Redesign of services for the 21st century
In 1948, just over half of the population lived longer than 65 years; today, more than 85 per cent of us live at least that long and by 2030 one in five of us will be over 65.
The King’s Fund has recently produced a report Making our health and care systems fit for an ageing population. It looks at each of the main components of care for older people reviewing the quality challenges that exist and summarising the evidence for what works, alongside examples of good practice and pointers to more detailed guidance.
The nine main components of integrated care are:
- Healthy, active ageing and supporting independence
- Living well with simple or stable long-term conditions
- Living well with complex co-morbidities, dementia and frailty
- Rapid support close to home in times of crisis
- Good acute hospital care when needed
- Good discharge planning and post-discharge support
- Good rehabilitation and re-ablement after acute illness or injury
- High-quality nursing and residential care for those who need it
- Choice, control and support towards the end of life
The report highlights three themes :
i. The importance of joint working between health, social care and wider public services to support older people to remain healthy, happy and independent. Crucially this includes providing the right housing to help maintain independence.
ii. Correct use of the comprehensive geriatric assessment and specialist support at the right time is another key theme.
iii. Treating older people with compassion, respect and dignity.
The golden thread that runs through all nine components of good care is integration, in which care is coordinated around the needs of the individual so that they receive the right mixture of services in the right place at the right time.
Whole-system changes are needed to deliver the right care at the right time, and in the right place, to meet older people’s care preferences and goals.
Ref: Catherine Foot and Richard Humphries at the King’s Fund