BMJ 2014;348:g1994 doi: 10.1136/bmj.g1994 (Published 7 March 2014)
Page 1 of 2
News
NEWS Services for older people need major change, says report Jacqui Wise London
How the United Kingdom manages its ageing population needs to change radically so that care is coordinated around all of a person’s needs rather than being based on single diseases, says a report from the health think tank the King’s Fund.1
The report also calls for care that prioritises prevention and supports independent living. It says that for this to be achieved more integrated working is needed, to ensure that the right mix of services is available. David Oliver, the report’s lead author and president elect of the British Geriatrics Society, said, “The health and care systems have a long way to go to adapt to the twin challenges of an ageing population and tighter funding. Many local service leaders are transforming services for older people, but we urgently need to see their experiences spread more widely.” He added, “But marginal change will not be enough; transformation is needed at scale and at pace.”
The report is designed to be a resource and reference guide for leaders of local services and gives practical advice on what is known to work. It covers 10 key components of care, such as enabling frail older people with dementia to remain as well and independent as possible and to avoid deterioration or complications. Another goal is to improve collaboration between the NHS and social care services to ensure that patients can leave hospital once their treatment is complete and get good support in the community. The report includes many examples of good practice, such as at Newcastle West Clinical Commissioning Group, which has developed an ageing well strategy. Part of the strategy includes case finding to identify older people who are vulnerable to
deterioration or dependency so that they can receive proactive support.
Mark Holland, vice president of the Society for Acute Medicine, welcomed the report. He said, “As a geriatrician working in an acute medical unit where 25% of patients are aged 85 years and above, I am only too familiar with the deficiencies highlighted in the report. “With the Francis report [into failings at Stafford Hospital] still fresh in our minds, [the King’s Fund report] is a welcome antidote, articulating solutions that are well within our grasp. It conveys a sense of optimism with excellent examples of good practice, implemented through an integrated and joined-up approach to care, which SAM [the Society for Acute Medicine] fully endorses. Whatever strategies are used to avoid unnecessary admissions to hospital, a significant number of older people will continue to require hospital care. By acknowledging this need, SAM is fully committed to providing the very best care for older people.
“This report suggests that areas could be created within the acute medical unit where care is specifically tailored to the needs of older people. The society again endorses this view; indeed multidisciplinary working was a founding principle of acute medicine. There are examples of this practice already emerging and led by the collaborative working of acute physicians and geriatricians.” 1
King’s Fund. Making our health and care systems fit for an ageing population. 6 Mar 2014. www.kingsfund.org.uk/publications/making-our-health-and-care-systems-fit-ageingpopulation.
Cite this as: BMJ 2014;348:g1994 © BMJ Publishing Group Ltd 2014
For personal use only: See rights and reprints http://www.bmj.com/permissions
Subscribe: http://www.bmj.com/subscribe
BMJ 2014;348:g1994 doi: 10.1136/bmj.g1994 (Published 7 March 2014)
Page 2 of 2
NEWS
Figure
For personal use only: See rights and reprints http://www.bmj.com/permissions
Subscribe: http://www.bmj.com/subscribe
Page 1 of 2
News
NEWS Services for older people need major change, says report Jacqui Wise London
How the United Kingdom manages its ageing population needs to change radically so that care is coordinated around all of a person’s needs rather than being based on single diseases, says a report from the health think tank the King’s Fund.1
The report also calls for care that prioritises prevention and supports independent living. It says that for this to be achieved more integrated working is needed, to ensure that the right mix of services is available. David Oliver, the report’s lead author and president elect of the British Geriatrics Society, said, “The health and care systems have a long way to go to adapt to the twin challenges of an ageing population and tighter funding. Many local service leaders are transforming services for older people, but we urgently need to see their experiences spread more widely.” He added, “But marginal change will not be enough; transformation is needed at scale and at pace.”
The report is designed to be a resource and reference guide for leaders of local services and gives practical advice on what is known to work. It covers 10 key components of care, such as enabling frail older people with dementia to remain as well and independent as possible and to avoid deterioration or complications. Another goal is to improve collaboration between the NHS and social care services to ensure that patients can leave hospital once their treatment is complete and get good support in the community. The report includes many examples of good practice, such as at Newcastle West Clinical Commissioning Group, which has developed an ageing well strategy. Part of the strategy includes case finding to identify older people who are vulnerable to
deterioration or dependency so that they can receive proactive support.
Mark Holland, vice president of the Society for Acute Medicine, welcomed the report. He said, “As a geriatrician working in an acute medical unit where 25% of patients are aged 85 years and above, I am only too familiar with the deficiencies highlighted in the report. “With the Francis report [into failings at Stafford Hospital] still fresh in our minds, [the King’s Fund report] is a welcome antidote, articulating solutions that are well within our grasp. It conveys a sense of optimism with excellent examples of good practice, implemented through an integrated and joined-up approach to care, which SAM [the Society for Acute Medicine] fully endorses. Whatever strategies are used to avoid unnecessary admissions to hospital, a significant number of older people will continue to require hospital care. By acknowledging this need, SAM is fully committed to providing the very best care for older people.
“This report suggests that areas could be created within the acute medical unit where care is specifically tailored to the needs of older people. The society again endorses this view; indeed multidisciplinary working was a founding principle of acute medicine. There are examples of this practice already emerging and led by the collaborative working of acute physicians and geriatricians.” 1
King’s Fund. Making our health and care systems fit for an ageing population. 6 Mar 2014. www.kingsfund.org.uk/publications/making-our-health-and-care-systems-fit-ageingpopulation.
Cite this as: BMJ 2014;348:g1994 © BMJ Publishing Group Ltd 2014
For personal use only: See rights and reprints http://www.bmj.com/permissions
Subscribe: http://www.bmj.com/subscribe
BMJ 2014;348:g1994 doi: 10.1136/bmj.g1994 (Published 7 March 2014)
Page 2 of 2
NEWS
Figure
For personal use only: See rights and reprints http://www.bmj.com/permissions
Subscribe: http://www.bmj.com/subscribe
