GPs forced to admit older people to hospital

General practitioners are being forced to admit vulnerable older
people to hospital in order to secure them a suitable care package,
it has been revealed, writes Katie
Leason.

In some places, GPs are finding that the only way for their
patients to receive urgent attention from social services is for
them to be admitted to hospital, even when they are not suffering
from an acute medical disorder.

During the second reading of the Community Care (Delayed
Discharges) Bill, chairperson of the health select committee David
Hinchliffe said consultants at Pinderfields hospital in Wakefield
had told him that around a third of the hospital’s beds were
occupied by people who did not need to be in them.

“Some were delayed discharges, but others had been
admitted inappropriately by GPs,” he said.

In response, Howard Stoate, MP for Dartford and a practising GP,
said: “GPs sometimes admit patients inappropriately purely
because they cannot get the care packages in the home that they
would like and which would keep people in their home. Improving
social services care would make that a thing of the
past.”

GP Andrew Dearden, chairperson of the British Medical
Association’s community care committee, confirmed that this
practice took place but only because of the difficulties in getting
community-based provision from social services.

“It can take two weeks to see a social worker and then two
more weeks to get an entire care package in place. If you have
someone who needs a care package in the next day or two, then
waiting for two weeks is unacceptable,” he said.

Dearden added that sometimes doctors were forced to admit a
frail older person because doing so was the only safe option,
pointing out that in situations where individuals needed immediate
attention but a social worker was not available, doctors had
“very few choices”.

But GP Joe Neary, chairperson of the clinical network of the
Royal College of General Practitioners, claimed that research
demonstrated that in more than 80 per cent of cases, GP admissions
for older people were made on “solid medical
grounds”.

“If it occurs then it occurs in a minority of cases not a
majority,” he said. “In my own case there has been the
odd occasion where people have had complex problems and in an ideal
society they wouldn’t need acute hospital management if we
had been able to secure a package of social care. It can be
difficult to get a social care assessment that might prevent
hospital admission”.