Noble’s Hospital has lost a 10th of its beds over the last three years.

Bed numbers have reduced from 350 to about 314 during that time.

But Health Minister David Ashford insisted that the hospital has never exceeded its bed capacity although there are occasions when all will be occupied.

Claims of a beds crisis at Noble’s have been raised over the last year.

In a Tynwald question for written reply during last month’s sitting, Mr Ashford was asked how many times Noble’s has been full or over capacity in the last three years.

He replied: ’The hospital has never exceeded its bed capacity. It would not be either practical or safe to do.

’There will of course be occasions when all beds are occupied but this will be for very short periods in a given day, and when such circumstances occur measures are taken to expedite flow out of the hospital in order to create the capacity required to meet emergency or elective demand.’

He said that over the last three or more years, the reduction in bed numbers at Noble’s from 350 to about 314 today has come about through either change of use or through a programme of planned decommissioning.

’Given the level of fluctuation that occurs throughout a given day, capacity utilisation will vary depending on the demand that is being generated for beds offset by the number of corresponding discharges from hospital that are being achieved.’

Traditionally bed occupancy levels are measured at 12 noon and midnight, he explained.

Bed numbers fluctuate during the course of the day - for example, day-case beds are not available at night and so the number of beds available at night will be fewer than those available during the day.

Medical beds have the highest occupancy levels, as would be expected in any acute hospital.

This is because the vast majority of patients admitted into medical beds are emergency patients, many of whom will require longer stays in hospital.

Surgical beds, on the other hand, while supporting emergency admissions, have a larger proportion of elective or planned admissions that have predictable shorter lengths of stay, said Mr Ashford.

Figures released in the written reply show that in 2015-16 there was an average of 120,221 beds available across Noble’s at midday, of which 79,367 were occupied.

In 2018-19, up to December 4, there was an average of 78,547 beds available at mid-day across the hospital, of which 48,751 were occupied.

Average midday occupancy was 66.2% in 2015-16 and it was 62.1 % last year - so about third of bed capacity is available.

The same has been true for midnight occupancy over the last three or so years.

Over the last three full years, the average occupancy across the medical wards at midday is 89% and 86.7% at midnight.

Mr Ashford said there is no capacity limit in the Accident and Emergency department given the ever-moving flow of patients.

There will be peaks and troughs in attendance and bottlenecks may occur on occasion, he said.

Attendances of more than 100 a day are considered to be higher than expected. Of the 1,344 days covered in the Tynwald question, 239 days (18%) saw attendances greater than 100.