1. What we are calling for
Everyone has the right to feel safe and supported when they’re in hospital.
Poor care in hospital is life-changing for someone with dementia. Becoming malnourished because you cannot communicate to hospital staff that you are not eating enough, or falling and breaking a hip because you weren’t helped to the toilet, can mean the difference between being well enough to return to your own home or being discharged to a residential home.
We place great trust in the NHS to take good care of us when we’re unwell and there are many examples of excellent care across the country – some of which we have showcased in this report – but our investigation into hospital care for people with dementia reveals a less comforting picture. It is one that has been obscured from the public by layers of bureaucracy, bad governance and weak regulation.
Our report looks at the problems people affected by dementia can face on admission to hospital, the care they receive throughout their stay, the issues they can face on discharge, and the disturbing trend of falls among patients with dementia. We have discovered that poor dementia care is widespread, that the quality of care varies widely between hospitals and that millions of pounds are being wasted on substandard care.
What we are calling for
Our 3 key recommendations must be built into the forthcoming implementation plan for the Prime Minister’s challenge on dementia 2020 (Department of Health, 2015) to ensure unified, system-wide change.
1. All hospitals to publish an annual statement of dementia care
This should include:
- satisfaction levels among patients with dementia and their carers
- the number of falls
- the number of inappropriate discharges, including those between 11pm and 6am, with less than 24 hours’ notice or with significant delays
- the number of emergency readmissions within 30 days
- the number of people who receive an appropriate assessment of health and wellbeing on arrival
- levels of staff and board dementia awareness and training
- the number of people with dementia being prescribed antipsychotic drugs
- examples of how care is being personalised (for example, using ‘This is Me’ appropriately)
- examples of integrated care (for example, whether trusts employ Dementia Support Workers)
2. Monitor and use the annual dementia statement as part of its Risk Assessment Framework to identify and take action in hospitals where dementia care is inadequate
3. Care Quality Commission (CQC) to appoint a specialist dementia adviser and include dementia care indicators as part of its Intelligent Monitoring work to improve regulation of dementia services in hospital.
Fundamental to our calls is the idea that by making hospitals more accountable, they will be motivated to address any issues relating to poor care. Regulators need to do more to support this by improving the way they target inspections of dementia care in hospital and enforcing change where needed so that no one has to experience poor quality care.
How you can help
It's only with the support of people like you that we can achieve change, pressuring central and local governments to give people affected by dementia what is their right.