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Winter is over, but the pressure is not. The British Medical Association predicts this summer could be as busy as the winters of 2015 or 2016, while the Royal College of Emergency Medicine recently warned that we could see these winter pressures extend into the summer.
Over the winter, British Red Cross helped thousands of extra people get home from hospital, easing some of the well-documented seasonal strain on the NHS. We made sure people had warm clothing, food in their fridges, arranged keys for carers and made follow-up visits – all the little things that add up to the greater impact of freeing up hospital beds and helping patient flow.
Doctors and other NHS clinicians working in primary and acute services as well as Red Cross staff and volunteers working in the hospital to home space, tell us that they are experiencing the same pressures. The anticipated respite following winter now only lasts for around two weeks, before the intensity builds again. Our year-round work in hospitals and communities will continue – and in some areas, Trusts have asked us to extend our winter support into spring.
It is important to understand that the NHS is under ongoing pressure. While scenes of ambulances queuing outside A&E garnered frenzied media attention this January, we need to look beyond these more obvious seasonal symptoms to the year-round causes.
Funding and resources for the NHS are under strain for many reasons, but the patients entering the NHS system come from somewhere. Often, especially in the case of older or more vulnerable people, they end up in coming into A&E due to a breakdown in the social care system or cuts to community services that could have supported them in the home.
Successive years of cuts mean far too many people are not receiving the early intervention they need. A lack of preventative care leads to deterioration and hospital admissions that could have been avoided. When the system is strained, all too often we see older and vulnerable people reaching crisis in their homes before they receive support. We need to stop people falling into a gap between hospital and home. Properly integrating health and social care services could create wrap-around care that focusses on the needs of the individual, not the part of the system they are in.
To address these issues requires long-term solutions, not repeated short term fixes when seasonal illness hits. We know from our work in both hospitals and out in communities that simple, low cost, non-clinical interventions can be invaluable at all times of year and relieve pressure on stretched clinical teams and services.
We provide Home from Hospital and Support at Home services. We know how valuable it is to our NHS colleagues, helping to get someone home who without a bit of support would otherwise be stuck in a hospital bed. And we know how much it means to someone to be able to go home and have that reassurance that someone will check on them, will check their home is safe. This means people are less likely to end up going back into hospital, putting pressure on the system, and going through the cycle of readmission again.
A British Red Cross report, In and Out of Hospital (PDF), identifies too many missed opportunities to help prevent people from falling into crisis. It recommends simple interventions that could be adopted at each stage of a patient’s journey, ensuring they are sent home from hospital appropriately and with full support, reducing the need for re-admission.
The government wants to see the integration of health and social care in every area of England by 2020. Will we see this with the anticipated Social Care Green Paper in the summer? For those most in need of support and our hardworking NHS colleagues, we certainly hope so.
Mike Adamson is chief executive of the British Red Cross
Thank you Mike, a good concise report. I have also read with interest the In and Out of Hospital report. I would like to be involved in the future but hope the Red Cross is not releasing the Government from its Statutory Obligations and that the Red Cross is adequately funded for this increasing task which provides benefit to many stakeholders.
Unfortunately ,A&E Assisted Discharge Service – Brighton & Hove is not going to operate from July ,as the funding has been stopped by CCG. I am really proud of the service, we have developed very good relationships with our community and Allied professionals at Royal Sussex County Hospital. We have made so much difference to so many people . We are really sorry that we have to leave so many vulnerable people who benefited so much from our service. We are really sorry that the service is potentially going to end with so many people are going to be left without our support. Unless, alternative funding can be sourced.
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