HEALTH authorities across Scotland are failing to meet standards of care for elderly patients, a report by the official watchdog revealed yesterday.
Frail pensioners are being treated in pressured hospitals when they should not be there, according to the investigation by NHS Quality Improvement Scotland.
The authors of the report call for better services to look after them in their own homes, operating outside office hours.
Hospitals throughout the country were visited by the inspectors as they examined what elderly patients experience in the NHS system.
Fewer than half of the areas inspected could mount a multi-skilled team to provide care and rehabilitation for an elderly patient at home within 24 hours of the need arising, the report said.
Only eight of 36 hospitals transferred elderly patients to a ward within two hours of their first assessment at accident and emergency, in line with the national standard, and only seven operated on patients with fractured hips within 24 hours of admission, though this is considered important.
The number of pensioners needlessly admitted to hospital also concerned the inspectors. They said: ''The review visits found that the physical care offered to older patients who are admitted to hospital is good, but once in hospital their journey of care can sometimes go wrong.
''Patients may find they are moved from ward to ward and can suffer from having their discharge delayed. This highlights the importance of preventing avoidable admissions, particularly for frail people. They are especially at risk of immobility, infections and delayed discharge once admitted.''
The report praised multi-agency teams providing help for people at home, which prevented the need for hospital admissions. But most of these were available five days a week, not seven, and the teams could respond to a patient's needs with a care package within 24 hours in only 14 out of the 36 areas visited.
When it came to discharging patients from hospital, the inspectors again found standards were patchy. Only 16 of the 36 hospitals had an effective pharmacy service on the wards to check that elderly patients could manage their medication safely. The report said: ''In many areas, discharge services were fragmented and poorly co-ordinated.''
Lord Naren Patel, chairman of NHS QIS, said: ''Care of older people accounts for 40% of the health service budget and it is important that services meet their needs. This report details many examples of good practice, but it also shows that there is too much variability across the country.''
He said they would continue to monitor the situation to ensure services improve and that ''older people get the care that they deserve''.
Shona Robison, health spokeswoman for the SNP, said: ''It is totally unacceptable that in 78% of A&E sites it is taking longer than two hours to transfer elderly patients. This means that many OAPs are having to languish on trolleys for hours before they can be transferred to the appropriate care setting, which can be very frustrating and distressing.
''The executive's policy of reducing acute bed numbers is taking its toll on some of the most vulnerable people in society. The health minister must give assurances that he will do everything in his power to stop this problem occurring.''
Maureen O'Neill, director of Age Concern Scotland, said progress since the standards on how elderly patients are dealt with were set, in 2001, had not been ''as fast or as complete as it should be''.
She supported moves to avoid admitting pensioners to hospital if they could be looked after at home, saying: ''The longer you are in hospital the more you are cared for, the more everything is done for you, the more fearful you become about having to do everything on your own again
. . . If you are still in your own home, your confidence does not diminish.''
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