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Basic care of older people can be assured by expanding capacity and both the NHS and social care workforce

7 September 2022

Responding to the findings in the Emergency Medicine Journal article Emergency departments not set up to meet basic care needs of frail older people, Dr Rachael Morris-Smith, Chair of the Older People in Emergency Medicine Special Interest Group at The Royal College of Emergency Medicine, said:

“Although the study is small and only conducted in England, these shocking findings will be familiar to some Emergency Medicine staff. Many older patients require assistance with eating, drinking, toileting and have a need for clear communication and care throughout their patient journey. It is completely unacceptable that these aspects of care are not always addressed; no member of staff would wish for these fundamental care duties to be missed.

“There is no doubt that Health and Social care is in a deep crisis. Many of the issues highlighted are a direct consequence of widespread staff and bed shortages, exit block and the crisis in social care. Health care workers are distressed and face moral injury every day due to their inability to provide the quality of care they are trained to provide. Older patients are disproportionately affected by this crisis. Hospital Episodic Statistics show that the older the patient attending an Emergency Department the longer they have to wait to be seen for treatment from their time of arrival in the Emergency Department.

“We urge the new Prime Minister Liz Truss to commit to publishing a fully-funded long-term NHS workforce plan and to bolster the social care workforce. It is also crucial that the government fulfils its pledge to open 7,000 more beds this winter. With a greater social care workforce, more NHS staff and more beds, the basic care needs of older patients will be assured.”

Responding to the findings of the EMJ article, Dr Anu Mitra, Topic Lead for the Care of Older People Quality Improvement Project, said:

“The College recognises the urgent need for better care for older patients – especially with an ageing population. To highlight these issues and to advocate for and improve the care of older people, the College has an active working group – Older People in Emergency Medicine Special Interest Group. Care of Older People is also a key priority in the College’s National Quality Improvement Programme. We accept that, despite the wider challenges in the Urgent & Emergency Care landscape, there is the potential for Emergency Departments to improve the quality of care for older patients.

“Many departments are already delivering innovative pathways for older patients. These include Acute Frailty Units, Hospital at Home Teams, and specialist Geriatric Emergency Medicine Teams which work to reduce the harm caused to older patients from long waits in the Emergency Department.

“Despite this good work, many older patients continue to face negative experiences in Emergency care. Overstretched staff cannot be expected to deliver more. We urgently need investment in these services, expansion of social care, and recruitment into the NHS. We must not abandon older and more vulnerable patients to long, uncomfortable and dangerous waiting times, and fail to provide even the most basic care duties.”

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