Older people in care homes ‘denied basic NHS services’

Older people in care homes cannot get access to even the most basic NHS care, doctors warn today.

A report by the British Geriatrics Society (BGS) found that many of the UK’s 420,000 care home residents could not access GPs, physiotherapists or out-of-hours care.

Though some areas were providing good healthcare for care home residents, many were not, especially where there was an abundance of care homes.

It said that the cause of this variation was a lack of clarity around the responsibilities of the NHS towards those in care homes. It concluded the prevalence of the social model in the sector meant healthcare needs were often overlooked.

NHS care for people in care homes was also rarely commissioned as a specific service.

Dr Finbarr Martin, president of the BGS, said he wanted the report to “galvanise decision-makers into action”. He added: “It is a strange paradox that older people with the greatest needs for healthcare are denied it because of their postcode.”

“A lack of regular contact with a GP is not only bad for patients, it also increases pressure on more expensive out-of-hours and emergency services,” said Michelle Mitchell, charity director at Age UK.

The report recommends that the Department of Health include scrutiny of NHS provision in care homes as part of statutory regulations.

“To be effective, there must be a partnership between the care home providers, social care commissioners and practitioners.,” said Martin. “Leadership is required not only from the NHS, statutory regulators and governments but also from health and social care professionals.”

“It is vital that leadership and co-ordinated action from social care, health care and local authorities urgently happens to ensure that those who are at the most vulnerable point in their lives receive the care and support they need,” said Dr Lorna Layward of the Stroke Association.

A Department of Health spokesperson said: “Our proposals for modernising the NHS seek to achieve genuine integration of services across the system.  They will ensure care home residents get the services they need.”

The BGS study follows calls yesterday for a duty to be put on GPs to co-ordinate healthcare for care home residents, in a report from the Centre for Social Justice on tackling pensioner poverty.

The think-tank said the current system led to high levels of expensive emergency hospital admissions, and that single GP practices should be aligned with specific care homes, with doctors committed to visiting regularly and proactively case managing residents.

The report, Age of Opportunity, also called for:-

• Local authorities to have to justify the fees they pay care homes through a “fair price of care” methodology to prevent underfunding of places.
• GPs to be able to directly prescribe respite care for carers.
• Councils and the NHS to jointly commission preventive care teams to identify and work with older people at high risk of hospital admission.
• Health visiting services to be set up for older people as a preventive measure.

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