Hundreds of thousands of older people in England are having to endure chronic pain, anxiety and unmet support needs owing to the worsening shortage of social care staff and care home beds.
Age UK has said older people with chronic conditions such as diabetes, high blood pressure and heart failure are increasingly struggling with living in their own homes because of a lack of help with everyday tasks such as getting out of bed, dressing and eating.
The decline in the amount of support and care provided to older people is piling pressure on families and carers and leaving the NHS in constant crisis mode, contributing heavily to ambulance queues outside A&E departments, the charity said in a report published on Friday.
It warned that there would be a repeat of the NHS crisis this winter – in which rising numbers of elderly people have been unnecessarily stuck in hospital because of an acute lack of social care – without a shift to preventing unnecessary admissions.
The report, Fixing the Foundations, highlighted declines in the numbers of older people receiving long-term care and those feeling supported to manage their health conditions at home, which it said had been exacerbated by the pandemic.
It said a result of this was 12% of people over 50, equating to 2.6 million people, having unmet social care needs, increasing to 15% of people in their 70s and 21% of people in their 80s.
The charity said this growing lack of support explained the significant rise in unplanned hospital admissions for older people with chronic conditions, especially the oldest.
The primary cause of this and subsequent delays in discharging older people from hospital was the “huge and growing” shortfalls of staff in the NHS and social care, which are considerably worse than before the outbreak of Covid-19.
Ruthe Isden, the head of health and social care influencing at Age UK, said there were about 165,000 vacancies in social care, mostly in roles that provided home care, such as nursing assistants, home health aides and care home staff.
She said: “That’s about a 50% increase just between 2020-21 and 2021-22. We’ve always had a problem with workforce vacancies but it’s really escalated.
“One of the hidden aspects of this is the lack of workforce often means care home beds are mothballed. They’ve had to close a floor because they can’t staff it. That’s why we’re seeing big delays in assessment, big delays in delivering care, and big delays in discharge from hospital. There’s a huge backlog in the number of people who could be supported. The whole picture is [fewer] people receiving less care.”
Half (49%) of all people arriving in A&E by ambulance are over 65 and more than a third (36%) are over 75, according to NHS figures published in September.
Prof Adam Gordon, the president of the British Geriatrics Society, said Age UK’s report reflected what he was hearing from geriatricians across the country.
“The levels of excess mortality and of morbidity [and] suffering that we’re seeing in the system as a consequence means that this is now a healthcare crisis which is every bit as bad and important as the pandemic.”
Gordon said NHS England last year postponed funding for anticipatory care – to support frail older people with complex care needs to live at home – and it was anticipated that this funding may not be provided again this coming financial year.
A Department of Health and Social Care spokesperson said: “We’re improving care for elderly and frail patients through our urgent and emergency care plan, which will expand community teams and virtual wards – allowing the most vulnerable patients to continue living independently or recover at home.
“We’re also investing an additional £200m to free up hospital beds and reduce pressures on A&E and £50m to expand hospital capacity, on top of our £500m discharge fund and £3.8bn made available in long-term grants last year to help local authorities meet their social care needs.”
