Creating Solutions in Care for Older Adults

We’ve seen a lot of discussion over the past week or so about the ‘problems’ created by older people who sometimes remain in hospital when there are no appropriate and suitable services in the community to assist in their rehabilitation goal – which is callously referred to in policy-making ivory towers as ‘bed blocking’ – a term I’m wholly opposed to.

Last week, Mike Farrar, the Chief Executive of the NHS Confederation stated that 1 in 4 people who were in acute hospital beds could recover at home if better support were available.

Over the weekend, the government in their own now predictable fashion, entered the ‘policy making’ platform by flinging £170 million at the ‘problem’ of older people taking up these valuable hospital beds. That computes according to this article in the Guardian as a one off payment of £1m to each council to help deal with this awkward problem.

The thing is while not wanting to scoff at money offered, it’s hardly the best targeted or thought through way of delivering a better system of care for older people.
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Recovering at Home

Yesterday Mike Farrar, the Chief Executive of the NHS Confederation made the news by claiming that 1 in 4 patients in hospital beds could be cared for and could recover at home.

The difficulties of arranging appropriate discharges from hospitals is a matter that’s particularly close to my heart. Not least because I’ve been involved in the process for over a decade through my work. I’ve seen many changes (notably the Community Care (Delayed Discharge) Act 2003). Some steps forward. Some hefty leaps backwards.

And who are these ‘1 in 4’ that Farrar mentions. Well, unsurprisingly, he is referring to older adults.

The Guardian article says

One big issue is elderly care. Farrar said NHS leaders believed that at least 25% of patients in hospital beds could be better looked after in the community or could look after themselves at home rather than in the “outdated hospital model of care”.

With money short, there has been increasing concern that support for vulnerable patients from social care, paid for by councils, or from NHS-funded nursing in the community, has been cut back. The result is bed-blocking as patients face increasing delays in being discharged from hospital.

I have no doubt that better care could be potentially provided in the community but the block is very much services and more importantly access to appropriate services both from NHS primary care and from social care which are both being cut at the moment. Continue reading