Health Secretary Jeremy Hunt has announced plans for a new strategy for the care of vulnerable, older people - the largest subgroup of NHS users - to help drive up efficiency and outcomes across the system.
Touching on the perceived crisis in A&E (which he noted has now actually been hitting targets over the last five weeks), Hunt told delegates at the NHS Confederation conference that the fundamental problem is that the health service is not geared up to preventing patients from seeking urgent care in the first place.
The NHS, he claims, is performing very well under difficult circumstances, with recent achievements including 400,000 more operations being carried out since the coalition took power, low waiting times, and MRSA rates having been slashed in half.
But ensuring an effective service for the ageing demographic – which is placing an unprecedented strain on the system – needs continued action across the entire healthcare landscape.
Data shows that £7 out of every £10 spent on the health budget is linked to patients with long-term conditions such as dementia, and the over 75s account for 35% of emergency admissions, many of which may be unnecessary.
“A&E and hospitals aren’t the right place for people with dementia,” he noted, adding that people who do not need to be in A&E take up a huge amount of time and resource, underscoring the need to address underlying causes of why they have ended up there.
To that end, the government is putting together a plan for vulnerable older people that will be published in October and implemented in April 2014, he told delegates.
The plan, he said, will cover three key elements: access to primary care, particularly what happens to patients before and after ‘crisis point’; enhanced urgent and emergency care, a review of which is currently being undertaken by Sir Bruce Keogh; and removing barriers to integration, with better care planning for patients with long-term conditions.
Hunt also said he would like GPs to become accountable clinicians for vulnerable patients once discharged from hospital, arguing “we need to rediscover in a modern context the idea of the family doctor”.