Despite attempts to improve health and other care services for older people in England in the past five years, progress has been inconsistent and patchy, a joint report from three inspection bodies has found.
The Audit Commission, the Healthcare Commission, and the Commission for Social Care Inspection looked at developments in services since the 10 year national service framework for older people was published in March 2001.
Their report highlights the lack of dignity and respect in the way older people are treated when they are in hospital. Standards of care are still “unacceptably poor.” Examples include using wards and bays designated as single sex for both sexes and moving older people from ward to ward, sometimes in the middle of the night and not always for clinical reasons.
Older people with mental health problems were particularly vulnerable in hospital, said the report. It also criticises the meal arrangements: “The inspections found instances where people were not well monitored to ensure that they liked—or had even eaten—the food prepared for them, and meals were taken away untouched.”
On a more positive note, access for older people to operations such as hip and knee replacements and heart procedures has improved, the report says: “[Better access may be because of] a revision of policies on age discrimination but this explanation is not conclusive, as the demand by older people for these procedures has risen.”
But discrimination is also a common theme outside hospitals. One leisure centre had barred older people from using a treadmill in its gym after an older man had a heart attack using the equipment, for example.
Anna Walker, the chief executive of the Healthcare Commission, which monitors the quality of healthcare, said that the challenge was to provide better care for older people closer to home. “Older people are the biggest users of health care, occupying almost two thirds of our hospital beds,” she said. “Yet they continue to be a low priority in both the planning and development of our health service. Health and social care organisations and local authorities need to work better on behalf of older people.”
The three inspectorates assessed 10 communities throughout England—Brent, Buckinghamshire, Dorset, Greenwich, Leicester, Liverpool, Medway, Portsmouth, Wiltshire, and Redcar and Cleveland. These areas covered 40 NHS trusts, all of which were included in the review.
Age Concern believes the report presents an accurate picture. “It is shocking that so many hospitals and social services departments are still failing to meet the needs of older people—the main users of these services,” said Gordon Lishman, its director general. “Sadly, too many older people in need of public services are currently treated as second class citizens.”
Paul Cann, the director of policy at Help the Aged, added, “It is troubling to see that mental health services for older people remain the Cinderella service of an already neglected part of our health system. Mental health services for older people are in need of a complete overhaul.”
The report was published days before a separate review of social care spending was due to be announced (on Thursday 30 March) by Sir Derek Wanless, the former chief of NatWest bank.
Responding to the report, the minister for care services, Liam Byrne, said that he was due to announce the second phase of the 10 year plan for older people’s services in the next month. “I would like to see society’s attitudes to older people completely overturned,” he said. “We need everyone to understand that our older people are not a burden, but a precious resource.”
According to reports in the Financial Times (27 March, p 4), Mr Byrne will be setting up a review of social care funding, with the Association of British Insurers, voluntary and statutory organisations, and Sir Derek, to look into different funding models.
The report, Living Well in Later Life , is available at www.healthcarecommission.org.uk.