Faced with an ageing population and a growing number of people with long-term conditions, a common concern for policy makers has been that high levels of emergency hospital admissions concentrate too many resources in expensive, acute care, leaving insufficient funding to invest in community-based alternatives. Under successive governments, this has led to a series of attempts to make more effective use of hospital beds, recognising that these are scarce resources for which demand outstrips supply.
While various approaches have been adopted over time, pressures on acute care remain intense and the received wisdom is that admissions continue to be influenced in part by the help-seeking behaviour of patients, of their carers and sometimes of paid care workers in the community (with patients and professionals alike ‘still ‘defaulting’ to hospital in a crisis).
Overall, we believe that part of the problem is that emergency hospital admissions occur for diverse and complex reasons – and that different stakeholders often have different views as to the nature of the problem and the best course of action. In response, this study seeks to draw on multiple methods of exploring emergency admissions and on different perspectives from research, from practice and from the lived experience older people and their families. This is crucial if an issue as multi-faceted as emergency admissions is to be fully understood in the round and – where appropriate – reduced.
With this in mind, HSMC new research will review the formal evidence about the rate and cause of potentially avoidable admissions. However, we will supplement this with original research to explore older people’s experiences of emergency admission and their ideas for more preventative approaches. Where the older people and their families would like to, this will also include consideration of a family/carer perspective. In addition we will work with local health and social care professionals to examine their ideas about the scale and cause of potentially avoidable admissions, and any service developments that could prevent admissions altogether.