Challen Kirsty, Walter Darren
Emergency Department, South Manchester University Hospitals Trust, Manchester M23 9LT, UK.
BMC Public Health. 2006 Apr 26;6:108. doi: 10.1186/1471-2458-6-108.
Since October 2002 in the UK Primary Care Trusts (PCTs) have had statutory responsibility for having and maintaining a Major Incident plan and since 2005 they have been obliged to co-operate with other responders to an incident. We aimed to establish the number of beds in our Trust which could be freed up over set periods of time in the event of a major incident and the nature and quantity of support which might be required from PCTs in order to achieve this.
Repeated survey over 12 days in 3 months of hospital bed occupancy by type of condition and discharge capacity in an 855-bed UK tertiary teaching hospital also providing secondary care services. Outcome measures were bed spaces which could be generated, timescale over which this could happen and level and type of PCT support which would be required to achieve this.
Mean beds available were 78 immediately, a further 69 in 1-4 hours and a further 155 in 4-12 hours, generating a total of 302 beds (36% of hospital capacity) within 12 hours of an incident. This would require support from a PCT of 150,000 population of 10 nursing care beds, 20 therapy-supported intermediate care beds, and 25 care packages in patients' own homes.
In order to fulfill the requirements of the Civil Contingencies Act 2004, PCTs should plan to have surge capacity in the order of 30 residential placements and 25 community support packages per 150,000 population to support Acute Trusts in the event of a major incident.
自2002年10月起，英国初级保健信托机构（PCTs）就承担了制定和维护重大事件计划的法定责任，自2005年起，它们必须与其他事件响应方合作。我们旨在确定本信托机构在发生重大事件时，在规定时间段内可腾出的病床数量，以及为实现这一目标PCTs可能需要提供的支持的性质和数量。
在一家拥有855张床位、提供二级护理服务的英国三级教学医院，对3个月内连续12天按病情类型和出院能力统计的医院床位占用情况进行重复调查。结果指标包括可腾出的床位空间、实现这一目标所需的时间尺度以及实现这一目标所需的PCTs支持的水平和类型。
事件发生后立即平均有78张可用床位，1 - 4小时内可增加69张，4 - 12小时内可再增加155张，在12小时内总共可腾出302张床位（占医院床位容量的36%）。这需要一个服务15万人口的PCTs提供支持，包括10张护理床位、20张有治疗支持的中级护理床位以及25个患者家中护理包。
为了满足2004年《民事突发事件法案》的要求，PCTs应计划每15万人口具备约30个住院安置床位和25个社区支持包的应急能力，以便在发生重大事件时支持急症信托机构。
