Imagine Basil Fawlty as a callhandler for NHS Direct, all the information at his fingertips but none of the interpersonal skills to communicate it in a helpful way.
The underlying message of this book is that we look for more than technical competence in the providers of health and social care. The chapters arise from the first phase of a project called Advancing Gerontological Education in Nursing, which aims to help nurses and other staff who work with older people. An extensive review of relevant research informs the content. Specific areas such as learning disabilities, mental health and palliative care are covered as well as cross-cutting issues such as rehabilitation and community care.
The publication is timely, given the national service framework for older people, which puts person-centred care as a key value in service planning and provision. It contains useful examples of the impact of staff behaviour on the experience of older people and their families. It highlights the risk of equating functional independence with successful ageing and the need to accept people's definition of what constitutes a good life for them, rather than imposing professional definitions.
The authors illustrate the way that lack of clear service objectives, inappropriate organisational cultures and systems prevent staff from working effectively with older people. As a way forward, they suggest that there are six key aspects of experience, which they call 'senses', that should influence the relationships between older people and staff.
Included in the research cited are items that could stimulate further debate on current policy direction. For example, the lack of evidence that a higher proportion of qualified nurses in care homes improves quality of care is interesting in light of current work to define the circumstances when someone needs care from a qualified nurse. They note a paucity of research on alternatives to standard residential care - for example, 'foster homes', which makes existing policy difficult to evaluate.
The chapter on palliative care highlights the continuing focus of services on people with cancer to the exclusion of those with other terminal conditions.
Interestingly, the framework links supportive and palliative care for people with chronic conditions or who are approaching the end of their lives, suggesting a blurring of previous distinctions.
The book is chocked with references, making it an excellent source for students, researchers and policy makers.
However, the density of such material makes it less readable, and it is hard to find the snappy summarised information that people with limited time will look for.
Given that this is work in progress, it is probably too early to expect a set of principles that could be applied to the training and development of professionals.
It is a useful contribution to the debate about working with service users and carers as experts and active participants in their care.
Margaret Edwards Project manager for primary care trusts and older people, King's Fund.