"Struggling" hospitals are on the brink of collapse unless GP out of hours services come to the rescue.
A report by the Royal College of Physicians Hospitals on the edge? The time for action notes there are a third fewer general and acute beds than there were 25 years ago, yet the last decade has seen a 37% increase in emergency admissions.
It is claimed hospital buildings, services and staff are "not equipped" to deal with multiple, complex needs, including dementia, even though nearly two-thirds (65%) of people admitted to hospital are said to be over 65 years old.
The report cites research showing medical and nursing staff feel older patients "shouldn't be in hospital" - a perception the RCP claims has been shown to reduce the quality of care and builds attitudes of resentment from both medical and nursing staff.
Unsurprisingly, RCP members reported a lack of continuity of care as their biggest concern about the current health service.
As well as calling for a reorganisation of hospital care, the RCP report has asked for help from primary care colleagues in recommending an improvement in GP out of hours care to relieve pressure on A&E services.
Professor Tim Evans, Lead Fellow of the RCP's Future Hospital Commission has described the report's findings as "very distressing".
"All hospital inpatients deserve to receive safe, high-quality, sustainable care centred around their needs and delivered in an appropriate setting by respectful, compassionate, expert health professionals," he said.
" Yet it is increasingly clear that our hospitals are struggling to cope with the challenge of an ageing population who increasingly present to our hospitals with multiple, complex diseases. We must act now to make the drastic changes required to provide the care they deserve."
Sir Richard Thompson, President of the RCP, said the government, medical profession and the wider NHS must work together to address the problems highlighted in the report.