HOSPITAL STAFF in England are badly trained to deal with dementia patients, and British government plans to improve care over the next five years must be “urgently” reviewed, a top audit body warned yesterday.
Dementia affects more than half a million people in England alone, and the numbers will double over the next 30 years, while the costs of coping with them will rise from £15 billion (€17 billion) to nearly £35 billion in just 15 years, the National Audit Office (NAO) said.
Expressing concerns about training standards for doctors, nurses and carers, the NAO said society’s lack of interest in dementia care is affecting “the morale and motivation” of those caring for patients daily.
“Almost every health professional comes into contact with patients who have dementia, yet there is no required basic training in how to understand and support them,” said the audit body, in a report issued yesterday.
Care is affected because staff turnover is too high in nursing and residential homes: up to a quarter quit their jobs in nursing homes every year, while one in five leaves residential homes.
The department of health produced an “ambitious and comprehensive strategy” in 2007, but it has not addressed it as urgently as efforts to improve cancer and heart disease treatments.
“It has not been given the levers or urgency normally expected for such a priority and there is a risk that value for money will remain poor unless these weaknesses are addressed urgently,” the NAO found.
“Joined-up working remains very patchy and as a result people with dementia are still being unnecessarily admitted to hospital, have longer lengths of stay and enter residential care prematurely,” the report said.
The head of the NAO, Amyas Morse, said the government’s performance to date has “not so far matched the rhetoric in terms of urgency”, and it is “unlikely” that targets will be met.
A succession of reports has highlighted poor standards. One-quarter of care homes in the east of England and the West Midlands have been rated as poor, while one in eight in the northeast and London fail to make the grade.
Up to 150,000 people are wrongly given anti-psychotic drugs, contrary to medical rules, drugs which are blamed for 1,800 deaths a year, according to a department of healthcommissioned report published last November.
Equally, some people who should be receiving cholinesterase inhibitors – drugs which slow down the progress of dementia – are not getting them depending on where they live, with the elderly in the West Midlands suffering most.
Only one-third of people with dementia are formally diagnosed, which means that a majority of sufferers miss out on early intervention and specialist care that could improve the quality of their lives – and the situation is worst in the southwest of England.
Given age patterns, the National Audit Office’s Improving Dementia Services in England warned that the southwest and the East Midlands face “the biggest challenge”; “London is best placed, with a more slowly ageing population.”
Though 21 million English people know someone with dementia, public awareness is poor: 28 per cent wrongly believe it is “a natural part of ageing” and 22 per cent also wrongly believed that there is no way to reduce the risk of suffering from it.
“The stigma, amongst health and social care staff as well as the public, contributes to a negativity about dementia resembling the attitude to cancer in the 1950s.
“Promising scientific research is under way and much can be done to promote quality of life for people with dementia, even in the very late stages, but this is not widely understood even by health and social care professionals,” the NAO said.