Organise urgent care better, NHS told

Ambulance The King's Fund review focussed on how to reduce admissions and lengths of stay among patients needing urgent care

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Elderly people would need to spend less time in hospital if care in England were better organised, experts say.

A review by the King's Fund found there was scope to reduce the number of overnight stays by 2.3 million.

That would free up 7,000 beds - 6% of the total - saving the NHS nearly £500m a year, according to the think-tank.

The figures were based on all hospitals performing as well as the best 25% in terms of admissions and lengths of stay for the over-65s who need urgent care.

This group of patients excludes those admitted to hospital for routine check-ups and non-emergency operations such as knee and hip replacements.

Instead, it covers the ones admitted via accident and emergency or sent to hospital by GPs for urgent help.


The review said the factors underpinning their use of hospitals were complex.

But the think-tank said its work suggested there were some key areas the NHS could prioritise to reduce their need for hospital care.

Start Quote

This report shows that driving up quality is not only good for patients but can also save the NHS money”

End Quote Anne Milton Health minister

These included minimising admissions by working closely with GPs and other health services in the community to help prevent illnesses worsening to the point where patients needed emergency help.

The presence of senior doctors at the point of admission could also help reduce numbers by ensuring the elderly were channelled to the best services sooner, the report said.

Meanwhile, better integration with social care would help speed up discharge and, therefore, reduce length of stay in hospital.

Report author Candace Imison said focussing on this issue made sense for both the patient and the NHS budget.

"We have the opportunity to significantly reduce the number and length of hospital stays for older people," she said.

"This would avoid often destabilising and distressing emergency hospital admissions.

"In a climate where resources are scarce and getting scarcer this will also build a model of care that is far more clinically and financially sustainable."

Alex Mair, chief executive of the British Geriatrics Society, said: "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."

He added another key issue was the lack of specialist skills to care and support frail, elderly people.

Health Minister Anne Milton said ministers were working hard to reduce unnecessary stays in hospital.

"This report shows that driving up quality is not only good for patients but can also save the NHS money," she added.


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  • rate this

    Comment number 38.

    The key point of the article refers to closer monitoring of patients to ensure illnesses do not progress to a level that requires hospital admission. Forgive me for being jaundiced on this point but that is what is supposed to happen all the time but personal experience has taught me not to rely upon follow ups, pertinent questioning or basic common sense where first line treatment is concerned.

  • rate this

    Comment number 31.

    How about the NHS passing the cost of their looking after the elderly/frail/disabled/... who are bed blocking etc onto the Social Services?

    Might give the local councils reason to have the services available and allow the NHS to concentrate on what they are meant to be doing.

  • rate this

    Comment number 26.

    The sad fact is that many of these people who work for the NHS and Councils and make these decisions will one day get old and need medical care themselves - I hope they get the health care they deserve which I hope will be poor or none at all. They think it won't happen to them but unfortunately it will. That's if we still have an NHS.

  • rate this

    Comment number 3.

    This seems like an ongoing battle between the local councils & NHS with both trying to minimize their responsibilities and save money by form/filling,and appropriate support either not available or in short supply.
    Watching both vested interests fight to save their budgets,when both come directly or indirectly from the patient truly is sick !
    Maybe we should cut-up some of those PFI contracts ?!!


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