Better care for the elderly would free up 855,000 slots in A&E each year, damning report reveals

Almost a million emergency hospital admissions could be avoided each year if elderly people received better care at home, a damning report has revealed.

The health and care system is failing to meet the needs of an ageing population, with a ‘hidden crisis unfolding behind closed doors’, Age UK has warned.

Poor provision of services in the community means health problems go unnoticed until they ‘mushroom’ into major issues, the charity added.

Many admissions come within 30 days of previously being discharged, with patients not receiving proper preventative care in the community.

Pensioners also risk losing their mental sharpness and mobility if they become trapped on wards for long periods waiting to be discharged.

The health and care system is failing to meet the needs of an ageing population, with a ‘hidden crisis unfolding behind closed doors’, Age UK has warned (stock image)

The Age UK review found 36,000 fewer older people receive long-term care from their local authority since 2017/18, as district nursing posts have been slashed.

It means some 1.6million people aged 65 and older have unmet care and support needs, robbing them of their independence and leaving them struggling to eat, wash or dress.

Furthermore, 45 per cent are concerned about their ability to access their GP when they fall ill, the report said.

Age UK wants the country to switch from its ‘over-reliance’ on hospitals to a principle of ‘home first’, with greater access to physiotherapists, doctors and nurses through primary care. It is also calling for a ‘laser focus’ on prevention and early intervention to enable the elderly to stay fit and well in their own homes for longer.

The report said there were 4.8million A&E attendances by older people in 2021/22, with the rate increasing by 40 per cent among the over-80s between 2012/13 and 2021/22. Some 855,000 such admissions could have been avoided in 2019 alone with the right care at the right time, the latest figures suggest.

Once admitted, older people have longer hospital stays and are more likely to experience delayed discharge than younger patients.

Between 13,000 and 14,000 patients considered medically fit for discharge were stranded in hospital on any given day last winter, up from 4,500 over the same period in 2018/19. 

Once discharged, one in six patients aged over 75 is caught in ‘terrible vicious circle’ and readmitted within 30 days, Age UK said.

It follows a 24 per cent reduction in the number of nursing posts in social care between 2015 and 2020 and a 12 per cent fall in district nurses. 

Ruthe Isden, health influencing programme director at Age UK, said there is a crisis in the NHS and a ‘hidden crisis unfolding behind closed doors’.

‘It’s older people who are suffering, who aren’t getting the help that they need,’ she added. ‘Their health is deteriorating, they’re experiencing these avoidable crises – falls, urinary tract infections – that are taking them into hospital and turning their lives upside down.’

However, Age UK said there were ‘glimmers of hope’ in parts of the country taking action to boost community care (stock image)

However, Age UK said there were ‘glimmers of hope’ in parts of the country taking action to boost community care. It pointed to the development of falls services, hospital at home services, virtual wards and integrated frailty services, although there is a postcode lottery in access.

There are 10.5million people aged 65 and over in England, with 74 per cent living with at least one long-term condition, rising to 86 per cent among those aged over 85. Some are struggling more since the pandemic as a result of increased isolation, the report noted.

Caroline Abrahams, charity director of Age UK, called for a Social Care Workforce Plan, like the one recently published for the NHS, outlining how the Government plans to recruit and retain more staff.

A Department of Health and Social Care spokesman said: ‘We are spending up to £700million on adult social care reform over the next two years, including £250million for the workforce.

‘We are also investing a record £1.6billion over the same period to support timely and safe discharge from hospitals into the community. And last year we set up new integrated care systems, which help join up health and care. 

‘They are already making a difference by bringing together local NHS organisations along with social care and the voluntary sector to benefit patients.’