Nearly half of all emergency admissions to hospital from care homes could be avoided

Better working relationship GPs and the upskilling of care home staff could be the answer.

Matt Bodell
25 July 2019
Elderly Emergency Room

Chest infections, pressure sores and urinary tract infections were some of the primary reasons for admission.

A joint initiative between NHS England and the Health Foundation has found that more than around 40% of emergency admissions to hospital involving care home residents could be potentially avoided.

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The analysis comes as the NHS rolls out the Enhanced Health in Care Homes (EHCH) project to improve residents’ health and reduce avoidable emergency admissions.

Conditions such as chest infections, pressure sores and urinary tract infections were found to be some of the primary reason for hospital admissions.

The ThinkTank claims that a better working relationship GPs, hospitals, community services and care homes alongside upskilling care home staff to deliver a wider variety of care could be the answer.

Four pilot sites for the project showed a decrease in potentially avoidable emergency admissions to hospital of up to 27%, decreases in emergency admissions of up to 23% or reductions in A&E visits of up to 29% from care home residents.

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Hospitals not the best place for the elderly.

The Royal College of Nursing says that currently care home staff are often left with “few options” but to call an ambulance for clients.

Wendy Preston, RCN Head of Nursing Practice, said: “Nursing staff in care homes want more than anyone to try and prevent the residents they care for from being admitted to hospital as emergencies.

“But, at present, if a care home resident has a fall or develops a urinary tract infection (UTI), particularly out of hours, staff have very few options and are often advised to call an ambulance by NHS 111 or managers.

“What is needed are dedicated primary care teams including advanced practice nurses who can promptly assess and treat residents who fall ill or injure themselves – a few areas currently have such teams, but we need them to be rolled out nationwide.

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“Hospital is not the best place for most frail elderly people and nurses are often the solution to this problem despite services not always receiving the correct funding.”

The best possible quality of life.

NHS England claims the project could also see the quality of life of hundreds of thousands of residents.

Professor Alistair Burns, National Clinical Director for Dementia and Older People’s Mental Health at NHS England, said: “People want to know their mum or grandad is being properly looked after and helping them to live well and with the best possible quality of life is key to that.

“That’s why we are rolling out extra support to care homes as part of the Long Term Plan to reduce unnecessary medication and strengthen the ties between GPs and care homes.

“In some of the vanguard areas, which today’s report with the Health Foundation shows, these measures made a huge difference to residents’ health and when fully rolled out they will mean older people in every part of the country will benefit from personalised, specialist support in their care home.”

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