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FEB 26/2014

How the NHS is changing to provide better care for older people

Doctors and nurses across the NHS are set to see a number of changes to their responsibilities and working practices over the coming years due to a concerted effort to improve the standard of care offered to older people.

Ensuring the elderly and vulnerable are properly looked after has always been a key NHS priority, but the current government is making a particularly concerted effort to tackle the issue, with a number of reforms and structural changes currently taking place to support the move.

Many of the ways in which these goals are being pursued will have various consequences in terms of recruitment levels, working hours and best practice guidelines, making it vital that staff educate themselves on what is being done.

The impetus for change
The elderly and infirm are among the heaviest users of NHS services, but health secretary Jeremy Hunt has expressed the view that the current setup does not always serve their needs well enough. In many cases, the systems in place do not give them a proper chance of remaining healthy and independent at home, meaning they become more reliant on hospital care than is necessary.

Not only does this decrease their quality of life, it also places undue pressure on accident and emergency care, with staff having to regularly deal with older patients with chronic conditions that require long-term management. Given that the average age of the UK population is increasing due to people living longer, it is expected that this trend will continue to gather momentum.

Improving standards with new methods of working
The efforts to address this issue are multifaceted and involve tackling the problem from multiple angles at the same time. However, the reforms have a unifying theme - ensuring that older people receive greater access to a wider variety of care services, so they receive the support they need in a community setting instead of depending on hospital treatment.

This will tie in with wider efforts within the NHS to improve integration of care, ensuring the entire health service acts as a unified whole, rather than a series of disparate departments thatpatients are passed between.

As such, the government is looking to emphasise the role that lesser-used community-based care services can play in helping elderly patients to manage long-term conditions. By increasing investment in fields such as pharmacy, home care and physiotherapy, patients will be able to receive treatment and guidance in non-emergency settings, meaning they can keep their conditions under control proactively, rather than waiting until a serious incident hospitalises them.

GPs will take on key responsibilities within this new service model, with the recent GP contract update set to include provisions for older patients to be assigned a named clinician, who will act as a single contact to coordinate their care on an individual basis. Patients will be reassured by the continuity and familiarity this provides, while health professionals will find it easier to keep track of what treatment options patients have used, as well as what pathways remain available.

Other changes include offering expanded out-of-hours care options, with e-consultations, telecare and web consultations bringing new ways for people to connect with their GP and local services. Meanwhile, more efforts will be made to share clinical data effectively between different departments, making it easier for older patients to choose their own treatment approaches, safe in the knowledge that the details of their case will not be lost.

The changes the government has laid out will require adjustments to working practices, staffing levels and organisational infrastructures, but if they are successful, they are expected to enhance care quality for some of society's most vulnerable, while also offering efficiency benefits for the NHS.

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