Older people and the “patient centred” NHS

Editor—Rowland and Pollock highlight another of the inequities of the NHS plan, with its heavy emphasis on acute hospital waiting and admission times, and the consequent impact on frail and chronically ill elderly people.¹

Elderly mental health beds will not be included in the delayed discharge legislation because they are not considered to be acute, though how beds that are needed to admit patients sectioned under the Mental Health Act are not considered acute beggars belief.

This exemption could be seen as recognition of the need for careful and often complex community care arrangements for these patients. However, social workers, who are already unable to provide the care packages they need to discharge these patients from acute hospitals, once subject to fines for the delays will inevitably see patients with depression or dementia, for whom they will not be fined, with even lower priority than they do now. The current staggering delays will lengthen further with their attendant effects on acute services.

Patients are already inappropriately admitted to and languish in acute wards, unable to be discharged or transferred to suitable therapeutic environments because of lack of investment, some of which is spent on devising ever more inventive ways of manipulating waiting lists.

The choice for these patients is already lamentable, but it will become even more restricted once this legislation is enacted.