Tens of thousands of elderly and vulnerable people will receive tailored support at home as part of a new NHS plan to improve waiting times for emergency care.
The announcement comes as the Government and the NHS has published a new urgent and emergency care plan. A key part of the plan will be reforming the way the NHS provides services to adapt to the population’s changing needs, including by expanding care outside of hospitals
Falls and frailty teams mainly consist of nurses and, while already in existence, this plan goes further and will see the standardisation and scaling up of these services. Building on learnings from this winter, it will aim to ensure more services are in place in time for next winter, with local areas developing plans to do this. These teams join up care by connecting hospital expertise with emergency services and use technology to reduce the risk of falls by remotely monitoring patients.
With an ageing population, falls are becoming increasingly common, and some people are less able to cope and recover from accidents, physical illness or other stressful events, which can lead to serious injuries, hospital admission and subsequent moves into long-term care. These services support vulnerable patients at home and in the community to remain living independently for longer, with up to 20% of emergency hospital admissions avoidable with the right care in place.
The NHS has already rolled out virtual wards – treating patients in their own homes – with growing evidence that these are a safe and efficient alternative to hospital care, particularly for frail patients. These see patients being supported by clinicians to recover in the comfort of their own home, rather than in hospital – and have increased the number of patients that can be cared for in this way by 7,000, a 50% increase since last summer. Another 3,000 ‘hospital at home’ beds will be created before next winter and the plan will include an ambition to see up to 50,000 people supported a month.
High-tech virtual wards currently support frail elderly patients or those with acute respiratory infections and cardiac conditions. Patients are reviewed daily by the clinical team who may visit them at home or use video technology to monitor and check how they are recovering.
Health and Social Care Secretary Steve Barclay said: "The health and care service is facing significant pressures and, while there is no quick fix, we can take immediate action to reduce long waits for urgent and emergency care. Up to 20% of hospital admissions are avoidable with the right care in place. By expanding the care provided in the community, the most vulnerable, frail and elderly patients can be better supported to continue living independently or recover at home.
"This includes rolling out more services to help with falls and frailty, as well as supporting up to 50,000 patients a month to recover in the comfort of their own homes. Not only will patients benefit from better experiences and outcomes, it will ease pressure on our busy emergency departments."
Urgent community response teams will also be scaled up to increase the number of referrals and patients seen by a range of health and social care professionals within 2 hours, with services running 12 hours a day. According to the latest data, across the country, over 80% of patients referred were seen within 2 hours. These teams work with 111 and 999 services to provide urgent care to people in their homes, avoiding the need for hospital admissions and enabling people to live independently for longer, backed by a planned £77 million investment to support systems to continue to improve community health services in 2023 to 2024.
Falls and frailty services have already been shown to improve patients’ experiences, and reduce pressure on urgent and emergency departments. For example, South Warwickshire University NHS Foundation Trust has rolled out an integrated frailty service linking up emergency services and hospitals.
As part of this, ambulance crews who are with the patient at their home can arrange a remote consultation with input from a consultant to agree the best course of action – from monitoring on a virtual ward to a face-to-face assessment. Thanks to this approach, there has been a 16% reduction in the number of patients aged over 75 being taken to hospital in an ambulance, enabling frail older adults to recover at home, where that is best for them.
