A Loughborough academic has contributed to a national report that concludes better integration of healthcare and community services is vital to slow the rate of unplanned hospital admissions of people aged 85 and over.

In England, between 2007/8 and 2009/10, the rate hospital admissions for 85 and overs rose from 48 to 52 per 100, with substantial variation across the country.

Dr Ran Bhamra from the Wolfson School was part of a research team to review sites where admissions had sharply risen or declined, to identify the factors that have led to lower figures. 

Each of the six ‘improving’ or ‘deteriorating’ sites comprised an acute hospital trust, its linked primary care trust or clinical commissioning group, the provider of community health services, and adult social care.

In deteriorating sites, there were problems with general practitioner access, pressures on emergency departments and a lack of community-based alternatives to admission. But the most striking difference between improving and deteriorating sites was not the presence or absence of specific services, but the extent to which integration within and between types of service had been achieved.

There were also overwhelming differences in leadership, culture and strategic development at the system level.

Dr Bhamra said:

“Rising admission rates for older people were seen in places where several parts of the system were under strain. Places which had stemmed the rising tide of admissions had done so through strong, stable leadership, a shared vision and strategy, and common values across the system - in a large, highly complex organisational system, this is a very hard thing to sustain.”

The £380K study (of which £73K was held by Dr Bhamra) was led by Leicester University and was funded through the National Institute for Health Research Health Services and Delivery Research programme.

View the report online.