As more elderly patients find themselves in need of medical attention, either for ongoing illness or treatment for incidental trauma, hospitals throughout the UK are facing an impressive amount of pressure regarding cost and the quality of care provided. The increased number of older patients seeking care within NHS trusts has also created a phenomenon known as bed-blocking, where individuals are forced to stay in the hospital long after they are medically cleared to be discharged and sent home. According to a recent report, the occurrence of bed-blocking rose by more than 40% from December 2015 to December 2016, leaving new patients visiting A&E departments for care experiencing prolonged wait times and delayed admittance.
The widespread issue of bed-blocking has been on the NHS radar for some time now, due in part to the stark reduction in social care services available outside the public healthcare system. Over a three-month period, 69 home care providers have exited the market, and nearly 25% of the remaining providers in the UK are threatened with insolvency. Without timely access to social care services in the community, elderly patients have no choice but to remain in the hospital until such care can be arranged.
An Integrative Mandate
This month, the Department of Health issued a mandate for the 2017/2018 year focused on bringing the prevalence of bed-blocking down along with other initiatives laid out by the UK government. Within the newly focused guidelines, NHS trusts are encouraged to integrate social care services for elderly patients to reduce prolonged hospital stays by 3.5%, effectively opening up more than 2,000 beds each day. Currently, more than 7,000 elderly patients stay in the hospital for longer than medically necessary due to an inability to secure adequate care at home, and the revised mandate is meant to tackle this growing challenge before it becomes an epidemic.
The Department of Health mandate details a pilot program taking place in a large NHS clinical commissioning group that aims to integrate public and social healthcare at a deeper level. Through the program, elderly patients are discharged from the hospital as soon as they are medically able to do so, but instead of putting the pressure of finding appropriate social care outside the system, NHS staff will coordinate with the patient to provide ongoing care in the patient’s home. Trained nurses will assist patients with completing activities of daily living, including bathing and eating, changing dressings, and medication adherence when needed. The shift toward more integrative social and public healthcare will be funded by a significant investment meant to offset the costs of nursing care, as well as additional capital funding directed toward A&E departments.
Avoiding the Perfect Storm
Several advocacy groups for both healthcare providers and the patient population at large are in favour of the Department of Health and its forward movement toward providing greater access to social care for elderly patients outside the hospital system. A representative from a medical negligence specialist law firm shares that the UK has long needed a better method for managing the issues that constantly face older individuals in need of medical attention. A perfect storm of an increased number of patients and the inability to move patients to social care environments creates major problems that, when left untouched, are difficult to correct. Elderly patients deserve to have access to social care in their own home, and the patients in need of emergency care across A&E units deserve access to immediate attention. An increased integration between health and social care services helps thwart the negative outcomes caused by prolonged stays in the hospital for all parties involved.
It is difficult to say with certainty that the updated mandate for extending health services to a patient’s home directly through NHS staff is a sustainable model, but the Department of Health mandate points to a clear sign of progress for the elderly patients who so desperately need the highest quality care available. Combining the integration of health and social care services with increased funding, targets for A&E wait time reduction, and extended hours for GPs and nursing staff creates a stronger possibility for success in the years to come. As the population continues to age at a rapid pace, and more individuals face a need for medical attention, programs like the pilot social care extension will become increasingly valuable to the healthcare system as a whole and the patients it treats each day.
