Scrap 10% of hospital beds for dementia care, say MPs and peers
An all-party group has said that less of the £20bn annual cost of looking after people with dementia should go to hospitals
A report by Parliament’s All-Party Parliamentary Group on Dementia has said that the NHS should close at least a tenth of its hospital beds to allow it to spend £1bn more on community based dementia services.
The document, titled The £20bn question and supported by the Alzheimer’s Society, calls for the different sectors involved in local dementia care to collaborate in considering how resources could be used more effectively.
It says that a quarter of hospital beds are occupied by patients with dementia, which as well as being expensive is often very traumatic for patients, with many leaving hospital in worse shape than they arrive. The problem is increasing, as there are currently about 750,000 people living with dementia in the UK, but this figure is predicted to rise to over one million by 2021. The cost of dementia is set also set to rise, from some £20bn each year to reach £27bn a year by 2018.
“A well balanced and integrated approach to providing support for people with dementia requires joint planning and also consideration of how costs and savings can be shared,” the document says.
The different sectors involved in dementia care, such as hospital psychiatric liaison teams, care home outreach teams and palliative care outreach teams, should sharing expertise to improve the quality and cost-effectiveness of services, it argues. It calls for early intervention as both cost-effective and likely to improve the quality of life of people with dementia and their carers and improved co-ordination of dementia services to improve outcomes and increase efficiency of services.
Making £1bn available for such dementia services would significantly reduce the number of people needing hospital care, the group argues, and reduce the length of hospital stays as people would be able to return home sooner. It says that £141m could give every person with dementia access to an adviser while £68m could provide all care homes in the UK with health service support, with the aim of improving care and reducing the use of antipsychotic drugs.
The report also calls for increased use of key workers to act as a single point of contact and a co-ordinator of care, plus better sharing of information and data between different sectors.
Health and social care staff receive poor dementia training, the report says. The group wants to see the implementation of NICE guidelines that all staff working with older people in the health, social care and voluntary sectors have access to training in dementia care that is consistent with their roles and responsibilities.
Rates of diagnosis must increase in order to ensure people with dementia have access to treatment, services and information. The group calls for campaigns to raise public awareness and reduce stigma and for GPs to have they support they need to response appropriately to patients who are concerned they may have dementia.
The group, which is chaired by Baroness Sally Greengross with former health secretary David Blunkett as her deputy, says that its findings should be incorporated within the government’s current health and social care reforms.
Greengross commented: “The Dilnot Commission last week put caring for older people firmly in the spotlight, but its recommendations are not yet a reality. Our report shows there are many ways to save money and improve care now.”
“We can’t keep using the chicken and egg excuse that it’s not possible to cut hospital beds, and release funds, until community services are in place,” added Jeremy Hughes, chief executive of the Alzheimer’s Society. “The reality is, money is not being spent in the best way and NHS bosses must find a way to change this.”
The report quotes Angela Smith, from Kent, who cared for her husband Freddie who died with dementia. “Freddie had to spend six weeks in hospital at one stage, which was awful. He was just left in a heap and there was hardly any interaction with him,” she said.
“If we had had support earlier on, the whole trauma could have been avoided. The support I finally received at home was a lifeline because it meant I could look after him where we both wanted him to be.”