Lack of care packages forces GPs to refer older patients to hospital

General practitioners are being forced to refer vulnerable older
people to hospital to secure suitable care packages for them, it
has been revealed.

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 illness.

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 about one-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 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 refer 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

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.”

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