NHS could ‘lose’ 7,000 beds if home care for elderly improved, says charity

King’s Fund says if all PCTs worked to best standards, £462m could be saved with cut of 2.3m overnight hospital stays

The NHS could manage with 7,000 fewer emergency beds if all areas of the UK performed as well as the best in keeping the over-65s out of hospital, according to the The King’s Fund.

The healthcare thinktank, in a new report, says rates of admission of older people to hospital and the length of time they stay vary greatly from one primary care trust to another.

If all the trusts worked as well as the best the NHS could cut the number of overnight stays by 2.3m a year, saving £462m to reinvest in community and primary care services, the fund says.

Hospital stays are a high risk for elderly people, and expensive for the NHS. Patients become susceptible to infections on the ward, elderly people often do not eat and drink properly while there, and they can lose their independence.

There is a consensus that such patients should be treated in their own home or in the community if at all possible.

But every year there are 2m unplanned admissions of people aged over 65, a number accounting for more than two-thirds of all hospital emergency bed days. The King’s Fund report shows that there is a four times higher rate of emergency bed use for the over-65s in some primary care trusts than in others.

The study looked at four groups of 10 trusts. It found the reasons behind high or low emergency bed use were complicated. But there were some key issues.

In rural areas emergency bed use for over 65s was much lower than in cities. All the trusts with the lowest bed use were in rural areas – Herefordshire, Cornwall and Devon, were among those trusts studied with the least use – and seven of 10 with the highest emergency bed use were in London.

Trafford, Manchester, Hounslow and Wandsworth had the highest bed use of the 40 trusts examined.

Those that had low use of emergency beds were also those with large numbers of elderly people, suggesting they had strategies in place to keep those people out of hospital.

The report also found that trusts with high bed use tended to have patients who were waiting for a long time to move out of their own home and into supported care. That, says the fund , suggests that community, primary and acute services are poorly integrated.

“An emergency admission to hospital can be distressing and unsettling for older people and increase their dependency,” said Candace Imison, deputy director of policy at The King’s Fund and the report’s lead author. “Currently two-thirds of emergency bed admissions are for elderly people and our research suggests that we can significantly reduce these numbers. Not only would this minimise exposure to psychological and clinical risk but would provide a model of care that is far more clinically and financially sustainable.”