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In my locality we have seen a substantial decline in social care services, brought on by the current “austerity measures”. It often doesn’t feel like it, but healthcare has been relatively spared from the cuts. However because health and social care are largely separated in England, social care has been significantly cut back: our local council laid off a large number of care workers last year, and we are certainly feeling it now. Increasingly I am seeing patients whose social care package has failed, and for whom the only choice left is hospital admission. They then spend weeks on the ward waiting for a new package that fails again following discharge (most memorably of late, for want of a commode). Unfortunately the appetite for high-tech healthcare that keeps people alive at all costs is not matched by an appetite to provide social care for the survivors. Jonathan. From: Accident and Emergency Academic List [mailto:[log in to unmask]] On Behalf Of Julian Humphrey Sent: 07 January 2013 21:41 To: [log in to unmask] Subject: Re: Social admissions 20% increase in admissions through the ED of patients over 80 years old, in the last 18 months, here in Barnsley. Julian Sent from my iPhone On 7 Jan 2013, at 20:23, Doc Holiday <[log in to unmask]> wrote: From: [log in to unmask] > Not necessarily the best term --> Agreed. Not too clear what it includes exactly. > elderly patients with inadequate care at home --> From my own experience and that of colleagues in 3 other EDs in the UK, the "verdict" is that, while there might be more of these around this time, it's in keeping with past years. BUT there IS a major increase in admissions of elderly people with D&V and exacerbated respiratory conditions, who are not "very" unwell, but who do require admission for MEDICAL reasons. I am not getting the impression of non-medical reasons being the reason for what is a substantially busier period than what I recall in the past.