Keep elderly out of ‘dangerous’ hospitals, say NHS Alliance

Elderly patients need to be treated in the community instead of in hospitals “which can be dangerous places”, says the NHS Alliance, which represents doctors, nurses and managers on the front line.

The NHS alliance has launched a manifesto for primary care calling for an end to non-urgent care in hospitals.

The manifesto comes in the wake of the scandal at Mid-Staffordshire Trust which saw patients suffering appalling neglect.

Speaking at the launch of the manifesto for primary care, chairman of the NHS Alliance, Dr Michael Dixon said: “It is no longer economically sustainable for us to remain one of the Western World’s most prolific users of hospitals.

“Patients want to be looked after closer to home – especially the frail elderly and those with long term disease.”

In a recent letter to The Times, the president of the NHS Alliance, Dr Chris Drinkwater, and Dr Dixon, wrote: “Hospitals can be dangerous, particularly for older patients and those with long-term conditions. There is a risk of infection and nutrition is complicated for those who cannot feed themselves.”

The manifesto aims to create primary care that will be able to cope with and provide sustainable care for the UK’s ageing population.

The manifesto described a need to break the boundaries of hospitals into the wider community, and make them become last resort places for healthcare, especially for vulnerable older people.

Dr Dixon told The Times: “We need to work towards the point when acute hospital admissions should be regarded as a failure rather than a default position.”

The manifesto wants to see a healthcare system where far fewer people go to hospital for an unplanned admission, and unscheduled admissions will trigger an analysis of the cause to prevent it happening repeatedly in the future.

Dr Minoo Irani, clinical director in Berkshire and NHS Alliance specialists network lead is quoted in the manifesto, saying: “There are few other places in the world that are better at provision of emergency care at times of crisis. This does raise the question as to why we have a system that allows the crisis to develop in the first place? Why do we, in effect, deny access to specialist skills until damage has progressed significantly for that individual?”

The letter to The Times, written by Dr Dixon also said: “If we are to put people before numbers and achieve high quality of care, as well as keeping an NHS free at the point of need for future generations, we must, as an immediate imperative, shift all non-urgent care from hospital into the community.”

The manifesto demands that people working in primary care create new partnerships and working relationships with other professionals across the wider community.

The possibilities that personal health and wellbeing plans have for creating a gateway to the wider society and services such as housing, crime prevention, personal safety and well being were also described. The manifesto describes how personal health plans should be used more to help patients make choices about their own health.

Professor Lord Darzi, chair of the institute of Global Health Innovation, Imperial College London said: “Chronic conditions require a different skill and workforce mix, orbiting around primary care. This means fewer specialists in hospitals, but more nurses, allied health professionals and para-professionals (for example, fitness and nutritional experts) working in the community.”

Mental health, community health and social care services have all been included as part of the extended primary care service described in the manifesto that will work alongside the wider community and voluntary groups to ensure that people receive care before the need for hospitalisation.

In response to the manifesto, a Department of Health spokesperson said: “The vast majority of patients get excellent care, but if the NHS is to meet the needs of an ageing population, it needs to seriously look at how it can improve how care is being provided, particularly to older patients and those with long-term conditions.

“We want the NHS to provide more preventative and integrated care, which will mean fewer patients need to be admitted to hospital.”