Neglect of elderly fuels 500,000 hospital admissions

More than half a million elderly people are being admitted to hospital with conditions which could have been avoided if they had not been neglected by GPs, care homes and social services, regulators have said.

A damning report by the Care Quality Commission (CQC) highlights increasing numbers of patients being admitted to hospital as an emergency suffering from complaints which are often caused by poor care and neglect.

These problems include malnutrition, pressure sores and urinary tract infections.

There has been a 64 per cent increase in the last six years in pneumonia admissions among older people, while inhalation of food or liquid has led to a 52% rise, and admissions for urinary tract infections have seen a 45 per cent increase.

The report says hospitals have made “no improvement” in monitoring the quality of patient care in light of the Mid Staffs scandal and “no improvement” in keeping patients safe or treating them with dignity.

Poor hospital care in the last year was also more likely to have had a negative impact on patients than the previous year, the review of NHS and social care services in England found.

The report said: “In the aftermath of the failures of care at Mid Staffordshire NHS Foundation Trust, our inspectors’ biggest concern in 2012/13 was that acute hospitals made no improvement in assessing and monitoring the quality of care they provided.

“We also found no improvement in safety and safeguarding, or in hospital patients being treated with dignity and respect.

“Around half (47 per cent) of the problems we uncovered in our inspections in the NHS in 2012/13 had a major or moderate impact on patients.

“This is a deterioration from the previous year (39 per cent).”

Overall, CQC inspectors found poor care in around one in 10 of all hospital inspections.

Looking at dignity and nutrition for older people, the CQC said it was “alarmed to see that there were fewer hospitals where patients were always treated with dignity and their privacy and independence respected”.

It said it was “clearly unacceptable that this position, poor to begin with, had deteriorated further.”

Problems included staff discussing confidential patient details in public and staff “talking over patients as though they were not there”.

Patients could not always reach call bells and some staff did not respond to them in a reasonable time, the report went on.

On social care, the report said the care received by many people in 2012/13 was “still poor”.

One in five nursing home inspections revealed safety concerns, such as failing to give out medicines safely.

In half (51 per cent) of cases where inspectors found problems with adult social care, this had a major or moderate impact on people which was “no better than the previous year”.

The report added: “We issued more warning notices to tackle this poor care – 818 in 2012/13, compared with 598 the previous year – an increase of almost 40 per cent.”

The report sets out CQC’s findings about the quality of care in the year to March 31 2013, and is based on more than 35,000 inspections.

The study found the number of older people being admitted to hospital in an emergency, with conditions which could have been avoided is increasing faster than the growth in the older population.

Those admitted with avoidable conditions is up from 374,000 in 2007/8 to 530,000 in 2012/13.

Among people aged 75 and over, a quarter of all emergency admissions in 2012/13 were avoidable, up from 21 per cent in 2009/10.

Among people living in care homes, hospital admissions for avoidable conditions were 30 per cent higher for those who had dementia compared with those without dementia.

David Behan, chief executive of the CQC, said: “Those responsible for care in local areas need to work together quickly to address the number of avoidable emergency admissions to hospital.

“GPs, care homes, home care agencies, community health services and hospitals, with local commissioners, must plan effectively to make sure our older and more vulnerable people are cared for in the way they deserve.

“Where care can be provided for people outside of hospitals, it is better for them and eases pressures on hospital services.

Professor Keith Willett, NHS England’s director for acute episodes of care, said: “We’ve got to provide better services outside of hospital.

“Our urgent care system will always be there to provide a safety net but we must make sure it’s used effectively. It’s clear there are opportunities for improvement in many parts of the country and we need to change the way we provide services in order to deliver better services for patients .

“Health services across the country, particularly those in difficulty, need to look at the areas which are doing well. Those areas succeeding have very high elderly populations and have learned the skills of how to deal with their problems effectively in the community.”

Dr Peter Carter, chief executive of the Royal College of Nursing (RCN), said: “Thousands of older and vulnerable patients are waiting for hours in A&E corridors with conditions which could have been prevented. Thousands more are battling loneliness as paid carers are forced to reduce the time they spend visiting patients due to financial cutbacks.

“We support moving care from hospitals to communities because it is better for patients.

Shadow minister for care and older people Liz Kendall said: “This report shows the full scale of David Cameron’s care crisis.

“Avoidable emergency admissions to hospital for the over-65s have topped half a million for the first time, and are rising faster than the increase in the ageing population.

“This is terrible for older people, and putting huge extra pressure on already-struggling A&Es. It is also an appalling waste of taxpayers’ money, costing around a billion pounds a year.”
 
       
Source The Telegraph