Nottingham University Hospitals is forecasting a shortage of around 40 beds during the busiest winter months despite a £3.3 million allocation to manage seasonal pressures.
A winter plan due before the trust’s board on Thursday 12 November predicts a remaining gap of 40 beds in January and 41 in February after measures to reduce pressure have been taken into account.
The report explicitly states that the plan does not eliminate the need to use corridors or additional temporary spaces for patients, although it does not plan to increase their use.
The figures represent modelled average shortages across each month. The report warns that these averages conceal variations between individual days and weeks.
NUH’s plan uses an assumed occupancy rate of 98 per cent for general and acute beds, reflecting the trust’s daily experience.
The recommended winter planning approach is to operate at 96 per cent occupancy. The report says another 32 beds would be needed if NUH used that assumption with its current measures in place.
The trust says its winter plan aims to reduce the larger forecast gaps in January and February to levels similar to those experienced during other months.
It also aims to maintain services for cancer patients and people awaiting planned treatment while accommodating increased emergency demand.
Board members will be asked to approve the plan and commit the £3.3 million already allocated for seasonal pressures.
The report sets out an emergency process for authorising additional resources if demand exceeds forecasts or planned improvements do not provide the expected capacity.
Its first priority in those circumstances would be purchasing additional community care packages to help patients leave hospital when they are ready to return home but need support.
A separate report to the same meeting explains why NUH missed its commitment to eliminate emergency department corridor care by 30 September.
It says early improvements in July were not sustained through September and October as demand exceeded planning assumptions and improvements in admissions, hospital stays and supported discharge did not consistently deliver enough capacity.
During the period examined, emergency department attendances were 2.4 per cent above plan, ambulance arrivals were seven per cent above plan and admissions, including same-day emergency care, were 4.5 per cent above plan.
The report says operating at around 98 per cent bed occupancy leaves limited room to absorb additional demand, discharge delays or disruption to capacity.
It also reports a doubling since January 2025 in the number of patients delayed in leaving hospital while awaiting supported discharge.
Changes to wards and reductions in the time some patients spend in hospital have helped NUH absorb additional demand, according to the report, but have not delivered the intended further reductions in corridor care.
The trust declared a critical incident on 20 October when it required additional support to manage immediate risks.
The report describes pressures on emergency care, including cardiology patients needing monitored transfers to City Hospital after earlier lift failures had restricted access to some cardiology beds and treatment facilities.
NUH says work to reduce corridor care will continue alongside the winter plan, including improvements to patient discharge, assessment capacity and ambulance handovers.
The winter plan acknowledges that its forecasts will not be completely accurate and says arrangements will need to remain flexible as demand changes.
