21 April 2006
The government has given the NHS and social care services five years to stamp out a pervasive negative culture of attitudes to older people which often results in poor quality care and neglect. But areas hit by deficits may have to wait for longer, a minister indicated.
Launching the second phase of the Older People's National Service Framework on April 20, minister for social care Liam Byrne acknowledged that negative attitudes were found 'in some staff who work in the NHS and social care as well as in the… private sector.'
Those attitudes held back standards of care for the older people who use the bulk of health and social care services, he said, and would now be treated with 'zero tolerance'.
The nutrition of older people in hospitals and care homes, work force skills, dignity for those with mental illness and end of life care have all been singled out as areas of particular concern by the Department of Health.
Up to £20bn of previously announced funding will be available to help promote change in local areas, said Byrne, but he acknowledged that success would require joint working between local authorities and the NHS.
'In the areas where the NHS is under pressure, things are going to move more slowly than elsewhere,' he told Public Finance. Although there will not be more inspections, the Commission for Social Care Inspection, Audit Commission and Healthcare Commission will be asked to 'get tougher on dignity,' said the DoH's director for older people Ian Philp. Patients and residents will also be encouraged and incentivised to use improved complaint systems.
'We cannot change the whole culture overnight, but within the life span of this NSF – and it has five years to go – we want the public to be assured that almost without exception they will know that their elderly loved ones will be treated with respect and dignity,' said Philp.
The NSF was first published in 2001, but Byrne denied that the continued neglect of older people meant it had been a failure.
'The health and social care system is very complex,' he said. 'There are 1.2m people working in the NHS and 1.5m in social care. In any kind of complex system like that you are going to have incidents where care is not provided to the standard that we'd all like.'
Byrne said that the first five years of the NSF had focused on ending age discrimination in the NHS, which had previously seen people over 70 denied certain operations or services.
The DoH's move to focus on the impact staff and commissioner's attitudes have on the quality of care follows two recent critical reports from the CSCI. In December last year, the Commission found that up to half of care homes for older people were 'reckless' in their failure to implement statutory recruitment checks on new members staff and that over a quarter were understaffed.
In February this year a separate report contributed to growing anecdotal evidence that some care homes use prescription drugs as a means to subdue residents by revealing that 45% of care homes for older people failed to meet the national standards for administering drugs to residents.
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