NHS could avoid another crisis next winter ‘if elderly were cared for better in their own home’

Providing better care for elderly people at home could prevent another crisis in the NHS next winter, a damning report says.

The review by Age UK claims too many pensioners are ‘badly let down’ and trapped in hospital because the services they need to remain independent are ‘clunky and under-resourced’.

A failure to invest properly in community and social care leads to repeat admissions that pile pressure on the NHS and make it harder for people of all ages to get operations and ambulances, it adds.

Delivering support ‘proactively’ before an older person’s health deteriorates can reduce the chances of them needing to go to hospital.

And improving the help patients receive at home after a hospital stay can aid their recovery and slash the odds of readmission, the authors say.

The charity says accessing support has become ‘harder than ever’ and warns that when care for the elderly is ‘rationed’ it has a knock-on effect on the NHS, which is a ‘terrible false economy’.

This has fuelled record waits for routine operations, A&E and 999 ambulances, with ‘exhausted NHS staff trying to respond to an overwhelming tide of need’.

Between 2016/17 and 2021/22 the proportion of older people receiving long term support from their local authority fell by 13.5 per cent, the report reveals.

More than two thirds of people over 85 live with multiple conditions – and 35 per cent of older people live with some form of frailty.

But the proportion of older people feeling supported to manage their health condition has fallen by around a fifth since 2016/17, the charity said.

It estimates that more than 1.6 million older people are failing to get all the help they need with the likes of dressing, washing and cooking.

Age UK says the rationing of care for the elderly has fuelled record waits for routine operations, A&E and 999 ambulances, with ‘exhausted NHS staff trying to respond to an overwhelming tide of need’

Avoidable hospital admissions for conditions that should be managed in the community, such as diabetes and high blood pressure, rose for older people in the five years up to 2019/20 ‘particularly for the oldest old’ who are 90 and over.

Meanwhile, almost half (49 per cent) of all people arriving in A&E by ambulance last year were over 65 and a third (35 per cent) over 75.

The charity’s report, ‘Fixing the Foundations’, says: ‘The bottom line is simply that far too many older people still do not receive the coordinated, wrap-around support at home that they need.

‘And the problem is becoming more pressing by the day.

‘Care that can support and sustain older people to stay well at home can be the foundations of an effective and sustainable health and care system.

‘At the moment, these foundations are often broken or simply not there at all.’

The charity said shortages of home care staff are having a ‘devastating effect’ leaving ‘many older people stuck in hospital who could be at home with the right support’.

Ruthe Isden, head of health and social care influencing at Age UK, said a growing older population living longer with increasingly complex needs and many without children to provide informal care means there is not a ‘safety net in quite the same way’ as there has been in the past.

She said there is ‘broad agreement across the NHS, we cannot go through another winter like the one that we’ve just been through’.

Caroline Abrahams, Age UK Charity Director, said: ‘Too many older people are ending up in hospital, needing crisis care, because we are failing to provide them with the joined up, more preventive health and care services that would help them to manage in their own homes.

‘Then, too many are getting stuck in a hospital bed when medically fit to leave because there’s no social care to support them at home.

‘It’s an entirely predictable vicious circle and one that’s causing enormous heartache and distress for our older population – and huge difficulties for the NHS too.

‘We need to turbocharge our efforts to recruit, retain and support all the brilliant professionals that older people depend on to help them stay well at home, especially if they are struggling to manage several serious health conditions, like heart disease and diabetes, as many are.’

She added: ‘The fact is we know what has to happen to unblock our jammed-up hospitals and give older people the dignified health and social care support they need and deserve, and it’s down to the Government above all, to provide the leadership and resources to make it happen.’

David Fothergill, chairman of the Local Government Association community well-being board, described preventative care and support as ‘an absolutely crucial part of our social care system’ but said ‘sufficient funding’ was key.

He said: ‘We have consistently said that £13billion is needed for social care so that its many pressures can be addressed and councils can deliver on all of their statutory duties including those related to preventing or delaying the onset of conditions which, if left unsupported, can lead to hospital admissions.

‘This is the level of investment needed to ensure people of all ages can live an equal life and reduce the need for hospital treatment.’

A spokesperson for the Department of Health and Social Care said: ‘We are determined to fix the NHS and social care system with £14.1billion over the next two years, the biggest funding increase in history.

‘That includes up to £7.5billion for adult social care.

‘We’re improving care for elderly and frail patients through our urgent and emergency care plan, which will expand community teams and virtual wards – allowing the most vulnerable patients to continue living independently or recover at home.

‘We’re also investing an additional £200million to free up hospital beds and reduce pressures on A&E and £50million to expand hospital capacity, on top of our £500million discharge fund, and £3.8billion made available in long-term grants last year to help local authorities meet their social care needs.’