According to a report by Age UK hundreds of thousands of older people in England are having to endure chronic pain, anxiety and unmet support needs owing to the worsening shortage of social care staff and care home beds.
Age UK has said older people with chronic conditions such as diabetes, high blood pressure and heart failure are increasingly struggling with living in their own homes because of a lack of help with everyday tasks such as getting out of bed, dressing and eating.
The decline in the amount of support and care provided to older people is piling pressure on families and carers and leaving the NHS in constant crisis mode, contributing heavily to ambulance queues outside A&E departments, the charity said in a report published on Friday.
It warned that there would be a repeat of the NHS crisis this winter – in which rising numbers of elderly people have been unnecessarily stuck in hospital because of an acute lack of social care – without a shift to preventing unnecessary admissions.
Decline in the numbers of older people receiving long-term care.
The report, Fixing the Foundations, highlighted declines in the numbers of older people receiving long-term care and those feeling supported to manage their health conditions at home, which it said had been exacerbated by the pandemic.
It said a result of this was 12% of people over 50, equating to 2.6 million people, having unmet social care needs, increasing to 15% of people in their 70s and 21% of people in their 80s.
The charity said this growing lack of support explained the significant rise in unplanned hospital admissions for older people with chronic conditions, especially the oldest.
The primary cause of this and subsequent delays in discharging older people from hospital was the “huge and growing” shortfalls of staff in the NHS and social care, which are considerably worse than before the outbreak of Covid-19.
Impact on care home beds
Ruthe Isden, the head of health and social care influencing at Age UK, says:
“One of the hidden aspects of this is the lack of workforce often means care home beds are mothballed. They’ve had to close a floor because they can’t staff it. That’s why we’re seeing big delays in assessment, big delays in delivering care, and big delays in discharge from hospital.
There’s a huge backlog in the number of people who could be supported.”
Half (49%) of all people arriving in A&E by ambulance are over 65 and more than a third (36%) are over 75, according to NHS figures.
Prevention of hospital admissions
Prof Adam Gordon, the president of the British Geriatrics Society, said Age UK’s report reflected what he was hearing from geriatricians across the country.
“The levels of excess mortality and of morbidity [and] suffering that we’re seeing in the system as a consequence means that this is now a healthcare crisis which is every bit as bad and important as the pandemic.”
Gordon said NHS England last year postponed funding for anticipatory care – to support frail older people with complex care needs to live at home – and it was anticipated that this funding may not be provided again this year.
Summary
The Age UK Report ‘Fixing Foundations’ highlights the increase in the number of people who are suffering because of the shortage of staff and care home beds. The report attributes the lack of care home beds to the crises situation faced by the NHS this winter.
The Government claim that they have taken steps to address the difficulties in recruiting staff, but as Prof Adam Gordon says last year they postponed funding for anticipatory care, essential to supporting frail older people who live at home.
Unless we see a change of heart by the Government to reinstate funding for anticipatory care and more action to support the recruitment of staff, more people will struggle with chronic health conditions, and we will see the NHS in crisis again next winter.
Albert Cook BA, MA & Fellow Charted Quality Institute Managing Director Bettal Quality Consultancy