Nottingham University Hospitals NHS Trust is forecasting a significant shortfall in available hospital beds during the peak of winter, even after emergency measures and escalation plans are put in place.
A Winter Plan 2025/26 report due to be discussed at the Trust Board meeting on 8 January sets out modelling which shows the trust could face a peak bed gap of up to 154 beds in February.
The report explains that initial modelling identified a shortfall of 112 beds, but revised assumptions — including higher demand, occupancy levels of up to 96 per cent and longer lengths of stay — increased the projected gap.
After applying a range of demand and capacity mitigations, including expanded urgent treatment services, virtual wards, discharge initiatives and system-wide working with partners, the trust estimates the gap could be reduced significantly but not eliminated.
Even with the Full Capacity Protocol activated, adding escalation spaces across hospital sites, the papers warn a residual shortfall of around 13 beds could remain in February, rising to around 26 beds in March.
The board papers state that while the plan represents the maximum achievable mitigation within current constraints, further dynamic decisions may still be required if demand exceeds forecasts or system-wide capacity does not materialise as expected.
The plan relies heavily on improved patient flow, faster discharges, community support to avoid admissions, and close coordination with system partners across Nottinghamshire.
Trust leaders are asking the board to approve the winter plan while acknowledging that the residual bed gap presents ongoing risk, particularly during periods of sustained high demand.
