Critical analysis of access to and availability of intensive care

In intensive care, there appears to be an ever-increasing demand for resources and it is widely recognized that there is often a shortage of vacant beds available, compounded by an inadequate level of appropriately qualified nursing staff. Either of these deficiencies may lead to delayed or even refused admission for a patient who is critically ill. This review of the literature contains examination of the access and availability of intensive care facilities within the National Health Service and discussion of the problems that arise in gaining admission to such facilities. Being refused admission to the local intensive care unit may have important implications for a critically ill patient, resulting in transfer to another hospital, perhaps many miles away, or inadequate treatment and care in a general ward. These issues are also examined and strategies for action are proposed.