The BGS welcomes a new report from the Nuffield Trust which illustrates the growing issue of long waits in A&E and shows that older people are the worst affected. The problem of long waits is not new, and it is time we saw real action to tackle it.
The report adds to the ever-increasing evidence that long waits and corridor care are highly detrimental to older people’s health and wellbeing. In February this year, 43% of patients aged over 80 who were admitted spent 12 hours or more in A&E from arrival to admission. The paper challenges the common assumption that longer waits for older people are not simply because they are more likely to be admitted: the analysis shows that older adults who are admitted are still more likely to wait longer than younger age groups.
Many people presenting to A&E live with multiple long-term conditions, frailty and/or dementia as well as mental health issues and challenging social circumstances. When older people present to A&E, their complex needs are best addressed through prompt identification and specialist care. They can be fast tracked to the right team via Front Door Frailty services, which can often eliminate the need for admission and overnight stays. But there is wide variation across the country in the availability and quality of such services.
Most importantly, as pointed out in the report, this is a system-wide problem rather than just in the A&E department and as such solutions lie in a system wide approach. Lack of community and social care services, overcrowded hospitals with insufficient beds, poor flow and delayed discharges all contribute to the harmful delays experienced by older people when they present to A&E. At the BGS, we know that services in the community can proactively identify people at risk of deterioration and provide personalised interventions. These services work across health and social care to help support people to remain well and in their own homes, drastically cutting the number of older people needing emergency care in hospital.
Professor Jugdeep Dhesi, President of the BGS, said:
Another day, another report highlighting the ever-worsening issues of A&E waits and corridor care. The figures and graphs from the Nuffield Trust starkly illustrate that despite the BGS and others campaigning and offering solutions for some years now, the problem is still getting worse.
We welcome recent initiatives that, when implemented, will improve services for older people, including the shift from hospital to community, the national focus on frailty through the upcoming Modern Service Framework for Frailty and Dementia and the Frailty Improvement Collaborative, as well as the Prime Minister’s recent announcements on social care. Implementation now needs strong leadership and support for wider structural changes to deliver services that meet the needs of the biggest group using health and social care services – older people.
