Intensive care in the ailing UK health care system

We are fortunate to work in a 12-bedded intensive care unit (ICU), which is large by UK standards, with a full-time medical director and a full complement of nursing and resident medical staff in a London teaching hospital that is not under threat of closure in the UK National Health Service reforms. We are, however, concerned by the shortage of intensive care beds in London. Our anxieties have been further heightened by the threatened so-called rationalisation (with probable overall loss of beds) of other London teaching hospitals. Over the past three months (November, 1994, to January, 1995) our activity has increased by 10% compared with the same period last year (number of admissions 287 and 258, number of patient days 978 and 886, respectively). Our bed occupancy has been persistently greater than 90%, such that although we are approached up to four times a day, we are unable to offer ICU beds to other overstretched London hospitals...