Elderly care and freeing up beds key to easing NHS crisis, says health boss
Providing more care for elderly in their homes and discharging people from hospital at the right times is key to solving the national NHS crisis, a health boss has said.
A&E waiting times are at their worst level on record with just 83.6 per cent of patients being seen within four hours on average. Performance is much worse at some hospitals, including Russells Hall in Dudley and Sandwell Hospital.
Toby Lewis, chief executive of the Sandwell and West Birmingham NHS Trust, which runs Sandwell and City hospitals, said a solution for delivering care to the elderly was crucial.
Just 70 per cent were seen on time at the hospitals in October.
Mr Lewis said: "I think we have all got to do better around the services we offer, particularly to adults who are 80, 85, 90 years old.
"If you look at the biggest rise in attendances at A&E departments across the country who then need of admission to hospital or some form of ongoing care, it's in that cohort.
"By 2030 there will be three times as many people over the age of 85 living in Sandwell than there were five years ago.
"We need to make sure that working with care homes, working with the local authority, working particularly with the voluntary sector we've got the best possible service offer.
"We've funded projects to go and work in care homes, we're looking at a nationally funded research trial for how we can provide more acute and geriatric medicine in care homes to try and support people to live in their own home and not have to come into A&E."
Getting patients out of hospital and freeing up beds at the right time is also important, Mr Lewis said.
"The big issue in most systems and in our system is making sure we can discharge people safely and well, thus meaning that maybe only nine out of 10 beds are filled so when somebody new arrives there's an available bed," he said.
"Usually this get simplified into a conversation about so-called delayed discharges but the reality is we just need to get smarter for most people who are discharged about having them leave the hospital in the morning rather than at night, on Sundays and Saturdays as well as on Mondays and Fridays. That's where we need to do better and it is a change in mindset and it's not easy."
Mr Lewis has refused to criticise the 95 per cent target which many say is unrealistic. He said it was important to continually aim to improve.
"If I was coming into a hospital I would want to be seen as quickly as I could be seen," he said.
"The reality is it's a good and a sensible standard. We know if you spend more than six or eight hours waiting in an emergency department for admission it does have an impact on your health and wellbeing and it can have an impact on your outcome. The idea the four-hour standard is just a political one I'm afraid is one I think is wrong. If you believe something is important, even though you're failing to do it, it is still important."
