Published: 10/10/2002, Volume II2, No.5826 Page 22 23

I am pleased that HSJ has highlighted my determination to ensure all older people will be treated with dignity and respect in acute hospital settings (news, 19 September).

It is important to make clear we have put measures in place to achieve this objective. These include meeting standards in the national service framework:

All general hospitals which care for older people to have identified an old-age specialist multidisciplinary team with agreed interfaces throughout the hospital for the care of older people.

All general hospitals will have a nursing structure which clearly identifies nursing leaders with responsibility for older people.

Consideration will have been given to nurse specialist/nurse consultant and clinical leaders (modern matrons).

In addition, the care group workforce team for older people's services, which I chair, has commissioned the development of a skills and competency framework for staff working with older people.

One of the outputs from this work will be an audit tool to help hospitals to identify the education and training needs of those working with older people.

We are undertaking national benchmarking and audit using the 'essence of care' approach to meeting the fundamentals of care for older people in acute hospitals.

And we have a major programme of capital development to convert old Nightingale wards to meet the needs for privacy, and promoting recovery of function for older people.

I want to go further than this. I have visited some hospitals which not only deliver the fundamentals of care, but also have a stunning impact on the quality of care.

For example, when I visited Epsom and St Helier stroke unit recently, I met patients and relatives who were not just satisfied with their care, but deeply and universally grateful to the staff for how well they were cared for.

The staff were immensely proud of their unit. Managers, from the chief executive to the ward housekeepers, provided the leadership, organised systems and empowered staff to make this happen. Every week I see services which have these vital ingredients.

I am sure that we have the right financial and organisational environment to deliver the standards in the framework for older people.

My aspiration is to do more than simply meet the milestones, helping to liberate staff and managers to achieve the stunning level of quality in care, which is evident in many parts of our system.

Professor Ian Philp National director of older people's services