With around two-thirds of all hospital beds occupied by people over the age of 65, care for elderly patients has long been recognized as key to the sustainability of the NHS. So how does it respond to this challenge and what can the industry do to support it? Oli Hudson, chief content officer at Wilmington Healthcare, explains what’s changing and how the industry should respond.
It cannot be overemphasized that the backlog of 6.8 million care is, in large part, a backlog of elderly care – making it a critical area for the mission of the NHS.
Like our recent State of the Nation report shows that older age groups have been disproportionately affected by the withdrawal of health services during the pandemic. Adult patients in the 55+ age brackets experienced 2.5 million fewer hospital care episodes in 2020-21 compared to the previous year, with those over 85 seeing more than one million fewer episodes alone.
Lanes are also compromised by serious and long-standing shortages in the provision of social care – a problem the Health Secretary is seeking to address through a new £500m winter fund announced more early this fall – along with the well-recognized labor shortages and capacity challenges affecting services.
New ways to deliver care
For all these reasons, elderly patients are of vital strategic importance to integrated systems of care (ICS), and many are now working with health and care organizations to introduce new ways of caring for them. This includes:
- The introduction of technology-enabled care, such as virtual wards and other telemonitoring solutions, which can enable more patients to be cared for safely at home (or in a nursing home).
- The expansion of preventive health services, such as frailty clinics or fall assessment services, the presence of social prescribing professionals in medical offices and greater collaboration with social services and health teams mental health, to help identify and support those at risk.
- Investment in multidisciplinary community health support, such as improved after-hours crisis response services and a more proactive approach to nursing home support through the Enhanced Health In Care program Home.
- Changes in the operation of hospital services, such as the introduction of same-day urgent care services, patient-initiated follow-up (PIFU) for outpatient care, and the continued expansion of virtual clinics to support patients and primary care teams.
Understand the practical implications of change
All of this has practical implications for how the pharmaceutical industry works with the NHS.
First and foremost, there will be significant changes in the care pathway, involving different entry points (e.g. digital or community referral) and involving a much wider range of health and care professionals.
In particular, there will be expanded roles for nurses, allied health professionals, pharmacists and advanced practitioners, as well as greater overlap between acute/specialist and community teams – which will need to be considered in planning for the brand.
Pharma will also need to work closely with NHS organizations to help them manage risk, while directly supporting older people and their carers to educate and inform them of changes in their care.
Specific challenges and complexities can emerge when it comes to decisions about how drugs are administered. Oral or subcutaneous methods have gained popularity over hospital-based infusion for convenience during the pandemic, but may create compliance issues in some older patients.
How these risks can be mitigated – either by improving the skills of frailty teams and community health professionals, or by returning to more traditional hospital-based infusion methods – must be part of the conversation that pharma has. with NHS customers.
Build a credible answer
Industry’s response must also be weighed against the headwinds that many healthcare organizations will face. Insufficient access to diagnostics, delays in discharge from hospital due to lack of social care schemes, and labor and skills shortages along the journey can limit what the NHS can do with realistic way for his elderly patients.
So how should the pharmaceutical industry build a credible case?
First, it is important to understand local realities. This may include reviewing current referral patterns, wait times and other access issues, workforce capacity challenges and development plans, and current commitments. taken to improve service delivery for elderly patients in the CSI five-year plan. Be sure to leverage all relevant data and evidence to inform your approaches.
Second, it can be useful to invoke national politics to argue for change. For example, it is worth examining the growing collection of Getting It Right First Time (GIRFT) reports, which describe best practice case studies and outline variations in clinical practice across a range of specialties (including geriatric medicine). The NICE guidelines are also essential reading.
Third, it is important to work with CSIs and the wider clinical community to raise awareness of the disease and facilitate best practices. The pharmaceutical industry can rely on a multitude of national and international experiences to influence the thinking of local decision-makers. Developing relevant, evidence-based case studies can help illustrate the potential difference your offer can make.
In short, no one doubts that the challenge of caring for growing numbers of elderly patients is here to stay – indeed, the number of over-85s living in England is set to double over the next 25 years.
This will likely bring huge challenges for NHS customers, but also – of necessity – present important opportunities to rethink how the health and care system supports us as we age and become more frail.
Pharmacy must be actively involved in this debate. By engaging intelligently with CSIs, it can make a significant difference for many cohorts of older patients today – and play a role in making the health and care system more efficient and resilient for the future.
Wilmington Healthcare has unrivaled healthcare knowledge, data and intelligence across the NHS. We can help you truly engage SCIs by understanding their individual operating models, needs, priorities and goals. To find out more about how we can support your NHS partnerships, visit www.wilmingtonhealthcare.com.