Older patients are finding it difficult to access GP support

Significant numbers of older patients are finding it difficult to access the support they need from their GP, according to a new report from Age UK.

The State of Health and Care of Older People in England 2023 documents how our health and care system is struggling, and too often failing, to meet the needs of our growing older population.

The Charity says this shows that as a nation we need to switch away from our current over-reliance on acute hospital based care, towards a laser focus on prevention and early intervention to enable older people to stay fit and well in their own homes, and in care homes. This would be far better for older people and would also alleviate pressures on hospitals.

It found that one in six emergency admissions of people over 75 occur within 30 days of last being discharged from hospital and 36,000 fewer older people a year are receiving long-term care.

Small health problems mushroom into crises for older patients

The new report also shows how significant numbers of hospital admissions of older people could be avoided if they received help earlier on, before small health problems mushroom into crises requiring urgent clinical support.

Other findings include:

• In 2021/22 there were 4.8 million A&E attendances by older people.
• The rate of A&E attendances amongst over 80s went up by 40% between 2012/13 and 2021/22.
• In 2019/20 alone there were 855,000 emergency admissions to hospital of older people which could have been avoided with the right care at the right time.
• Once admitted, older people have longer hospital stays and are more likely to experience delayed discharge. Over winter 2022/23, between 13,000 and 14,000 patients were stranded in hospital on any given day, up from around 4,500 in the same period in 2018/19.
• 45% of older people were concerned about their ability to access their GP.
•  40% of older people did not feel they had enough support to manage their health conditions.
• One in five (20%) unpaid carers are aged 65 plus and many are having to pick up many hours of support.
• 85% of older carers are worried about whether they would be able to keep caring or providing support.

Paul Farmer CBE, Chief Executive of Age UK said: “In many ways the picture painted by our new report is deeply depressing, but what strikes me the most is the wonderful opportunity we have now to switch to a much more effective approach to providing health and social care services for older people in their own homes and in care homes. After all, if we don’t do it on the back of findings like these, when will we?

“It’s clear that we need services to reach out to older people much sooner, particularly those living at home, quite often alone, whose health is fragile or declining. This would not only be great news for older people, and their families, providing much needed reassurance, it would be cost-effective too. And it would go a long way to relieving the enormous pressure on hospitals as well.

“Sometimes older people do need to go to hospital of course, but at the moment too many are doing so for want of the help they need at home. Then if they are admitted they are at risk of getting stuck in a hospital bed once medically fit to leave. That’s incredibly miserable for them and also jeopardises their recovery.”

The report calls for:

• A strong strategic push, nationally and locally, to reverse the decline of primary and community health services and social care, so many more older people get more help, earlier, enabling them to stay well for longer at home and reducing their reliance on crisis health care in hospitals.
• More community-based services to be developed and joined up in local areas so they include doctors, nurses, physiotherapists, social care staff, among others, and the voluntary sector too, working closely with GPs and their practice teams. These services also need to be able to flex to respond to older people’s and their unpaid carers’ needs, especially where the latter are themselves older people, as in the case of older couples.
• The principle of ‘home first’ as the foundation of our approach to health and social care for older people now and into the future.