Headlines: February 4th, 2000

The hospital beds crisis resulting from the recent flu epidemic and findings from the National Beds Inquiry launched last year have changed the strategic direction of the health service. Bed blocking by elderly patients is a long standing problem, but the extent and implications of the issue have only recently been recongnised.The National Beds Inquiry revealed that some two thirds of all hospital beds are occupied by patients aged 65 or over. Since the mid 90’s a quarter of the increase in emergency admissions were for frail or infirm patients aged 75 or over. They had no identifiable clinical condition.

In response to this situation the new health strategy will move away from managing health institutions and move towards managing clinical conditions that span component services. To achieve this end the present three strand strategy of empowering patients through NHS Direct, primary care and acute care, will be supplemented by a fourth intermediary care strand. This will form a bridge between a patient’s home and hospital and take pressure off acute care services.

Intermediate care will be provided in different ways. Some hospital wards will be set aside for the purpose and they will be managed by the newly created ‘nurse consultants’. Facilities will be developed in the community, and cottage hospitals will get a new lease of life. Private finance will be used extensively to provide the facilities. Finally, there will be new care facilities in the home.