John Myatt, director of strategic development, Serco Health
It is well documented that people are living longer. This is a good thing, worth celebrating. It is also true that in our later years of life we access health and care services with greater frequency. Today, there are many older people spending significant amounts of time in hospital. Terrible scandals in hospitals and residential care homes have shocked us all and highlighted the need to change – for us all to listen more.
There is much to be proud of too: good is far less reported than bad and it can often be small things that make the difference. I believe that everyone working in health and care will want to find practical ways to help improve the care that older people receive in hospital. That is why I am delighted to be supporting Dame Julie Moore in this commission. By listening carefully we can deliver better care for older people in hospitals.
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- Commission on Hospital Care for Frail Older People: editor’s introduction
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Professor David Oliver
The growing focus on prevention, wellbeing and proactive care closer to home is welcome and long overdue. But however well we do all these things, older people with complex needs will continue to present to hospital with acute illness or injury, generally complicating life-limiting long-term conditions, frailty, dementia or disability.
When acute care is indicated older people should never be denied the full facilities of the general hospital or evidence-based treatment, any more than we would deny younger people. While we should ensure older people are hospitalised for no longer than necessary, with a consistent focus on discharge and post discharge support, we have to face the reality of modern hospital case mix.
Older people with multiple morbidities, often using multiple services and reliant on carers, are now the biggest group of patients in acute hospital beds and will continue to be so. So instead of wishing them away, we need to ensure that buildings, staff, services, skills and attitudes are “age proof and fit for purpose” instead of labelling older people in hospital as a problem.
Anyone coming into the caring professions in 2013 should be prepared for the care of our oldest old to be a major part of their job, and regard this as a privilege and a skilled endeavour. At the moment there are far too many gaps and variations in the quality of services we offer. And if we do not improve the care of older people in hospital, we will fail to deal with the financial pressures on services.
Jenny Ritchie-Campbell, director of cancer services and innovation, Macmillan
The number of older people in the UK aged 65 and over and living with cancer will more than treble by 2040 to 4.1 million. Currently, older cancer patients face a multitude of barriers to getting the best care and treatment. For cancer survival to improve, older people must be given the right treatment at the correct level of intensity, together with the practical support to enable them to take it up.
Macmillan is calling for a more effective way of assessing older people for treatment, more short-term practical support to enable older people to take up recommended treatment and training for professionals working with older people within the NHS to promote age equality.
We know the hospital care of vulnerable groups, such as frail elderly patients, is currently not good enough. There have been too many recent examples of unacceptable levels of neglect, and people being treated with a lack of dignity and respect.
The commission needs to address the root causes of these problems and identify solutions that will: improve the training and competence levels of hospital staff to deal with frail elderly patients; encourage a more open culture where staff concerns over levels of care can be shared and resolved; and acknowledge and place greater importance on the role of carers of frail elderly patients.
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