Too many elderly people in acute NHS care

Variations in the level of acute hospital admissions for elderly people point to a need for integrated care, according to the King’s Fund.

If admission rates and hospital stays for elderly people were standardised at the rates of the best 25% of PCTs, the NHS could save £500m per year.

The King’s Fund said no single change could bring major improvement: the only solution was better integration of acute care with primary and social care.

The think tank found that rates of emergency admission for elderly patients varied fourfold across the NHS, while average lengths of stay varied from 6–13 days for patients aged over 65.

If all PCTs achieved the same admission rates and stay lengths as the lowest 25%, the NHS could free 7,000 hospital beds and cut its annual costs by £500m.

The report recommended that acute trusts work with GPs to improve primary care of long-term conditions and work with local authorities to help keep patients safe at home.

Study author Candace Imison said there was no “magic bullet” to address the issue, but the answer lay in better integrated care: “The areas that have shown a long-term commitment to integration – for example through joint teams, shared records and joint budgets – demonstrate better results and much lower use of emergency hospital beds.”

Such an approach would be “far more clinically and financially sustainable” than the current model, she concluded.