More than 1,100 people aged 65 and over have shared their experiences of using local health services, in a survey designed to help the NHS to improve the quality of support offered to older residents.
The survey, which asked participants about their biggest health worries, their experiences of seeing health professionals, what makes them feel confident and safe, and to share their experiences and ideas for improvement, highlighted the challenges and opportunities in delivering care for the growing number of older people living in the area.
People aged 65 and over are the fastest growing age group in Hertfordshire and west Essex, with the number of people in this age bracket set to dramatically increase by around 25% in the next 15 years. Meanwhile the proportion of working age adults is expected to stay steady, with the number of children anticipated to decline slightly over the same period.
One of the main findings from the survey is that 90% of over 65s would prefer to receive their care and treatment in their local neighbourhoods – at a GP practice, in a local health centre, or at home. Only 10% of those surveyed said they preferred to be treated in hospital, with some commenting that they tried to avoid going to hospital unless it was really necessary.
These findings align well with the new national NHS 10-Year Health Plan which is currently out for public consultation. The plan sets out to deliver more NHS services closer to home in community settings rather than hospitals as one of its key priorities.
Dr Rachel Joyce, Medical Director at Hertfordshire and West Essex Integrated Care Board said: “I want to thank everyone who took the time to complete the survey. These results provide valuable insight that will help to shape local NHS services.
“Over the next decade we know that our older population is going to increase sharply, and so it’s important that we are planning to meet their needs and have the right health help in the right place.
“We want people to access the care they need quickly, in a convenient place and seeing the health professional that can best help them. For frail and older people, a stay in hospital could put them at greater risk of complications like infections, falls and losing their mobility. Where it is right for them, treating older adults in their own homes or in community clinics can help them to recover faster, maintain their independence, and reduce the likelihood of them needing to go back into hospital soon afterwards. We would also encourage people who take multiple medications to have regular reviews, as this can lead to harmful side effects, like falls and confusion.”
All the NHS organisations in Hertfordshire and west Essex are working together to provide more ‘neighbourhood’ health care, which will help to reduce the number of avoidable admissions to hospital for older people. The work focuses on:
- Putting greater emphasis on helping people to stay strong and well as they age
- Encouraging people to plan ahead and make decisions now about what is important to them and record their wishes in an advance care plan
- Making it easier for people to get early help, so that health problems are spotted and treated before they become more serious
- Offering medicine reviews, particularly for people who are taking more than eight prescription medicines who are most likely to have side effects and interactions.
- Asking family members to play an active role in helping older people come home from hospital.
Research from the British Geriatric Society shows that on average 15% of older people discharged from hospital are readmitted within 28 days. Having family and friends around makes the return home easier, for example by checking in, daily at first, to make sure there is food and drink available and they have the support they need.
Access to GP services
Overall, survey participants had lots of good things to say about local NHS services, praising the standards of care and the dedication of staff. The biggest concern they raised was getting to see a GP, with 42% of people saying their one of their worries was how long it takes to get through on the phone, followed by 12% who expressed concerns about getting to an appointment. Hertfordshire and West Essex ICB has been working with GP practices to address this, with GPs offering more appointments across the day and upgrades to phone systems to help people get through more easily, but the survey shows there is still more work to do.
There is a range of options to help you get the right care in the right place including via the NHS website, your pharmacy, 111 or urgent treatment centres. GP practices are working closely with pharmacies and within integrated neighbourhood teams to improve their services and provide proactive care to frail elderly patients at risk of admission.
Planning for the future
When asked, ‘What is the biggest worry regarding your future health?’, some people highlighted their balance and mobility, social isolation and practical issues like the burden of caring on family members. And of those surveyed, only 24% of people said they had recorded their wishes about their future care, also known as an ‘advance care plan’.
This means that for the remaining three quarters of our older population, there is an opportunity for the NHS and its partners in local councils and voluntary organisations to support people to have conversations with loved ones about how they would like to be cared for in the future.
Advanced care planning is an opportunity to ensure someone’s care is personalised and aligned to their best interests. It is a discussion between an individual, their family and care providers. It aims to make a person’s wishes and priorities clear at an early stage and before their health deteriorates to a point where they are no longer able to make decisions.
Advanced care planning can include discussing if hospital would be the right place for someone’s care, or whether care provided by ‘Hospital at Home’ or other community care, might be better for them.
There is also work to be done to help people age well and feel ‘stronger for longer’, to help build healthy habits now that will help people to manage their health conditions and ensure the medicines they take remain right for them if they are becoming frail.
More information on how to age well and keep yourself living independently for longer, can be found on the ICB website: www.hertsandwestessex.ics.nhs.uk/age-well