Bring back cottage hospitals to free capacity in NHS, says senior health leader

Many hospital are struggling to discharge patients into the community (Stock image)  (PA Archive)
Many hospital are struggling to discharge patients into the community (Stock image) (PA Archive)

The NHS needs a “rethink” in how it deals with the public getting older with chronic diseases, a senior health leader has said.

Professor Dame Clare Gerada, chair of the Royal College of GPs, said a new generation of cottage hospitals could offer better treatment to elderly people living with long-term health issues.

Cottage hospitals were a small type of hospital first developed in the UK in the mid-1800s and they provided outpatient and day-patient care, with patients with minor illnesses able to recover in a bed near their homes and family.

These hospitals were eventually nationalised and incorporated into the NHS, before being replaced by district general hospitals in the 1960s.

A contributory factor to recent healthcare issues is that many hospitals are struggling to discharge patients as they have nowhere else to go due to a lack of capacity in the social care system.

On Monday the Standard reported that an average of 1,458 London hospital beds were occupied by patients who were fit to be discharged in the week up to January 8 – a rise of 14 per cent in a month.

Dame Gerada told Times Radio: “The problem with the NHS at the moment isn’t obesity, not really, and it isn’t really because we’re getting older, it’s actually because we’re getting older with chronic disease.

“So for the last 20 years of our life, most of us are suffering from three, four, five, even 10 long-term conditions and we’re living with those until our late 80s and early 90s.

“And the NHS was designed for a time when the average life expectancy was 67, when you tended to become unwell not long before that, and the NHS was geared up to provide acute care for those acute illnesses.

“But clearly what we need now is a rethink, not a top-down reorganisation, but a rethink about where the staff are, where staff are trained, where the resources are, how we develop what I would call cottage hospitals – we used to have them and they all got closed down.”

The Standard has contacted the Department of Health and Social Care (DHSC) for comment.

Dame Gerada said that increasing care closer to home could help to “deliver the two extremes of what patients need, which is one of acute necessary care, you break your leg, you’ve got an acute infection… but for the vast majority of patients today it’s the long-term chronic disease which isn’t really treated in a way that it should be.”