Viewpoint: GPs must work with partners to improve community services

The King's Fund says over 2m elderly and vulnerable people are ending up in hospital because of poor care in the community. GPs should work collaboratively to improve the situation, writes Mike Adamson, managing director of operations, British Red Cross.

Over 2m elderly and vulnerable people are ending up in hospital because of poor care in the community.
Over 2m elderly and vulnerable people are ending up in hospital because of poor care in the community.

Yesterday's coverage of The King’s Fund report highlighting that over 2m elderly and vulnerable people are ending up in hospital because of poor care in the community is extremely worrying for the sector, and extremely upsetting for the patients themselves.
However it is not a surprise. Too frequently services in the community are not joined up or integrated with the acute sector, leading to poor experiences and often poor outcomes for those involved. This can also result in an over-reliance on hospital services even when there is no clear clinical need, as the report highlights. There have been many attempts to rectify this, and there are several signs of movement in the right direction (including the draft Care and Support Bill’s new duties around preventative care), but it is moving far too slowly.

Cuts in community care
Earlier this summer British Red Cross research with GPs showed that cuts and under-investment are rife in precisely the kind of community care services that could help keep people out of hospital and free up some of the 7,000 hospital beds highlighted in the The King’s Fund report. In our survey three quarters of GPs said there were not enough preventative services in their area to help patients avoid hospital admissions, and more than 90% thought that extra money should be spent on preventing people from needing intensive health and social care.
The British Red Cross totally agrees with the GPs’ views. Each year our staff and volunteers support more than 400,000 elderly and vulnerable people in their own homes and communities to rebuild their confidence, independence and resilience. This support, which bridges the gap between hospital and the community addresses their wellbeing holistically, and helps them live healthier and happier lives.

For vulnerable people at times of potential crisis in their lives we often find that just a little bit of practical and emotional support can make the difference between coping or not, between a hospital admission or not. For example the pensioner who needed a simple course of antibiotics to recover from her illness, but who would have been unable to remember to take the vital tablets every day without our support. Or the cancer sufferer who returned to his house to find it had flooded while he was in hospital, something that could have easily resulted in an emotional crisis had we not been on hand to provide support.

Savings for commissioners
And as well as making a huge difference to elderly and vulnerable people’s lives, this kind of support can also make a huge savings for commissioners. An independent economic analysis of the Red Cross’s lower-level and preventative care services showed they can save the state up to £10,000 per patient in reduced bed days and preventing conditions worsening. This is often achieved by effective signposting and helping individuals to build better links with community services.
So it can be done. And as The King’s Fund report highlights, the answer to these well-known problems is to be found in a joined-up approach. GPs, hospitals, councils, commissioners, politicians and voluntary sector community providers, all need to work together to make community services the best they can be. Then not only will patients be getting the joined-up care they need, but the system will also save hundreds of millions of pounds.

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