Henry Calls On NHS To Plan Now For Challenge Of An Ageing Scotland

New Report Predicts Big Increases in Health Needs of Older People

Government and the NHS in Scotland must start planning now to make sure services meet the future health needs of the half a million extra Scots pensioners it will care for within the next 30 years.

That was the clear message from Scottish Deputy Health Minister Hugh Henry at the launch of a major new report on the care Scotland's older people receive from the NHS.

Scotland's Chief Medical Officer, Mac Armstrong, who chaired the Expert Group looking into NHS care for older people, said care for older people must be seen as 'core business' for the NHS in the future.

The report Adding Life to Years, by his Expert Group on the Healthcare of Older People, was set up to investigate the needs of older people both now, and over the coming decades.

Its publication fulfils another key pledge in the Scottish Health Plan, launched in December 2000.

In drawing up this report, the Expert Group cast its net as wide as possible. Involved in the preparation were specialists, patients, representatives of the voluntary sector and other groups involved in the provision of services to older people.

A specially commissioned MORI survey was also carried to find out the views of older people on the services NHSScotland provides; their experiences of these services; and, in particular, whether they felt they were being discriminated against because of their age in terms of the services they received.

In broad terms the research showed that older people are generally satisfied with NHSScotland, and many examples were given of excellent care received and staff at all levels were mentioned for praise. The results of the MORI survey are also being published today.

Central findings of the Expert Group Report include:

• no evidence that ageism in the NHS is a significant problem in practice, although the NHS needs to recognise the concerns of older people and their families and take steps to allay fears;
• the rise in the numbers of elderly people by 2030 needs to be fully built into NHS planning. Increases in provision for older people, such as hip replacements, are taking place already, but the NHS needs to build on this, treating older people as its 'core business';
• good levels of services for older people exist already in many parts of Scotland, but they need to be spread across all areas of Scotland and variations in care reduced and eliminated;
• much good work is already being done on the 'big three' NHS priorities - cancer, heart disease and mental health, from which many older people suffer;
• better co-operation between different NHS services and between NHSScotland and social work departments is needed to help prepare older people for discharge from hospital, and to support them when they get back home.

Now the CMO is to head up an Implementation Group, to drive through the recommendations, and monitor the progress of change.

Responding to the report, Deputy Health Minister Hugh Henry said:

"My generation has a debt to repay to older people in our community. Their efforts created the NHS and the opportunities we take for granted. Now we need to ensure that in their later years they are treated with dignity and respect, and get the care they need."

"We commissioned this report because we were aware of serious concerns about the health care of older people. Concerns raised by older people themselves."

"I believe that this report, and the work that will flow from it, will do much to reassure older people about the quality of their care. I am re-assured by the report's conclusion that there is little or no systematic evidence of ageism in our NHS. But I share the Group's view that concerns about ageism must be addressed. I agree that the most effective way we can do that is by bringing about a widespread and visible improvement in quality of services for older people. Implementation of this report will achieve that, coupled with all the work in hand. I'm thinking in particular of the work of the Clinical Standards Board for Scotland. It's about to pilot standards for older people in acute care."

"Delayed discharge is another core concern. The report does not mince its words about the distress this causes older people, their families and carers. It also recognises that we have done a lot of work in this area, especially with the creation of our Delayed Discharge Task Force Group. I fully accept the Expert Group's conclusions that reducing delays in discharge must be one of the top priorities for all agencies to work on together."

"There are also wider concerns over healthcare for older people in Scotland. The report highlights much we are doing already to increase both quality and capacity of care in NHSScotland, with our work through the Health Plan, the Care Development Group and the Joint Futures Group. Free nursing and personal care for older people will soon become a reality. Thousands more older people are being supported to stay independently in their own homes."

"Alongside our 16320 million Action Plan to tackle the delays older people face in being discharged from hospital into more appropriate care, and ongoing negotiations to bring real long-term stability to the independent care home sector, this approach represents the biggest ever Government investment in older people's care in Scotland."

"However, this report also makes clear that we need to be planning still more for the future. Our population is ageing. More of us will need more care. Our NHS needs to be there to deal with them."

"I want to see the NHS planning ahead. And I want to see the Health Department planning ahead. This is a significant challenge for the NHS - but I recognise also the challenge this places on Government. Health cannot be seen in isolation. Improving the quality of health services is a key part of our wider commitment to improved public services. Action under way across the Executive will help older people stay healthy by providing access to transport, to better-heated housing, and to leisure and learning opportunities. The information and conclusions of this important piece of work should help to shape our wider thinking as Government reviews its future long-term spending plans."

"This report sets out how to make that shift in emphasis, to put older people at the top of the NHSScotland agenda. I am determined that the services they use get both the leadership and the support to make that change."

"With the creation of 15 accountable, unified NHS Boards across Scotland, we are in a better position to meet this challenge than ever before. But to give focus to and drive forward the recommendations, I have asked the Chief Medical Officer to lead an Implementation Group. This will monitor the pace of change and advise on what is needed to make sure that our NHS continues to serve so well all the people of Scotland."

Dr Armstrong said:

"Older people already, and quite properly, occupy a large part of the work of NHSScotland. The 15 per cent of the population now over 65 already accounts for 40 per cent of health and social care spending. These figures are only going to rise. The Information and Statistics Division report on the Health and Well-being of Older People in Scotland, which has provided supporting information for the work of the Expert Group, and which is also being published today, highlights the increases in both the numbers and proportion of older people that is predicted to occur over the next 20 to 30 years."

"Half a million more pensioners aged over 65 by the year 2030. An 80 per cent increase in those aged 85 and over."

"That makes it vital that we takes steps now, not just to address these needs, but to change our way of thinking. Older people must be seen as the 'core business' of the NHS."

"In our research for this report, backed up by new statistics published today, we find that older people are largely satisfied with the care they receive. But there is no room for complacency. We have to plan not only for rising numbers of older people, but steadily rising expectations."

"By taking action now, we can ensure that as we all get older, we get the health care, support and dignity we deserve as individuals."

"That is why we have set out these recommendations, and why I will be leading an Implementation Group to ensure that this report delivers real change."

Notes

1. Facts on older people in Scotland and health services:

   Between 2000 and 2031 the numbers of people over 65 will increase from 787,000 to 1,200,000. The number of over 85 will rise from 84,000 to 150,000.

   Each year for the over 65's, NHSScotland currently provides:

   • 3,769,000 GP consultations
   • 287,000 new outpatient cases
   • 206,000 day cases and elective inpatient admissions
   • 185,000 emergency inpatient admissions
2. In drawing up this report, the Expert Group cast its net as wide as possible. Involved in the preparation were specialists, patients, representatives of the voluntary sector and other groups involved in the provision of services to older people.
3. Information to support the expert group was provided by the Information and Statistics Division of the Common Services Agency of NHSScotland. Detailed information about older people in Scotland is contained in the ISD report The Health and Well-being of Older People in Scotland - insights from national data which is being published alongside the expert group's report. This report includes information on the health of older people and influences on their health, as well as their use of health and social services and the potential for healthy ageing for the people of Scotland.