Care Homes and NHS Need to Work Together
Care homes and NHS healthcare services must work more closely together to improve levels of care for older people, according to a new study led by researchers at the University of Hertfordshire. The research was funded by the National Institute for Health Research Health Services and Delivery Research (NIHR HS&DR) Programme.
Most long term care for older people is provided by independent care homes. These older people have complex needs, and are the oldest and frailest of the population. Yet their access to NHS services is inconsistent and determined by local custom and practice rather than the particular needs of the care home residents.
Professor Claire Goodman, at the University of Hertfordshire’s Centre for Research in Primary and Community Care, said: “It is very clear that closer working and better integration of NHS services can promote more effective healthcare of older people living in care homes, and there are many good examples of where individual practitioners or services have tried to achieve this.
“However, our research found that there was not a particular model of working that ensured older people received consistent care, and few systems in place to evaluate what is being achieved. Over ten years ago, research highlighted that NHS provision to care homes was inequitable. Our findings suggest this is still the case and, if anything, it is worse.”
Many different NHS services visit older people in care homes, and they are very aware of the need to improve the way they work with the care homes to deliver their service. This has led to the development of a range of initiatives that range from the funding of NHS beds in care homes to the creation of specialist roles designed to promote better working between primary care and the care homes.
However, the study showed that tensions exist between the ways that the NHS services and the care homes provide care to older people. NHS services focus on diagnosis, treatment and support at specific times, whereas care homes prioritise on-going support and relationships that nurture a continuous review of the older person’s care.
The study also found that access to NHS services and identification of older peoples’ health care needs hardly ever involved joint review or discussion with care home staff, and even more rarely did it include the older person or one of their family.
Moving forwards, NHS services need to see care homes as partners in care and not just the solution to the problem of where to place older people who can no longer live at home. For care home residents, the recognition and inclusion of care home staff or a relative in the discussions on their health care needs provides the support for a more resident-focused care service. By adjusting ways of working, the NHS services can ensure it provides healthcare which takes into account the older person’s priorities and concerns as well as the care home staff that provide the care.
The three year study is published by the National Institute for Health Research Health Services and Delivery Research (NIHR HS&DR) Programme. It was led by Claire Goodman at the University of Hertfordshire in collaboration with the University of Surrey, Lancaster University, Brunel University and University College London.
Notes to Editor
“A study to develop integrated working between primary health care services and care homes”” is published by the National Institute for Health Research.
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About the National Institute of Health Research Health Services and Delivery Research Programme
The National Institute of Health Research Health Services and Delivery Research (NIHR HS&DR) Programme was established to fund a broad range of research. It builds on the strengths and contributions of two NIHR research programmes: the Health Services Research (HSR) Programme and the Service Delivery and Organisation (SDO) Programme, which merged in January 2012. The programme aims to produce rigorous and relevant evidence on the quality, access and organisation of health services, including costs and outcomes. The programme will enhance the strategic focus on research that matters to the NHS. The HS&DR programme is funded by the NIHR, with specific contributions from the Chief Scientist Office (CSO) in Scotland and the National Institute for Social Care and Health Research (NISCHR) in Wales. www.netscc.ac.uk/hsdr/
About the National Institute for Health Research (NIHR)
The National Institute for Health Research (NIHR) is funded by the Department of Health to improve the health and wealth of the nation through research. Since its establishment in April 2006, the NIHR has transformed research in the NHS. It has increased the volume of applied health research for the bene fi t of patients and the public, driven faster translation of basic science discoveries into tangible bene fi ts for patients and the economy, and developed and supported the people who conduct and contribute to applied health research. The NIHR plays a key role in the Government’s strategy for economic growth, attracting investment by the life-sciences industries through its world-class infrastructure for health research. Together, the NIHR people, programmes, centres of excellence and systems represent the most integrated health research system in the world. For further information, visit the NIHR website ( www.nihr.ac.uk ).
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