Published: 19/09/2002, Volume II2, No. 5823 Page 6

Care of older people on acute wards has deteriorated since the publication of the national service framework for older people, and is unlikely to meet the required standards for two or three years, according to the elderly care czar.

Speaking at the annual conference of the British Society of Gerontology about dignity on wards, national director for older people Professor Ian Philp said: 'I do not think It is improved. I think we have gone backwards in the 18 months since the framework was published.'

Though money was being spent on improving the fabric of wards, he told the Birmingham conference that older people often lacked privacy and were being treated in a way that undermined their dignity.

He added that the NHS needed to pay more attention to dying patients. Staff should be ready to discuss death with them. 'We do not give consistently good endof-life care, ' he said.

The framework requires all hospitals to identify clinical leaders as 'modern matrons' to oversee the care of older people in wards.

Professor Philp said he believes this is a good basis for improvement.

'But the levers for change take some time. It will take two to three years to turn it round. By 2005, my hope is that we will have introduced catalytic change in the care for older people.'

Professor Philp said better training for healthcare assistants was a priority in the long-term care sector, which suffered from a poor image.

The framework also requires the NHS and councils to draw up a three-year plan for implementing intermediate care schemes to keep older people out of hospital and maximise their independence.

The NHS plan says£900m will be made available for the development of intermediate care by 2003-04.

Professor Philp said there had been many promising developments in intermediate care and some schemes, such as those in Liverpool, had achieved a real 'wow factor', with high levels of staff involvement.

'But as a doctor, I am worried about doctors' lack of interest in it, ' he told the conference audience of more than 150 university researchers and older people's representatives.

It was important doctors did not undermine worthwhile developments simply because they were not leading them, he warned.

Professor Philp told the conference there had been 'huge failures' over the delivery of equipment to enable older people to remain at home.

A joint Age Concern/British Geriatrics Society report published earlier this year evaluating progress on the framework, warned that it was failing to create equality for older people in accessing services and called for more resources.

A spokesperson for Age Concern said this week: 'There are big variations and we are still getting reports of older people on wards not being treated appropriately.'