Discrimination ‘denying care home residents hospital access’, study suggests

Elderly people in care homes are being denied access to basic NHS services available to everyone because of discrimination, a major study suggests.

By John Bingham, Social Affairs Editor

6:40AM BST 29 Mar 2012

Analysis of the health records of more than 120,000 older people shows that those in residential care are significantly less likely to use their local hospital than those still living in their own homes.

When it comes to routine appointments, people in care homes are half as likely to visit their local hospital as the rest of the elderly population, research by the Nuffield Trust, a health think tank, shows.

The researchers said it could mean that their needs are being met in their care homes, avoiding the need to use hospitals, or that it shows “discrimination” against the elderly.

They went through hospital and social care records from people aged over 75 in four separate areas.

It showed that most of those receiving care had been to a hospital in the previous year, either as an emergency admission, for an operation or as an outpatient.

But while 73 per cent of those receiving care in their homes had been admitted to hospital in that period, only 58 per cent of those in care homes had.

When it came to more routine matters, those living in care homes had an average of 1.09 outpatient appointments in a year whereas those who were not receiving any care at all had almost twice as many, an average of 1.99 appointments.

In a research paper published in the Journal of Health Services Research and Policy, the said this could be because care homes were acting as a “substitute” for hospitals meeting many of the elderly people’s needs, or the opposite, that they have “reduced access”.

Dr Martin Bardsley, head of research at the Nuffield Trust said the pattern could be a “good thing” or a “bad thing”.

He wrote: “Is it that for some people care homes are not helping get the access to hospital care that they should have?

“Are we seeing an example of discrimination against some older people living in care homes?” he concluded that the reason was “probably both”.

Harvey Zemmel, a former care home boss who now runs the website www.findingacarehome.co.uk said: “This might show that care homes and hospitals are doing everything right but I am sceptical.

“This clearly points to a culture of discrimination against the elderly when it comes to access to basic services.

“In my experience, unless there is a relative or advocate screaming from the rooftops, elderly people actually won’t seen and get access to decent quality care.

“This shows that they are not a priority.

“Homes need to be really strong advocates but I suspect that a lot of care homes are not as strong an advocate as they should be.”

The findings follow a study by the British Geriatrics Society last month which showed that more than half of people in care homes are being denied access to some key services or forced to wait up to three months.

Tom Thorpe of the BGS said that some schemes in areas such as Manchester and Sheffield where care homes and the NHS work together, hospital admissions can be deliberately reduced.

But he added: “However, as the BGS’s recent report Failing the Frail found, for the 400,000 older people in England resident in care homes access specialist health and primary care services is dependent on their postcode. For instance, only 60 per cent of commissioners ensured access to a geriatrician.”



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