NHS activity and capacity during the coronavirus (COVID-19) pandemic: 14 July 2022

In response to the coronavirus (COVID-19) pandemic, daily information on health care has been produced to support transparency and understanding of the NHS activity and capacity. The release includes figures on invasive ventilated beds by use, and admissions and hospitalisations of COVID-19 related patients.

• In the last 7 days, an average of 23 people a day were admitted to hospital with confirmed or suspected COVID-19. This is an increase compared to the average of 19 for the week to 5 July 2022 and is at comparable levels to late August 2021.
• As of 12 July 2022, 1,104 beds were occupied with COVID-19 related patients (confirmed, suspected and recovering), representing 12.5% of all hospitalisations. This is an increase from 916 on 5 July 2022 (10.2% of all hospitalisations) and is at comparable levels to late January 2022.
• The number of beds occupied with COVID-19 related patients (confirmed, suspected and recovering) fluctuates. The number of COVID-19 related patients has increased by 188 over the latest week. This was due to an increase in confirmed (85 more occupied beds), recovering patients (94 more occupied beds) and in suspected patient (9 more occupied beds).
• As of 12 July 2022, 611 beds in acute hospitals were occupied with patients with confirmed COVID-19 and 88 (14.4%) of these patients were actively treated for COVID-19.
• As of 12 July 2022, 16 invasive ventilated beds were occupied with COVID-19 related patients (confirmed and suspected). This compares to 16 invasive ventilated beds on 5 July 2022 and is at comparable levels to early-February 2021.
• In the latest week, the number of beds occupied with COVID-19 related patients has increased to the highest level since early-May 2022, although the number of invasive ventilated beds occupied with COVID-19 related patients remains similar to the levels seen in early-May 2022.

In line with the principles of the transition from pandemic to endemic, we are continuing to review our regular statistical reporting on COVID-19. As part of this, we are considering the ongoing need to publish this monthly report, though the data behind it would continue to be available on StatsWales. We would welcome any views from users. If you would like to feed into this review please email KAS.COVID19@gov.wales with the subject line ‘COVID-19 NHS statistics’.

Statistics on NHS staff absence are also available on StatsWales.

The data are taken from management information and are subject to change. They have not been subject to the same validation processes undertaken for official statistics releases. Where available, the official statistics should continue to be considered the authoritative source of data. Please see the Chief Statistician’s blog for more information on reporting management information, data quality and transparency.

This section covers the number of admissions and hospitalisations of COVID-19 related patients and invasive ventilated beds occupied with COVID-19 related patients, to support transparency and provide an understanding of NHS activity and capacity during the COVID-19 pandemic.

Hospital coverage has changed over time, please see the quality and methodology information section for more information.

Hospital admissions

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NHS hospital admissions by date and patient type (StatsWales)

Notes

Admissions are the number of patients admitted to hospital within a 24-hour period from midnight to midnight each day, for example, 00:00 to 23:59 Monday to be reported on a Tuesday. COVID-19 related admissions include COVID-19 suspected or confirmed patients.

Please see the quality and methodology information section for the complete set of notes and historical changes relating to admission figures.

Main points

• The number of new daily admissions with suspected or confirmed COVID-19 fluctuates. Taking that into account, the 7 day rolling average generally decreased from January 2021 to June 2021, before increasing again until mid-September 2021. After a period of fluctuation, the average generally decreased between November 2021 and late December 2021.
• In 2022 admissions have continued to fluctuate, with increases in January, March and June.
• In the last 7 days, an average of 23 people a day were admitted to hospital with confirmed or suspected COVID-19. This is an increase compared to the average of 19 for the week to 5 July.

Hospitalisations

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NHS hospitalisations by date and patient type (StatsWales)

Notes

Recovering patients was a category introduced on 26 May 2020 to capture patients who were COVID-19 positive in hospital and who showed no symptoms for 14+ days but remained in hospital on a COVID-19 treatment pathway, often for rehabilitation. There have been some differences in reporting by health boards in the time series which are outlined in more detail in the quality and methodology information section.

Please see the Chief Statistician’s blog for more information on reporting on recovering patients.

Please see the quality and methodology information section for the complete set of notes and historical changes relating to hospitalisation figures.

Main points

• The total number of beds occupied with COVID-19 related patients (confirmed, suspected and recovering) increased from the end of September 2020 and reached its highest reported level on 12 January 2021 (2,879 patients). From January 2021 to June 2021, COVID-19 related patients generally decreased and reached the lowest reported levels on 30 June 2021 and 4 July 2021 at 86 patients.
• Numbers have fluctuated over the past year and have recently seen a sharp increase.
• The number of confirmed COVID-19 patients and the number of recovering COVID-19 patients peaked at different times; with highest numbers of confirmed patients occurring early in January 2021 (1,643 on 4 January 2021) and highest numbers of recovering patients seen a few weeks later (1,192 on 31 January 2021).

As at 12 June 2022

• 1,104 beds were occupied with COVID-19 related patients (confirmed, suspected and recovering), representing 12.5% of all hospitalisations. Of these, 713 were confirmed COVID-19 patients, 27 were suspected COVID-19 patients and 364 were recovering patients. This is an increase from 916 on 5 July 2022 (10.2% of all hospitalisations) and is at comparable levels to late January 2021.
• The number of beds occupied with COVID-19 related patients (confirmed, suspected and recovering) fluctuates. The number of COVID-19 related patients has increased by 188 over the latest week. This was due to a increase in confirmed (85 more occupied beds), recovering patients (94 more occupied beds) and in suspected patient (9 more occupied beds).

Invasive ventilated beds

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NHS beds by date and use (StatsWales)

Notes

Baseline relates to the number of beds that were available prior to the COVID-19 pandemic. There are usually 152 critical care beds available. Invasive ventilated beds include beds in and outside a critical care setting, and include surge capacity. COVID-19 patients in this chart include suspected, confirmed, and recovering COVID-19 patients. Between 26 May 2020 and 17 January 2021 some patients were categorised as ‘recovering’. From 18 January 2021 these patients were categorised as confirmed COVID-19 patients. This change did not affect the overall number of COVID-19 related patients.

Please see the quality and methodology information section for the complete set of notes and historical changes relating to the invasive ventilated beds figures.

Main points

• The number of invasive ventilated beds occupied with COVID-19 related patients generally increased from September 2020, reaching 150 on 12 January 2021. After this, the number decreased to its lowest levels since reporting began. Only 1 occupied invasive bed was reported for several days during May 2021 and June 2021.
• From late June 2021 to mid-September 2021, the number of invasive beds occupied with COVID-19 related patients increased to levels comparable to late February 2021. Despite daily fluctuations, the number of occupied invasive ventilated beds generally decreased from early November 2021 to late December 2021. Following a period of stabilisation, the number continued to decrease to levels seen in mid-July 2021.

As at 12 June 2022

• 16 invasive ventilated beds were occupied with COVID-19 related patients (confirmed and suspected). This compares to 16 occupied beds on 5 July 2022.
• 164 invasive ventilated beds were occupied with non-COVID-19 related patients. This is 8 fewer beds compared to 172 occupied beds on 5 July 2022.
• There were 47 vacant invasive ventilated beds that could be staffed. This is 3 more beds compared to 44 vacant beds on 5 July 2022.

Information on healthcare presented in the UK Government COVID-19 dashboard and in the Public Health Wales (PHW) dashboard differ from this publication. Please see the quality and methodology information section and the comparability with other publications section for more information.

COVID-19 patients actively treated for COVID-19

Main points

• Since reporting began on 17 January 2022, the number of patients with confirmed COVID-19 and the number of patients treated for COVID-19 generally decreased until early March 2022. In late March 2022 there was an increase in the number of patients with confirmed COVID-19; however this number has decreased until June 2022. This figure has increased in recent weeks. The percentage of patients treated for COVID-19 in acute hospitals has generally decreased since reporting began.
• The percentage of patients treated for COVID-19 in critical care beds is markedly higher than the percentage treated for COVID-19 in general and acute beds. Since reporting began, the percentage of patients treated for COVID-19 in critical care beds has ranged between 33.3% and 100%, while for general and acute beds the percentage has ranged between 6.9% and 44.9%.

As at 12 June 2022

• 611 beds in acute hospitals were occupied with patients with confirmed COVID-19 and 88 (14.4%) of these patients were actively treated for COVID-19.
• 15 critical care beds in acute hospitals were occupied with patients with confirmed COVID-19 and 10 (66.7%) of these patients were actively treated for COVID-19.

Notes

This is a new data collection. Health boards have been asked to categorise inpatients with confirmed COVID-19 according to whether or not they are actively being treated for COVID-19. Patients not actively being treated for COVID-19 are those where the infection is incidental to the main cause for their hospitalisation.

There is no standard definition for ‘actively being treated for COVID-19’ and there are some differences across Health Boards and settings in the methods used to make the decision. Work to understand the quality and consistency of the data is ongoing, but the figures are considered to be suitable for providing a high level estimate.

The data are taken from management information and are subject to change. They have not been subject to the same validation processes undertaken for official statistics releases. However, they are provided to support transparency and understanding of NHS activity at this time. The official statistics should continue to be considered the authoritative source of data.

Historic data are subject to revisions and therefore may differ slightly to previously published information.

Hospital activity and capacity

The health minister announced on 13 March 2020 that all non-urgent activity should stop to prepare for the pandemic.

Following further validation, admissions and hospitalisation data prior to 1 April 2020 were decided to not be suitable for publication. Therefore, the time series begins on 1 April 2020.

Figures on hospitalisations and activity include data from acute hospitals from 1 April 2020, field hospitals from 20 April 2020, community hospitals from 23 April 2020, mental health units from 10 July 2020, and exclude data from private hospitals.

Hospital admissions

Admissions are the number of patients admitted to hospital within a 24-hour period from midnight to midnight each day, for example, 00:00 to 23:59 Monday to be reported on a Tuesday. COVID-19 related admissions include COVID-19 suspected or confirmed patients.

A COVID-19 related admission is defined as an emergency admission to any medical specialty and is either:

• within 14 days of a positive COVID-19 sample being taken; or
• where a COVID-19 sample is taken on the first day of the admission, regardless of whether the result is positive or negative

The emergency medical admissions criteria are intended to provide an approximation for suspected COVID-19 patients.  

Patients transferred between hospitals within the same organisation should be excluded from the count of admissions.

Please note that during July 2021, August 2021 and October 2021 Betsi Cadwaladr University Health Board were unable to supply data on the number of patients admitted to Ysbyty Glan Clwyd due to a data processing issue. For the specific dates please see the note on StatsWales.

From 3 July 2020, guidance was updated to only include emergency admissions in the COVID-19 related admissions figures.

From 29 June 2020, the guidance changed to explicitly ask health boards to exclude transfers between acute and community hospitals from admissions figures. Prior to this, some transfers may have been captured as new admissions.

From 29 June 2020, patients admitted for elective procedures were only included in COVID-19 related admissions if they received a positive COVID-19 test result on arrival at the hospital.

Following the re-introduction of elective procedures from June 2020, patients admitted for elective procedures suspected of having COVID-19 were initially captured in COVID-19 related admissions, even if they received a negative test later. This inflated the numbers of suspected cases in hospital at the time of reporting.

Hospitalisations

The number of COVID-19 related hospitalisations is the number of staffed beds occupied by a patient that satisfies the definition of a ‘Confirmed’, ‘Suspected’ or ‘Recovering’ patient as set out below.

A patient is defined as ‘Confirmed’ COVID-19 only following a positive test and will remain until downgrading criteria are met. (See recovering COVID-19 below).

A patient is defined as ‘Suspected’ COVID-19 if they are awaiting the result of a test having been admitted as an emergency under a medical specialty or if they become symptomatic following admission for any other reason. This also includes patients testing negative but continuing to display COVID-19 symptoms, patients returning a low level positive test result prior to a retest, and discharged COVID-19 patients readmitted with COVID-19 symptoms prior to a retest.

A patient is defined as ‘Recovering’ COVID-19 if either they have a negative test result as confirmation of transition to recovering COVID or they meet the following criteria:

• completed 10 days post a positive COVID-19 test
• shown clinical improvement in their condition, with at least some respiratory recovery
• had no fever (> 37.8°C) for 48 hours
• no underlying severe immunosuppression

A ‘Non-COVID-19’ related patient is a patient that does not satisfy any of the suspected, confirmed or recovering COVID-19 criteria described above. Where a patient has acquired a COVID-19 infection during their hospital stay and subsequently meets the downgrading criteria set out above, they should be reported as non-COVID-19.

From 24 March 2022, health boards implemented the updated COVID-19 testing guidance across the hospital estate. All patients will continue to be tested on admission. However, patients who remain asymptomatic during their stay, no longer require a test. This means that a number of incidental / nosocomial cases will no longer be captured, and this will have an impact on the figures reported.

Some health boards had incorrectly classified some patients as recovering from COVID-19 rather than as non-COVID patients. These were confirmed COVID-19 patients who had not been actively treated for COVID-19 and had completed 10 days post a positive COVID-19 test. This resulted in a larger number of patients classified as recovering than should have been the case. From 16 February 2022, guidance was reiterated to resolve this, which resulted in a significant fall in patients recovering from COVID-19 and a corresponding increase in non-COVID patients.

From 18 January 2022, to ensure accurate and consistent reporting of recovering COVID-19 patients, guidance for SITREP reporting was reissued amongst health boards. Health boards were asked to ensure that the downgrading criterion was changed from the patient requiring 14 days post a positive COVID-19 test to requiring 10 days.

To ensure accurate and consistent reporting of COVID-19 recovering patients in the hospitalisations data, all health boards were reminded to follow the national guidance for SITREP reporting, and asked to ensure any necessary changes to their daily reporting were implemented by 12 April 2021. Contrary to the guidance, some health boards were counting long stay patients who had fully recovered from COVID-19 in the COVID-19 recovering category, rather than the non-COVID-19 category, which inflated the number of COVID-19 recovering patients. This change resulted in a step-change decrease in the number of recovering patients (a decrease of around 123 patients at the point of implementation). Whilst the impact was seen across most health boards, it mainly impacted the Swansea Bay University Health Board.

From 8 March 2021, Cardiff and Vale University health board aligned their data more closely to the national guidance for SITREP reporting. This change had a small impact on the hospitalisation figures, which resulted in a small increase in the number of confirmed COVID-19 patients and a small decrease in the number of recovering COVID-19 patients.

From 1 February 2021, guidance was reiterated to health boards that patients who were already in hospital and contracted COVID-19, but have now recovered and are back on their original setting, should be reported as non-COVID-19. This may have affected a small number of patients who were in acute hospitals or mental health settings and may have resulted in a decrease in recovering patients and an increase in non-COVID-19 patients.

From 16 November 2020, data is included from the Grange University Hospital in Aneurin Bevan University Health board. This increased the total number of beds available by around 450 beds.

Data from mental health units were included retroactively from 10 July 2020 for the first time in the release on 20 August 2020. The inclusion of mental health beds had a small impact on beds occupied with COVID-19 patients’ figures but a large impact on all beds occupied with non-COVID19 patients and vacant beds, as the majority of mental health beds are not occupied by COVID-19 patients. Mental health units’ data are submitted each Friday, and the Friday position is used as proxy for the following week, unless there is a major change in circumstances.

Recovering patients was a category introduced on 26 May 2020 to capture patients who were COVID-19 positive in hospital and who showed no symptoms for 14+ days but remained in hospital on a COVID-19 treatment pathway, often for rehabilitation. There have been some differences in reporting by health boards in the time series which are outlined below.

Please see the Chief Statistician’s blog for more information on reporting on recovering patients.

On reporting recovering patients, Aneurin Bevan started reporting recovering patients from 7 June 2020, but these were captured in the confirmed COVID-19 category before. Cardiff and Vale classified recovering patients as non-COVID-19 patients between 1 May 2020 and 22 May 2020. Following the change in guidance, Cardiff and Vale re-categorised these patients as COVID-19 patients, capturing them in the confirmed COVID-19 category until the recovering category was introduced on 26 May 2020.

From June 2020, hospitals began closing some of the additional surge capacity that was previously put in place for the COVID-19 pandemic.

Invasive ventilated beds

From 18 January 2021, no patients occupying an invasive ventilated bed (critical care bed) should be counted as ‘recovering’ COVID-19 patients as they are still requiring a high level of care. Any patient previously reported as ‘recovering’ are now counted under ‘confirmed’. This resulted in an increase in the number of invasive ventilated beds occupied by ‘confirmed’ COVID-19 patients (an increase of around 14 patients at the point of implementation) and no invasive ventilated beds showing as occupied by ‘recovering’ patients. This change had no impact on the total number of COVID-19 related patients.

From 13 November 2020, only critical care beds that could be staffed were included as available. Previously all critical care beds had been included regardless of whether they could be staffed. Staffed beds are those that can be staffed at the time of the census. General and acute beds only include beds that can be staffed. However, not all health boards implemented this change on that date. Following and update to guidance, more local health boards implemented this change from 4 December 2020.

From 19 October 2020, data for specialist critical care beds (such as those in Burns and Plastic in Morriston) and other specialist acute beds (such as maternity) across other acute sites have been included. These beds have been included in the data as they are part of the available bed stock, and may be used for COVID-19 patients in exceptional circumstances. The majority of these beds are not occupied with COVID-19 patients. Therefore the inclusion of these had very little impact on the number of beds occupied with COVID-19 patients but a larger impact on vacant beds and those occupied with non-COVID19 patients.

Comparability

Please see the UK Government COVID-19 dashboard for information on healthcare at a UK level. Note: the healthcare data presented in the UK dashboard differs from this publication. Data for Wales on the UK dashboard includes data for acute hospitals only which was initially provided to enable better comparability with other countries. Whereas this publication includes data from acute, community, field hospitals and mental health units to provide a more comprehensive view of the system in Wales. From 11 December 2020, data for England presented on the UK dashboard was updated to align with NHS England publications and as a result the full time series for this item was revised. Data for England on the UK dashboard now includes data from acute, community, field hospitals and mental health units. Due to this reporting change, we are reviewing the suitability of data currently provided for Wales. Estimates of the number of people who had coronavirus in England and Wales is also published by the Office for National Statistics in Coronavirus (COVID-19) Infection Survey.

Please note that health care surveillance data presented in the Public Health Wales (PHW) dashboard differ from this publication. The PHW dashboard uses data systematically collected through ICNET, the hospital infection control data system used across Wales. It includes hospital in-patients with a laboratory confirmed result and does not count any patients who were admitted and discharged on the same day.

The Welsh Government publication uses data sourced from daily management information provided by health boards. Guidance was issued to local health boards for completion and submission of the data return. However, data collection methods may vary between health boards. It includes COVID-19 related patients as suspected, confirmed and recovering, as well as non-COVID-19 patients.

The narrower definition used by PHW will likely result in smaller numbers of reported COVID-related admissions compared to the Welsh Government publication, but provides a systematic way of carrying out surveillance of patients requiring hospital stays with confirmed COVID-19.

National Statistics status

These statistics are not National Statistics. However, as far as has been practicable, they have been collected and validated in accordance with the pillars and principles within the Code of Practice for Statistics. We continue to develop the data collection and quality assurance process to improve the data.

These statistics have been produced quickly in response to developing world events.

Well-being of Future Generations Act (WFG)

The Well-being of Future Generations Act 2015 is about improving the social, economic, environmental and cultural wellbeing of Wales. The Act puts in place seven wellbeing goals for Wales. These are for a more equal, prosperous, resilient, healthier and globally responsible Wales, with cohesive communities and a vibrant culture and thriving Welsh language. Under section (10)(1) of the Act, the Welsh Ministers must (a) publish indicators (“national indicators”) that must be applied for the purpose of measuring progress towards the achievement of the wellbeing goals, and (b) lay a copy of the national indicators before Senedd Cymru. Under section 10(8) of the Well-being of Future Generations Act, where the Welsh Ministers revise the national indicators, they must as soon as reasonably practicable (a) publish the indicators as revised and (b) lay a copy of them before the Senedd. These national indicators were laid before the Senedd in 2021. The indicators laid on 14 December 2021 replace the set laid on 16 March 2016.

Information on the indicators, along with narratives for each of the wellbeing goals and associated technical information is available in the Wellbeing of Wales report.

Further information on the Well-being of Future Generations (Wales) Act 2015.

The statistics included in this release could also provide supporting narrative to the national indicators and be used by public services boards in relation to their local wellbeing assessments and local wellbeing plans.

In line with the principles of the transition from pandemic to endemic, we are continuing to review our regular statistical reporting on COVID-19. As part of this, we are considering the ongoing need to publish this monthly report, though the data behind it would continue to be available on StatsWales. We would welcome any views from users. If you would like to feed into this review please email KAS.COVID19@gov.wales with the subject line ‘COVID-19 NHS statistics’.

For queries about the data:
Statistician: Ryan Pike
Email: kas.covid19@gov.wales

Media: 0300 025 8099

SFR 171/2022