Hospital care could be “on brink of collapse”

HOSPITALS in England are failing to keep pace with rising demand and increasingly complex patient needs, according to a report from the Royal College of Physicians.

It said there are a third fewer general and acute beds now than there were 25 years ago despite a 37 per cent rise in emergency admissions in the past 10 years.

This comes amid a backdrop of changing patient needs as nearly two-thirds (65 per cent) of people admitted to hospital are over 65. An increasing number are frail or have dementia. The report, Hospitals on the edge? The time for action, says hospital buildings, services and staff are often not equipped to deal with those with multiple, complex needs.

The RCP has said this is having “detrimental effects on patient care”, warning that acute hospital care could be “on the brink of collapse”.

RCP members have named a lack of continuity of care as their biggest concern about the current health service. The report said it is also 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.

The college is calling for a redesign of services to “better meet patients’ needs” which may include concentrating hospital services in fewer, larger sites that would be able to provide excellent care round-the-clock, seven days a week.

Community services must also be improved as many patients end up in hospital due to a lack of help close to home. This includes improved access to GP out-of-hours care.

RCP president Sir Richard Thompson 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.”

He said “drastic changes” are needed and called on the government, the medical profession and the wider NHS to work together to address the problems. He added that the RCP has set up the “groundbreaking” Future Hospital Commission to look for ways to improve processes and standards for treating medical inpatients.

Responding to the report, health minister Dr Dan Poulter told BBC News: “It is completely wrong to suggest that the NHS cannot cope - the NHS only uses approximately 85 per cent of the beds it has available, and more and more patients are being treated out of hospital, in the community or at home.

"But it is true that the NHS needs fundamental reform to cope with the challenges of the future. To truly provide dignity in care for older people, we need to see even more care out of hospitals. That's why we are modernising the NHS and putting the people who best understand patient's needs, doctors and nurses, in charge."