The impact of primary care quality on inpatient length of stay for people with dementia: an analysis by discharge destination

Dementia is a chronic and progressive condition, characterized by memory loss, mood swings, and difficulties in communication, mobility, reasoning and self-care. Around 800,000 individuals in the UK have dementia and the disease imposes a huge financial burden on the formal care systems, as well as having an enormous emotional impact on carers and their families. Older people with dementia currently occupy up to 25% of NHS hospital beds and stay longer than those without dementia. Hospital admission can have a significant negative impact on the person with dementia, adversely affecting their general physical health as well as their dementia symptoms. Since 2006, GPs have been paid to identify and review patients with dementia as part of the Quality and Outcomes Framework (QOF). The dementia QOF review should focus on the patient's and carer's support needs, address the patient's physical and mental health, and assess communication and coordination arrangements across care boundaries. Where appropriate, this includes ensuring that suitable discharge arrangements are in place for patients admitted to hospital, for example by linking the patient to the local community mental health team. The QOF review may help facilitate timely discharge, but this has not previously been tested.