11.11.15
Intermediate care services ‘must double’ to meet demand ahead of winter crisis
Although essential to the successful development of new models of care, intermediate care services are deteriorating nationwide, with older people waiting up to 9 days to get some kind of help.
The National Audit of Intermediate Care (NAIC) will launch its fourth annual report at its conference in Birmingham today (11 November), being held alongside the NHS Providers conference – but its content shows the future is bleak.
The auditor has highlighted increasingly limited capacity to deal with intermediate care in the NHS, meaning patients are waiting longer times than ever before.
Waiting times now average three days for bed-based care, 6.3 days for home-based services and 8.7 days for reablement, which is vital to get people back on their feet after an injury or illness.
John Young, NHS England’s national clinical director for integration and frail elderly, said: “Intermediate care services act as a critical sense check of whole system integrity and performance for ‘at risk’ older people.
“Yet they remain curiously invisible to commissioners, managers and the general population. The success, or otherwise, of the new models of care, and other current whole system initiatives, will depend upon capacity building in the intermediate tier.
“This year’s NAIC reveals why we need to bring these services out of the shadows: it’s imperative that decision-makers heed and respond to its findings.”
Although the report acknowledged that demand had already outstripped capacity before, the current situation is so grave that intermediate care provision needs to double to meet growing demand.
But, instead, funding has remained static over the last three years, ultimately undermining any attempt to reduce hospital admissions.
High-quality intermediate care has been previously linked to healthier outcomes for patients and less pressures on acute and social care services.
Intermediate care has also been shown to improve working practices and collaboration between the NHS and social care services, with 52% of CCGs now using pooled Better Care Fund budgets – up from 38% last year.
On the other hand, delays in accessing intermediate care services force patients to hospitals when they could have remained in their own home, lead to significant delays in discharging and, importantly, inflate pressures on acute services over winter months.
And it is exactly because of the imminent ‘winter crisis’ in hospitals and emergency departments that the Royal College of Nursing warned that the report’s harsh findings can no longer be ignored.
Its professional lead for older people and dementia care, Dawne Garrett, said: “This report shows the impact of failing to invest in intermediate care services, but it is also a warning that much worse is to come this winter without immediate investment.
“Intermediate services keep people out of hospital and support them to return home as quickly as possible. Aside from the obvious financial costs, every unnecessary visit to hospital has a personal cost of patients and their families.
“Preventative services are not optional, and if they are not properly funded the health service cannot function. The government must take action now before it is too late.”