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Community care must be improved to reduce bed use

Doctors say King's Fund advice unworkable without resources

Jo Carlowe

Tuesday, 14 August 2012

Doctors’ leaders have said community services for older people must be improved if hospital admissions are to be reduced.

Last week the King’s Fund published a report revealing a fourfold variation in the use of emergency hospital beds by patients over 65.

The think tank said the NHS could save £462m a year by reducing the duration and rate of admissions for these patients.

The report called on PCTs with the highest acute bed use to develop strategies across the care system and to align ways of working to identify ways to reduce usage. It also stated that all commissioning groups would benefit from benchmarking the relative use of acute beds in their area, and the related rates of admission and length of stay.

However, this week BMA GPs committee chair Laurence Buckman said the proposals were not achievable without ‘an enormous expenditure on staff and resources’ in the community.

“These have been cut over the past 10 years to the point that there are many places where there is little or no real community service at all,” he said.

GPC deputy chair Richard Vautrey said community, general practice and social care services were already “struggling under significant workload pressures”.

“They can only do more if new resources are put in place, and a failure to do so risks existing services breaking down.”

BMA consultants committee acting chair Ian Wilson said there was an assumption that intermediate care would be ready to take patients, but in many cases the infrastructure did not exist.

“Hospitals are trying to get patients back out into the community, but they have nowhere to go. We know what we want to do, but we can’t do it,” he said.

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