Commission outlines key principles for revolutionising urgent care for older people

An independent commission has called for a fundamental change to the way care for older people is designed and delivered, so that care is tailored around individuals rather than institutions.

In a new report published this week, the Commission on Improving Urgent Care for Older People outlines eight key principles the health and care sector can adopt to improve urgent care for older people.

They include starting with care driven by a person’s needs and goals, having a greater focus on proactive care and allowing local leaders the space to build relationships and sustainable solutions.

Growing old together, the commission’s final report, says by changing the way services to older people are organised, care for this group can be improved and growing pressure on acute hospitals relieved. It highlights compelling ways organisations and health and care systems across the country are revolutionising care for older people.

‘Unacceptable’

“We have talked too much in the past about integrating the providers of services and not enough about integrating care around people. It is the coordination of personal care for individuals that really matters,” Dr Newbold said on Thursday. “It is unacceptable to expect older people and carers to navigate a very complex system.” 

“We want to help people to stay well both mentally and physically and receive care that responds to care needs and personal wishes. Achieving this is better for both the individual and the wider care system.”

Chaired by Dr Mark Newbold, the commission has drawn experts from across the health and care sector to examine best practice examples of truly integrated care, where initiatives have improved patient care and taken pressure off hospital services.

The principles in the report are based on the commission’s vision for achieving greater joined up, proactive and preventive care for older people to be delivered nationally.

Growing old together outlines the following practical principles for improving urgent care for older people:

• Start with care driven by the person’s needs and goals.
• Have a greater focus on proactive care.
• Allow local leaders the space to build relationships and sustainable solutions to the challenges they face.
• Care coordination that offers older people a single point of contact to guide older people through an often complex system.
• Make greater use of multi-disciplinary teams.
• Ensure workforce, training and care skills reflect the care needs of older people today.
• Enable leadership to support staff to innovate and make a difference.
• The way that NHS outcomes and performance is measured needs to allow local leaders to focus on individual needs, delivered by the whole health and care system.

The report uncovers compelling evidence of truly innovative initiatives taking place across the country and calls for best practice initiatives are rolled out nationally. The following examples were examined as part of the report:

• By using a geriatric assessment team, Sheffield Teaching Hospital has cut down hospital stay days from 5.5 days to 1.1 days.
• Introducing a care coordinator function commissioned by Age UK in Cornwall has resulted in a 31 per cent reduction in all hospital admissions and a 26 per cent reduction in non-elective admissions.
• By providing a home-based emergency assessment and treatment service, North East London NHS Foundation Trust and London Ambulance Service have saved around £108,000 by avoiding ambulance trips and reducing the need for A&E admission and assessment.

Read the full report for further examples of integrated care or view the case studies section.