The NHS could save nearly half a billion pounds annually by reducing emergency admissions and hospital stays among older patients, according to a King’s Fund report shared with HSJ.

The report, which analysed the use of emergency beds by over 65s across England, found huge variation in performance among primary care trusts.

It concluded 2.3 million hospital bed days were used by over 65s every year when patients could instead have been supported at home or treated in the community. If all PCTs performed as well as the top 25 per cent, 7,000 fewer hospital beds would be needed, freeing up £462m a year to reinvest in community and primary care services, said the report.

Older People and Emergency Bed Use showed there was a “big opportunity” to make improvements in this area, said lead author Candace Imison, King’s Fund deputy director of policy.

“The scale of difference was really striking,” she told HSJ. “It is absolutely crucial for everyone to understand where they sit on that spectrum. This is an area that has significant opportunity for improvement if there is genuine collaboration.”

The analysis found a marked difference between PCTs with high bed use and others with lower or falling bed use when it came to length of stay for over 65s who previously lived at home but were in hospital before moving on to supported accommodation.

The average length of stay among those with the highest bed use was 36 days, at least nine days higher than the best performing PCTs.

The report found areas with well-developed, integrated services for older people had lower rates of hospital bed use. However, analysis of the performance of care trusts showed “organisational integration alone will not deliver improved performance”, and a prioritisation of older people’s care was required.