DOCTORS' CONFERENCE:NURSING HOMES are transferring patients to hospital when their deaths are imminent to avoid having people dying on their premises, a GP conference heard at the weekend.
Mayo South coroner John O’Dwyer told the annual general meeting of the Irish College of General Practitioners that deaths occurring in nursing homes must be reported to a coroner but to avoid having to do this he believes “a conscious decision” is being made by homes to transfer patients near death to hospital.
“There is a noticeable trend that patients are being transferred late to local hospitals when it’s clear that what they need is palliative care which they could have got in the nursing home . . . in simple terms there is an issue about lots of patients being transferred late so as to avoid having them dying in nursing homes,” he said. “As a coroner I have noticed that people are being transferred very late, almost at the end of life.
“They are being transferred late and many are dying in accident and emergency departments or certainly within 24 hours of admission to hospital.
“This is also being noticed by hospitals,” he added.
“This is a matter which needs to be resolved between the HSE on behalf of the hospitals with the nursing homes,” he said.
Mr O’Dwyer stressed he was “not saying there is a concealment” going on, given that hospitals will report the deaths to him, rather homes just didn’t want to have high rates of deaths in their facilities.
Tadhg Daly of Nursing Homes Ireland, which represents the majority of private nursing homes, said yesterday he was not aware of this, but if evidence was produced that it was happening he would be happy to sit down and discuss it with coroners and the HSE.
“All of us would have an interest in ensuring that older people at end of life would get the best possible care,” he said.
Separately, GPs attending the conference were urged to check the date on drugs both in their surgeries and in their bags for house calls at least once a week to ensure patients didn’t end up getting medication which was out of date. Suzanne Browne, general manager of Medisec Ireland which arranges professional indemnity insurance for GPs, said one family had claimed compensation after a GP gave an out-of-date injection to a minor. While it didn’t cause any harm the parents were very upset and sued, she said.
She also said there had been a number of cases taken in relation to a long-acting but reversible contraceptive device which is inserted in a woman’s uterus. In the main claims occurred when the contraception failed or if it was inserted too deeply, leading to difficulties with its removal. It was vital GPs had training in the insertion of the device, she said.