Published: 31/01/2002, Volume II2, No. 5790 Page 9

A leading academic has warned that only half the key targets of the national service framework for older people can be met and that at least two are 'undeliverable'.

Malcolm Johnson, professor of health and social policy at Bristol University, has said the government risks a 'crisis of confidence' in the care of older people unless it drastically 'reassesses what is achievable'.

Professor Johnson, who is also director of the International Institute on Health and Ageing, told a London conference of managers last week that four of the eight framework standards are 'eminently deliverable, but that the other four present huge problems', and two cannot be met. Standards for person-centred care and age discrimination were 'unachievable' he said. 'As objectives, they are highly desirable. . but to set up timescales and milestones' without consensus or the necessary research was 'not sensible'. It was 'tilting at windmills'.

He told HSJ: 'As a way of racheting up priority areas for older people, the framework has a lot to commend it', but 'as a quality and assessment tool it is misconceived'.

Delegates were also concerned that no funding had been earmarked - as it had been for cancer and heart disease - and suggested that this discriminated against older people. Targets for stroke, intermediate care, falls and general hospital care were achievable, Professor Johnson said. But those for mental health, promotion of health and active life, person-centred care and age discrimination were seriously hindered by a poor or non-existent evidence base, a lack of professional consensus and a lack of 'sensible measures'.

He said the government needed 'to reassess what is achievable and create differential timescales for those framework standard areas where there are serious delivery problems so that people are not chastised for not achieving the unachievable'.