Yet another study that shows better health care in the community saves money ! Shock !
£500 million and 7000 beds could be saved by cutting the numbers of elderly people in emergency admissions to A+E, the Kings Fund say. We all know that the care of the elderly in the NHS is poor and that the absence of proper community support and an integrated health and social care system often results in hospital stays which actually make things worse.
I remember at our last ACEVO health conference one of the new CCG leads saying they know that the way they commission dementia and elderly care is bad and often ends up making things worse for people not better.
The real issue is not the interesting results of this study, but that the NHS seem unable to act on the findings.
And the reason they are not is that we have a health service that is dominated by acute care in hospitals. We have to shift resources from hospitals to community and prevention services. That means closing hospitals.
It also means expanding choice and, yes, using a greater number of providers; especially from the charity and social enterprise sector.
And it is an inevitable conclusion that to achieve change we need to move resources from state run NHS services into third sector run provision. Age UK have been campaigning for radical change and have been pioneering new approaches. As the thinking over the next spending review starts we have to tackle the hold that hospitals have on the system. We need a national health service but we get a national sickness service.
We also need to put resources into prevention. Sir Hugh Taylor, Chair off my old hospital Guy's and Tommie's ( and former Perm Sec at DH ) is currently chairing an ACEVO task force on prevention; aiming to report in the autumn. It draws together leading figures from health , social care and councils with our own ACEVO CEOs. I hope it will make an important contribution to the debate on moving resources in an increasingly cash strapped NHS.