Public services failing to consider older people, says new report
27 March 2006
Public services often fail to consider the special needs of
older people, according to a new report by three independent
watchdogs published today.
It suggests that "deep-rooted cultural attitudes to ageing" in
local public services are hampering wider Government plans to
improve health, social care and local council services for older
people.
The report has been produced jointly by the Healthcare
Commission, the Audit Commission and the Commission for Social Care
Inspection.
Called Living well in later life, it assesses progress five
years into a 10 year Government plan to improve services for people
over the age of 50.
The three inspectorates joined forces to provide a comprehensive
assessment of services for older people, the biggest users of
health and social care, and services that contribute towards older
people's wellbeing and quality of life.
The report found that services have improved since the March
2001 publication of the Government's 10 year National Service
Framework for Older People. But this progress was not evident
consistently across the country and improvement in some areas has
been slow.
At this halfway stage, none of the communities inspected had
reached all Government-set milestones to enable them to meet the
standards in the national service framework.
The report found:
- Improvements in how most public services are addressing age
discrimination. All communities inspected had taken steps to ensure
that policies and eligibility criteria for access to services did
not discriminate against older people.
- More people, who have had a stroke, than ever before have
access to good quality hospital care. But more still needs to be
done to improve rehabilitation outside hospital and access to
specialist units.
- More people are supported to live at home. There is a reduction
in the number of older people admitted to care homes, with health
and social care services supporting more frail older people to live
independently.
Despite this the report found a number of areas of concern:
- Evidence of a lack of priority being given to the needs of
older people when planning and commissioning services. For example,
local authorities were not considering the needs of older people in
planning public transport, when a high proportion of older people
do not drive. And podiatry and foot care services were given a very
low priority from primary care trusts, resulting in older people
losing mobility and becoming socially isolated.
- Evidence of a lack of dignity and respect in the way older
people are treated when in hospital. Many older people experienced
poorly managed discharge after being rushed through the system,
repetitive moving from one ward to another to free up surgical
beds, and having meals taken away before they can eat them due to a
lack of support at meal times.
- A lack of consultation by service providers with older people
to find out exactly what they want. Ninety five per cent of older
people surveyed had not been asked their views on NHS or council
services in the last year, and 80 per cent did not think that they
influenced the planning of services.
- Mental health services for older people were particularly poor.
Older people reported a noticeable difference in their experiences
of accessing services as they reached and passed 65. Out-of-hours
services for psychiatric advice and crisis management are much less
developed than for working age adults and older people with
dementia experience unacceptably long waits for specialist
care.
- Some examples of excellent partnership working were found
between different public service providers. However, a lack of
shared direction and desired outcomes between partner organisations
in most communities have resulted in services that are fragmented
and confusing.
Anna Walker, Chief Executive of the Healthcare Commission,
said:
"Older people are the biggest users of healthcare, occupying
almost two thirds of our hospital beds. Yet they continue to be a
low priority in both the planning and development of our health
service. The challenge now is to provide much better care for older
people closer to home. Health and social care organisations and
local authorities need to work better together on behalf of older
people. We will be monitoring the health service's progress against
national targets, and in working with partners as part of our new
annual health check, to make sure improvements in the care of older
people continue."
Steve Bundred, Chief Executive of the Audit Commission,
said:
"This report provides a snapshot of the national state of
services for older people. It confirms that councils and their
partners are increasingly aware of their responsibility to support
the wellbeing and independence of older people, who now comprise
over a quarter of the population. But our findings show that
progress has been patchy and services are not as well coordinated
as they should be. Additionally, older people do not feel they are
given a voice in shaping the way services are delivered. The Audit
Commission will continue to focus and report on this area in our
assessment of councils."
David Behan, Chief Inspector of the Commission for Social Care
Inspection, said:
"The best services involve the people they are there to serve.
They must be responsive to their needs and assist them to lead
independent, fulfilling lives. The evidence from this study is that
older people are not involved in the design of services and
consequently services are not tailored to their needs and
aspirations. It is vital to understand and respond to the specific
needs of older people."
The three inspectorates assessed 10 communities across England.
They inspected each local authority and 40 NHS trusts across Brent,
Buckinghamshire, Dorset, Greenwich, Leicester, Liverpool, Medway,
Portsmouth, Wiltshire, and Redcar and Cleveland.
In order to tackle the issues highlighted in this report, the
three commissions have made the following recommendations:
- Managers from all organisations must make sure that older
people are treated with dignity and respect and that their basic
human rights are upheld at all times;
- NHS trusts and local authorities must take action to ensure
that the standards set out in the national service framework for
older people are met;
- Partner organisations involved in providing health and local
government services need to work together to develop a joint
strategy for the promotion of good health and wellbeing for older
people; and
- Partner organisations need to work together to ensure that
there is a systematic and coordinated approach to engagement that
recognises the diversity of the population served.
Unless these overarching issues are tackled as a priority, older
people's experience of public services is unlikely to improve
significantly.
The three commissions, as regulatory bodies with
responsibilities across healthcare, social care and local
government, have committed to take action to ensure that there is
continuous improvement of services for older people.
The Audit Commission will monitor progress through the older
people's theme within the corporate assessment, part of the
Commission's Comprehensive Performance Assessment (CPA) of local
authorities.
The Commission for Social Care Inspection will monitor
organisations' progress through the annual assessment of councils
and inspections of social services for older people.
The Healthcare Commission, as part of the new annual health
check, will continue to monitor progress against national targets,
including supporting older people to live independently at home and
treating patients with dignity and respect.
Ends
Notes to editors
The Healthcare Commission exists to promote improvements in the
quality of healthcare and public health through independent,
authoritative, patient-centred assessments of the performance of
those who provide services.
The Audit Commission is an independent body responsible for
ensuring that public money is spent economically, efficiently and
effectively, to achieve high quality local services for the public.
The Commission's audit and inspection work covers local government,
health, housing, community safety and fire and rescue services.
The Commission for Social Care Inspection is the single
inspectorate for social care in England, responsible for regulating
and inspecting all social care providers - whether in the public or
independent sector. The Commission's primary aim is to improve
social care by putting the needs of people who use care services
first.