Overly risk-averse care decisions hampering hospitals with unnecessary admissions, LGA
Hospitals are hampered by unnecessary admissions, overly risk-averse care decisions and a lack of integration with home and community treatment options, new research claims.
The Local Government Association (LGA), which represents more than 370 councils in England and Wales, commissioned the research in part to explore if better integrating care services could save money – and, if so, where the savings would come from.
The report found practitioners pinpointed a “significant lack of consistency in decision-making” and estimated up to 45% care “pathway” decisions could be improved.
“There are penalties and ramifications for missed diagnoses, but no penalties for widespread over-provision of care,” it read.
The study also said professionals may be unaware of the full scope of treatment options open to patients or bend to “undue influence” exerted by a patient, family or carer.
It claimed helping more people receive home or community care could deliver the national system an annualised savings boost of more than £1 billion, achieved namely by “shifting resources to support people living more independently”.
The most money could be saved by avoiding unnecessary attendances and emergency admissions, with the “greatest preventative opportunities” identified as falls prevention and tackling loneliness, it said.
The report stated: “In over a quarter (26%) of the cases reviewed where people had been admitted to an acute hospital, there had been missed opportunities to make interventions that would have avoided the need for the admission.”
The chairman of the LGA’s community wellbeing board, councillor Izzi Seccombe, said the study highlighted the need for “robust reviews” by different professionals at critical decision-making junctures.
She added: “Councils, care providers, charities and the NHS are all united around the need for central Government to fully fund adult social care.
“This is essential if we are to move away from just trying to keep people alive to ensuring they can live independent, fulfilling lives, as well as alleviating the pressure on the NHS.
“We must all aspire to ensuring the care our loved ones receive goes beyond just helping them to get washed, dressed and fed – but to supporting them to live dignified, independent lives.”
The LGA-commissioned research comes after the The Academy of Medical Royal Colleges (AMRC) recorded 40 regularly-used medical procedures as largely pointless.
A study carried out last year also found 82% of doctors admitted prescribing or carrying out a treatment that they knew to be unnecessary.
The LGA enlisted consultants Newton Europe to undertake the study, which involved analysing attendance and admission data dating from the past two years and holding local workshops with medical professionals including GPs, district nurses and discharge coordinators.
The case notes were drawn from five different parts of the country – Kent, Pennine Lancashire, Greenwich, Swindon and Sunderland – which were selected to represent a mix of environments.
A Department of Health spokesman said: “Patients should never be in hospital unnecessarily, and we are determined to make health and social care more integrated so they get relevant, high-quality care in hospital and community settings. That’s why we have given local authorities access to up to £3.5 billion to spend on social care and we will be investing an extra £10 billion a year so the NHS can introduce its own plan for the future.”
“Nice (National Institute for Health and Care Excellence) has guidelines for better coordination between health and social care, and we are working with NHS England, NHS Improvement and local government on wide-ranging support to improve quality and efficiency.”
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