Social Care & the Need for Greater Integration
Elliot Bidgood, 12 March 2013
The Care Quality Commission (CQC), the regulator tasked with ensuring standards in health and social care, has today released a report showing that severe problems remain with dementia care in care homes and the NHS and that many facilities are still “struggling” to provide proper care.
In 52% of Primary Care Trust areas, care homes were failing to identify and treat dehydration, pneumonia, malnutrition, infections, bed sores and broken bones in people who had dementia, denying them basic care and creating a situation which the Alzheimer’s Society described as “Russian roulette”. The CQC investigation also raised concerns about what dementia patients face in hospitals.
This demonstrates that our current system is not equipped to deal with the ever-increasing pressure being placed on the system by population aging and associated ailments, as care for conditions like dementia continues to be too inconsistent and episodic to meet the needs of an aging population. Moreover, this persists in spite of the existence of a rich store of examples of more integrated care the NHS can look to. In contrast to the NHS in Great Britain, it has long been the case that the equivalent service in Northern Ireland, Health and Social Care in Northern Ireland, prioritises integration. Despite some issues there, notably a common concern that the system is still excessively health and hospital-based, this means that in Northern Ireland care is still comparatively less episodic than in the rest of the UK. This is on top of experiments in individual British localities such as Torbay and Lanarkshire and examples in the US and the Netherlands.
Further, contradicting some in the British Medical Association (BMA) who see integration as an alternative to competition, rather than as a potential complement to it under the right circumstances, the private non-profit Kaiser Permanente and Geisinger Health Maintenance Organisation (HMO) networks in the US also offer respected examples of integration.
If are to guarantee proper care to dementia sufferers, it seems that the NHS and UK social care must learn fundamental lessons, both from abroad and from their own more innovative corners.