The NHS and private healthcare are not providing good enough basic care to a large portion of the population in England, especially older and frailer people, according to a study by researchers at the University of East Anglia.
Treatment for ischaemic heart disease rated well with 83% of appropriate care actually being given, but just 29% of recommended care was received by people with osteoarthritis. The researchers also found that substantially more care was provided for general medical conditions (74%) than for geriatric conditions (57%), the latter comprising falls, osteoarthritis, urinary incontinence, vision problems (cataract), hearing problems, and osteoporosis.
Medical conditions that GPs receive extra rewards for dealing with, under the Quality and Outcomes Framework, were subject to better care. In 75% of such cases, people received the right treatment, compared to 58% when conditions were not covered by the contract. Conditions associated with disability and frailty had the largest shortfalls in terms of the care that people were not receiving.
The researchers concluded that initiatives to improve quality for nearly all conditions are needed but the greatest scope for improvement is in chronic conditions that affect the quality of life of older people. They suggested that including geriatric conditions in future payment for performance schemes for GPs would improve quality.
Responding to the report, published in the BMJ, Gordon Lishman, director general of Age Concern, said: “It is absolutely disgraceful that over a third of the healthcare older people need is never actually received. These figures show that age discrimination within the NHS is still rife.
