Commissioners have been urged to double their investment in intermediate care, after an audit showed these services were unable to reduce the burden on hospitals due to ‘capacity’ issues.
The report – published today – found ‘little evidence’ that investment had increased nationally since last year when the first National Audit on Intermediary Care was published.
It warned that 70% of intermediary care users came from hospital wards in 2013, an increase from 65% in 2012.
It also identified that specialists in geriatric care should – in light of an increasing average age of intermediate care patients – play a greater role, as the ‘majority of people receiving intermediate care at home or in a care home receive medical cover from their GP and do not necessarily have access to other specialists.’
The report found: ‘With the exception of two CCGs who have doubled investment in their areas, there is little evidence from the audit that investment and capacity have increased nationally in 2013’
The audit covered half of the UK’s population and also focussed on the quality of services, obtaining feedback from over 8,000 service users for evaluation. The results suggest, generally, good patient experiences and positive clinical outcomes.
The report was published as NHS England medical director Sir Bruce Keogh published a report that stressed that care should be increasingly delivered in the community as A&E departments were ‘creaking at the seams’.
Professor John Young, national clinical director for integration and frail elderly at NHS England, said: ‘These services offer clear alternatives to our dominant system response of hospital care: step up care for admission avoidance; step down care for early hospital discharges.
‘It has shown that the provision of these important community services is still only about half of that needed. This is likely to be causing poor care experiences and delays across the whole health and social care system.’
Claire Holditch, project director for the National Audit of Intermediate Care, NHS Benchmarking Network said: ‘Commissioners need to give serious consideration to the overall capacity of their intermediate care services and particularly to what capacity is available to prevent admissions from happening in the first place. Additional investment in services which provide care in the community is vital if pressure on hospitals is to be reduced.’