Joint Statement by BHB and Ministry of Health: Update on Emergency Department patient flow and bed capacity management

Tuesday 2 June 2026: The Ministry of Health and the Bermuda Hospitals Board are providing an update on ongoing work to improve patient flow, reduce Emergency Department overcrowding, and strengthen Bermuda’s acute and long-term care capacity. This update forms part of the shared commitment to keep the public informed as progress continues, particularly at King Edward VII Memorial Hospital, Bermuda’s only emergency department.

BHB has set a clear operational target of six hours for Emergency Department (ED) boarding, which is the time between the decision to admit a patient and their transfer to an inpatient bed. This benchmark is consistent with the standard used by the US Centers for Medicare & Medicaid Services and is the primary measure of ED flow.

Hallway care, delayed discharges, and lost acute care bed days all affect how many inpatient beds are available. Because they are connected, these issues are managed together under the boarding target. Bermuda faces a special challenge: King Edward VII Memorial Hospital is the country’s only emergency department, and there are no other local facilities where patients can be sent instead.

For admitted patients, time in the Emergency Department has two parts: the time it takes to reach a decision to admit, and the time spent boarding until an inpatient bed becomes available. As of May 2026, admitted patients waited a median of about five hours for a decision to admit, followed by a further median of about twenty hours boarding. This resulted in a typical total of roughly twenty-four hours in the ED before transferring to a ward. While this remains above the six hour target, boarding times have improved meaningfully over the past several months. Most patients who are not admitted continue to be treated and discharged within a median of under four hours.

A review of 29,512 ED encounters between April 2025 and March 2026 found that roughly 25 to 35 percent of patients, about 20 to 28 patients per day, could have potentially been treated in primary or community care settings. This work supports ongoing efforts to strengthen primary care access and reduce avoidable ED demand.

Since the introduction of the Bed Capacity Management Plan, BHB has seen measurable improvements. Median boarding time has dropped from around fifty hours earlier in 2026 to around twenty hours in May 2026, a reduction of about sixty percent. ED overcrowding has eased as a result, supported by enhanced discharge processes and the use of the new discharge lounge.

Performance still varies week to week, and boarding remains above target. The progress to date reflects the commitment of clinical teams and the coordinated approach between BHB and the Ministry of Health. To support long-term system sustainability, BHB will be adding thirty long-term care beds at MWI. This is part of the broader strategy to address the projected need for approximately 365 skilled nursing facility beds by 2035. In addition, a robust and expedited procurement process for the independent review of ED access is nearing completion.

Although an external reviewer has not yet been appointed, the process is actively progressing under the governance oversight of the Chairman of the Bermuda Hospitals Board. Updates will be provided at appropriate stages to ensure transparency while protecting the independence and integrity of the review.

As of 1 June 2026, forty-one patients who are medically fit for discharge were occupying acute care beds. Their median length of stay to date is about seventy three days, with an average of about one hundred and eleven days. Seventeen patients with stays of ninety days or longer account for seventy eight percent of all bed days used by this group. These patients are predominantly older adults, with a median age of seventy four, and require skilled nursing or long term care placement, which is the main reason for the delay. Work continues across the system to support timely and appropriate placement options.

The Minister of Health The Hon. Kim Wilson said: “The progress we are seeing is the result of strong collaboration between BHB and the Ministry, and I want to acknowledge the dedication of the teams who are working every day to improve patient flow and strengthen the system. While there is more work ahead, we are encouraged by the improvements already achieved and remain committed to supporting BHB as they continue this important work.”

The Acting CEO of BHB Ms. Judy Richardson added: “Our staff have been working extremely hard to improve the experience for patients and families, and the reduction in boarding times reflects that effort. We appreciate the Ministry’s ongoing support as we continue to implement the Bed Capacity Management Plan and expand long-term care capacity. We are committed to building on this progress and ensuring that patients receive timely, safe, and appropriate care.”

BHB, with the full support of the Ministry of Health, remains committed to reducing ED boarding times, improving patient flow, expanding long-term care capacity, strengthening primary and community care pathways, and maintaining transparency as this work continues.

Correction to Royal Gazette story on acute care beds

Saturday 21 February 2026: Correction to references in the Saturday 21 February 2026 edition of The Royal Gazette and on royalgazette.com:

In reference to incorrect articles printed in the Saturday 21 February 2026 edition of The Royal Gazette and posted online, BHB has no plans to build a new acute care facility or add acute care beds. As BHB said in a statement provided to The Royal Gazette on 20 February, “The capital infusion that will allow BHB to bring on line 30 additional long-term care beds this year will enable us to improve internal bed flow so that medically fit for discharge patients can be transferred from the Acute Care Wing into the KEMH General Wing.”

KEMH has sufficient beds to meet the demand for acute care. However, a large number of those acute care beds are consistently occupied by patients who are medically fit for discharge and no longer need hospital care. This prevents newly admitted acutely ill patients from moving into those beds.

The capital funding announced in the Budget Statement will allow BHB to convert space within its existing facilities, adding 30 additional long-term care beds. This means patients who are medically fit for discharge can move out of the acute care units to a lower level of care. Acute care patients who are boarding in the Emergency Department waiting for a bed can then move into the vacated acute care beds, which in turn relieves pressure on Emergency.

Hyperbaric chamber unavailable until 18 February

Tuesday 10 February 2026: The hyperbaric chamber at King Edward VII Memorial Hospital will not be available for diving emergencies starting today. It is expected to reopen to divers on Wednesday 18 February 2026.

The hyperbaric team started emergency treatment today of a patient who requires a series of sessions in the chamber over the next week. As a result, the hyperbaric chamber will not be able to offer emergency dives during this period.

Hyperbaric chamber temporary closure

We are taking active steps to resolve the situation. We are currently training staff members to become certified chamber attendants and have initiated a recruitment process. In the mean time, we advise the diving community that the hyperbaric service will not be available in the event of a diving accident.

BHB calls for community voices in its Vision 2030 strategic plan

Friday 5 December 2025: If you want to have your say in the future direction of your hospital services, you should pop by the City Hall foyer in Hamilton between 11am and 3pm on Monday 8 December.

BHB is developing its 2026 to 2030 strategic plan, called Vision 2030 in partnership with the University of Toronto’s Institute of Health Policy, Management and Evaluation at the Dalla Lana School of Public Health.

The team will be on hand to present their findings to date, and also shared will be BHB data and over 700 responses from people in Bermuda from community surveys.

CEO & President Scott Pearman wants the community to know how important their voices are in developing a strategic plan.

“The people in Bermuda who rely on and use our services have a unique perspective that will help us understand what matters most to our community,” he says.

“This event is for our patients, families and anyone with an interest in healthcare. Come and review what BHB data and survey responses are suggesting about improving and developing our services, and tell us if you agree. Where do you see opportunities? What in your experience needs to be addressed most urgently?

“It won’t require too much of your time. There aren’t long presentations – you can just pop any time between 11am to 3pm, see the gathered information and chat to the team.”

Mr Pearman adds: “I would like to thank the University of Toronto team, who will attend to present their pro bono work, which has formed part of their Master of Health Informatics field experience. I would also like to extend my appreciation to BermudaAir, whose assistance has made the team’s travel to Bermuda affordable, enabling this presentation of information to the community take place.”