Improving dementia care and treatment saves the NHS thousands of pounds

Improving staff dementia training and reducing the amount of harmful medicines prescribed could save the NHS thousands of pounds a year, according to a new study.

Care homes that treated residents with a new cost-effective care plan devised by experts saved the NHS up to £4,000 after nine months.

Patients were less agitated under the new programme and so less strain was put on the NHS as the number of A&E and GP were appointments reduced.

Led by the University of Exeter, King’s College London and Oxford Health NHS Foundation Trust, researchers compared 549 patients in 69 care homes receiving usual treatment to those treated under the Wellbeing and Health for people with Dementia training programme (WHELD).

Two carers delivered WHELD in each of the homes – which encourages patients to be involved in decisions that affect them.

Previous research found the average care home resident engages in just two minutes of social interaction in a six hour period – but WHELD increased this to ten minutes.

It achieved similar results to commonly-used cholinesterase inhibitor drugs.

But whereas these drugs cost around £35,000 when they were first approved for use in the UK, the programme costs around £1,400 per resident and significantly improves agitation.

The inhibitor drugs are also known to increase the harm to people with dementia.

Part of the WHELD programme includes GP training to reduce prescribing antipsychotics, known to significantly increase the risk of stroke and death in people with dementia.

Senior author Professor of Age-Related Diseases Clive Ballard, from the University of Exeter Medical School, said: “People with dementia living in care homes are among the most vulnerable in our society.

“We now know we have a programme that provides huge value in improving their quality of life and reducing agitation – and now crucially, we know this saves money.

“Our research has previously shown that only four of 170 carer training manuals available on the market were based on evidence that they work. We must roll this out to benefit those in need.”

Corresponding author Senior Lecturer in Health Economics Renee Romeo, from King’s College London, said: “As a person’s dementia progresses they will need more intensive care and support and often residential care is seen as the best option by those who care for them.

“Our research can assist commissioning decisions around care and treatment options in these settings. By providing the evidence, that effective and affordable care responses following consultation around individual preferences do exist.

“The failure to recognise and introduce such interventions in not only ethically questionable but very costly.”

Alzheimer’s Society policy director Sally Copley said: “As 70 per cent of people in care homes have dementia, it is essential that staff working there have the right training to provide good quality dementia care.

“This study supports what we know from our own research: that training is crucial to provide this kind of specialist care, and has huge benefits for people with dementia in care homes and for the wider system, and that anti-psychotics are often overused and sometimes harmful – an area we have campaigned on for many years.

“With many care homes on the brink of collapse and the NHS under pressure, cost-efficient initiatives like WHELD could make all the difference.”

The study was published in Alzheimer’s & Dementia: The Journal of the Alzheimer’s Association.

 

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