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Why is the NHS failing people with dementia?

  • Comments (21)

According to the Care Quality Commission the health and social care system is “struggling” to care properly for people with dementia.

People with dementia living in care homes are more likely to be admitted to hospital with avoidable conditions - such as urinary tract infections, pressure ulcers and dehydration. Once in hospital, patients with dementia are more likely to stay there longer, be readmitted or to die there.

The CQC called for “better identification of dementia” and comprehensive training for care staff after the report also found that almost a third of hospital admissions for people with the condition did not include a record of their dementia, even though it had been identified in the past.

 

CQC: NHS ‘failing dementia patients’

  • Comments (21)

Readers' comments (21)

  • Anonymous

    I have had recent experience of a relative with dementia in hospital care and it was frightening. A week after admission my relative was discharged with a pyrexia, dehydration and a had lost a stone in weight. Really shocking.

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  • Anonymous

    Anonymous | 18-Mar-2013 6:20 pm

    why is this still being allowed to go on despite all the media attention?

    we are human beings? if we were animals we would be far better protected.

    bring in private medicine now and let people choose who looks after them and services providing poor care will not survive.

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  • Anonymous

    Anonymous | 18-Mar-2013 6:44 pm

    Not so. My relative had a much worse experience at the hands of a private health care home. Private health care is not the answer.

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  • Anonymous

    Anonymous | 18-Mar-2013 6:44 pm

    Hmm. More accurate would be:

    bring in private medicine now and let people choose who looks after them and services providing care for the poor will not survive.

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  • Anonymous

    Anonymous | 19-Mar-2013 7:43 am

    Exactly.

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  • Anonymous

    Anonymous | 18-Mar-2013 7:47 pm

    countries with well managed private health services for the whole nation (not half - half as currently in the UK) offer far better, fairer, more rapid and more comprehensive tailor made care than the nhs and it does not necessarily cost the patients any more. the only difference is that it is paid for up front as and when needed so diagnostic tests, treatment and care are entirely patient focussed.

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  • Anonymous

    Anonymous | 19-Mar-2013 10:25 am

    Having worked in quite a few countries, most recently Singapore, I'm afraid that I would largely disgree with your over-simplified analysis of overseas healthcare. The grass isn't always greener elsewhere. There are aspects of some systems which could easily be adopted here to make the NHS work more efficiently. However, wholesale transference to private healthcare systems would certainly create at least a two-tier system in this country. I understand that there are probably ideological reasons for favouring this model. Fundamentally, the shareholder, not the patient is key. There are some who don't feel inclined to contribute to the healthcare of the least affluent and those with costly, chronic conditions. If you are relatively well off (although it is better to be really well off), educated and medically knowledgeable, private care presents itself as an attractive alternative and may indeed be advantageous for the individual. However, the vast majority of people in any country are not all of those things.

    The problems with the NHS are nothing to do with the principles on which it was founded, and everything to do with successive government mismanagement. There is enough money to run the NHS efficiently, but there is not the political will or ideology. The NHS could and should be delivering high quality care which is free at point of delivery, not basing care on ability (or not) to pay.

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  • Anonymous

    Anonymous19-Mar-2013 3:01 pm

    Anonymous | 19-Mar-2013 10:25 am

    The Singapore system enjoys an excellent reputation and although I know little about it I wonder if there is anything there which could benefit the UK system.

    I read with interest your views on the private healthcare system but not all are designed to benefit the rich at the expense of the poor. Most in Europe are fully comprehensive to include all citizens.

    As I have said previously, tax payers are already paying for the NHS but payments do not go directly to meet their needs and are not transparent so they have no idea where their money is going. This also means they do not always get care when needed due to the GP gate keeping system and long waiting lists and sometimes they do not even get what they need at all and in some case it is substandard. Instead of paying tax this money could equally well be paid to a single state insurance, or private insurance companies of their choice. Obviously the insurance model would have to be totally different to the existing plans. It seems that many people associate private insurance with the current system in the UK which is quite a different and inappropriate system if everybody is to be provided with private care as an alternative to the NHS. It is this existing system in the UK which is a two tier system which favours those who can afford to pay.

    I have lived and worked in Europe with an all private system for over 30 years and any advice or a doctor's appointment at the patients convenience or based on an urgent clinical need with a GP or any specialist practitioner of their choice is only a phone call away. For emergencies and out of hours there is always an on call service and A&E departments. All care and clinical need is entirely patient based and the quality is very high otherwise services fail to survive as poor standards are not tolerated.

    Basic insurance in recent years has become compulsory for all residents and covers all illnesses and all pre-existing conditions for newcomers to the country joining later in life. Extra insurance for those who choose it covers a private room, additional convalescence and visits to a spa, etc. and a wider range of complimentary therapies than with the basic insurance, and more home care and assistance after hospitalisation beyond the basic cover but has no effect on the standard of care and is superfluous to the needs of most people. Insurance premiums are modest and tax deductible. A choice of how much of the bills patients wish to cover themselves can further help to reduce premiums and this can be changed once a year on renewal. Patients pay 10% of all outpatient bills up to a certain limit just beyond that chosen sum. These payments are also tax deductible. Those whose income is below subsistence level are entitled to financial aid which also covers their premiums.

    Outside the district and university hospitals which are funded by their local councils and by private insurance, there are private hospitals for those who have additional private insurance or those wishing to pay themselves such as foreign non-residents without insurance. Some of these are managed by foreign companies, which I imagine is also the case in the UK and in some other countries.

    Like you, I am not convinced that the NHS is short of funding rather than a question of poor allocation and misuse but I think if it cannot return to its founding principles a wholly privatised system would be the answer but not half-half for the rich and the poor as is currently the case. I am not convinced that it would be possible to disband it entirely in favour of privatisation and believe we will just end up with a mish-mash of neither one or the other, and who is to say if the NHS can no longer be managed effectively whether any other system could be managed any better.



    What concerns me if private companies start running services for the NHS it will just lead to further fragmentation, a lack of seamless services to patients and further fragmentation in quality control whereas in Europe quality control is more standardised so you know what you are getting and what you are paying for.

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  • Anonymous

    Anonymous | 19-Mar-2013 4:24 pm

    Singapore works well if you can afford it. And it is not free at point of delivery. I am also fully cognisant of the funding arrangements in many of the European countries.

    Like I said, I guess it does come done to ideology. I am not interested in a visit to a spa or a private room or complimentary services. Those are also available here if you are prepared to pay a little extra. All the other services and facilities you have listed, and more, are entirely possible with a properly run NHS. The basic framework remains, just. Although, the current government is making a dog's dinner of the latest 'reforms/privatisation'. It is costing billions. A complete dismantling of the NHS in favour of a completely different private system actually shows a complete lack of aspiration. It also shows no understanding of what the NHS means to the people of this country. This country is a magnet for major medical research because of it's highly skilled workforce, standardised quality control, joined up services and unparalleled access to potential recruits with full and accurate medical records. All because we have a National Health Service. No. It would be easier, less expensive and most importantly, better for patients, to turn the NHS around.

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  • Anonymous

    Anonymous | 19-Mar-2013 6:38 pm

    Anonymous | 19-Mar-2013 4:24 pm

    As I said the spa, etc. are optional extras and not part of the basic obligatory insurance and not everybody wishes or needs these.

    I agree the best choice would be to turn the NHS around and back to its original values and concept but I cannot see this happening and it was conceived for very different times and different health needs of the population and the European Models would be a more modern and effective way forward or even chosing an amalgam of the world's best whilst the opportunity is there.

    The NHS has been in steady and serious decline, as far as I am concerned, since the 1980s with the introduction of general management and non-clinical managers put in charge of clinical services with the idea of relieving highly qualified and experienced clinical staff of many of their administrative duties to allow them more time to care for their patients; and we all know the results of this failed experiment! On line with this, medical technology has advanced, the population has dramatically increased as have demands on the health services and many other factors. To me managerial practices, so successful because of their cost-effectiveness in the manufacturing industries, applied to the care of patients with all their individual needs and various reactions to therapies, attempting to processing them through a system like goods on a conveyor belt and applying a limited range of packages of care instead of assessing and treating individual needs in order to meet certain management targets and hypothetical quality controls when they come out at the other end, is a total disaster. Money should follow the care of each individual and not the other way round.

    Clinicians and nurses know what is needed to turn the NHS around but how are they going to convince everybody else so that they all pull their weight to work together towards providing a world class service for the population they serve.

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