Over 40% of emergency hospital admissions from care homes ‘could be avoided’

By Jane Kirby, Health Editor25th July 2019News EnglandAccident and Emergency, Care Homes, Hospitals, Integrated Care, News England, NHS, Older People

More than four in 10 emergency hospital admissions from care homes could be avoided, experts have said.

NHS researchers found that 41% of emergency admissions were for potentially avoidable conditions such as chest infections, pressure sores and urinary tract infections that could be treated in the community, or were a result of poor care or neglect.

The NHS in England is trying to reduce pressure on hospitals by cutting emergency admissions but also says elderly people would prefer not to go to hospital, with long stays leading to loss of muscle mass and independence.

A new briefing from the Improvement Analytics Unit, a joint initiative between NHS England and the Health Foundation, said that if people were looked after better in the community, they would need fewer trips to hospital.

The researchers found that one in 12 emergency admissions to hospital was for people living in a care home – an estimated 192,000 each year. This represents 7.9% of emergency admissions.

A&E attendances from care homes reach 269,000 per year – 6.5% of all attendances for those aged 65 and over.

An estimated 340,000 older people in England live in residential or nursing care homes, including one in seven over-85s.

Across England, six development groups are working with the NHS, local authorities who provide social care, charities, carers and families to improve the health of care home residents and cut hospital admissions.

Their work has led to residents in Wakefield, West Yorkshire, having 27% fewer potentially avoidable emergency admissions, while in Rushcliffe, Nottinghamshire, there were 29% fewer A&E attendances.

Adam Steventon, director of data analytics at the Health Foundation, said: “Emergency admissions to hospital can expose care home residents to stress, loss of independence, risk of infection and rapid muscle deterioration.

“Around 70% of care home residents have dementia and can find the hospital environment even more stressful and disorienting as a result.

“Reducing avoidable emergency admissions and A&E attendances is good for residents and will help reduce pressure on the NHS.”

The evaluation found that increasing NHS support, bringing in staff such as dietitians and improving the skills of care home staff all had an impact.

But Mr Steventon also said urgent reform and investment for social care were needed.

Nationally, emergency admissions to hospital are around 22% higher for people living in residential care homes – where care is provided by non-medical staff – compared with those living in nursing homes, where care is provided by nursing staff.

There are also around 32% more A&E attendances for those living in residential care homes compared with those in nursing homes.

Sally Copley, director of policy and campaigns at the Alzheimer’s Society, said: “It is sadly not surprising to hear that more and more people with dementia are being taken to hospital in crisis.

“Last year the cost of 70,000 avoidable admissions of people with dementia to the NHS was estimated to be £400m.

“The social care crisis is leaving the NHS facing bigger financial strain, beds taken up in hospitals and people unable to leave their care because there is such little support to return home.

“The human cost on people with dementia cannot be pushed aside any longer.

“The new Prime Minister Boris Johnson must address our calls for an immediate investment in a NHS Dementia Fund to give people the vital financial support they need whilst also addressing long term reform.”

Professor Alistair Burns, national clinical director for dementia and older people’s mental health at NHS England, said: “People want to know their mum or grandad is being properly looked after and helping them to live well and with the best possible quality of life is key to that.

“That’s why we are rolling out extra support to care homes as part of the long-term plan to reduce unnecessary medication and strengthen the ties between GPs and care homes.”