Intermediate care helps older people avoid unnecessary admissions to hospital, return home after leaving hospital, and delay moving into costly residential or nursing homes.
High-quality provision of intermediate care has been shown to improve outcomes for patients, and reduce pressures on acute and social care services. This includes patients admitted to hospital when they could have remained in their own home, or waiting longer in a hospital bed when they could have been supported to return home earlier.
Conversely, any delays in accessing intermediate care may lead to delays in discharging typically older patients from hospital, increasing pressure on acute services over the busy winter months; reports predict that winter pressures will be particularly challenging in 2015-16.
Speaking on behalf of the NAIC, Professor John Young 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 public. In many ways, the success or otherwise of the New Models of Care, and other current whole system initiatives, will ultimately depend on capacity building in the intermediate tier. This year’s National Audit of Intermediate Care reveals why we need to bring these services out of the shadows: it’s imperative that decision-makers heed and respond to its findings.”
Data published in the NAIC’s 2015 report shows that demand for intermediate care continues to outstrip capacity. The provision of intermediate care needs to approximately double to meet increasing demand. Instead, funding has remained static over the last three years, impacting negatively on the availability of services for older people, and undermining the Government’s ambition to reduce hospital admissions.
The evidence also shows intermediate care driving improved working practices and closer working between the NHS and Adult Social Care services (52% of CCGs now use pooled Better Care Fund budgets, up from 38% last year), and that these improvements lead to better patient outcomes for older people (including their chances of returning home, improving their daily living activities, and reducing loneliness and isolation).
The 2015 National Audit of Intermediate Care analysed data across four service categories (crisis response, home based intermediate care, bed based intermediate care and re-ablement services), covering 340 services and 12,000 responses from service users to build up a comprehensive picture of intermediate care services across the UK.