Lead author Professor Claire Goodman from the University of Hertfordshire’s Centre for Research in Primary and Community Care, said: “It is essential that residents in care homes – some of the oldest and frailest in society – have access to healthcare that is equitable and equivalent to those received by older people living at home.
“The Optimal study shows what needs to be in place for this to happen and found many examples of effective integrated working. Across England, however, access to healthcare for care home residents continues to be highly unpredictable.”
Goodman, who is also a NIHR Senior Investigator, continued: “There is an unrelentingly negative narrative in the public consciousness around bad care in care homes. Yet with 460,000 people living in UK care homes, occupying three times the number of NHS hospital beds, care homes should be seen as an integral and important part of the health and social care system.
“Just as we talk about ‘improving’ and ‘outstanding’ schools, we need to develop a positive vision for what a good care home looks like and the Optimal study has sought to support this. If we see care homes as part of the landscape of care – as a solution not a problem – then we have a real opportunity to get the delivery of healthcare in care homes right.
“Our study has shown that the provision of healthcare services to care homes is likely to be most effective when NHS services have time to learn how to work with care homes and value the work. Access to expertise in dementia care is important for both NHS and care home staff, as is ongoing GP involvement.”
“When the NHS views a care home as a valued partner then there is a greater willingness to work together to solve problems and a culture of blame recedes. When healthcare for care homes is co-ordinated and recognised as important by the NHS then residents benefit and there is a much more appropriate use of hospital services.”
The three-year study, funded by NIHR, involved seven UK partner universities – the University of Hertfordshire (lead), University of Nottingham, University of Surrey, Brunel University, Kings College London, University College London and City, University of London.
The full Optimal study report: Optimal NHS service delivery to care homes: a realist evaluation of the features and mechanisms that support effective working for the continuing care of older people in residential settings can be accessed here.