Unplanned hospital admissions

The unplanned hospital admissions section includes information about:

  • ambulatory care and urgent care sensitive conditions
  • falls (65+)
  • delayed transfers of care
  • total hospital bed days

Ambulatory care and urgent care sensitive conditions

Why this is important

There are large inequalities in the rate of unplanned hospitalisation for chronic ambulatory care sensitive and urgent care sensitive conditions when comparing the most and least deprived areas nationally.

Providing information on the level of inequalities within CCGs will shine a spotlight on variations in practice and will provide data to enable CCGs to explore levels of inequalities in order to address and reduce these. This indicator reflects variations in the quality of management of long-term conditions in primary, community and outpatient care as well as urgent care. It will help identify areas of good practice and those where improvements should be made for the benefit of patients and the local health economy.

It is seen as being sensitive to in-year change as a direct result of local action.

The Barnsley picture and how we compare

Barnsley has consistently higher rates than the England average for unplanned hospitalisation for chronic ambulatory care sensitive conditions.

When compared to other clinical commissioning groups (CCGs) within the Yorkshire and Humber region, Barnsley is ranked 7th highest out of 19.

When compared to similar CCGs, Barnsley is ranked 4th lowest out of 10.

View the trend and comparator data charts.



Falls (65+)

Why this is important

The rate of hip fractures in Barnsley for people aged 65 and over (2018/19) is 596 per 100,000, similar to the England rate of 558 per 100,000. This is the equivalent of 270 Barnsley residents in the aged 65 and over population, and is the lowest rate since 2010/11.

Hip fracture is a debilitating condition. Only one in three sufferers return to their former levels of independence and one in three ends up leaving their own home and moving to long-term care. Hip fractures are almost as common and costly as strokes and the incidence is rising. In the UK, about 75,000 hip fractures occur annually at an estimated health and social cost of about £2 billion a year. The incidence is projected to increase by 34% in 2020, with an associated increase in annual expenditure.

You can read the National Institute for Health and Clinical Excellence (2017) report, The management of hip fracture in adults.

As well as physical injury, people who experience falls are likely to experience loss of confidence, independence, social isolation and loneliness.

We aim to raise awareness of the risks involved with falls for this age group and give advice on how to prevent falls. We're committed to #LiveIt by helping people to live independently at home for longer.

There are a number of reasons why people fall:

  • cold weather has a direct effect on falls
  • high blood pressure
  • visual or hearing impairment
  • bone health and muscle mass
  • reduced strength and balance
  • environment, for example, hazards at home
  • medication
  • alcohol
  • hydration and nutrition
  • urinary incontinence
  • ill fitting shoes or feet problems
  • cognitive impairment

Find out more.

The National Institute for Health and Clinical Excellence (NICE) has produced Quality Standard 86: falls in older people that covers assessment after a fall and preventing further falls (secondary prevention) in older people living in the community and during a hospital stay. The standard is designed to drive measurable improvements in the three dimensions of quality which are patient safety, patient experience and clinical effectiveness through the delivery of quality statements.

Local actions are expected to contribute to improvements in the following outcomes:

  • prevention of falls in the 65 and over age range
  • reduction in hip fractures
  • rates of osteoporosis
  • excess winter deaths
  • morbidity
  • rates of hospital admissions and re-admissions
  • demand on social care

The Barnsley picture and how we compare

  • In 2018/19, Barnsley’s rate for emergency hospital admissions due to falls in people aged 65 and over (2,632 per 100,000) was significantly higher than the England rate of 2,198 per 100,000.

  • Out of 16 similar local authorities, Barnsley’s rate was the fourth highest.

  • In terms of numbers, the rate of 2,632 represents just over 1,200 people aged 65 and over in Barnsley who were admitted to hospital as a result of a fall in 2018/19.

  • Rates have increased in recent years, although the 2018/19 rate is the lowest since 2014/15.

  • Similarly, the rates for those aged 65-79 and 80+ are significantly higher than the England average.

What we're doing and the assets or services we have

We are reviewing our prevention messages across the life course, and a number of key strategic work programmes:

Frailty

  • Multi-agency working to use Rockwood scoring to identify frail people and those at risk of falling
  • Programme working around falls and osteoporosis
  • Identification of those residents who are most frail
  • Delivery of Red Bag Scheme in care homes
  • A new Frailty Assessment Unit is discharging over 75% of frail patients the same day

Falls prevention

  • A Community Falls Service is being delivered by South West Yorkshire Partnership Foundation Trust (SWYPFT) which offers secondary prevention advice
  • A baseline service assessment of our falls prevention service provision is being conducted and will make recommendations for primary prevention
  • Barnsley is a member of the UK Age Friendly Communities Network
  • Berneslai Homes scheme managers are trained to deliver gentle exercise and healthy bones classes to residents of independent living schemes
  • Community Healthy Bones (strength and balance) exercise class is available
  • #Mindyourstep Barnsley falls prevention campaign was launched in June 2019
  • The possibility of developing a Yorkshire and Humber falls prevention campaign is being explored

Excess winter deaths

  • Identification of people at risk of excess winter morbidity and mortality is taking place
  • A borough wide assessment of people at risk of excess winter morbidity and mortality is to be implemented
  • Implementation or signposting to interventions to address winter morbidity and mortality is taking place
  • Monitoring and evaluation of the impact of actions to address winter morbidity and mortality is underway
  • A system wide communication plan for the public and stakeholders exists
  • Awareness is being raised of the impact of adverse weather through alerts, emergency preparedness and building community resilience

Flu vaccination uptake (2018/2019)

  • In the 65+ age group, Barnsley’s uptake rate (72.3%) was slightly higher than the England rate (72.0 %)
  • Uptake in the under 65’s (at risk) group (51.5%) was also higher than regional and national rates

Dementia

  • The Barnsley Dementia Strategy Action Plan identifies the increased falls risk for people living with dementia compared to cognitively healthy older adults, and links strategically to the Falls Prevention Plan.

Vision

  • Those with vision impairment/sight loss are at risk of falling. The Barnsley Vision Strategy Action Plan identifies work to prevent falls.

Alcohol Plan and Food Plan

  • Work is ongoing to identify correlations between food, nutrition, hydration, alcohol and falls.

Oral health improvement

  • Poor oral health can impact on the types of food a person can eat. Poor nutrition and hydration can be a risk factor for falls. Work is ongoing to link the two work programmes.

Opportunities for improvement or future development

  • Primary prevention messages are to be targeted across the life course

  • Work with Area Councils to increase provision of physical activity for older people

  • Work with the Active in Barnsley partnership to promote physical activity with ‘What’s your move?’ campaign

  • Identification of those at risk of a fall earlier in the life course

  • Those at risk of osteoporosis and hip fracture to be identified sooner and given prevention advice and sign posting.

  • Strength and balance exercise to be available for those who are identified as at risk of falling

  • Clear communication of prevention messages (primary, secondary and tertiary) are to be provided, especially when someone may be more at risk of a fall, to the workforce and the public.

  • Collaborative working, for example, the Integrated Care System

  • Integrated Workforce Development.

Resources and supporting documents



Delayed transfers of care

Why this is important

This measures the impact of hospital services (acute, mental health and non-acute) and community-based care in facilitating timely and appropriate transfer from all hospitals for all adults.

This indicates the ability of the whole system to ensure appropriate transfer from hospital for the entire adult population and is an indicator of the effectiveness of the interface within the NHS, and between health and social care services.

Minimising delayed transfers of care and enabling people to live independently at home is one of the desired outcomes of social care.

The Barnsley picture and how we compare

Barnsley’s rates per 100,000 for delayed transfers of care have been consistently lower than regional and national rates since 2010/11.

When compared to other local authorities within the Yorkshire and Humber region in 2018/19, Barnsley has the lowest rate.

When compared to similar CCGs, Barnsley has the lowest rate.

View the trend and comparator data charts.

Resources and supporting documents



Total hospital bed days

Why this is important

To ensure unnecessary hospital admissions are avoided and so that people are able to spend less time in hospital.

The Barnsley picture and how we compare

Although Barnsley’s rates have been consistently higher than regional and national rates over recent years, the current rate (April 2019) of 54.66 per 1,000 registered population is similar to the Yorkshire and the Humber and England rate.

When compared to similar CCGs, Barnsley is ranked 5th highest out of 11.

View the trend and comparator data charts. 

Resources and supporting documents