Intended for healthcare professionals

Views And Reviews Acute Perspective

David Oliver: Base care on need, not age

BMJ 2016; 355 doi: https://doi.org/10.1136/bmj.i5788 (Published 28 October 2016) Cite this as: BMJ 2016;355:i5788
  1. David Oliver, consultant in geriatrics and acute general medicine
  1. Berkshire
  1. davidoliver372{at}googlemail.com

In 2010 the NHS chief, David Nicholson, proposed a revolution in hospital inpatient care for older (not younger) people, akin to the closure of long stay psychiatric hospitals.1 But hospital admissions of older people continue to rise, and delays in discharge have worsened alongside fewer beds.2

One recurring policy idea that defies evidence and experience is that most “high need, high cost”3 older people can be kept away from hospital through lower tech, lower cost community interventions.4 5 But, in describing inappropriate occupancy of acute beds by these pesky old folk who …

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