The British Geriatrics Society (BGS), supported by organisations including medical Royal Colleges1, has expressed grave concerns about the impact of the winter months on the health and wellbeing of older people.
BGS members, who include health professionals from across the workforce, say that services are already critically overloaded in many parts of the country and have been so throughout the summer months.
This is principally due to ongoing workforce shortages across the NHS, which result in a recurring cycle of crisis. There are not enough healthcare professionals to care for the complex needs of an ageing population. The need to train and recruit more professionals from across the multidisciplinary team into older people’s healthcare has never been more urgent.
The government has pledged to transform health and social care but none of these promised improvements will be in place before winter.
Now, the BGS is calling on the new government to act for the long term rather than with quick fixes for the winter that do not address root causes. Service transformation must start now. The BGS proposes seven evidence-based actions that will make a sustainable difference to older people’s care across the UK:
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Services for older people living with frailty and multiple long-term conditions should take a coordinated and person-centred approach. This is laid out in the BGS’s Blueprint, Joining the Dots, and it sets a standard for high-quality care for older people.
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Investment in good quality healthcare support for care homes reduces avoidable hospital admissions. This would ensure better care is delivered in care homes and enable discussions of resident and family preferences about what should happen in the event of an acute healthcare crisis.
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Experts in older people’s care must be included in Government and NHS policy planning. Older people are the largest group of people who use NHS services, accounting for 40% of hospital admissions and 62% of hospital bed days.
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All older people with frailty should receive comprehensive multidisciplinary assessment as soon as possible after they arrive in hospital. This can initiate early treatment to prevent deterioration and enable timely discharge to community services at home.
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Focus on preventing, identifying and managing both deconditioning and delirium in hospital. Both issues are avoidable and are associated with increased length of stay in hospital and increased dependency on discharge.
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The government and health and social care providers must protect and preserve the right to rehabilitation for all older people who need it. Older people must be supported by multidisciplinary rehabilitation teams wherever they receive care.
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There should be continued investment in a multi-professional urgent community response that provides intensive short-term hospital-level care at home through Hospital at Home. Such services must work closely with ambulance, ambulatory care and same day emergency care services as an integrated local network.
Professor Adam Gordon MBE, President of the BGS, said:
‘Yet again, we are approaching another winter season that promises to be just as challenging as previous years for both older people and those working in health and social care.
‘The only way to break the recurring cycle of crisis is to invest sustainably in the systems change that will deliver high-quality integrated care for those who use the health service the most. This paper outlines those priorities but also highlights immediate steps that we can take as winter approaches.
‘The evidence and the solutions are well-known. Now what is required is leadership and investment in a strategy that will be fit for the future and for an ageing population. We urge the new government to act swiftly.’
Dr Mumtaz Patel, acting as president of the Royal College of Physicians, said:
‘The BGS is right to call for urgent action ahead of the coming winter. As the report highlights, older patients living with frailty and multiple long-term conditions use health and social care services more than any other population group. The need for system transformation to meet the needs of this growing ageing population is clear, and the NHS ten-year plan presents an opportunity to do that.
‘We endorse the immediate actions proposed by the BGS, which will not only improve the health of older people but also alleviate wider system pressures such as avoidable hospital admissions and discharge delays. Central to this is the need to address workforce shortages, ensuring that we have the right professionals in place, at the right time, to deliver high-quality care.’
Mike McKirdy, President of the Royal College of Physicians and Surgeons of Glasgow, said:
‘Year on year, our NHS faces increasing pressure. Where we were once preparing for a tough winter, we now see similar levels of need as early as the summer months. These pressures often affect older adults at a time when they are most vulnerable and in need of our care.
‘As we all know well, the solutions are grounded in a well-funded, well-functioning, and properly integrated health and social care service. This begins with caring for our workforce and addressing the ongoing challenges they still face.
‘As a College, we support the recommendations outlined by the BGS. We will continue to work with them and other organisations to ensure health professionals are supported to deliver the best possible care.’
Professor Andrew Elder, President of the Royal College of Physicians of Edinburgh, said:
‘As another NHS winter approaches It is deeply concerning that so little has changed within our health and social care systems that might make the coming months any easier for older people, their families, and staff.
‘We ask our new government in Westminster, in their first winter, to heed the clear calls we again make in this document. Each and all of our requests can lead to improvements in the care of older people if they are heard and acted upon. The ageing of our population is a societal triumph – we risk turning it into a disaster if we do not act to improve our services in the near future.’
