Those aged over 65 are bearing the greatest impact of the current health and social care crisis, the British Geriatrics Society (BGS) has said, calling on the Government to take urgent action to protect older people.
In a statement backed by the Royal College of Physicians (RCP) and RCP Edinburgh, the BGS has called on the government to take short- and long-term action to ensure that there is a stable social care workforce in place to support older people affected by the crisis.
Longer waits for ambulances, prolonged trolley waits, multiple moves within hospitals, and lengthy delays awaiting community services are some of the biggest issues affecting older patients, and are creating an increased risk of death or increased dependence upon discharge, according to the BGS.
Professor Adam Gordon, president of the BGS, said: ‘While the current crisis in the NHS affects us all, it is older people who are bearing the brunt of it. It is predominantly older people who are stuck in ambulances outside emergency departments, on trolleys in hospital corridors, and waiting in hospital for care packages before they can be discharged.
‘We need the Government to act urgently to implement both short- and long-term changes to ensure that the NHS is there for older people when they need it most.’
People over 65 account for 40% of hospital admissions, occupy two-thirds of hospital inpatient beds, and are the most frequent users of health and social care services.
Furthermore, when older people leave hospital in poor health, they need rehabilitation and to support to recover; services that staff shortages make difficult to provide. Without it, their health deteriorates further – already on average 15% of older people being discharged from hospital are readmitted within 28 days.
While the Government has provided an additional £250m to support discharge from hospital into the community, the BGS statement said that ‘across health and social care, and around the country, colleagues tell us it is impossible to recruit the necessary expertise to deliver existing services.’
The BGS highlighted seven evidence-based short term actions and urged the Government to take urgent action to address the damage being done to the health of over 65s.
The BGS’s seven recommendations
1 – All older people should receive multidisciplinary assessment as soon as possible after they arrive in hospital.
2 – Focus on preventing, identifying, and managing delirium and deconditioning.
3 – Protect the right of older people to rehabilitation when they need it.
4 – Continue to invest in a multi-professional urgent community response through virtual wards and hospital at home.
5 – Invest in good quality healthcare support for care homes to reduce avoidable admissions.
6 – Services for older people living with multiple long-term conditions should take a coordinated and person-centred approach.
7 – Experts in older people’s care must be included in Government and NHS policy planning.
Responding to the latest NHS performance data, RCN Director for England, Patricia Marquis said: ‘Ministers – including the Prime Minister – have so far refused to acknowledge that health and care is in crisis, yet some of what we are hearing from the frontline beggars belief.
‘Corridor care appears to have become the norm. Some nurses are being booked to work in hospital corridors, others are being asked to buy Ikea hooks so intravenous drips can be attached to the corridor wall, and some patients are having cardiac arrests because of mistakes made using cumbersome oxygen cylinders to treat them. ‘
‘And ministers’ solution? Treat patients in cabins in car parks or move them to care homes who don’t have the staff to run extra beds or to hotel rooms.’
NHS England said that bed occupancy for adult general and acute beds was now at 96% with 14,069 patients remaining in hospital despite being fit for discharge, this is a 10% increase from only a week before.
A&E waiting times have gone up from last month. In December 2022, 54,532 patients were waiting more than 12 hours from decision to admit (an increase of 44% from 37,837 in November 2022). The figure for patients waiting 12 hours or more is the highest figure since Aug 2010 when the data started.