The NHS and Community Care Act 1990

Abstract

Aims and MethodThe Community Care Act came into effect in April 1993. In order to see what impact this would have on the discharge profile of dementia inpatients, prospective studies of inpatient discharges from a dementia assessment ward before the Act, and five and 41 months after the Act were conducted.ResultsThe proportion of patients discharged to their own homes and to residential/nursing homecare remained unaffected by the Act. Duration of hospital stay increased after the Act in 1993 and 1996 (P=O.02) largely due to delays in placement into care homes. Placement delay was increased both in 1993 and 1996, but by 1996 the difference was no longer statistically significant. Duration of hospital stay was unaffected by the Act for those patients discharged to their own homes.Clinical ImplicationsThe new care management process by social services was found to be associated with delayed discharges for people with dementia requiring residential/nursing home placements, thus causing pressures on beds and hig her in-patient costs.