Convalescent homes to make a comeback
BMJ 2000; 320 doi: https://doi.org/10.1136/bmj.320.7232.401 (Published 12 February 2000) Cite this as: BMJ 2000;320:401
Elderly hospital patients are to be given “intermediate” care in new convalescent homes and wards, the health secretary, Alan Milburn, announced last week.
Mr Milburn told a meeting at the King's Fund, London, that he would like to build a bridge between home and hospital for elderly people: “At the moment, for too many elderly people there is a false choice between hospital and home. That forces a lot of older people to stay in acute hospital beds because they are not fully recovered enough to go home.”
The new convalescent centres could be based in major hospitals, revitalised cottage or community hospitals, “hospital at home” systems, or newly built units, in some cases supported by private finance.
The initiative has been spurred by the findings of the Department of Health's inquiry into bed use and availability (the national beds inquiry), which is due to be published later this month. It has found that two thirds of hospital beds are occupied by patients aged over 65, and half the rapid increase in emergency admissions in the past five years has been accounted for by people over 75—one in two of whom have been admitted on grounds of “symptoms, signs and ill-defined conditions.”
Mr Milburn said that the findings called for a radically different approach to the management of care in the NHS. Traditionally, care had been about dealing with life's incidents—heart attacks and broken bones. “Now an ageing population and increasing chronic disease means NHS care has also to be about dealing with life's experiences—getting older and becoming frailer.” Moreover the steady reduction in the number of acute beds could no longer go on, he added.
Referring to the prime minister's declaration that spending on the NHS should be raised closer to the European average (22January, p205) and the Shipman trial, in which an English GP was found guilty of murdering 15 of his patients, he said that the past few weeks would be seen as a turning point for the NHS and one of the most significant periods in its history.