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A&E admissions for elderly varies nine-fold between CCGs

A&E admissions for elderly varies nine-fold between CCGs

28 January 2016

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The number of older people who are admitted to hospitals for an emergency varies “enormously” between clinical commissioning groups (CCGs), NHS Confederation found.

The number of older people who are admitted to hospitals for an emergency varies “enormously” between clinical commissioning groups (CCGs), NHS Confederation found.

There is more than a nine-fold variation between CCGs for rates of emergency hospital admission in the over 75s, the Confederation’s report Growing Old Togetherrevealed today.

Moreover, variation between admission rates from nursing and care homes is even more significant – nearly 93-fold even after excluding outliers. Varying access to alternative health services may be part of the explanation for that, the report stated.

Dr Mark Newbold, chair of the Commission on Improving Urgent Care for Older People responded: “Older people do need to access A&E at times, and the best hospitals tailor their service to meet their needs. But all too often, older people are forced to go to A&E because the alternative services that would help them be cared for at home are not available at the time they need them."

It is "unacceptable" to expect older people to navigate a very complex system, he added. 

The report also included examples of best practice. For example, by providing a home-based emergency assessment and treatment service, North East London Foundation Trust and London ambulance service have saved around £108,000 by avoiding ambulance trips and reducing the need for A&E admission and assessment.

Meanwhile, Sheffield Teaching Hospital has cut down hospital stay days from 5.5 days to 1.1 days by using a geriatric assessment team. The hospital is vertically integrated, and is co-terminous with both the city council and the city’s single CCG.

In Cornwall a care co-ordinator function has been commissioned by Age UK, resulting in a 31% reduction in all hospital admissions and a 26% reduction in non-elective admissions.

People aged over 85 are the fastest growing age group in England, while the population of those aged over 65 is expected to increase by 50% by 2030. 

The report also included eight ways that urgent care for older people could be improved, see below:

1.     Start with care driven by the person’s needs and goals.

2.     Have a greater focus on proactive care.

3.     Allow local leaders the space to build relationships and sustainable solutions to the challenges they face.

4.     Care coordination that offers older people a single point of contact to guide older people through an often complex system.

5.     Make greater use of multi-disciplinary teams.

6.     Ensure workforce, training and care skills reflect the care needs of older people today.

7.     Enable leadership to support staff to innovate and make a difference.

8.     The way that NHS outcomes and performance is measured needs to allow local leaders to focus on individual needs, delivered by the whole health and care system.

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