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NHS could shed 7000 beds by reducing over 65 hospital stays

The NHS could reinvest almost £500m into community and primary care services by reducing the rate of hospital admissions in the over 65s, it is claimed.

A report by The King's Fund Older people and emergency bed use: exploring variation found 7000 fewer emergency hospital beds would be needed by the NHS if PCTs achieved the rate of admission and average length of stay for the over 65s as those with the lowest use.

This would also mean a potential opportunity to reduce the number of overnight stays by 2.3 million per year and would lead to a reinvestment of £462m a year in community and primary care services.

Every year there are two million unplanned admissions among the over 65s, accounting for over two-thirds of all hospital emergency bed days.

The research found wide variation in the use of hospital beds in the older population. The rate of emergency bed use by the over 65s among PCTs with the highest use was four times greater than PCTs with the lowest bed use.

Across England the PCTs with the lowest rates of emergency bed use were found to be “leaders” in integrating health and social care, whereas urban settings appeared to drive up hospital bed use among the over 65s with seven out of ten PCTs reporting the highest emergency bed use located in London.

Areas with a greater proportion of older people also had lower rates of emergency hospital bed use, which the researchers have suggested shows how such areas have “prioritised the needs of older people and have put in place better strategies to minimise admissions”.

“An emergency admission to hospital can be distressing and unsettling for older people and increase their dependency,” said Candace Imison, Deputy Director of Policy at The King's Fund and the report's lead author.

“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 thinktank has recommended that in order to reduce hospital stays, local strategies need to look across the system “to align and co-ordinate services between primary, community and acute care”.

Researchers have also advised CCGs to “pay careful attention” to their relationship with providers as it is deemed crucial in allowing more integrated models of care to develop.

What do you think is the biggest reason for high hospital admission rates in the over 65s?