Integrated care - an unexpected solution to the A&E crisis

It was not the best start to 2015 as the word 'crisis' flashed up on our TV screens and headlines revealed our NHS cracking under pressure.

Hospitals up and down the country were experiencing crises in their Accident and Emergency departments, with some even declaring a 'major incident'. As the number of people attending A&E increased, fewer people were being treated within the four hour target time frame. A tent was even erected in the car park of Great Western hospital in Swindon in order to make extra room for patients to be treated.

The pressure on hospitals is exacerbated when patients who attend A&E in the first instance then require further attention elsewhere in the hospital. Patients were left on trolleys for hours on end, while the doctors and nurses around them struggled to find sufficient beds.

While there is no single solution, the care of older people is an element which needs to be looked at closely as a way to help reduce the burden on A&E departments, and hospitals in general. The UK has a rapidly ageing population which increases pressure on our healthcare system.

Shadow Health Secretary Andy Burnham MP has stated that when older people aren't able to receive medical attention in the community, they can often end up in hospital (whether that be via A&E, or directly into wards) and they become “trapped” there. This is often avoidable, and pressures on hospitals would be reduced if a more integrated approach to care was implemented in the UK.

Integrated care, which is provided to a very high standard in countries such as Sweden, would go a long way to ensuring that elderly people are able to receive the best and most appropriate care, in the community, at the time they need it. Integrated care addresses fragmentation in patient services.

It means that there is a strong link between doctors and carers, and that people are able to receive more person-centred care in their home. Integrated care is particularly important given an ageing population which is, on the whole, more susceptible to illness.

An integrated approach requires just that - integration. It needs the full co-operation and support from both health providers and social care providers. Integrated care has a record of success in countries where it has been implemented - so why isn't this system the norm in the UK?

In England, the NHS and social care providers rarely communicate with each other. Despite the Care Minister Norman Lamb advocating the benefits of integrated care, and the Better Care Fund being introduced in England in 2013 to encourage co-operation, and indeed a number of social care providers calling for this for some time, integrated care is only slowly making its way into the English healthcare system. There are initiatives in areas such as Kent, South Warwickshire and Central Manchester, but there can be no doubt that there is still some way to go until integrated care is the norm.

Could this A&E crisis prove to be a catalyst to moving integration towards the forefront of the healthcare agenda? As it increases, the ageing population is only going to put a heavier burden on the healthcare system, and even in the short term, this will come under increasing scrutiny in the run up to the General Election. Politicians and healthcare professionals alike need to take heed of the benefits of integration, and act.