The NHS and private healthcare are not providing good enough basic care to a large portion of the population in England, especially older and frailer people, according to a study published on bmj.com today.
Overall, only 62% of the care recommended for older adults is actually received, conclude the authors.
The research team led by the University of East Anglia studied whether effective healthcare interventions were received by people aged 50 and over with serious health conditions.
Results showed huge variations by health condition in whether or not people with particular health conditions received the appropriate intervention or care they should.
Treatment for ischaemic heart disease rated well with 83% of appropriate care actually being given, but just 29% of recommended care was received by people with osteoarthritis.
The researchers also found that substantially more care was provided for general medical conditions (74%) than for geriatric conditions (57%), the latter comprising falls, osteoarthritis, urinary incontinence, vision problems (cataract), hearing problems, and osteoporosis.
Medical conditions that GPs receive extra rewards for dealing with under the Quality and Outcomes Framework (QOF) of their current contract were attended to better. In 75% of such cases, people did get the right treatment, but only 58% of correct treatment was received by people with conditions not covered by the contract.
Worryingly, conditions associated with disability and frailty had the largest shortfalls in terms of the care that people were not receiving but should have been.
Receipt of care was also substantially higher for screening and preventive care (80%) than for treatment and follow-up care (64%), which in turn was higher than diagnostic care (60%).
The researchers say that initiatives to improve quality for nearly all conditions are needed but the greatest scope for improvement is in chronic conditions that affect the quality of life of older people. In particular, the quality of care for geriatric conditions was relatively poor in this study, say the researchers, and no geriatric conditions were included in the GP contract. They therefore suggest that including geriatric conditions in future payment for performance schemes for GPs would improve quality.
Are you worried about how geriatric care is progressing in the UK? What can be done to improve the service? Your comments: (Terms and conditions apply)
"The National Service Framework is failing to meet its targets. I am a retired nurse of long standing and now help unpaid carers to give voice to any issues that they may have on the care of the older person. Yes, we get far too many complaints of care not being met in the NHS. Please Rosina Jones raise your voice! We need people like you who care enough to put in print how you feel." - Katie Smith, York
"I am shocked at these findings! Surely any primary care service should be giving equal attention to ALL areas, not just those of which they receive extra financial backing! So it appears that the National Service Framework for older people is failing? Although any research I clearly understand can be manipulated, this research I find to be portraying that patients only receive the appropriate diagnostics and follow-up care if the GPs are given extra funding. There has to be a better way! Anyone, regardless of age should be treated equally! I have experiences within my own career where patients have been discriminated due to age and it makes me very frustrated! Unfortunately, as I have only been qualified a little under three years, my voice is rarely heard!" - Rosina Jones, West Midlands
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