Survivor ‘strain’ on A&E units
RECORD survival rates for heart attacks and strokes are heaping pressures on Accident & Emergency departments, a major study has found.
The research, published as watchdogs warned that the NHS is “straining at the seams”, found that emergency admissions are being fuelled by increasing numbers surviving deadly conditions. Today, the Care Quality Commission said the health and care system was “struggling to cope with 21st century problems” – with demand exacerbated by poor “lifestyle choices”.
Its report, which calls for a major overhaul of the system of health and social care, shows hospital occupancy is the highest in the history of the NHS. Sir David Behan, the CQC chief executive, suggested bulging waistlines and increasingly sedentary lifestyles were heaping strain on hospitals, driving increased rates of conditions like diabetes and heart disease.
The study, led by City, University of London and Imperial College London, found NHS improvements treating emergency arrivals are a major cause of the extra demand. Researchers tracked 10million hospital admissions for acute events, such as heart attacks or strokes, over a decade. They found that around 37 per cent of the subsequent rise in
emergency admissions was among those whose lives had previously been saved, thanks to advances in cardiac care. The improvements saved an extra 4.04 lives per 100 admissions, but also resulted in an additional 7.72 emergency admissions in the next year, from those who would previously not have been expected to survive.
The results, published in Health Services Research, found “the survival effect” caused around 426,000 extra emergency admissions annually by 2012. In today’s report, Sir David said the NHS and care system was not set up to deal with demands of patients now. Poor “lifestyle choices” meant an ageing population was living longer but suffering from multiple conditions, such as diabetes and heart disease.
“The NHS was created in the middle of the 20th century when the big issues it was attempting to deal with was diseases like TB and polio,” he said.
“Today the NHS and social care are dealing with obesity, diabetes, coronary heart disease, cancers, dementia – all of which are driven less by those diseases of the middle of the last century and more by lifestyle choices. Our healthy life expectancy is not keeping pace with our life expectancy and it is that which is driving the demand.”
The report warns hospitals are the most crowded in their history, with bed occupancy reaching a record high of 91.4 per cent this year, amid an increasingly “precarious” care sector.
“The system is normally deemed to be running efficiently when occupancy is 85 per cent and this is the highest ever occupancy that has been recorded for the NHS,” the chief executive said.
Meanwhile, the number of beds in nursing homes has plunged by 4,000 in the last two years, at a time when demand is rising. The watchdog also warned of rising shortages of staff in hospitals, highlighting a 40 per cent rise in medical and dental vacancies and a 22 per cent rise in nursing and midwifery vacancies over the period.
Caroline Abrahams, charity director at Age UK, said care in Britain was like “a rubber band that’s been stretched as far as it will go and can’t stretch any further”. She said it would be “reckless” for the Government to delay acting on the issue.