ABSTRACT
Increasing numbers of admissions with a concomitant decrease in length of stay in the ICU have been reported (Mitchell et al. 1995). Occupancy rates have been described as very high. The shortage of available ICU beds in London, UK, and elsewhere (Mitchell et al. 1995) has been detailed and a wide variation in provision of facilities has been recorded (Smith et al. 1995; Metcalfe et al. 1997). Cancelled operations due to the lack of available ICU beds (Smith et al. 1995) and high rates of refused admissions have been reported, both regionally (Working Party 1994) and nationally (Metcalfe et al. 1997). The transfer of patients over long distances in search of an ICU bed has also been reported (Bion 1995; Chadda 1995) and the potential dangers of transferring critically ill patients has been highlighted (Bion 1995). Premature discharge of patients has been described (Ryan et al. 1997; McQuillan et al. 1998).
