Sir David Nicholson, head of the NHS Commissioning Board, has expressed the view that NHS hospitals are “very bad places” when it comes to the standards of care for frail, elderly patients. He proposes that new ways must be found to treat elderly people in the community and – where possible – in their own homes.
“If you think about the average general hospital now, something like 40 per cent of the patients will have some form of dementia. They are very bad places for old, frail people. We need to find alternatives”.
The scale of the problem has been described as a “national scandal”, comparable to when large numbers of people with mental health problems were held in asylums during the 1960s and 1970s.
This is emerging as the official position on the part of the NHS Commissioning Board, and has been broadly endorsed by the British Medical Association and the NHS Confederation. The expansion of community treatment may result in the closure of some hospital facilities and concentration of services in a smaller number of larger, specialised centres.
Reflection: Much good work has taken place recently to improve standards of care, and to make hospital wards more dementia-friendly environments. It would be discouraging if all of these initiatives were dismissed casually as “too little, too late”. A careful and intelligent balance needs to be found, while recognising that integrated health and social care solutions are the way forwards.
NHS chief: Hospitals are bad for old people’s health. London: Independent, January 21st 2013.