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Improved elderly care would slash hospital stays


The number of overnight emergency hospital stays could be cut by 2.3 million a year if care services for older people were better organised in England, a think-tank has said.

A report by the King’s Fund found there was scope to free up 7,000 emergency hospital beds by prioritising a number of key areas, potentially saving the NHS an annual figure of £462 million.

The study said the reductions could be achieved if all hospitals performed as well as the best 25% in terms of admissions and lengths of stay for over-65s who need urgent care.

Patients requiring urgent care were classed as those who were admitted via accident and emergency or sent to hospital by GPs for urgent help, rather than those who attended for routine check-ups and non-emergency operations.

Candace Imison, the report’s lead author, said: “An emergency admission to hospital can be distressing and unsettling for older people and increase their dependency.

“Currently two-thirds of emergency bed admissions are for elderly people and our research suggests that we can significantly reduce these numbers.

“With better design and co-ordination of services focused on the needs of older people, we estimate that the NHS could reduce overnight hospital stays by 2.3 million annually.

“Not only would this minimise exposure to psychological and clinical risk but would provide a model of care that is far more clinically and financially sustainable.”

The think-tank said the NHS could prioritise a number of key areas to reduce elderly people’s need for urgent hospital care, but admitted the factors affecting the variation in bed use are complex.

Its report, entitled Older People and Emergency Bed Use: Exploring Variation, suggested admissions could be reduced through closer work with GPs and other health services in the community to prevent illnesses developing to the point where patients need emergency help.

Having senior physicians at the point of admission could also cut numbers by ensuring the elderly are channelled to the best services sooner, the study also found.

Alex Mair, chief executive of the British Geriatrics Society, told the BBC: “Health and social care services must adapt to meet the urgent care needs of older people.

“At the moment services are too fragmented and hampered by poor communication.”

There are two million unplanned hospital admissions among the over-65s every year, according to statistics.










Readers' comments (11)

  • Florence

    Amen to that I say !! And we have been saying this for years. Our Trust is re-organising our rehabilitation services and services aroud Older people. I am a Nurse with 20 years experience in Elderly care and rehabilitation. Myself and my colleagues have been saying the same thing for years.
    I was employed in a Falls clinic at one point which ran an urgent care service for Older people. It was expensive but it did reduce admissions !! Guess what they de- comissioned the service !!!
    In my area the community services are not adequatley set up to accomodate care for Older people and result in alot of avoidable admissions. Of course this leads to people remaining in hospital longer than necessary and the well - known consquences there in.
    Our Trust is re-structuring at the moment and hopefully expanding the Frail Elderly services.
    Im going to get as involved as I can and make my contribution. Ive felt disillusioned and powerless about the service we provide for a long time. Ive considered leaving Nursing too. However Im going to try and make a positive contribution . Whatever happens I will have tried.
    Its the first times in years Ive felt any real enthusiasm about my job.
    Wish me luck !!!!!

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  • Over 65 is classed as elderly - I didn't know that, I assumed we were talking about at least over 80 here.

    Yes, people should be seen at home by GPs and district nurses 24 hours a day. We also need to open community hospitals, rehab units, nursing home beds and hospices.

    Until that happens we will still have thousands of patients being admitted to hospital (of whatever age) who don't need to be there.

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  • anon 11 aug 9.56 am

    in an ideal world. i thought all these services had been cut because of the costs involved.

    it would probably be unaffordable to set them all up and develop them again although they would probably be cost saving in the long run and if managed well far better for everybody involved.

    maybe when all these private enterprises spring up everywhere it may be more doable but then I can't envisage how standards and the entitlement to the same services and quality of care would be available to all who need it, could be maintained or even who would pay for it.

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  • everything is easy in theory!

    care of the elderly should not need improving, it should already be available!

    have a look at the Swiss Model of care of the elderly and domiciliary care. It works!

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  • If people think things are bad now just wait until we are all retired and 'elderly'. There may not even by an 'free' NHS for us.

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  • I don't hold out any hope at all. No family, neighbours out all day and too tired and busy evenings and weekends and who wants to be a burden on others anyway and especially those one does not know well.they have had their own parents to deal with and i am sure wouldn't wish to start over again, and are growing older themselves. no friends nearby, and their situation is the same.

    times have changed. when i was growing up in the same house where I still live, my parents, doctor and nurse found time to help our elderly neighbours and visit them when they were ill or needed anything such as shopping. Those who knew my parents well weren't afraid to ask and my parents were always happy to help. it was never seen as a burden and their kindness and generosity was never abused. I think I would just have to go hungry now.

    I had always just assumed that i would receive the same care and attention my parents and my colleagues and i gave to others when needed. I just enjoyed the everyday challenges of care to whoever was admitted to our ward without any judgement or discrimination whatsoever. we just perceived the clinical and personal needs of our patients and did our very best for them whatever these were. However, we also enjoyed excellent facilities, more than adequate resources and very privileged working conditions so these never had to be questioned.

    I would just like to think and be reassured that if and when I need it I would also be offered the appropriate and understanding care that I need at the time.

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  • tinkerbell

    The majority of our inpatient services in our catchment area have closed with more due to close.

    Things are a lot tougher now to get quality elderly care, most private homes can't cope with anyone regarded as a 'management problem' or anyone a bit boisterous.

    Resources are already at breaking point within the NHS. We are now selling private beds.

    Will things improve in the future? I think the way things are going most elderly will be left to fend/fund for themselves unless they have a loving family/friends to help/support them.

    Will their children, if they have any, who work full time and are bringing up their own children be able to give up working to look after their parents who are living longer?

    It will take a wise wo/man to find the answers.

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  • tinkerbell

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  • and giving beds away to Tunisia!

    some will look after their parents but it doesn't mean anybody will look after them if there is nobody left in their family.

    many old people left to fend for themselves without help and support will just die. some because they can't cope for themselves and others just form loneliness because they have nothing to live for. is this really how we want to treat our fellow citizens?

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  • Care of the elderly classed as over 65's so the nursing staff of the future will be over 65 hmmm cause for thought, elderly looking after elderly - will the elderly nurses be fit enough for the demands of care of elderly wards? I for one wouldn't be up to it.

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