The availability and use of allied health care in care homes in the Midlands, UK

Aims: A review by an international charity for older people, Help the Aged, suggested that older people living in care homes in the UK do not receive the appropriate levels of access to health professionals. The authors aimed to establish the access to and use of services provided by allied health professions to care homes in Oxfordshire and Warwickshire. Methods: A postal survey with telephone follow up of the use of and access to allied health-care services in 121 Oxfordshire and Warwickshire care homes was conducted using an established questionnaire. Findings: The majority of homes reported using a chiropodist (91%), an optician (86%), hearing services (63%) and a physiotherapist (65%). Less than half of the homes reported using an occupational therapist (41%), a dietician (44%) or a speech and language therapist (39%). A third used an alternative therapist (35%) and a similar number (35%) a social activities organizer. There was inconsistency in the sources of funding and the reasons for referral, particularly regarding occupational therapy and the provision of aids and adaptations. Conclusions: The expertise of allied health-care professions available in UK hospital and domiciliary National Health Service (NHS) settings is not evident or accessible in the care home setting unless funded privately. When taking into account the high levels of impairments in these settings, access would appear to be contrary to the UK National Service Framework for Older People, which suggests that the NHS will provide a universal service for all based on clinical need, not ability to pay.