health NHS Hospital, Public Health Medicine and Community Health Service Medical and Dental Workforce Census England at 30 September 1999" are available in the Library. The September 2000 workforce censuses information will be published shortly. The Department of Health Vacancy Survey is carried out as at 31 March of each year and copies of the 1999 and 2000 surveys are available in the Library.
Critical care beds
The twice yearly census of available adult critical care beds counts open and staffed beds by location and the level of care, i.e. intensive or high dependency, provided on the census day. Use of critical care beds will vary depending on the clinical needs of the patient and the staffing available. This definition was also used for the 1 December special census.
326WCritical care beds include both general and specialist intensive care and high dependency beds in the following locations:
- intensive care unit
- high dependency unit
- combined intensive care and high dependency unit
- combined intensive care, high dependency and coronary care unit
- cardiothoracic unit
- neurological unit
- liver unit
- spinal injury
- burns unit
- general or specialist high dependency beds outside units.
Beds excluded from the census are those in coronary care units, short-term post-operative units linked to theatres, renal units and critical care for babies and children in paediatric and neonatal units.
Intensive care beds
An intensive care bed is a critical care bed that was being used for intensive care on the census day.
High dependency beds
A high dependency bed is a critical care bed that was being used for high dependency care on the census day.
Intermediate care beds
An intermediate care bed is a bed in a residential setting (such as community hospital, nursing home, rehabilitation centre, residential care home or step-down facility in an acute hospital) for people who are medically stable but need a short period of rehabilitation to enable them to re-gain sufficient physical functioning and confidence to return safely to their own home. This "residential rehabilitation" service model may be either 'step-down', i.e. following a stay in an acute hospital, or 'step-up', i.e. following a referral by (say) general practitioner, social services or rapid response team in cases which would otherwise necessitate acute admission or admission to longer-term residential care.
Acute beds
Acute beds include beds for adults and children, critical care for adults and children, coronary care, palliative care and younger physically disabled. The count of acute beds does not include maternity beds or beds on wards designated for older people or for people with mental illness or learning disabilities or residential care beds.