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Intermediate care and diversity: principles and practice.

The last few decades have seen a dramatic reduction in the number of hospital beds, despite the UK being an ageing society and the elderly being major users of hospital resources. The National Beds Inquiry (Department of Health, 2000a) and the British Geriatrics Society’s (2001) bed-blocking surveys confirmed the lack of sufficient community alternatives to hospital care, inappropriate use of hospital beds, and delays in hospital discharges as key factors for the high numbers of people who stay in an acute hospital longer than is desirable. At the same time the expectations of patients and their families have risen, and it is therefore easy to understand how many medical departments struggle to cope with large numbers of sick older people.