Fifty-nine hospitals 'failing seriously ill'

Dozens of hospitals should stop admitting seriously ill patients because they do not provide a full range of medical facilities, the Royal College of Physicians warns today.

A report by the college says 59 hospitals in England, Wales and Northern Ireland are unsuitable for patients with acute conditions such as heart or kidney failure, internal bleeding or chest infections.

The hospitals, which are not named, were found to lack one of more services considered essential to providing proper critical care and fast diagnoses. The requirements include an accident and emergency department, acute general surgery, resident anaesthetic cover, an intensive care unit and a cardiac care unit.

Unless hospitals provide all five services, the college says patients are more likely to experience delays in diagnosing their problem, spend longer in hospital because of shortages of surgical cover or require a temporary transfer to another hospital for diagnosis.

Dr Henry Connor, who conducted the survey for the college, said: "Hospitals which do not have critical care facilities and adequate diagnostic services are not appropriate sites for the admission of acutely ill patients who should be admitted to district general hospitals."

About 250 hospitals admit acutely ill patients. The survey suggests that about 20 per cent are unsuitable and should be "reconfigured" to provide intermediate care for patients or step-down care for patients recovering from serious illnesses.

Dr Connor said: "Once a definite diagnosis has been established, the patient's condition stabilised and a management plan formulated, some of these patients will be suitable for transfer."

The report was a response to consultants who were worried about admitting seriously ill patients to hospitals that did not have the resources.The number of acute admissions has risen by 5 to 10 per cent per annum. This has increased demand for beds in district general hospitals and other, less well-equipped hospitals.