Lack of dementia care putting pressure on A&E departments
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Essex has seen a dramatic increase in the number of dementia patents being looked after by A&E doctors – even though many are not physically ill.
Emergency admissions for dementia patients aged over 65 peaked at 13,968 in 2017/18 – the highest number since records began in 2012/13.
The figures from Public Health England cover admissions at hospitals in the Essex County Council and Southend and Thurrock unitary authority areas.
In the area run by ECC (excluding Southend and Thurrock), 2,174 dementia patients were looked after in A&E for a day or less in 2012/13, but this had increased to 3,156 by 2017/18.
It has led to calls for closer working between the county council, which has responsibility for adult social care, and the NHS itself.
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Leader of the Lib Dem group at ECC, Cllr Mike Mackrory, said: “This highlights the shortage of suitable accommodation for people with this condition and that puts more pressure on A&E departments.
“That enormous increase over such a short space of time is not something that the NHS can sustain.
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“The NHS and the adult social care service in Essex need to work together to make provision for these people. Clearly it is far more expensive to look after people in A&E when they shouldn’t really be there.
“It must be a cost benefit to work with ECC to provide spaces.”
Charities have said under-pressure social care services are struggling to provide those with dementia the care they need in the community, leading to avoidable trips to hospital.
The number of emergency admissions across the area as a whole have risen by 50% in six years, from 9,514 admissions in 2012/13 to 13,968 in 2017/18.
A quarter (27%) of the emergency admissions were for one night or less in Essex, while the figures for Thurrock and Southend were higher at 31% and 41% respectively - the latter being one of the highest rates in England.
Public Health England said changes in the surrounding environment can increase the levels of anxiety and stress for an individual, with people with dementia more susceptible.
While some admissions may be medically necessary, the NHS recommends they should be avoided if possible for this group.
Councillor John Spence, Essex County Council Cabinet Member for Health and Adult Social Care, said: “Essex County Council is firmly committed to working in partnership with our NHS colleagues.
“We continue to develop integrated models where the aim is to allow people to live at home independently and for longer.
“The rise in the number of emergency dementia admissions is in line with national trends in overall A&E admissions – indeed it was 26.5 per cent of the total over 65 admissions in 2012/13 and 26.9 per cent now.
“The Essex percentage is also below the national percentage of 28.9 per cent. Nevertheless we see both rises as a matter for concern and will continue to work with the NHS with a view to reversing these trends.”
The government has said councils are able to increase spending on adult social care by eight per cent in real terms from 2015/16 to 2019/20 and by 2023/24 the NHS budget will increase by £33.9 billion in cash terms, which is the equivalent of £20.5 billion in real terms.
It adds that since last February 2017, more than 2,280 beds per day have been freed up nationally by reducing NHS and social care delays.
A Department of Health and Social Care spokesman said: “We are committed to the integration of health, social care and public services, which must work seamlessly together to deliver better quality care, including through the Better Care Fund which is helping people to live independently in their communities for longer.
“We have given local authorities access to up to £3.9 billion more dedicated funding for adult social care in 2019/20, and a further £410 million is available for adults and children’s services.”
The spokesman said a forthcoming green paper would set out plans to reform the social care system to “make it sustainable for the future”.
In Essex, 4.1% of over 65s were recorded as having dementia in December 2018, up from 3.9% in September 2017.
Across England, there were 368,044 emergency admissions for over 65s with dementia in 2017/18, again the highest number since records began in 2012/13.