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Alternatives to hospital for older people must be found, says NHS chief

BMJ 2013; 346 doi: http://dx.doi.org/10.1136/bmj.f453 (Published 22 January 2013) Cite this as: BMJ 2013;346:f453
  1. Nigel Hawkes
  1. 1London

Hospitals are “very bad places for old, frail people,” the chief executive of the NHS Commissioning Board, David Nicholson, believes. Hospitals’ focus on getting a diagnosis, referring the patient to the right place, and getting treatment is unsuited to a patient population, 40% of whom will have some form of dementia, he told the Independent newspaper in an interview.1

“We need to find alternatives,” he said. “We need to put as much focus on that as we do on telling nurses to be more compassionate.” Nicholson used the example of people with dementia to emphasise the drive to take “large amounts” of care out of hospitals and into the community. He warned that hospitals would face a double challenge, losing services as a result of concentrating specialist care in fewer centres and of shifting services into the community. “How we manage that is going to be quite tricky,” he admitted.

Responding to Nicholson’s remarks, the Alzheimer’s Society …

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