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We can all help avoid admissions

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District nurses are key to avoiding admissions District nurses are key to avoiding admissions

There has been much in the news recently about initiatives to prevent avoidable hospital admissions and readmissions. General practitioners have been given the opportunity to provide an enhanced service aimed at preventing avoidable hospital admissions among their registered population.

This initiative is focused on the proactive identification of vulnerable people who are most at risk of A&E attendances and unplanned admissions to hospital. This will include frail older people and those living with long-term conditions – including children and young people. However, the majority are likely to be older people and those receiving end-of-life care.

The guidance for this work is provided online by NHS Employers. The enhanced service includes the provision of a priority telephone line or an extension number for health and social care professionals concerned with a patient who is at risk of an avoidable admission. Patients in this identified group on the GP register will also be provided with a 'same day' consultation in the practice or on the phone.

There is no doubt that avoiding hospital admission wherever possible should be a focus of our commissioned health services. Hospital is the last place that most people would like to be, if their condition can be managed at home. It is most definitely the place that most people would like to avoid for their end of life care, as research has shown. However, having more people supported at home rather than being admitted to hospital also requires appropriately qualified health and social care professionals available to provide the required care.

This excellent animation demonstrates the potential outcomes of an older person being admitted to hospital when it might have been avoided.

This is a powerful story which resonated with me immediately. There is much to be learned from examining this as a typical case of an avoidable admission of an older person and reflecting on whether this is happening in our own areas of practice. The actions we can take as practitioners within a multidisciplinary team, and systems we can influence as nurses to prevent this from occurring with such frequency, must surely be a priority in our practice.

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