By Debbie le Quesne

Changes needed to avoid extra 13,500 hospital beds

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I recently read in one of our heavyweight newspapers that if the care system does not change for our growing and ageing population we will need an additional 13,500 hospital beds to meet demand.

Like never before the pressure’s on everyone involved in the care loop to create a fix that offers quality years for the elderly.

Attempts to move care closer to home is not but major change is needed to achieve it, so says Nigel Edwards, a senior fellow at The King’s Fund.

Management of chronic illness in the community is key and heading off sickness is also a priority. Anything to keep our elderly out of hospital has to be considered.

Writing in The Guardian online, Edwards adds: “A great deal rests on community services: they could transform chronic disease management, support reductions in the number of people admitted to hospital and how long they stay there, and help primary care meet a growing demand.”

He outlines that previous initiatives have fallen pretty well at the first hurdle, but there’s a new approach.

Yes, I think we know that: Models to simplify, steam line, join up and end duplication. Oh yes, and we’ll do it all in the community.

Edwards adds: “We also need to wrap services around primary care practices and natural local communities. A common problem is the lack of contact between community staff and GP practices. They will both work more effectively if this is reversed. In some areas social services have changed their team structures to match this.

“Another key step is to create services that offer an alternative to hospital stay, and that can respond more quickly than many currently do. At least 20 per cent of admissions and half of days in hospital can be cared for in other settings, including the home. Where new models are developing, community care teams are intervening quickly to prevent admissions, diverting patients away from A&E or working with hospital wards to speed up patient discharge.”

But there’s a flaw in this plan which is supported by just about every care professional I know.

Edwards notes: “To be successful, however, there will need to be significant investment in developing the workforce and dealing with the impending shortage of community nurses.”

Investment – now that’s a challenge. The care industry is creaking Mr Cameron and some of the emerging business models, I suspect will not pass CQC’s sustainability scrutiny. Why? Because in responding to need – more and more clients are being decanted into the private sector from council-run social care services – and the only way to turn a profit in serving them is by keeping things lean.

Lean is certainly not smart. I’d like to think this is not the creative working the Cabinet envisaged.

The private sector is a central pillar to rolling out government policy on care. It’s time the rates local authorities are paying for it represent its true worth and the funding assigned to social care packages enough for clients to buy in a sustainable, quality service.


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