Whilst everyone with an interest in the crises faced by the NHS is fully aware that the situation is exacerbated by bed blocking caused through delays in discharging patients from hospital. What is not so widely known is that almost 1,000 elderly people a day are being admitted to hospital needlessly amid a crisis in social care, according to Age UK.
Analysis of NHS figures by the charity found that there were 341,074 avoidable emergency admissions for people aged 65 and over during the year to April 2017.
The number has risen by 107 per cent since 2003 for those aged 65 to 69, and by 119 per cent for older people aged 75-79.
Among the general population of England, the number has risen by 63 per cent.
Reason for admissions
The figures relate to admissions because of conditions such as ear, nose or throat infections, kidney and urinary tract infections, and angina, for which hospitalisation could potentially have been avoided had the person been better looked after.
Many older people rely on family and friends to help them in the absence of reliable social care, the charity warned.
One in three over-65s live alone, and one in ten have no children, and these figures are expected to rise as younger generations, who are less likely to have married or had children, reach retirement age.
Many of those who do have loved ones to care for them rely on elderly relatives who may have health problems of their own.
One case study highlighted by the charity involved a 67-year-old woman who has been a carer for 40 years, first for her parents and more recently for a younger sister who has Alzheimer’s disease.
In another case a 73-year-old woman has been the sole carer for her 75-year-old husband since he had a stroke and brain hemorrhage four years earlier. She cancelled previous at-home care because it was “unreliable and lacking in continuity”.
Its report also highlights the problem of older people stuck in hospital and unable to go home, putting more strain on the healthcare system.
Unavailability of care
Care not being in place was the main reason there were delays for older people leaving hospital in England last year, according to figures released by the NHS.
A social care green paper, set to be released this autumn, is due to set out the Government’s plan for reforming the sector. It was originally supposed to be released before the summer recess.
Caroline Abrahams, charity director of Age UK, said: “The safety net for older people living at home has worn dangerously thin after years of underfunding and an absence of workforce planning across both health and care – this is why the numbers of older people whose emergency admissions to hospital could have been avoided are rising so fast.”
Councils warned of a “crisis in adult social care”. Cllr Ian Hudspeth, chairman of the Local Government Association’s community wellbeing board, said: “With people living longer, increases in costs and decreases in funding, the system is at breaking point and is ramping up pressures on unpaid carers who the backbone of the care system.
A department of health and social care spokesman said: “Patients should only be admitted to hospital when absolutely necessary, and we expect the NHS to work closely with local authorities and ensure people have a care plan in place when they are discharged.
“The Government has committed to a long-term plan with a sustainable multi-year settlement for the NHS to help manage growing patient demand.
“Health and social care are two sides of the same coin and reforms must be aligned – that’s why our forthcoming Green Paper will be published in the autumn alongside the NHS plan.”
This report by Age UK into avoidable emergency admissions for people aged 65, brings to light that bed blocking is not the only contributor to the crises that besets the NHS. Unavoidable admissions can also be a preventable cause, if sufficient resources were made available to community social care services. Central government continues to exacerbate the problem, by continuing to take advantage of unpaid carers who form the backbone of the care system, rather than properly funding the social care service.
Albert Cook BA, MA & Fellow Charted Quality Institute
Bettal Quality Consultancy