‘Health STIs’ planned for people aged 65 and over arriving at A&E in England | National Health Service

People aged 65 and over arriving at A&E in England who appear frail will soon receive a “health MOT at the front door”, the head of the NHS will promise.

A&E units should begin testing everyone that age to see if they are frail or have any other underlying conditions and then organize any care they may need.

NHS England hopes the initiative will reduce the number of older people admitted to hospital and eliminate overcrowding, “tram waiting” and “corridor care”.

Amanda Pritchard, the organisation’s chief executive, will tell an audience of health service chiefs on Wednesday that they must ensure that by next April all A&E units start offering detailed assessments of older people’s health. However, the service will only operate for 10 hours a day.

“Health MOTs at the entrance door of emergency centers for the elderly could be a lifesaver for many. From blood pressure tests to a review of their fall history, these checks mean patients can be quickly assessed and directed to the appropriate support for their needs,” Pritchard will say.

“Although some people need to be admitted, it is not always the most appropriate place for the needs of older patients, and they can quickly lose mobility while in hospital.”

The initiative is an effort by the NHS to change the way care is delivered to relieve pressure on hospitals and adapt to the growing demands of an aging population.

Assessing frailty is important because falls and resulting injuries, such as bone fractures, are one of the most common reasons many older people spend time in the hospital.

“Half of hospitalized patients aged over 65 are affected by frailty, and the growing number of people with frailty will have a significant impact on future health and care services,” said Sir Julian Hartley, chief executive of NHS Providers. .

Although some hospital and community services offer innovative care to these people, “too many frail people who need well-planned, integrated care are still not receiving the support they need,” Hartley added.

Checks will also include testing of older patients’ heart health, mobility, risk of malnutrition and any history of respiratory problems. Anyone considered at risk of a fall will be referred to the hospital’s falls service, while those with other needs will receive care from specialist teams, such as those caring for people with dementia.

More than a million people aged over 75 are admitted to hospital each year in England and around one in five are seriously frail. Doctors are concerned that older patients will become “deconditioned” while hospitalized and lose muscle mass, which can increase their risk of falling and being readmitted to the hospital soon after.

Some hospitals are already giving older patients “ITVs” that will become standard next spring.

For example, the acute frailty assessment unit at the Princess Royal Hospital in Orpington, Kent, now gives a frailty score to more than nine in 10 patients it admits aged 65 and over. That has helped the hospital bring more patients home early and doubled the proportion of those discharged within a week.

A specialist clinical emergency nurse identifies frail older people, while the frailty team works closely with London Ambulance Service, community health services and local GPs.

However, emergency room doctors warned that the checks could obscure what they believe are the real reasons why so many people end up in A&E and often have to wait a long time for treatment.

“Focusing on interventions like this distracts from the root causes of long waits in emergency departments. These include a lack of staffed beds and difficulties discharging patients as social care and community services are struggling,” said Dr Ian Higginson, vice-president of the Royal College of Emergency Medicine.

“Unless these fundamental issues are addressed, we will continue to see long waits in our EDs (emergency departments) and patients will continue to be harmed as a result.” There was no evidence that frail patients contributed to ED overcrowding, he added.

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