Because hospital beds are economically scarce resources, there is naturally pressure to ensure high occupancy rates and therefore a minimal buffer of empty beds. However, because the volume of emergency admissions is unpredictable, hospitals with average occupancy levels above 85 per cent "can expect to have regular bed shortages and periodic bed crises."[3][4]
Shortage of beds can result in cancellations of admissions for planned (elective) surgery, admission to inappropriate wards (medical vs. surgical, male vs. female etc.), delay admitting emergency patients,[5] and transfers of existing inpatients between wards, which "will add a day to a patient’s length of stay".[1]
These can be politically sensitive issues in publicly funded healthcare systems. In the UK there has been concern over inaccurate and sometimes fraudulently manipulated waiting list statistics,[6] and claims that "the current A&E target is simply not achievable without the employment of dubious management tactics."[7] In 2013 two Stafford Hospital nurses were struck off the nursing register for falsifying A&E discharge times between 2000 and 2010 to avoid breaches of four-hour waiting targets.[8]