General practitioner Consultant

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GPs insist community resources are key to cutting beds

Doctors leaders have said community services for older people must be improved to reduce the rate of hospital admissions.

A report published today shows a fourfold variation in the use of emergency hospital beds by patients older than 65.

The NHS could save £462m a year by reducing the length of stay and rates of admission of older people, according to the King’s Fund report.

Older People and Emergency Bed Use: Exploring Variation claims that 7,000 fewer emergency hospital beds a year would be needed in England if all areas achieved the lowest rates of admission and average length of stay.

It also states the number of overnight stays could be reduced by 2.3 million per year if more people received help at home or in the community rather than being admitted to hospital.

However, BMA GPs committee chair Laurence Buckman said the proposals were not achievable without ‘an enormous expenditure on staff and resources’ in the community.

Workload pressures

He said: ‘These have both been cut over the past 10 years to the point that there are many places where there is little or no real community service at all.

‘Even with money, there are simply not enough nurses, physiotherapists and carers to look after all the people who could have been managed outside hospital if there would have been enough of them.’

GPC deputy chair Richard Vautrey added that community, general practice and social care services were already ‘struggling under significant workload pressures’.

‘They can only do more if new resources are put in place and a failure to do so risks existing services breaking down,’ he said.

The report finds that areas with a high proportion of older people had lower rates of emergency use, suggesting they had prioritised the needs of older people.

BMA consultants committee acting chair Ian Wilson said there was an assumption that intermediate care would be ready to take patients but in many cases the infrastructure did not exist.

‘Hospitals are trying to get patients back out into the community but they have nowhere to go. We know what we want to do but we can’t do it,’ he said.

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