Almost 900,000 older people are admitted to hospital in England every year as an emergency because the NHS is failing to keep them healthy at home, Age UK has warned.
A major lack of services outside hospitals means elderly people are also suffering avoidable harm, such as falls and urinary tract infections, the charity said.
In a new report it urges NHS bosses to push through huge changes to how the “hospital-oriented” service operates and establish “home first” as the principle of where care is provided.
Doing so would reduce the strain on overcrowded hospitals and leave the NHS better set up to respond to the increase in the number of over-65s and especially over-85s, Age UK said.
Its report, on the state of health and care of older people in England, concluded that “our health and care system is struggling, and too often failing, to meet the needs of our growing older population.”
It added that the “huge financial costs to our country and the harm to older people from continuing with our current outmoded way of working are too high” to allow the status quo to remain.
The NHS’s emphasis on hospitals and lack of community-based services mean that older people are more likely to fall ill and end up needing A&E care or a spell as an inpatient, Age UK said.
“It’s older people who are suffering, who aren’t getting the help that they need,” said Ruthe Isden, its head of health influencing.
“Their health is deteriorating, they’re experiencing these avoidable crises – falls, UTIs – that are taking them into hospital and turning their lives upside down.”
Hospitals in England admitted 855,000 older people as an emergency during 2019/20. “They could have been avoided with the right care at the right time,” the charity said.
“It’s deeply worrying that many older people are ending up in hospital due to lack of the right sort of services in the community. No one wants to be in hospital but for older people all too often it can lead to an avoidable deterioration in their health,” said Caroline Abrahams, Age UK’s charity director.
Prof Adam Gordon, the president of the British Geriatrics Society, said the report “makes grim reading [and] rightly identifies that older people are currently being let down by NHS and social care services”.
NHS care must give much greater priority to prevention of illness and early intervention, to stop older people ending up in a medical crisis to the extent that they need to go into hospital, and use community-based health teams to work in that way, he added.
Age UK said NHS England’s recent development of initiatives such as falls prevention schemes, “virtual wards” and hospital-at-home care were useful steps in the right direction. However, such services “are only patchily available” and need to become commonplace, it added.
Matthew Taylor, chief executive of the NHS Confederation, said: “With 855,000 older patients admitted as a potentially avoidable emergency in 2019/20, this report shows the scale of how many people could benefit from a ramping up of prevention initiatives and community services, along with long overdue investment in social care.”
The Department of Health and Social Care did not respond directly to Age UK’s concerns. Instead, a spokesperson listed several policies intended to improve care and support for older people. They include a plan to spend up to £700m improving adult social care and another £1.6bn “to support timely and safe discharge from hospitals into the community, giving people access to rehabilitation and prevention initiatives, including local falls services”.
