How prevalent are bed sores and how much are they costing the NHS?

Unfortunately, hospitals around the UK continue to experience unsafe levels of bed shortages due to the backlog caused by the COVID pandemic¹, demonstrating that it is more important than ever that we put our health first.

From home hospital beds to adjustable beds and riser recliner chairs, our comfort can come in all different shapes and sizes depending on our medical needs. It is no secret that beds are essential for our health and well-being, but if we are too inactive, this can lead to health problems. Pressure ulcers, also known as bed sores, are damage to the skin caused by prolonged pressure and are often acquired when people with reduced mobility sit for too long.

While anyone can develop bed sores, hospital patients are at greater risk due to the nature of their environment. Pressure sores are exacerbating the pressure of hospital stays, but at what rate? Using data from NHS hospitals across England, we can reveal this and the financial burdens that pressure sores are causing in hospitals.

Key Findings

• Bed sores have cost the NHS £34.8 million over the last two years.

• Rotherham Doncaster and South Humber NHS Foundation Trust have seen the highest number of patients develop pressure sores during their hospital stay.

• 39% of all NHS Trusts in England have avoided any reports of patients developing bed sores over the last year.

• Since last year, Doncaster and Bassetlaw Teaching Hospitals NHS Foundation Trust have seen triple the number of patients developing bed sores during hospital stays.

• More than 87% of all NHS Trusts have seen a reduction in bed sore cases between 2022-23 and 2023-24.

• Liverpool Women's NHS Foundation Trust and University Hospitals Sussex NHS Foundation Trust saw the biggest decrease in patients developing pressure sores during their hospital stay.

No NHS Trust has seen a bigger proportion of bed sores than Rotherham Doncaster and South Humber

While roughly 39% of all NHS Trusts in England have avoided any reports of patients developing bed sores over the last year, there have still been 3,265 cases of acquired pressure sores during hospital stays across the country during this time.1. Rotherham Doncaster And South Humber NHS Foundation Trust - 3.58% of patients

Rotherham Doncaster and South Humber NHS Foundation Trust have seen the highest number of patients develop pressure sores during their hospital stay, totalling 3.58% of all patients over the last year. This NHS Trust offers a range of services for older people, a demographic more at risk of developing a pressure ulcer due to lowered mobility.

Next on this list is the Lincolnshire Community Health Services NHS Trust. Of the 1,685 hospital admissions in the last year, just over 1% of the patients across this NHS Trust’s four community hospitals have developed a form of pressure ulcer during their stay.

3. George Eliot Hospital NHS Trust - 0.31% of patients

The George Eliot Hospital NHS Trust provides a range of medical services to the residents of Nuneaton, England. This organisation has received 165 reports of patients developing pressure sores during their hospital stay. While this figure is the highest of all the entries in this top three, it is worth noting that it only equates to 0.31% of this Trust’s total hospital admissions.

Doncaster and Bassetlaw Teaching Hospitals have seen the biggest increase in bed sores since 2022

1. Doncaster And Bassetlaw Teaching Hospitals NHS Foundation Trust - 200% increase

Since 2022, the Doncaster and Bassetlaw Teaching Hospitals NHS Foundation Trust have seen triple the number of patients developing bed sores during hospital stays. This figure is based on a change in pressure sore cases from just 10 in 2022-23 to 30 between 2023-24.

2. The Princess Alexandra Hospital NHS Trust - 100% increase

Like the first-place entry, the Princess Alexandra Hospital NHS Trust has also seen 30 reports of patients developing pressure sores during their hospital stay in the last year. However, this has doubled compared to the previous year, the second-highest change in this ranking.

3. Buckinghamshire Healthcare NHS Trust - 50% increase

This ranking is completed by the Buckinghamshire Healthcare NHS Trust, which has seen a 50% increase in patients developing bed sores during their stay. This group of hospitals has recorded 15 cases of bed sores in the last year, a figure which would free up hospital beds if reduced.

Hospitals in Liverpool and Sussex have seen a 100% decrease in the number of reported bed sores

The number of bed sores across hospitals in England has decreased over recent years, with more than 87% of all NHS Trusts having seen a reduction in cases between 2022-23 and 2023-24. Furthermore, the decline in bed sore reports during hospital stays across England has been significant, averaging nearly 59% nationwide.

 1. Liverpool Women's NHS Foundation Trust and

University Hospitals Sussex NHS Foundation Trust - 100% decrease

From immobile mothers in maternity wards to very ill patients in intensive care, Liverpool Women's NHS Foundation Trust and University Hospitals Sussex NHS Foundation Trust encounter patients at a high risk of developing pressure sores. Despite this, according to the most recent data, both Trusts have eradicated any reports of patients developing bed sores.

3. Royal Berkshire NHS Foundation Trust - 89.29% decrease

Although recent data shows that Royal Berkshire NHS Foundation Trust has still experienced cases of patients developing bed sores in the last year, it is undoubtedly heading in the right direction regarding the strain on hospital beds. When comparing the data from 2022-23 to that of 2023-24, this Foundation Trust has reduced its reports of bed sores by more than 89%.

Bed sores are costing Liverpool University Hospitals more on average than any other NHS Trust

Unfortunately, some cases of pressure sore developments during hospital stays are serious enough to warrant legal action, which has been the case in 503 instances between 2022-23 and 2023-24. When considering damages paid and legal costs, bed sores have cost the NHS £34.8 million over the last two years.

1. Liverpool University Hospitals NHS Foundation Trust - £140,727 per case

Since 2022, the Liverpool University Hospitals NHS Foundation Trust has paid more than £315,500 in damages to bed sore-related cases across the hospital. This, combined with legal fees, has cost the Trust £844,364 in total expenses, which equates to almost £141,000 per case.

2. George Eliot Hospital NHS Trust - £136,403 per case

Although the George Eliot Hospital NHS Trust has only had five litigation cases relating to bed sores since 2022, it appears second in this ranking. When considering factors such as the damages paid and legal costs, each case has cost the Trust an average of £136,000.

3. Sheffield Teaching Hospitals NHS Foundation Trust - £115,819 per case

Sheffield Teaching Hospitals NHS Foundation Trust completes this ranking, with an average cost of £115,819 per bed sore case. Despite appearing third on this list, it is worth noting that bed sores cost this NHS Trust more money than any other in terms of the damages paid and total cost, equating to £631,000 and more than £1.3 million, respectively.

North Middlesex University Hospital NHS Trust is experiencing the largest bed shortage in England

Data across England shows that hospital beds were 89% occupied between April and June of 2024, placing strain on hospitals and medical staff across the country.

1. North Middlesex University Hospital NHS Trust - 99.6% bed occupancy

North Middlesex University Hospital has been revealed as having the fewest number of hospital beds available across the general and acute, learning disabilities, maternity, and mental illness sectors. According to April and June 2024 figures, this NHS Trust only had two spare beds across the above sectors, equating to a 99.6% bed occupancy.

2. George Eliot Hospital NHS Trust - 99% bed occupancy

In addition to reports of patients developing bed sores, the George Eliot Hospital NHS Trust has also been dealing with a hospital bed shortage. When broken down by sector, this hospital’s maternity ward beds were 100% occupied between April and June 2024, contributing to the Trust’s average 99% bed occupancy rate.

3. University Hospitals Birmingham NHS Foundation Trust - 98% bed occupancy

Located in one of the most populated UK cities, it may be unsurprising that University Hospitals Birmingham NHS Foundation Trust has the most extensive number of beds available across the general and acute, learning disabilities, maternity, and mental illness sectors. According to data between April and June 2024, this Trust has also seen one of the most significant bed occupancy rates, totalling 98%.

The residents of Manchester are searching about bed sores than any other in the UK

1. Manchester - 1,821 Google searches per 100,000 residents

Whether it is the prevention, causes, or treatment of bed sores, the residents of Manchester appear keen to learn more as they top this ranking. In the last year alone, this northwestern city has made 10,560 bed sore-related Google searches, which equates to 1,821 per 100,000 residents.

2. Liverpool - 1,769 Google searches per 100,000 residents

From one northwest city to another, Liverpool appears next on this list. When considering the city’s population, Liverpool’s residents have the second-highest search rate for terms relating to bed sores, totalling 1,769 searches per 100,000 residents.

3. Newcastle upon Tyne - 1,724 Google searches per 100,000 residents

The Newcastle Hospitals NHS Foundation Trust has been vocal about its dedication to preventing bed sores where it can³. Their attempts to raise awareness are paying off, as this city has the third-highest number of Google searches around the topic, totalling 1,724 per 100,000 residents.

Plymouth has seen the biggest surge in bed sore-related searches over the last year, increasing by almost 35%

1. Plymouth - 34.94% increase

The Devonshire city of Plymouth saw a 34.94% increase in bed sore-related Google searches between 2022 and 2024. From the University Hospitals Plymouth NHS Trust to Livewell Southwest, many local medical services provide helpful information online about managing and preventing pressure sores.

2. Newcastle upon Tyne - 26.29% increase

Next on this ranking, with a 26.29% increase in searches, is Newcastle upon Tyne. The number of elderly residents in this city has increased in recent years⁴, which could account for the rise in bed sore-related Google searches as this demographic is more at risk of developing pressure ulcers.

3. Liverpool - 24.09% increase

After being revealed as having the second-highest Google search rate for bed sores in the UK, it may be unsurprising to see the city of Liverpool feature here, too. From 7,180 searches for information about the medical condition in 2022-23, this number has increased by more than 24% in the last year.

Methodology

A Freedom of Information (FOI) request was used to find the number of hospital admissions and patients who developed pressure sores during their hospital stay for 2022-23 and 2023-24. This request was sent to NHS England and was broken down by NHS Trust.

Note that data wasn’t provided for any trusts with fewer than eight cases, although figures for these trusts are included in overall totals.

To calculate the percentage of patients who developed pressure sores during their hospital stay, we divided the number of patients who developed pressure sores by the total number of hospital admissions.

We subtracted the number of patients who developed pressure sores during their hospital stay in 2023-24 by the 2022-23 figure before dividing this by the 2022-23 total to find the change in patients developing pressure sores during hospital stays for each NHS Trust.

A separate FOI request was sent to determine the number of litigation cases involving pressure sores and the associated costs between 2022-23 and 2023-24. We divided the total costs paid for litigation cases by the number of reported cases to find the average cost per case for each NHS Trust.

Note that data wasn’t provided for any trusts with fewer than five cases for this request, although figures for these trusts are included in overall totals.

We used NHS England to find the number of available beds, number of occupied beds, and percentage of beds occupied for the following sectors as of June 2024: General and Acute, Learning Disabilities, Maternity, and Mental Illness. We added these totals for each sector to give each Trust an average percentage of occupied beds.

We created a seeding list of the UK's most populated cities/ towns. We used Google Ads Keyword Planner to find the total number of Google searches for terms relating to pressure sores between November 2023 and October 2024 and the year-on-year change in Google searches.

We divided the total number of searches by each area’s population and multiplied this by 100,000 to calculate the number of Google searches per 100,000 residents.

Additional sources:

1. https://rcem.ac.uk/hospitals-remain-at-unsafe-levels-of-bed-occupancy-as-one-in-nine-faced-12-hour-waits-in-aes-in-december/#:~:text=11%20January%202024,bed%20occupancy%20down%20to%2085%25.
2. https://www.leicestershospitals.nhs.uk/aboutus/departments-services/
3. https://www.newcastle-hospitals.nhs.uk/home/nmahps/our-strategy/improve-quality/tissue-viability/#:~:text=The%20Newcastle%20Hospitals%20is%20dedicated,ulceration%20can%20sometimes%20be%20prevented.
4. https://www.ons.gov.uk/visualisations/censusareachanges/E08000021/