Organise urgent care better, NHS told

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

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.

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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