Last Updated on September 12, 2016

Regardless of the time of year, the pressures on acute hospital care are intense. In the context of an ageing population, growing demand and ongoing funding challenges, these pressures are likely to continue. With estimates of over 2 million unplanned hospital admissions per year of people aged over 65 questions are often asked such as: 'Do they really need to be there? Is there nowhere more suitable for them to go? What might prevent them coming into hospital?' Until now, little attention has been paid to the views of older people themselves, focusing more on the issues surrounding emergency admissions rather than looking at possible practical solutions.

However, a new study by the Health Services Management Centre and Department of Social Policy and Social Work, at the University of Birmingham, has addressed these issues from a different perspective.

104 older people were interviewed, exploring their experiences of emergency admissions. The research focused on whether the older people felt it was appropriate to be admitted to hospital and whether they thought anything could have prevented their admission.

45 surveys were received back from GPs or hospital doctors of the older people in the study. The study also involved interviews or focus groups with 47 health and social care professionals. Birmingham researchers believe this may be the first study in the UK (and possibly internationally) to estimate a rate of ‘inappropriate admissions’ from the perspective of older people.

Some key findings from the study include:

• Only nine older people (9%) felt they could have been cared for elsewhere. Their GPs or hospital doctors disagreed and felt their admissions (and those of other people on whom they commented) were entirely appropriate.
• Contrary to some media speculation, some older people appeared to have delayed getting in touch with emergency services, being very aware of the need to use scarce NHS resources wisely.
• While there was evidence of good initiatives to try to divert older people from hospital, the ways into these services were sometimes complicated, for older people and professionals alike.
• In the run up to admission, GPs and other primary care professionals were often in touch with the older people and at the point of admission, ambulance staff played a key role.
• Health staff felt that hospital admission was more likely to be avoided if older people had early access to specialist staff who understood the complexity of the health and social problems which older people may experience.
• Few older people mentioned receiving social care services prior to admission and staff felt that social care services needed more funding and capacity in order to prevent emergency admissions.
• A minority of respondents had dementia and their family members felt that some hospital services did not meet the needs of patients with dementia. They also felt that social care services were inadequate.

A number of themes for good practice emerged from the key findings. These key themes and other ‘top tips’ appear in a national guide to good practice which is being sent to every hospital, social services directorate and clinical commissioning group in the country. There is also a video summarising the key findings and highlighting the implications for practice.

The findings of this study confirm the belief that older people have an important role to play in helping understand the nature of emergency admissions and to devise appropriate responses to their rising numbers. The report's authors, Professor Jon Glasby, Professor of Health and Social Care and Rosemary Littlechild, Senior Lecturer in Social Work at the School of Social Policy, University of Birmingham say that ignoring this expertise could be detrimental to ensuring older people get the appropriate care they need.