A major government initiative to improve health and social services in the NHS is in grave danger of falling short of its target.

An Age Concern/British Geriatrics Society report reveals that one year on, the National Service Framework for Older People (NSF) urgently needs more resources if it is to fulfil its pledge to raise health and social care standards for older people.

‘Reasons for Optimism, Reasons for Concern’ reveals that geriatricians and Age Concern groups are concerned that the milestones set by the Department of Health are not always being met and that in some cases, beds are being ‘re-badged’ in an attempt to meet targets.

Although there was enthusiasm from medical and voluntary sector staff, as well as some encouraging signs of progress in medical and older people’s involvement, this is still patchy and may not be sustainable. In a survey of Age Concern groups and 150 geriatricians all over the country it has been found:

A Government milestone stated that 1,500 more intermediate care beds should be made available by 2001/2, than there had been in the previous year.
21% of geriatricians say their hospitals have switched a significant number of beds previously used for acute or rehabilitation care to intermediate care, contrary to the recommendations of the NSF.

A Government milestone promised that by June 2001 local arrangements for implemen-tation would be in place.
40% of local Age Concern groups did not know of any older people who had been involved in the implementation of the NSF in their area.

A Government milestone said that by April 2002 a single assessment process would be introduced, streamlining care and producing collaboration between professionals.
90% of respondents to the BGS survey reported new initiatives and funding in intermediate care, but in 64% of schemes there was no geriatrician involvement in daily clinical management, and in 40% of cases no clear operational link between intermediate care and the hospitals.

Gordon Lishman, Age Concern England’s Director General, said, “Age Concern is disappointed that the NSF for older people looks in danger of failing in its mission to create equality for older people when accessing treatment and health and social care services. It is important that complacency doesn’t set in and rot the good intentions of this framework.

“Resources are needed to encourage greater commitment to making the NSF work, as well as more older people being involved in its implementation.”

Cameron Swift, President of the British Geriatrics Society said, “The BGS is worried by the apparent gap between the excellent rhetorical aims of the NSF and the lack of local procedures, safeguards and resources to deliver its standards. It sometimes seems as if any invented scheme – good, bad, indifferent, or just re-labelled - will do for older people. This is not what informed users are telling us, and rightly so. On the contrary, their cry is for the highest clinical skills and for service continuity.

“The Department of Health must now take firmer action to deploy the resource to ensure that for each element of the NSF - the necessary committed consultant involvement, leadership and advice, are invariably in place.”

• Milestones should be identified which clearly illustrate qualitative changes and improvements for older people
  
• A national evaluation of the role of Champions
  
• An independent evaluation of the involvement of older people and examination of how this can be achieved
  
• Financial resources to enable a range of voluntary sector involvement in the NSF implementation
  
• Specialist consultants should be consistently involved in the planning process for the NSF
  
• Establishment of a clear operational link between hospitals, particularly departments of geriatric medicine and intermediate care provision

Press release provided by
Sophie Howells and Cheryl Elliott of Age Concern