A New Ambition for Old Age: next steps in implementing the National Service Framework for Older People

A report from Professor Ian Philp, National Director for Older People

A New Ambition for Old Age, published on 20 April 2006 by the Department of Health, sets out the priorities for the second phase of the government’s ten-year National Service Framework (NSF) for Older People under three themes: dignity in care, joined-up care and healthy ageing. The report acknowledges there are still deep-rooted negative attitudes and behaviours towards older people which impact on their experience of and quality of care.

There are to be ten programmes of activity to achieve changes in services, described briefly below:

  1. Dignity in care - a renewed commitment to ensuring respect for the dignity and human rights of older people. Activities will be strengthened in: nutrition and physical environment; skills, competence and leadership in the workforce; assuring quality; ensuring dignity for those with mental health problems; ensuring dignity at the end of life; equalities and human rights; and championing change.

  2. Dignity at the end of life - to spread best practice for end of life care of older people living at home and in care homes.

  3. Stroke services - work has begun on an 18 month programme to develop a new national strategy for stroke.

  4. Falls and bone health - outlines five components of an integrated falls service including improving emergency response to falls and reducing falls risk.

  5. Mental health in old age - to ensure age equality in the development of mental health care for adults of all ages, with access to services on the basis of need, not age.

  6. Complex needs - aims to achieve better coordination of care for people with complex needs; strengthen commissioning arrangements by the NHS and Councils for people with complex needs; develop managed networks for older people with complex needs; and to build on successful developments in intermediate care services.

  7. Urgent care - plans to redesign urgent care response to falls; to people with acute confusion and mental health care needs; and for stroke and transient ischaemic attack.

  8. Care records - the Single Assessment Process (SAP) underpins much of the reforms towards delivering personalised care, joined-up services, timely response to identified needs and the promotion of health and active life. To ensure potential benefits of SAP are maximised information technology to support efficient and secure sharing of information across health and social care needs to be developed further. Aims are to simplify and extend the SAP approach to all adults with long term conditions; fit SAP implementation into wider work across local and national government in developing personalised and integrated record systems; ensure that comprehensive assessment is undertaken prior to long-term or residential nursing home care.

  9. Healthy ageing - to improve physical fitness; overcome barriers to active life by giving more attention to equipment, foot care, oral health, low vision and hearing services; improve access to health care and health promotion services for 'excluded' groups; extend healthy life expectancy through disease prevention.

  10. Independence, well-being and choice - aims to increase the use of assistive technology; strengthen leadership and partnership between Councils, the local NHS and the voluntary sector; increase the use of direct payments and individual budgets; and to increase the uptake of assessment and response to carers' needs.

There are five key implementation levers to ensure progress:

  • Leadership
  • Regulation and Inspection
  • Public Service Agreement (PSA) Targets
  • Commissoning
  • Care Services Improvement Partnership (CSIP) and other service improvement agencies

More detailed information about the ten programmes can be found in an accompanying resource document and via the Department of Health website.



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