Damn­ing in­dict­ment of failing so­cial care sys­tem

Daily Mail - - Front Page - By So­phie Bor­land, Ben Spencer and Miles Dil­worth

POOR so­cial care has driven up emergency ad­mis­sions of dementia suf­fer­ers to nearly 1,000 a day.

The num­ber of dementia pa­tients ad­mit­ted to hos­pi­tal in an emergency has soared by a third in four years, of­fi­cial NHS fig­ures re­veal. Ex­perts said many pa­tients were end­ing up in hos­pi­tal ‘in cri­sis’ as a re­sult of basic fail­ings in so­cial care. Fig­ures com­piled by NHS Digital show there were 344,522 emergency ad­mis­sions in­volv­ing dementia pa­tients in 2017/18 – the equiv­a­lent to 944 a day and up from 257,559 cases in 2013/14.

The fig­ures in­clude pa­tients ad­mit­ted on to wards via A&E or af­ter be­ing re­ferred di­rectly by their GP as an emergency. Many would have suf­fered falls or devel­oped chest or uri­nary in­fec­tions, of­ten trig­gered by de­hy­dra­tion or mal­nu­tri­tion.

Once in hos­pi­tal they tend to de­te­ri­o­rate quickly, and up to half who are ad­mit­ted from their own home are too frail to ever re­turn.

The Daily Mail launched a ma­jor cam­paign last month call­ing on the new prime min­is­ter to fix the cri­sis in so­cial care for dementia pa­tients. Count­less fam­i­lies have to pay huge sums for care which is of­ten ap­palling in qual­ity.

There are 676,000 pa­tients with dementia in Eng­land, of whom 180,000 are living in care homes.

The Alzheimer’s So­ci­ety said some pa­tients were end­ing up in hos­pi­tal as a

re­sult of basic fail­ings, such as car­ers leav­ing a glass of wa­ter be­side their chair, but not prompt­ing them to drink.

Sally Co­p­ley, di­rec­tor of policy and cam­paigns at the char­ity, said: ‘It is sadly not sur­pris­ing to hear that more and more peo­ple with dementia are be­ing taken to hos­pi­tal in cri­sis.

‘We know thou­sands of peo­ple with dementia ev­ery year are hos­pi­talised by things that could have been pre­vented with bet­ter or more widely avail­able care in the com­mu­nity, and peo­ple are of­ten then trapped in hos­pi­tal be­cause of the lack of so­cial care when they’re well enough to leave.

‘The so­cial care cri­sis is leav­ing the NHS fac­ing big­ger fi­nan­cial strain, beds taken up in hos­pi­tals and peo­ple un­able to leave their care be­cause there is such lit­tle sup­port to re­turn home.

‘ The hu­man cost on peo­ple with dementia can­not be pushed aside any longer.

‘Boris Johnson must ad­dress our calls for an im­me­di­ate in­vest­ment in an NHS Dementia Fund to give peo­ple the vi­tal fi­nan­cial sup­port they need whilst also ad­dress­ing long-term re­form.’ Caro­line Abra­hams, char­ity di­rec­tor at Age UK, said: ‘The sharp rise in these fig­ures re­flects a so­cial care sys­tem un­der siege and shows that com­mu­nity health services are strug­gling too. Older peo­ple with dementia and other se­ri­ous health prob­lems need com­mit­ted care work­ers who know them well and who can spot when things are start­ing to go wrong, and re­spon­sive GPs and dis­trict nurses with the time and space to get in­volved quickly and nip emerg­ing health is­sues in the bud.

‘With­out rapid in­ter­ven­tion in the com­mu­nity these older peo­ple are likely to de­te­ri­o­rate fast, to the ex­tent they have to be whisked into hos­pi­tal on an emergency ba­sis. This is dis­tress­ing for them and threat­ens to un­der­mine their frag­ile health still fur­ther, and a big, avoid­able cost to the pub­lic purse as well.’

Re­search pub­lished last month found that 41 per cent of emergency ad­mis­sions from care homes were for avoid­able con­di­tions such as chest in­fec­tions, pres­sure sores and uri­nary tract in­fec­tions that could have been eas­ily treated or were a re­sult of poor care or ne­glect.

The data in­cluded all care home res­i­dents, but ex­perts said those with dementia – who make up more than two thirds of peo­ple in care homes – were bear­ing the brunt of the cri­sis.

The re­port by the Im­prove­ment An­a­lyt­ics Unit – a joint ini­tia­tive be­tween NHS Eng­land and the Health Foun­da­tion think-tank – said that if care was bet­ter, there would be fewer trips to hos­pi­tal. Adam Steven­ton, of the Health Foun­da­tion, said: ‘Around 70 per cent of care home res­i­dents have dementia and can find the hos­pi­tal en­vi­ron­ment even more stress­ful and dis­ori­ent­ing as a re­sult.

‘Our eval­u­a­tions show that by in­creas­ing NHS sup­port and im­prov­ing part­ner­ship work­ing with care homes, it is pos­si­ble to re­duce emergency ad­mis­sions to hos­pi­tal and A&E vis­its among care home res­i­dents. It also high­lights that bet­ter pre­ven­ta­tive care may help to re­duce un­nec­es­sary emergency hos­pi­tal ad­mis­sions, for ex­am­ple some fractures may be avoided with ap­pro­pri­ate risk as­sess­ment.’

Pre­vi­ous re­search by the Alzheimer’s So­ci­ety has found that dementia pa­tients typ­i­cally stay in hos­pi­tal twice as long as pa­tients with­out the ill­ness. The aver­age length of stay was 12 days com­pared to 5.5 days for all other pa­tients over 65. The re­search also found that just over half of dementia pa­tients ad­mit­ted to hos­pi­tal from their own home did not go back.

The De­part­ment of Health said the rise in ad­mis­sions was partly due to the ageing pop­u­la­tion, with more pa­tients now living with dementia. Im­proved ‘cod­ing’ in re­cent years – record­ing whether pa­tients have dementia when they come into hos­pi­tal – may also be a fac­tor.

A de­part­ment spokesman said: ‘Our ageing pop­u­la­tion means more peo­ple are living with dementia, and they should only be ad­mit­ted to hos­pi­tal when ab­so­lutely nec­es­sary. We are de­ter­mined to im­prove com­mu­nity and so­cial care services to en­sure ev­ery­one gets the best qual­ity care and can live in­de­pen­dently at home for longer.

‘We have given lo­cal au­thor­i­ties access to nearly £4 bil­lion more ded­i­cated fund­ing for adult so­cial care this year, and a fur­ther £410 mil­lion is avail­able for adults and children’s services. The Prime Min­is­ter has been clear he is com­mit­ted to fix­ing the so­cial care sys­tem and will out­line pro­pos­als as soon as pos­si­ble.’

‘Dis­tress­ing for pa­tients’

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