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Integrated care would cut '2.3 million emergency hospital admissions in older people'

More integrated care between GPs and community and social care services could prevent millions of emergency hospital admissions in the over-65s each year, a leading think tank has suggested.

The paper from the King's Fund said that if the bottom 75% of PCTs performed as well as the top 25%, PCTs could save £462m a year that could instead be used in community support and primary care services.

It said this would reduce emergency bed use in over-65s by 7,000 beds, equating to a reduction of overnight stays by 2.3 million per year.

The think tank said that while links between bed use and access to community services such as GPs, community nursing and social care are not clear-cut, areas with low bed use tended to run a more integrated service overall.

By contrast, the areas with the highest bed use tended to have excessive lengths of stay for patients for whom hospital was a transition between home and supported living, while areas that have well-developed, integrated services for older people have lower rates of bed use.

Interestingly, areas with higher numbers of older people were found to have proportionally lower rates of bed use. The think tank said these areas might be more likely to have prioritised the needs of older people and to have developed more integrated service models.

Candace Imison, deputy director of policy at The King's Fund, said: ‘There is no clear correlation between investment in community beds, social care or GPs and use of hospital beds.

‘The answer seems to lie in how the whole system operates together to ensure services deliver more than the sum of the individual parts.'

Dr David Jenner, a GP in Cullompton, Devon, and senior policy adviser at the NHS Alliance, said: ‘This research is hugely interesting for GPs in their CCG and commissioning roles, because hospital use has been estimated to count for up to two-thirds of CCG budgets if you take out prescribing costs.

‘They should look at the figures broken down by area and reflect on the reasons behind the variations.'

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