What more can be done to ease the pressure on local hospitals? 

Every day, over 30 people are unnecessarily in our local acute hospitals because their non-acute care can't be transferred elsewhere within the NHS or social care. More generally, most of the pressure on our hospitals comes from patients who would be better cared for somewhere else. This blocks further patient admissions, causing delays in A&E and waits for ambulances who can't go to the next call.

Long GP appointment waiting times also send more patients to A&E.

The big fall in community nursing and social care means hospital patients can't leave. In fact, community nurse statistics are disastrous. Most work unpaid overtime and nearly half are planning to retire early or leave. Social care also has a massive recruitment problem, made worse by Brexit as 7% of workers are from the EU. The Government is now raising the 'nurse tax', charging each overseas worker £625 a year to use the service they deliver.

Improving non-hospital staffing is the solution. But it isn't easy.

Recruiting and retaining community nurses must become a priority. Strengthening services like the Sevenoaks Minor Injuries Unit could keep more people out of hospital. Better supported GP services in 'medical hubs' could meet more patients' needs. The tax penalties which prevent doctors working extra shifts need sorting out. More training for staff in care homes would help patients who don't yet need acute care.

But the big shift is catering for the demographic time bomb as we get older and more frail. More than half over-65s have two or more non-acute medical conditions to be treated, which further complicates care. Investment in community health and social care would ease the pressure on our local hospitals, but this needs to happen - now.

Dr Merilyn Canet