Tuesday 17 July 2018
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Delivering innovations in the care of older people: an opportunity to brag, steal, learn and deliver?

Older people, especially those who are frail or live with dementia or complex chronic conditions, are becoming the ‘core business’ of health and social care. This trend will only increase: by 2030, one in five people in England will be over 65, and those over 80 are the fastest growing demographic. Living longer is a cause for celebration, but it can present challenges for the health and social care system.

Our recent paper, Making our health and care systems fit for an ageing population, set out a framework and tools to help local service leaders improve the care they provide for older people across nine key components.

Building on this research, we are hosting a one-day event next week on Innovations in the delivery of care for older people. In the lead-up to the event we invited people to send us examples of innovative projects that are improving care for older people. We were delighted to receive 70 diverse submissions – all interesting in their own way, from a variety of sectors and from all four UK nations.

Just to pick out a few: North Staffordshire Clinical Commissioning Group offers a range of enhanced clinical services to local care home residents; Aneurin Bevan University Health Board has been working hard to improve advance care planning and end-of-life care in their local nursing homes; and East of England Ambulance Service in Cambridgeshire has been delivering rapid response services for frail older people at home who are at risk of imminent crisis, avoiding inappropriate hospital admissions. There are many more examples, from acute hospitals and primary and community care to the third sector and private sector organisations collaborating in service innovations.

We have ample evidence of what good care for older people looks like and numerous service models delivering it, yet we aren’t very good at disseminating good practice, and worse still at adopting and implementing improvements at scale and pace. Given our ageing demographic, financial pressures, and the concerns about quality and safety thrown up by reports such as the Francis Inquiry, we need ‘the rest as good as the best’ pronto.

There are recent examples of social movements and initiatives, including the Dementia Action Alliance and the National Hip Fracture Database, that have involved staff from a wide range of services working together to drive quality and service transformation and to share learning from initiatives. This prevents the need to ‘reinvent the wheel’ in every organisation. Now the time is right for similar concerted action around care for older people.

There are several national-level initiatives that aim to improve care for older people, including the Health Service Journal Commission on Hospital Care for Frail Older People, NHS England’s work on safe compassionate care and various campaigns and resources from the British Geriatrics Society. The governments in Scotland, Northern Ireland and Wales all have programmes of activity focused on joined-up and preventive care for older people.

Events on improving older people’s care can be inspiring. But when the party’s over and the delegates have gone home and returned to the reality of hard-pressed local services and their day job a sense of deflation can kick in. This time let’s create some real momentum – by sharing best practice, learning from others and helping to make change happen on the ground. Together, we can make a real difference to the lives of older people and their families, so that NHS staff like me can feel proud of the services they work in.