Admiral Nursing case management in Enhanced Healthcare in Care Homes

The United Kingdom’s (UK) older population is higher than the global average. Over the next 20 years, England will see an increase in the number of older people who have higher levels of dependency, dementia, and comorbidity many of whom may require 24-hour care. Currently it is estimated that 70% of residents in nursing and residential care homes either have dementia on admission or develop it whilst residing in the care home. The provision of high-quality care for this population is a challenge with a lack of consistency in the provision of primary care and specialist services and a known gap in knowledge and skills. The NHS Long Term Plan aims to move care closer to home and improve out of hospital care which includes people who live in care homes by introducing Enhanced Health in Care Homes (EHCH). However, such services need to be equipped with the correct skill mix to meet the needs of the care home population. Admiral Nurses are specialists in dementia care and are well placed to support the delivery of EHCH and improve access to specialist support to care home residents, their families, care home staff and the wider health and social care system. This paper discusses current gaps in service provision and how both the EHCH framework, and the inclusion of Admiral Nurses, might redress these and improve outcomes.