Hospital health warning for elderly patients who stay longer than they should

Unnecessary stays in hospital can “actively harm” the elderly and make it more difficult for them to regain their independence.

Monday, 25th March 2019, 5:55 pm
Updated Monday, 25th March 2019, 5:58 pm
Intermediate care services are designed to keep elderly patients out of hospital - or get them home quickly if they have been admitted. (Image: Corbis)

That was the warning from a medic leading a review of services designed to reduce the time which patients spend on the wards in Lancashire.

“There is a process called deconditioning, where you quite quickly start to lose the physical reserve to look after yourself,” Jo Andrews, from healthcare consultancy Carnall Farrar, told a meeting of the county’s health and wellbeing board.

“You also start to lose that psychological reserve – and the ability to return people to independence decreases the longer they are in hospital,” the former consultant anaesthetist added.

A study is currently under way examining how so-called “intermediate care” is used by the NHS and local authorities in Lancashire.

Intermediate support services can be delivered in residential facilities in the community or even within an individual’s own home. They can be deployed either to speed up a patient’s discharge from hospital by providing them with the help they need once they leave – or to prevent them being admitted to hospital in the first place.

The meeting heard that there is a variation in the use being made of intermediate care across the county – and that a gap exists in the provision of the services available for people at home.

The meeting also heard that more evidence is needed about the type of intermediate services which are most effective, while “no correlation” has been established between the amount spent on them and good outcomes for patients.

Lancashire’s director of public health, Sakthi Karunanithi, warned that the terms used to describe intermediate care need to be standardised if patients are to engage fully with the system.

“We really need to sort the language, because the public doesn’t understand – we need to simplify it maybe to either ‘community-based care’ and ‘hospital-based care’,” he said.

Figures reveal that hospital discharge delays across Lancashire increased by 13 percent between October and December 2018, compared to the previous three months. That put the number of unnecessary days spent in hospital in Lancashire at 10,186 – almost 9 percent higher than the target level.

The position has, however, improved compared to the third quarter in both 2016 and 2017.

Meanwhile, 86.3 per cent of people offered “reablement” services to help them regain their independence after a hospital stay were still at home three months after being discharged – above the national benchmark average of 84 per cent. Almost 1,100 people received reablement support in Lancashire between October and December 2018.