NHS EnglandThe NHS is providing a second-class service to many of the 280,000 people with dementia who live in care homes in England, according to an investigation.

An investigation by the Alzheimer’s Society has uncovered that almost half of care home managers feel the NHS isn’t providing residents with dementia adequate and timely access to vital services like physiotherapy, continence and mental health services. This has led to instances where people have been left bed-bound, incontinent and sedated because the health service is too slow in responding to their needs.

The investigation, part of the Alzheimer’s Society’s Fix Dementia Care campaign, involved a survey of more than 285 care home managers in England conducted jointly by the Alzheimer’s Society and Care England, as well as first-hand testimonies of carers of people with dementia living in care homes.

It also revealed that 1 in 5 care homes surveyed are being wrongly charged by GP practices for services that should be free on the NHS – up to as much as £36,000 a year. The total cost of GP charges to care homes is estimated to exceed £26 million a year.

Alzheimer’s Society is concerned that people with dementia, who like any other taxpayer have funded the NHS, are paying again to see a GP through their care home fees, or being denied timely access to services. 

The charity says that money care homes are spending on GP services could be much better spent on one-to-one care for people with dementia. The average GP charge of £12,191 a year is enough to fund care for a person with dementia for nearly six months.

The investigation found a range of examples of poor practice and outcomes. This included people with dementia in care homes:

• Being prescribed pain relief over the phone for a broken collar bone 

• Being prescribed the wrong drugs as a result of a GP’s insistence on conducting consultations over the phone

• Waiting three months for continence products

• Being restrained under an emergency Deprivation of Liberty Safeguard due to a lack of mental health care 

• Waiting a year for physiotherapy following surgery 

• Being refused an out-of-hours appointment in their care home by a GP.

These practices contravene the NHS Constitution, which states that everyone, regardless of who they are or where they live, should have access to the NHS services they need free at the point of use.

Jeremy Hughes, chief executive of Alzheimer’s Society, said: “People with dementia living in care homes are just as entitled to receive free care from the NHS as anyone else. A care home is, after all, a person’s home and health services must treat care homes as a vital part of the community, instead of holding them in disregard.

“It’s unacceptable that this NHS double standard is leaving people with dementia waiting months for physiotherapy, incontinence and mental health services. In that time we are concerned they’re being robbed of essential care and pain relief, as well as their dignity, self-esteem and independence. 

“With 70% of care home residents living with dementia, we’re urging everyone to get behind our campaign to transform the second-class service that many receive.” 

Martin Green, chief executive of Care England, said: “Our research and report with Alzheimer's Society identifies that many people living with dementia in care homes, and the care staff who are responsible for their care, are being all but abandoned by primary care. 

“Sadly, this charging has been going on for far too long: we have called for years for this practice to be put to a stop, and for care homes and residents with dementia to be more visible and equal in the eyes of the health service.

“As the Health Select Committee has recently recommended, access to primary care must be improved. Older people living with dementia in care homes have the same rights to primary care, health and support as any other citizen, and the government and NHS must act to ensure that these services are available to everyone when they are needed.”