Care homes ‘lack access to specialist doctors’

Care homes residents are missing out on access to specialist care from older people’s doctors despite guidance backing their use, according to research published today.

A survey found that just 16% of geriatric medicine departments across England allocated time for care home work – equating to just 1% of total consultant geriatricians’ time.

The study, funded by the British Geriatrics Society (BGS), which represents medical professionals specialising in older people’s care, also found that just 18% of primary care trusts were funding specialists’ involvement with care homes.

No involvement in admissions

It also found that 68% of geriatric medicine departments reported no involvement in admissions to residential care homes.

This is despite guidance from the BGS, Royal College of Physicians and the Royal College of Nursing which recommends geriatricians’ involvement in complex assessments of older people before admission to care homes, as well as the training of care home staff.

Expertise not used

BGS care home lead Dr Eileen Burns said: “We are concerned that our expertise in assessment of frail older people, who may be living with several chronic conditions, is not being drawn upon to support the care of these complex patients.”

Nearly half of all geriatric departments reported PCTs carrying out programmes to support care homes without their knowledge, while 73% of departments said they would favour greater involvement in care homes.

The report, by geriatricians at Guy’s and St Thomas’s NHS Foundation Trust, said the findings could mean that specialist care in care homes was a low priority for PCTs. However, it also suggested that geriatricians’ involvement in acute care in general hospitals was precluding their deployment in care homes.

Lack of training for GPs

GPs are responsible for primary health care in care homes but the research found that less than 40% of GPs had had any specialist training in geriatric medicine.

Burns said geriatricians should be involved in assessments, providing advice to GPs, nurses and care home managers, and helping in the design of services, saying this could help cut unnecessary hospital admissions.

Sheila Scott, chief executive of the National Care Association, which represents care home providers, said: “There is not the speciality health care available that somebody young would receive. This is about age.”

Researchers surveyed 109 geriatric departments and 141 PCTs for the study, which was published today in Clinical Medicine, the journal of the Royal College of Physicians.

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