Ageing population expected to pile pressure on services

Numbers of over 80s will increase by half in Yorkshire to 130,000 in the next two decades.

Around 60,000 people have dementia in the region but in the next 15 years numbers are expected to increase by 50 per cent, although in some parts, notably and East and North Yorkshire, it could be closer to 70 per cent.

Many frail patients do not need to be in expensive hospital beds but due a lack of support at home or poorly-developed community services, many find themselves spending longer in hospital.

Key to helping people leave hospital earlier or preventing their admission in the first place is improving community care with better co-ordination between GPs, community NHS teams and social services.

Efforts are also under way to improve healthcare in care homes amid evidence as many as 25 per cent of emergency hospital admissions from them are avoidable, with one analysis in Sheffield finding an eight-fold variation in admissions between care homes.

Further work is being directed at improving end-of-life care. More than half of people die in hospital instead of spending their final days at home.

One innovative venture in the Aire and Wharfe valleys around Keighley, Haworth and Ilkley has seen 1,200 mainly elderly patients being cared for at home or in care home beds during the last year for by nurses, physiotherapists, occupational therapists, social workers, mental health and other staff in the Airedale Collaborative Care Team.

The patients have heart or breathing problems, dementia or have suffered falls. Last month the service received a record 138 referrals for care which now even includes infusions of antibiotics by specialist nurses.

Its team leader Stephanie Lawrence said staff could visit as many times as needed but usually four times during the day, while overnight care was also available. It was not necessarily cheap, but it offered patients better quality care in their own environment.

Rob Dearden, director of nursing at the Airedale trust which faced the toughest target in the region in 2011-12 to shave £11.5m, nearly nine per cent, from its budget, said its resources were being shifted into the community. It had closed 30 hospital beds a year ago but 15 more had been opened in nursing homes alongside “virtual” beds in people’s homes.

“Most patients don’t want to come into hospital unless it’s necessary. It’s a question of treating the right patient in the right place at the right time,” he said.

In future it was hoped the trust could expand its outpatient services in Ilkley, Skipton and Settle, while patients in the Dales town of Grassington were accessing consultations with their hospital team using telemedicine.