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Pensioners` hospital unit saves NHS millions of pounds.

September 03, 2002

A study by Newcastle University has shown that a unique out-patient hospital facility for older patients has provided enormous savings for the NHS - equivalent to freeing up a whole ward for a year.

The research showed the syncope (fainting) and falls day case facility at the Royal Victoria Infirmary (RVI) in Newcastle upon Tyne, UK, helped relieve pressure on accident and emergency services, saving the NHS about £2.5m.per year.

Syncope, collapse and falls are the commonest reason for older adults to attend the accident and emergency (A&E) department - accounting for up to 45 per cent of all older patients - and is a major financial burden on the NHS. Each year 35 per cent of adults over 65 and 45 per cent of adults over 80 years old suffer at least once, with ten per cent of these being incidents which result in a bone fracture.

The RVI day case facility was set up in 1991 to provide older patients with rapid access to hospital treatment after suffering syncope and collapse events, and is the only one in the UK. A&E doctors can refer the patients to the facility, where they are seen within the week. Three consultants see 3,500 patients each year, and there are 1,500 new admissions annually.    GPs and other health services specialists are also able to refer their patients to the unit.

The study, published in the current edition of the academic journal Age and Ageing, was led by Rose Anne Kenny, professor of cardiovascular research with Newcastle University`s Institute for Ageing and Health. It compared the RVI`s records for people diagnosed with syncope and collapse in 1999 with those in 1990 before the facility opened. It also made comparisons with 13 similar hospitals across the UK, concluding that the RVI`s day case facility had relieved substantial pressure on emergency admissions.

At the RVI, 35 per cent of syncope and collapse patients were treated as emergencies during 1999, compared to 97 per cent at the other hospitals. Compared to the other UK hospitals, the RVI used 6616 less `bed days` during 1999 and had an average length of stay of 2.4 days for syncope and collapse patients compared with 8.6 at the other institutions and 10.9 days in 1990 at the RVI.

Further analysis showed that 15 times more resources were needed to treat the syncope and falls patients in other hospitals compared with the day case facility.

Professor Kenny, who is also the director of the day case facility, said:

"This research also shows the enormous savings to acute hospital beds and has major implications for bed shortages which currently bedevil the health service.

"Rapid access to this service for accident and emergency staff, admitting teams, general practitioners and consultant colleagues was critical for the beneficial impact on emergency activity and performance.

"It also benefits the patients. Before the facility opened, many of these people were never fully investigated.   Now they are fully investigated, with tests on both their nervous system and their cardiovascular system. The doctors in A&E discharge them knowing that they will be seen quickly by appropriate specialists within the week, at which time at least 70% of people are provided with a treatable diagnosis.

"Our findings are significant given the recent National Service Framework for older adults, whose guidelines recommend new integrated falls services to improve care and treatment."

The Wellcome Trust funded the research.

Newcastle upon Tyne, University of