Don’t get old and frail – if you can avoid it – in our covertly post-code rationed services

The UK Health Services are all different, by post code, and by design. Despite paying the same taxes citizens will get different services everywhere, Chris Smyth reports 16th August 2016: Dementia patients face a care lottery. We all know this but we don’t seem to care – until it’s our own nearest and dearest who suffer, have not planned with advanced directives, and are then semi- abandoned. Don’t get old and frail – if you can avoid it – in our covertly post-code rationed services.

Image result for abandon the elderly cartoon

Dementia patients are facing a postcode lottery with figures showing that the quality of care varies wildly around the country.

Campaigners condemned patchy NHS services as official data high- lighted big variations in the number of emergency hospital admissions of people with the condition. They said it was unacceptable that patients had to gamble on whether they would get good care for an increasingly common illness.

In some areas, patients routinely go a year without having their condition reviewed while in others most people with dementia are denied their wish to die at home, according to data published today.

The NHS Dementia Atlas also shows that the rate of emergency hospital admissions of older people with the condition was 6,046 per 100,000 people in Bradford compared with 1,840 in Croydon, south London.

George McNamara, head of policy at the Alzheimer’s Society, said: “We must urgently explore why [the needs of] people with dementia are escalating to this point and what can be done in the community to prevent crisis admissions among this vulnerable group.”

He said that the variations in patient reviews were “extremely important” owing to the progressive nature of the condition. “The causes of variation need to be investigated to ensure care is never a gamble,” he added. Only 49 per cent of patients in Somerset have an annual review, compared with 86 per cent in northeast Lincolnshire.

East London fares worst for well-planned deaths, with barely a third of patients dying at home, which most people say they would prefer to do.

Caroline Abrahams, of Age UK, said: “This is an unacceptable postcode lottery of care. We must continue to improve access and quality of care for the growing number of us with dementia. In some areas help is really good but elsewhere services are frankly not up to scratch, with only a few people receiving at least an annual review of care.”

More than 850,000 people in Britain have dementia and the number is expected to exceed one million within a decade as the population ages. Jeremy Hunt, the health secretary, has pledged to make improving care a priority and argues that naming and shaming the worst performing areas will encourage them to improve. “By publishing current levels of care we are shining a spotlight on areas where there is still work to be done,” he said. “We still have much further to go to promise everyone that they will be able to live well with the condition. The impact of dementia tears at families and at our social fabric — that’s why making progress is a key government priority.”

This week people from the age of 40 will also start having dementia checks as GPs are told to encourage them to lose weight and exercise more. Assessments of people’s risk of dementia will be included in NHS health checks in a pilot scheme.

Charles Alessi, senior adviser to the programme, said: “Unlike cancer or heart disease, people are unaware that there are positive steps they can take to improve their health and reduce their risk of dementia.”

Carey Mulligan, has been signed up as the face of a campaign to urge businesses to train their staff to deal better with people who have dementia. The actress, 31, whose grandmother suffers from the condition, said: “I have experienced first-hand how devastating it can be.”

Live longer with dementia: Mr Hunt pillories the profession. Most doctors will be making “living wills” to avoid over-zealous care and prolonged demented lives…

Dementia – the truth comes out due to focus on prevalence rather than incidence. The ethics need further discussion.

Dementia carers feel brutalised: it’s a national and a systemic problem. Better to be honest about what we cannot afford..

Perverse Incentive? GPs to be paid £55 for each dementia diagnosis. “…an intellectual and ethical travesty.”

Image result for abandon the elderly cartoonUpdate 17th August. The BBC 16th August supplies comparative map for dementia care. “NHS dementia atlas reveals patchy care”.

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This entry was posted in A Personal View, Perverse Incentives, Post Code Lottery, Rationing, Stories in the Media on by .

About Roger Burns - retired GP

I am a retired GP and medical educator. I have supported patient participation throughout my career, and my practice, St Thomas; Surgery, has had a longstanding and active Patient Participation Group (PPG). I support the idea of Community Health Councils, although I feel they should be funded at arms length from government. I have taught GP trainees for 30 years, and been a Programme Director for GP training in Pembrokeshire 20 years. I served on the Pembrokeshire LHG and LHB for a total of 10 years. I completed an MBA in 1996, and I along with most others, never had an exit interview from any job in the NHS! I completed an MBA in 1996, and was a runner up for the Adam Smith prize for economy and efficiency in government in that year. This was owing to a suggestion (St Thomas' Mutual) that practices had incentives for saving by being allowed to buy rationed out services in the following year.

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