RCoA survey shows resources needed for vulnerable patients

More than half of anaesthetic doctors would feel uncomfortable with a relative or close friend with dementia being admitted to an NHS hospital this winter, a survey from the Royal College of Anaesthetists has today revealed.

The survey, undertaken by the RCoA in collaboration with Alzheimer’s Society, found that 57 per cent of respondents would be uncomfortable with the possibility of a relative or close friend with a diagnosis of dementia receiving treatment in an NHS hospital.

While extra money for the NHS in the Autumn Budget was welcomed, it delivered less than half of the new resource that NHS England Chief Executive Simon Stevens had said was needed to meet demand. The survey was conducted before the Budget announcements, and reveals clinical concerns about the resources to deliver safe care.

Nearly eight out of ten (78 per cent) respondents rejected the proposition that the NHS has the resources needed to guarantee the safety of elderly and vulnerable patients this winter, including those with dementia.

On average, a person with dementia will stay in hospital more than twice as long as other patients over 65, which rises to as much as seven times longer in the worst-performing hospitals. At present, people with dementia occupy a quarter* of hospital beds.

Dr Liam Brennan, President of the Royal College of Anaesthetists, said:
“I wish I could say I was shocked by these findings, but the truth is that pressures on the NHS will inevitably have an impact on frontline staff and the concerns of people up and down the country will be shared by doctors as well.

“The NHS will turn 70 next year, and while this anniversary is to be celebrated, it also provides an opportunity for a real drive to improve elderly care throughout the health and social care systems. Sadly, the current resources are not nearly enough to address rising demand for NHS services and we lack a long-term plan to manage growth in prevalence of dementia.”

More than nine out of ten (96 per cent) survey respondents said that a patient with dementia who remains in hospital due to a delayed transfer of care would experience a worsening of their condition. A delayed transfer of care describes a situation where a medically fit patient is unable to be discharged from hospital. For those with dementia, this is often due to a lack of community or residential social care.

Jeremy Hughes, Chief Executive at Alzheimer’s Society, said:
“These results tell a tale we hear all too often – people with dementia trapped in hospital, with their health deteriorating, despite being well enough to go home.

“One million people will have dementia by 2021, yet local authorities’ social care budgets are woefully inadequate and no new money has been promised in the budget to cope with increasing demand.

“With healthcare professionals saying they don’t have the resources to keep people with dementia safe, it’s time the Government put pounds behind its promises on social care to ease some of that pressure on the NHS.”

The Mandate to NHS England set a target to reduce delayed transfers of care to 3.5 per cent by September 2017.  However analysis from NHS Providers** suggests a rate of consistently between 5 and 6 per cent, and that the 3.5 per cent target hasn’t been met since 2014.

Dr Brennan added:
“There is a time to be in hospital and there is a time to be at home supported by social care, but unwarranted delayed transfers of care are making that distinction harder to see. With the right political attention and investment to match, the next 12 months could be transformational for our health service. We hope that this opportunity is seized.”

*Dementia:Written question - 213473. Answered on 10 November 2014 
**NHS Providers. Briefing: The Rise of Delayed Transfers of Care. August 2017

21 December 2017

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