NHS: Accident and Emergency Services

Baroness Gale Excerpts

Thursday 15th January 2015 Lords Chamber

[Baroness Gale (Lab)]

My Lords, I, too, thank the right reverend Prelate for bringing this important debate before us today. I may take a slightly different angle from other noble Lords. We are all aware of the problems facing accident and emergency services, but the current pressures on them are exacerbated by a consistent failure to properly support people with long-term conditions such as Parkinson’s, both before and after hospital admission.

In 2012-13, people with Parkinson’s had more than 65,000 unplanned or emergency admissions to hospital, often due to falls, infections or cognitive issues. In England, those over 65 with Parkinson’s are three times more likely to have an unplanned admission to hospital than other people of the same age. In addition to creating serious pressures on already overstretched hospitals, this costs the NHS around £177 million each year. However, with proper support at an early stage, many of these admissions could be avoided.

Giving people with Parkinson’s the right information and equipment can often help them to manage their condition, rather than relying on accident and emergency services once they reach crisis point. Services such as physiotherapy, dietician support or falls prevention are also a great help in averting health crises, yet access to these services remains inconsistent. Good quality early intervention would significantly reduce the high number of people with Parkinson’s coming into accident and emergency departments in the first place, thereby relieving some of the pressures that hospitals are now facing.

There is also an urgent need to improve care for people with Parkinson’s once they are admitted to hospital, in order to reduce both avoidable harm and the length of time they are required to stay. Patients with this condition currently spend around 75% longer in hospitals than others of a similar age, equating to more than 128,000 excess bed-days a year. In 2012-13, these excess days cost the NHS more than £20 million. A key reason for this is that many people with Parkinson’s who are admitted to hospital often experience serious disruption to their medication. Parkinson’s medication regimes are often complex, sometimes requiring up to 30 doses at specific points throughout the day. It is vital that people receive their medication on time, because delays can rapidly worsen their symptoms. We have discussed many times in your Lordships’ House the need for these patients to get their medication on time, every time. Anyone with Parkinson’s who does not receive their medication on time is put at risk, and these incidents can create a vicious cycle of escalating care needs for patients with Parkinson’s and overwhelming pressures on hospital staff.

However, there are a number of straightforward and cost-effective steps that hospitals can take to reduce medication errors and excess bed-days for people with the condition. They include giving patients the option to administer their own medication, as recommended under existing guidelines; taking up Parkinson’s UK’s training opportunities on the importance of medication timing; and making sure that there is always a supply of Parkinson’s drugs in emergency medication cupboards so that they are easily accessible when someone with the condition is admitted.

I am sure the Minister recognises that there is a clear link between the lack of adequate support for people with long-term conditions like Parkinson’s, and the serious pressures being experienced by accident and emergency services. Taking steps to reduce both avoidable admissions and avoidable harm will protect individuals, alleviate the strain on hospitals, and benefit our health service as a whole. I hope that the Minister will take the opportunity to outline how these problems can be addressed as part of the Government’s wider response to the current situation.