Monday 18 December 2017
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NHS double standard for people with dementia in care homes

The NHS is providing a second-class service to many of the 280,000 people with dementia who live in care homes in England.

An Alzheimer’s Society investigation has uncovered that almost half* of care home managers feel the NHS isn’t providing residents with dementia adequate and timely access to vital services like physiotherapy, continence and mental health services. This has led to instances where people have been left bed-bound, incontinent and sedated because the health service is too slow in responding to their needs.

The investigation, which is part of the Fix Dementia Care campaign, involved a survey of over 285 care home managers in England conducted jointly by Alzheimer’s Society and Care England, as well as first-hand testimonies of carers of people with dementia living in care homes.

It also revealed that one in five care homes surveyed are being wrongly charged by GP practices for services that should be free on the NHS – up to as much as £36,000 a year. The total cost of GP charges to care homes is estimated to exceed £26 million a year.

Alzheimer’s Society is concerned that in their hour of need people with dementia, who like any other tax payer have funded the NHS, are paying again to see a GP through their care home fees, or being denied timely access to services.

The money that care homes are spending on GP services - that are free on the NHS to all those living in the community - could be much better spent on one-to-one care for people with dementia. The average GP charge of £12,191 a year is enough to fund care for a person with dementia for nearly six months**.

Poor access to NHS services is penalising some of the most vulnerable people in society. Care home managers told us:

On access to mental health services: 'A resident who was saying she felt suicidal had to wait over eight weeks to be referred to mental health services.'
On access to physiotherapy: 'We had one [person] who fell and had a hip fracture. Physio follow-up in the community took over a year.'
On access to continence services: 'Residents have to go without continence aids, leaving them isolated, with no dignity and low self-esteem.'

The investigation found shocking examples of the effect of long waiting times and lack of local services. This included people with dementia in care homes:

being prescribed pain relief over the phone for a broken collar bone
being prescribed the wrong drugs as a result of a GP’s insistence on conducting consultations over the phone
waiting three months for continence products
being restrained under an emergency Deprivation of Liberty Safeguard due to a lack of mental health care 
waiting a year for physiotherapy following surgery 
being refused an out-of-hours appointment in their care home by a GP

These practices contravene the NHS Constitution, which states that everyone, regardless of who they are or where they live, should have access to the NHS services they need free at the point of use.