Everything you need to stay up to date on patient safety and workforce, plus my take on the most important under the radar stories. Contact me in confidence. Shaun Lintern, patient safety senior correspondent.
New report provides evidence for care
By 2040, nearly one in seven people in the UK are projected to be over 75. That is the startling statistic in the opening lines of a new report by the National Institute for Health Research looking at the evidence for comprehensive care of frail older people in hospital.
The report considers the evidence from 53 NIHR studies looking at care for the elderly. This topic is nothing new; it’s not a surprise that we are all living longer and as such the NHS is already dealing with large numbers of frail patients. But do we care for these patients adequately? Sadly, that is not always true and far too many families have stories of their elderly relatives being mistreated, neglected and otherwise not prioritised.
The focus on elderly care by the NIHR is welcome. The report highlights that hospitals carrying out a comprehensive geriatric assessment and planning care accordingly see reductions in unplanned readmissions. This increases the chance the patient will remain in their home – with evidence showing that for every 20 patients with a CGA, one long term care home placement can be avoided.
But the National Audit Office reported in 2016 that just 42 per cent of hospitals were undertaking early geriatric assessments. Does your trust?
The NIHR also highlights evidence supporting the use of a tool using GP data to identify the most vulnerable frail patients. Including it in the summary care record helps hospitals immediately identify frail patients in their care.
The report identifies where things need improving such as awareness of delirium among staff, while pressure sensors used to reduce falls make no difference unless they are part of a wider plan for staff working with patients at risk.
While there are lots of areas that need further research, the report has some valuable nuggets of information on areas like pharmacy checks to reduce medication errors, discharge planning and gaps in person centred care – only a third of hospitals train healthcare assistants on relationships with frail elderly patients.
The NIHR challenges those on trust boards to ensure they are providing evidence based care for their elderly patients. The report says: “Whilst frailty can be described, managing frailty is not yet well understood and the evidence base for caring for people living with frailty in hospitals is developing and incomplete. We want to establish the current state of knowledge, including the gaps, in order to both inform staff who are deciding how to treat people on a day to day basis and to inform the future research agenda.”
There are many reports, strategies, and policies churned out in the NHS – not all are evidence based and designed to prompt improvements in care at an organisational and team level.
I’d recommend reading the NIHR report and understanding how far from the evidence of best practice is the care in your trust.