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Hospitals ‘on the edge’ of collapse

Acute care cannot cope with demands, warns RCP

Jo Carlowe

Thursday, 13 September 2012

Demand on clinical services is increasing to the point where hospitals cannot keep up.

This is the stark warning from the Royal College of Physicians which today published its report Hospitals on the edge? The time for action.

The hard-hitting report highlights that there are a third fewer general and acute beds now than there were 25 years ago, yet the last decade alone has seen a 37% increase in emergency admission.

This is coupled with a change in patients’ needs, it states. Nearly two thirds (65%) of people admitted to hospital are over 65 and an increasing number are frail or have a diagnosis of dementia. However, all too often hospital buildings, services and staff are not equipped to deal with those with multiple, complex needs including dementia.

This is having detrimental effects on patient care, it continues. RCP members have reported a lack of continuity of care as their biggest concern about the current health service.

It is not uncommon for patients, particularly older patients, to be moved four or five times during a hospital stay, often with incomplete notes and no formal handover.

Research shows that medical and nursing staff often feel that older patients ‘shouldn’t be there’.

Being perceived as the ‘wrong patient on the wrong ward’ has been shown to reduce the quality of care, building attitudes of resentment from both medical and nursing staff.

Given these findings, the RCP is calling for all health professionals to promote patient-centred care and to treat all patients with dignity at all times. In addition it calls for a redesign of services to better meet patients’ needs but says the planning and implementation of new services must be clinically led. And it says any reorganisation must enable patients to access expert services seven days a week, with improved access to primary care to relive pressure on A&E services.

Sir Richard Thompson, president of the RCP said: “One doctor told me that his trust does not function well at night or at the weekend and he is ‘relieved’ that nothing catastrophic has happened when he arrives at work on Monday morning. This is no way to run a health service. Excellent care must be available to patients at all times of the day and night. We call on government, the medical profession and the wider NHS to work together to address these problems. This is why the RCP has established the groundbreaking Future Hospital Commission, to bring stakeholders together to examine better processes and standards for treating medical inpatients.”

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