The majority of hospital staff do not feel that they have enough training to care for people with dementia, according to a national clinical audit published today.
Consequently, care for people with dementia in hospitals is badly lacking, concludes the first full report of the National Audit of Dementia.
The audit says significant improvements are needed to care for people with dementia in hospital such as improvements in hospital ward environments, staff training and the overall approach to care delivery for patients.
The audit was carried out by the Royal College of Psychiatrists’ Centre for Quality Improvement in partnership with other organizations including the RCGP, the Royal College of Physicians and the Alzheimer’s Society. Data was collected from 210 hospitals across England and Wales, and ward level data was collected from a sample of 145 wards across 55 hospitals. This included 2,211 staff questionnaires, and 105 observations of care on the ward, carried out by hospital staff.
Although the majority of wards meet basic safety requirements, the audit shows that many had not addressed simple measures that could reduce distress caused to dementia patients by an unfamiliar and confusing hospital environment.
Deficiencies in staff training were noted and only 32% of staff said that their training and development in dementia care was sufficient.
One staff member surveyed said: “I have never had any training related to caring with patients with dementia or Alzheimer’s.”
Half of staff felt they had not received sufficient training in communication skills specific to people with dementia, and 54% felt they had not received sufficient training in dealing with challenging or aggressive behaviour.
The audit also found that only 6% of hospitals had a care pathway in place for people with dementia.
The report makes a series of recommendations including a recommendation that all staff should be provided with basic training in dementia awareness, and a specified proportion of ward staff should receive higher level training.
In addition, assessment of staffing levels should take account of the additional support needs of people with dementia, and a senior clinical lead for dementia should be appointed in each hospital with designated time in their job role to develop, implement and review the dementia pathway. Hospitals have begun work locally to address problems after receiving local reports from the audit team earlier in the year and many have submitted action plans.
Professor Peter Crome, chair of the audit steering group, said: “This report provides further concrete evidence that the care of patients with dementia in hospital is in need of a radical shake-up.
“We have a provided a number of recommendations that if implemented will enable patients and their families to have confidence in their hospital treatment.”
Jeremy Hughes, chief executive of the Alzheimer’s Society, said: “This shocking report proves once again that we urgently need a radical shake-up of hospital care.
“Given that people with dementia occupy a quarter of hospital beds and that many leave in worse health than when they were admitted, it is unacceptable that training in dementia care is not the norm.”
Care services minister Paul Burstow said: “The result of this audit should be a must read for every medical and nursing director. It is time for the NHS to put in place the training and support that improves the care and treatment of people with dementia and saves money too.”