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.

'Complex'

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
    0

    Comment number 43.

    Successive governments have created more beuracracy as front line staff are made redundant. The reason why organisations and departments don't work more efficently together is that managers with budgets to manage (they see this as power) constantly try to save money by passing the buck to another organisation/service. It's all about targets and numbers and the patients a distant second.

  • rate this
    -1

    Comment number 42.

    34. "the NHS, Walsall Council and private care providers couldn't co-operate effectively in organizing his post-discharge care package."

    "If the NHS can't even get simple things like this right, what hope have we got?"

    I can say from experience that arranging that kind of care (properly) is often far from simple.

  • rate this
    +1

    Comment number 41.

    #36 £10,000 per night for an intensive care bed. Can you afford that? I can't and I'm on well over UK median wage.

    More to the point we pay 9% of GDP towards healthcare, Germany pay 12%, the US 17.5%. Average life expectancy in all 3 countries is virtually the same. The NHS is damned good value.

  • rate this
    0

    Comment number 40.

    Perhaps they need conflict training.

  • rate this
    0

    Comment number 39.

    Information flow is another huge factor here & impacts safety & efficiency. Ask any patient - they well tell you how they'e had to wait around until the doctor has "checked the results". As an A&E doctor I am deliberately delaying patients because it is easier for me to batch process results in order to be able get on and work. On the wards, the consequence can be a fataly delayed diagnosis.

  • rate this
    +2

    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
    0

    Comment number 37.

    please explain Mrs health minister on bu-per and god knows what else you can feather your nest with, what is a unnecessary stay in hospital?

  • rate this
    +1

    Comment number 36.

    "33.
    Peter_Sym

    30. firemensaction
    For those who remember before NHS, the doctor actually KNEW YOU, and if you called him, he came out within 2 hours.
    --
    Because you paid him handsomely to do so."


    And we still do - those who work or have worked anyway. I'd rather pay £100 one-off for the plumber than £50 a year for the rest of my working life.

  • rate this
    -1

    Comment number 35.

    Presumably if they can get people out of the beds the only way there is any saving is by closing beds, wards, hospitals. Otherwise the savings line is so much nonsense.
    You get better care at home with your family aided by district nurses.

  • rate this
    +2

    Comment number 34.

    When my elderly grandfather went into hospital after a fall last year, his stay there was extended by at least a week simply because the NHS, Walsall Council and private care providers couldn't co-operate effectively in organizing his post-discharge care package.

    If the NHS can't even get simple things like this right, what hope have we got?

    This is why social care needs reforming.

  • rate this
    +2

    Comment number 33.

    30. firemensaction
    For those who remember before NHS, the doctor actually KNEW YOU, and if you called him, he came out within 2 hours.
    --
    Because you paid him handsomely to do so. I can get a plumber to come out in under 2hrs... for £100. Not a problem for Winston Churchill, big problem if you're on a state pension.

  • rate this
    +3

    Comment number 32.

    The NHS - especailly the GP part of it will go the way way of the dentists if the government lets it.

    Which of course they want it to - namely private.

    No home visits - no weekend work already.

    Difficult to get an urgent appointment.

    The burden will fall on the overworked A&E departments as a result.

    I went to a "walk in" centre the other day and it was SHUT!

  • rate this
    0

    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
    +2

    Comment number 30.

    Winston Churchill lost the 1945 general election because he made a comment that "If the NHS is established, it will necessitate it having a vast Gestapo-like organisation"
    Well,Old Winston was right.
    We are now told off if we choose to live outside "guidelines",etc.
    For those who remember before NHS, the doctor actually KNEW YOU, and if you called him, he came out within 2 hours.
    Improved NHS?

  • rate this
    +1

    Comment number 29.

    Ask any nurse in any hospital what the "problem" is and she will say "Managers"
    Me, I stay away from docs and hosp as much as possible, and manage to sty quite fit.
    Bliar and brown ushered in a Socialist nightmare coddlestate.
    Now people think they must "consult an expert" if they have the slightest thing "wrong" with them.
    "Special needs" is an example of how Socialism grows `Crats to control!

  • rate this
    +1

    Comment number 28.

    "If things were better, it would be better"

    Brilliantly vague stuff!

  • rate this
    +6

    Comment number 27.

    I wonder how much this 'Kings fund' were given to promote this load of old nonsense....

  • rate this
    +3

    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
    +1

    Comment number 25.

    yes let us get e'm out of hospitals they have not long left make room for the healthy,they are past there sell by date time is money.they have had enough spent on them.they would be a lot happier dying at home.what a country, we know the price of everything the value of nothing,our senior citizens are nothing more than units on a balance sheet.we should not need to review care for the elderly.

  • rate this
    +5

    Comment number 24.

    Are these professionals, novices or dimwits!

    For goodness sake these supposed to be professional people who care and treat ill people back to a normal life!

    If this is the way they are behaving why are they allow to get away with it?

    Simple, it's trust managers getting high salaries, gold plated pensions and hiring cheap labour - it stinks!

    While the health ministers sits on his backside?

 

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