Reducing end of life hospital admissions from care homes

Dr Ian Jones, GP, Glyn Ebwy Surgery, Ebbw Vale

Aneurin Bevan University Health Board

Blaenau Gwent West Neighbourhood Care Network (NCN)


Care home patients are usually elderly and more frail than the general population. Between 2018-2020, 833 care home patients died in hospital in the Aneurin Bevan University Health Board area.

Line graph showing care home patient hospital deaths - Aneurin Bevan Health Board 2018-2020

We carried out research which found that care home residents are admitted to hospital at end of life for a variety of reasons, including acute admission by GPs, care home staff calling emergency ambulances, family expectation, trauma (usually fractured neck of femur) and symptom control. There is also variation in admissions between individual homes, and between individual groups of professionals.

Our research determined that reducing admissions from care homes at end of life could only be addressed by looking at the individual circumstances of each admission and working across homes and organisations to address any perceived gaps in patient care.

Project Aims

The overall aim of the project is to improve the management of care home patients at end of life. The intention is not to reduce hospital admissions from care homes. Although it is likely, if the project succeeds, that such overall hospital admission rates would fall.

Person comforting an elderly individual


Next Steps

The project cannot restart until lockdown restrictions are lifted. A Clinical nurse Specialist from our local hospice will carry out case analyses, with the GP lead overseeing the work.

Our neighbouring NCN (Blaenau Gwent East) has around 150 nursing home beds and it would be ideal to incorporate these homes and their linked GP surgeries into the project.

As of January 2021, discussions are taking place on linking this work with the Compassionate Communities model of care currently running across Blaenau Gwent.

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