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Procure bed frames for use in medical or surgical hospital wards with the following features as standard:
a design that prevents patient migration (sliding down the bed)
can be adjusted to a low height position
an ergonomic brake system
steering assistance (for example, a fifth wheel or double-bogie castor configuration).
Do not pay more for bed frames for use in medical or surgical hospital wards simply because they have any of the following features:
turn assistance (for turning or repositioning the patient)
power drive (motorised to assist with moving the bed)
connectivity (between the bed and other systems or appliances).
There is not enough evidence to determine whether price variations between bed frames for use in medical or surgical hospital wards because of in-built weighing scales or bed exit alarms are justified.
Procure the most appropriate bed frames for use in medical or surgical hospital wards, accounting for:
the preferences of the multidisciplinary teams using the bed frames
full life-cycle costs of the bed frames (including the cost of repair and maintenance)
response and turnaround time for repair
compatibility with existing accessories and fixtures (such as hoists and mattresses) within the local trust
staff training needs
whether the bed frames have features to reduce injuries to the person using the bed, patient infections and patient falls
lifespan and obsolescence of the bed frames.
If more than one bed frame model is appropriate for use in medical or surgical hospital wards, choose the one that is least expensive.
More information is needed to show if price variation between bed frames for use in medical or surgical hospital wards with in-built weighing scales or bed exit alarms can be justified. Key outcomes that should be captured include those relating to:
patient subgroups who may be affected differently by particular bed frame features, such as people with cognitive impairment
the impact of bed exit alarms on patient falls
the impact of in-built weighing scales on musculoskeletal injuries to the person using the bed
the accuracy of measurements from in-built weighing scales.
Evidence should be generated across different groups of people (patients and people using the bed frames) in real-world settings and contexts, including:
acute medical units
general medical wards
surgical wards.
The recommendations in this guidance do not apply to specialised hospital wards, such as psychiatric units, maternity wards or intensive care units. Bed frames for use in medical or surgical wards should be able to meet the different needs of people across a range of physical health conditions.
Some features of bed frames for use in medical or surgical wards may be more suited to one NHS trust than another. For example, hospitals on large sites may benefit from features that help with moving beds across the site.
NHS trusts should not expect to pay more to procure bed frames with the features that are identified as standard for bed frames for use in medical or surgical hospital wards.
Exploratory modelling indicates that features that reduce the incidence of patient falls, infections and musculoskeletal injuries to the person using the bed have the biggest potential cost savings. Reductions of 10% in the rate of patient falls, infections and musculoskeletal injuries could give savings of £487, £503 and £640 per bed frame per year, respectively.
Bed frames for use in medical or surgical wards can have many different combinations of features, so it is difficult to estimate how much an individual feature contributes to the overall cost of a bed frame. But some features are more likely than others to increase the cost of a bed frame. These include bed exit alarms, in-built weighing scales and features enabling connectivity (including Bluetooth connectivity, patient assistance features and e-medical records).
Healthcare professionals may identify that a patient needs a different bed frame from what is available. If so, an NHS trust may be able to rent or hire a specialist bed on a short-term basis.
Bed frames for adults in medical or surgical hospital wards have a range of features to help reduce incidents such as musculoskeletal injuries to the person using the bed or patient falls, pressure ulcers and infections. This assessment aims to determine whether the differences in clinical, economic and non-clinical outcomes attributed to the different features could justify price variation.
The features that should be included as standard are highlighted as important to people using bed frames from the user preference assessment, and are not expected to add cost to the bed frame.
There is some evidence related to technical outcomes for power drive and turn assistance, but these features are not widely available and are less important to users. There is no evidence of the impact of connectivity features on incident rates, technical outcomes or resource use. Connectivity is likely to be a driver of bed frame cost, but is less important to users. So, procurement teams should not pay more for beds simply because they have power drive, turn assistance or connectivity features.
Evidence of the effectiveness of in-built weighing scales and bed exit alarms is uncertain. Some groups of people could benefit from these features, but there is no evidence to show this. So, more information is needed to justify price variations because of these features.
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