Elderly forced into A&E as faith lost in care outside hospitals

The number of elderly people being taken to accident and emergency units has doubled in five years, amid warnings from senior doctors that patients and health professionals are losing faith in care outside hospitals.

Official statistics released on Tuesday showed a 93 per cent rise in the number of patients over the age of 90 going to casualty, with the number sent by ambulance more than doubling.

Dr Cliff Mann, president of the College of Emergency Medicine, said millions of frail and vulnerable patients were being treated as an emergency because neither they nor those employed to care for them had confidence in GP out-of-hours care.

The senior doctor said far too many pensioners were being sent to casualty units, where they were likely to become increasingly confused and disoriented, because they were not treated for simple infections in time.

The figures from the Health and Social Care Information Centre show that in 2012-13, 1.16 million patients in their 80s arrived in casualty units — a rise of 65 per cent in five years, with a 75 per cent increase in the number sent by ambulance.

Last year, more than 362,800 patients above the age of 90 arrived at A&Es — a rise of 93 per cent since 2007-08.

The figures cover the last two years of the Labour government, when the steepest rises took place, as well as the three years since the last election.

Rising A&E attendances by age

 Age             2007/8            2012/2013         Rise

0-9 1.68m 2.66m 58
10-19 1.71m 2.13m 24
20-29 1.97m 2.95m 49
30-39 1.53m 2.18m 42
40-49 1.35m 2.08m 53
50-59 0.96m 1.65m 65
60-69 0.85m 1.4m 65
70-79 0.81m 1.3m 56
80-89 0.69m 1.16m 65
90+ 0.19m 0.36m 93
TOTAL 11.9m 18m 51


Dr Mann, an A&E consultant, said: “Increasingly, what we are seeing is a default situation where older people end up in A&E, without even phoning GP out-of-hours services, because they, or those caring for them, have given up on them.

“Staff in nursing homes will call for an ambulance because they know one will be there quickly — whereas they have learnt from experience that it is far more difficult for them to try to get a doctor out.”

Labour on Tuesday night blamed the increases on cuts to social care and reduced council budgets for services such as home helps.

However, Jeremy Hunt, the Health Secretary, said that too many elderly people were ending up in hospital because of the flawed GP contract that allowed family doctors to abandon responsibility for out-of-hours care.

From April, GPs will have to take around-the-clock responsibility for the care of all patients aged 75 and over.

Mr Hunt said: “Labour’s disastrous 2004 GP contract left many vulnerable elderly patients without good out-of-hours care, so it’s rank hypocrisy for them now to complain about the consequences of their historic mistake. We have ripped up that contract and are bringing back proper family doctoring, with named GPs for older people to help relieve A&E pressures.”

The figures also show a 65 per cent rise in A&E attendances among people in their 50s and 60s over the five years, and a 56 per cent rise among those in their 70s. Across all age groups, the increase in patients attending A&E was 51 per cent.

Since the 2010 election, there has been a 25 per cent rise in people in their 80s attending A&E units in England, and numbers rose by 44 per cent for among those in their nineties.

Last year, the head of the Care Quality Commission said emergency services were “out of control” in large parts of the country because of increasing numbers of frail elderly patients being admitted instead of being given care to keep them out of hospital.

Despite mild weather in most areas and unusually low levels of flu in recent weeks, most NHS trusts with large A&E units have missed targets to treat 95 per cent of patients within four hours.

Caroline Abrahams, the charity director of Age UK, said: “It is important that older people receive the treatment and care they need, and sometimes this means going to hospital. However, we know that in some cases being admitted to hospital is the consequence of not getting good quality care at home.”

Andy Burnham, the shadow health secretary, said: “The Government’s severe cuts to social care have left thousands of older people without the support they need — at risk of going into hospital and getting trapped there. It is one of the root causes of David Cameron’s A&E crisis.

“It is appalling to think that, every week, there are thousands of frail and frightened people speeding through our towns and cities in the backs of ambulances to be left in a busy A&E. This is often the worst place for them to be and a disorientating experience that can cause real distress. With proper support in the home, this could all be avoided.”