Dementia experts in the United Kingdom have appealed for a new approach to supporting dementia patients and their carers, after identifying gaps in current health and social care provision. The findings are highlighted in a new report, written by a panel of some of England’s leading experts in dementia care, launched in the House of Lords today.
The group found that current service provision for dementia is failing to support patients and their carers — that’s the people who look after them — in many key aspects of day-to-day life. As a result, many of these patients end up in an inappropriate care setting. Together, the group sets out a new approach to dementia care, outlining practical steps that will improve patient and carer experience at a lower cost to the NHS and local government.
Specifically, the report:
– Identifies where patients and carers are currently being let down within today’s system of careÂ – areas of unmet need include stimulation, respite care and access to round-the-clock clinical care.
– Lists the care settings in which these needs are at most risk of going unmet (i.e. residential homes, state-funded care etc).
– Defines and maps a new model of care that will result in better, more efficient care, and reduce hospital admissions.
– Concludes that a single point of access to service and support, available 24/7 would greatly improve care and reduce hospital admissions.
– Finds that moving patients onto a clearly mapped home-based care pathway could save over GBP127million a year for the NHS whilst in avoidable hospital admissions.
– Calls upon the Department of Health to identify the true costs of dementia by developing a usable tariff or capitated payment method, which identifies the actual cost of dementia care in today’s system.
Reducing admissions and cost of care
There is little consistency in the diagnosis of dementia, or in the way care is commissioned and provided. Inadequate data also make it hard to quantify the true costs of the disease to the state, to patients and to carers.
Currently, 25% of all patients admitted to hospital have a diagnosis of dementia, and it is widely accepted that many hospital admissions could be prevented if patients and their carers were better supported at home. The report finds that the cost of caring for dementia patients can be reduced by up to a quarter if the recommendations for a home-based model of care were implemented.
Ruth Poole, Group Clinical Director of Healthcare at Home comments: “When it comes to treating dementia, today’s system is not fit for purpose. Patients and carers are left to navigate their way through a complex and often baffling health and social care system. This can lead to the all-too-familiar outcome of patients ending up in inappropriate care settings, because anything else seemed too complicated, the options available did not match their needs, or they were scared and confused and did not know where else to go. Put simply, we as a health and social care system need to get our act together.”
Nada Savitch, Director, Innovations in Dementia Community Interest Company, added: “The people with dementia we work with at Innovations in Dementia tell us that they find the artificial barriers between health and social care a barrier at best and a minefield at worst. All too often people with dementia and their carers are left to find their own way through a labyrinth of services and providers. A single point of access for all health and social care needs, regardless of provider, is crucial in making sure people get the right services at the right time. People with dementia need to be at the heart of services designed for them.”
Pam Garside, Judge Business School, University of Cambridge, and reference group chair, comments: “As a society and a health sector we are just realising the scale and projected prevalence of dementia in our population. Today’s failings in dementia care are something we – as a mixed health and social care economy – need to tackle collectively. There are proven models from other diseases, sectors and indeed industries, where multiple service or care routes are brought together through a single point of access. We should learn from these ideas and adapt them to patients, families and local circumstances.”
The full report can be downloaded at http://www.hah.co.uk/media-centre
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