Old person hospital admissionA new report from NHS Benchmarking has for the first time combined financial, workforce, quality and outcome data to paint a uniquely detailed picture of current standards in acute hospital care for older people.

Key findings from this innovative new report show that 46% of older people admitted to a specialist ward have a condition associated with frailty, but that only 42% of hospital trusts currently have a specific frailty unit in place.

The report also provides detailed new data on the use of acute beds, and the amount of hospital capacity taken up by patients with complex needs. Figures show that 45% of total bed days were used by the 6% of patients who remain in hospital for longer than 21 days.

Other figures reveal that 34% of hospital trusts or local health boards have a dedicated geriatric medicine team located in accident & emergency wards, and that 86% of hospital wards specialising in care for older people practice Comprehensive Geriatric Assessment.

Speaking at the launch of the report, Project Director of NHS Benchmarking Claire Holditch said: “Although the new models of care mean that older people are increasingly being cared for outside hospital, there will always be occasions when an older person needs a period of acute hospital care.It is essential that we understand what happens when an older person is admitted to hospital, and identify factors which can improve the quality of their care or help them to get them home quickly."

This new benchmarking review of the acute pathway concentrates on four elements: admission avoidance in A&E, assessment in the acute pathway, inpatient ward care, and supported discharge. It gives us new details about what is happening currently in acute care, and offers an analysis of best practice in the care of older people.

The project also looks at new models of acute hospital care: interface geriatrics, frailty units, linkages with intermediate care services, primary care, community care and specialist mental health services, and new models for discharging patients from hospital like “discharge to assess”. We hope that Trusts / LHBs will find the report useful, and that its outputs will drive improvements and feedback for the future.”

Professor David Oliver, President of the British Geriatrics Society, said: "People over 65 account for around half the admissions and three quarters of bed days in NHS hospitals. Many have frailty, dementia, disability and complex co-morbidities. Their care is very variable in terms of processes, assessments, activity and outcomes."

NHS Benchmarking have produced a very broad and deep set of measurements to describe variation, care gaps and areas for improvement which can help clinicians understand their own services, compare them to others and drive improvements in care for patients. I hope that every acute hospital can adopt this audit as a matter of course"