Procure bed frames for use in acute medical or surgical hospital wards with the following standard features, as a minimum:
a design that prevents patient migration (sliding down the bed)
adjustable to a low height position
an ergonomic brake system
steering assistance (for example, a fifth wheel or double-bogie castor configuration).
There is not enough evidence to determine whether price variation is justified between bed frames for other features, including:
in-built weighing scales
bed exit alarms
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).
Procure the most appropriate bed frames, taking into account, among other considerations:
patient needs and safety, including whether the bed frames have features to reduce injuries to the person using the bed, patient infections and patient falls
the preferences of the multidisciplinary teams using the bed frames, including the usability of bed frames and their features, and staff training needs
compatibility with existing accessories and fixtures (such as hoists and mattresses) within the local NHS trust
full life-cycle costs of the bed frames, including costs and turnaround time for repair and maintenance, and availability of spare parts and accessories
lifespan and obsolescence of the bed frames, including sustainability and environmental impact, digital integration and future proofing.
If more than one bed frame model is appropriate, choose the one that is least expensive.
More information is needed to show if price variation between bed frames for use in acute medical or surgical hospital wards with the features outlined in recommendation 1.2 can be justified. Key outcomes that should be captured include those relating to:
specific groups of patients, such as people with cognitive impairment, who may be affected differently by particular bed frame features
the impact of bed exit alarms on patient falls
the impact of in-built weighing scales, turn assistance and power drive on musculoskeletal injuries to the person using the bed
the accuracy of measurements from in-built weighing scales
the safety, effectiveness and impact on resource use associated with connectivity features.
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 and surgical wards.
What this means in practice
Procurement and commissioning considerations
NHS trusts should not expect to pay more to procure bed frames with the features identified in recommendation 1.1, as these should come as standard on bed frames for use in acute medical or surgical hospital wards.
The features in recommendation 1.2 may be more suited to some NHS trusts than others. For example, hospitals on large sites may benefit from features that help with moving beds across the site.
NHS trusts may consider standardising bed frame models within their hospital. This may mean shorter turnaround times for bed frame repair and potentially fewer risks because of familiarity with the bed frames and their features.
The recommendations in this guidance do not apply to specialised hospital wards, such as psychiatric units, maternity wards or intensive care units. Specialised bed frames that may be rented on a short-term basis, such as bariatric beds, are also excluded from this assessment. Bed frames for use in acute medical or surgical wards should be able to meet the different needs of people across a range of physical health conditions.
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 acute 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).
Considerations for healthcare professionals
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 a specialist bed on a short-term basis.
NICE has produced tools and resources to support the implementation of this guidance.
Bed frames for adults in acute 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 identified in recommendation 1.1 should be included as standard, as a minimum. These features were highlighted as being important to people using bed frames in the user preference assessment and are not expected to add cost to the bed frame.
In-built weighing scales and bed exit alarms are likely to be drivers of bed frame cost, but evidence of their effectiveness is uncertain. Some groups of people could benefit from these features, but currently there is no evidence to show this.
There is some evidence related to technical outcomes for power drive and turn assistance, but there is no evidence of their impact on user injuries. Connectivity features are likely to be drivers of bed frame cost, but there is no evidence of their impact on safety, effectiveness or resource use. Connectivity features on bed frames may be important in the future to support a digitally integrated NHS. More information is needed to justify price variation between bed frames because of these features.
Bed frames may have other features that are not included in these recommendations. But there is no evidence to justify price variation between bed frames because of any other feature.