Poor home care leads to millions of elderly being admitted to hospital
Millions of elderly people are admitted to hospital as emergencies because of poor care in the community research study has found.The failure of GPs, community health services and social care services to work together means large numbers of over 65s are admitted to hospitals, the King’s Fund think tank has found.
Researchers found that 2.3 million overnight stays in hospital could be prevented if all areas of the country performed as well as the top 25 per cent.
This is the equivalent of 7,000 hospital beds, or several medium sized hospitals full of elderly emergency cases every night of the year.
Savings of £462 million could be made which could be reinvested in community services to keep the elderly well at home, the report said.
However, there are growing concerns that swinging cuts in local authority budgets are already affecting social care for the elderly and putting further pressure on the NHS.
The King’s Fund found there was a fourfold variation in the use of emergency hospital beds between the best and worst performing primary care trust areas.
Where hospital services were well integrated with community services such as primary care nurses, GPs and social care, emergency bed use was low.
Rural primary care trusts and those with large elderly populations also had low emergency bed use, it was found.
Experts said the findings were ‘important’ and proved that the NHS needed to move away from providing so much care in expensive hospitals and invest more in care closer to home.
High bed use was a combination of large numbers of emergency admissions and those patients staying a relatively long time in hospital, the report said.
The primary care trusts with the highest emergency bed use were: Trafford, Manchester, Hounslow, Wandsworth, Haringey Teaching, Waltham Forest, Lambeth, Hammersmith and Fulham, Bristol, and Ealing.
Those with the lowest were: Torbay, Herefordshire, Cornwall and the Isles of Scilly, Devon, North Staffordshire, Shropshire County, Great Yarmouth and Waveney, North East Essex, Norfolk, Redcar and Cleveland.
The report concluded: “Our analysis demonstrates a significant opportunity to reduce the overall rate of use of emergency hospital beds by people over 65 while at the same time not threatening and potentially improving the quality of patient care.
Katherine Murphy, chief executive of the Patients Association: “This is a really important report and its implications need to be recognised.
“However, even whilst the NHS is forced to adopt huge efficiency savings, the needs of patients must be put first. Where clinically viable, patients want to leave hospital as quickly as they can.
“But we don’t want to see a return to the days of targets that distort clinical outcomes. Patients should be treated for as long as needed, and clinicians should not be put under pressure to discharge patients before it is safe to do so.”
“Patients also need to be given the choice of where they want to be treated and many would opt for treatment in their own home or in the community but we must make sure the services are available to them in the community to allow this to happen.”
Tags: Accident and Emergency, Care Professionals, Doctors, Health, Health Professionals, healthcare, Patients' Association, preventable crisis