A nursing home manager in Northern Ireland criticizes the Department of Health for its slow progress in reforming the social care system. She highlights the need for consistency and integration, advocating for better communication and collaboration between hospitals and nursing homes. The article also explores the challenges of limited bed space in hospitals and the impact of inadequate care packages on patient discharge.
A nursing home manager has expressed frustration over the Department of Health 's lack of progress in reforming Northern Ireland 's social care system. Linda Graham, regional manager of nine nursing homes, emphasized the need for a consistent and integrated approach. She highlighted the desire to provide care within nursing homes rather than in emergency departments or ambulances.
The Department of Health acknowledged the issue, stating that its three-year plan includes investment in alternatives to emergency departments for vulnerable citizens. Long waits at emergency departments have been widely reported, with a shortage of bed space contributing to the problem. Patients who are medically fit for discharge may remain in hospitals due to the absence of adequate care packages at home or the need for placements in nursing or residential homes. While health and social care are integrated in Northern Ireland, unlike the rest of the UK, staff in both hospitals and the community report a lack of evidence indicating effective collaboration.Ms. Graham stated that the Department of Health has been informed about the necessary changes but has yet to deliver results. She advocated for direct communication between nursing homes and hospitals, bypassing the GP, to facilitate advice and, when appropriate, hospital teams visiting residents in nursing homes. Michael Stevenson, an 80-year-old resident, is temporarily staying in a nursing home while efforts are made to secure a carers package and adjust his home. He expressed his desire to receive care in his own home, stating that he needs support but not institutionalization. Dr. Darshan Kumar, Clinical Director in Acute Medicine at the Northern Health Trust, emphasized the need for a unified approach to keeping older individuals out of hospitals. While other trusts operate a hospital at home scheme, the Northern Trust utilizes a direct assessment unit where GPs can consult directly with consultants for diagnosis and treatment, bypassing emergency departments. Dr. Kumar believes a consensus on the most beneficial model would save time, resources, and money.Senior health trust sources indicate their frustration with the Department of Health's slow progress and their intention to implement change independently. Several initiatives exist to keep older individuals at home, but they lack a comprehensive strategy with ministerial direction. Betty McKenzie, an 88-year-old patient, receives hospital care at home in Comber through the South Eastern Health Trust. She benefits from a multi-disciplinary team, including nurses, a geriatrician, and a physiotherapist, along with a carers package. She praises the service, highlighting its cost-effectiveness and convenience compared to hospital care. The hospital at home scheme, currently operational in North Down and Newtownards, aims to expand to Lisburn and Down by April, reaching 40 patients. By September, the trust hopes to extend it to 60 people, but the program's sustainability hinges on securing a strategy and dedicated funding.The trust is committed to expanding the hospital at home service and ensuring equitable access across the entire trust. The staff recognizes the financial benefits of providing care at home, compared to the substantial costs associated with hospital care. While the Department of Health acknowledges the need for systemic reform, investment in the workforce, and collaboration across healthcare sectors, a tangible implementation of these changes remains uncertain.
SOCIAL CARE NORTHERN IRELAND NURSING HOMES HEALTHCARE SYSTEM EMERGENCY DEPARTMENTS PATIENT CARE
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