National Service Framework for Older People - Essay Example

National Service Framework for Older People The National Service Framework for older people is a vital cog in the health promotion of UK’s ageing population. This paper aims to discuss the standards of care set by the NSF for older people. It will discuss the key features of the NSF and why it is necessary. It will also describe what the Department of Health hopes the NSF will achieve. This paper will discuss the major health improvements that the NSF wishes to incorporate into the lives of UK’s older population. It shall also discuss how the NSF can help promote the health of the older age group in UK. An overview of the different agencies involved in the implementation of the NSF for older people will also be presented in this paper. It shall identify and describe several factors that make the NSF difficult to implement and describe ways on how these problems may be overcome. The National Service Framework (NSF) for older people is based on a knowledge-based partnership between those who receive and those who actually provide services for older patients. The NSF focuses on the health and social services for older clients in the home-care, hospital, or in the residential setting. The standards of care set by the NSF focuses on rooting out discrimination, providing patient-centred care, promoting older people’s health and independence, and fitting services around people’s needs. The NSF for older people is necessary because England’s population is ageing. The number of older people is England is set to double by the year 2025, with their numbers expected to represent a large part of the overall population of the country. Because of these alarming numbers, the main users of health and social services are expectedly the older population. Reports of poor, unresponsive, insensitive, and in some cases discriminatory services involving older clients have been coming out in recent years. Through the NSF, these problems would be addressed via sustainable and long-term solutions. The Department of Health through the National Service Framework hopes to get a picture of the problems that older people encounter in their health care and social services. The Department of Health aims to care for the older population by supporting their independence, promoting their good health, supporting services for vital health problems, and establishing a culture wherein they are always treated with kindness and respect (Director of Social Services, 2001). The major improvements that the NSF seeks to achieve for the care of older people are the following: rooting out age discrimination, achieving person-centred care, providing intermediate care, provide general hospital care, prevent strokes and falls, and promote a healthy and active life for the older population. In terms of rooting out age discrimination, the NSF seeks to achieve this by making sure that National Health Services will be provided to clients regardless of age. As regards person-centred care, the NSF seeks to enable the older people to make their own choices about their own care. The NSF has also made provisions to give access to intermediate care to older people in their homes and in other health care settings. The NSF has also set measures to promote the independence of older people by preventing unnecessary hospital admission and preventing early admission in long-term residential care. In order to achieve general hospital care, the NSF has established measures to ensure that older patients get appropriate specialist care and are assigned hospital staff with the right skills to meet their needs. The NSF has also undertaken some preventive measures in order to reduce and prevent strokes and falls in older patients. They have set up easy access to diagnostic, specialist, rehabilitation, and secondary prevention services for those at risk for stroke and those who have previously suffered strokes. In order to prevent falls, the NSF has undertaken public health strategies to prevent incidence of falls, and to prevent osteoarthritis in older clients. Services now include improvement of care and rehabilitation of clients who have experienced falls. In caring for the mental health of older people, the NSF has provided for measures to prevent mental health problems like dementia and depression. Finally in order to promote a healthy and active life for older people, the NSF has prepared a coordinated programme led by the NHS with necessary support from the councils. By providing for access to mainstream health promotion and disease prevention programmes, older people have a better chance to achieve increased physical activity, and improved nutrition and diet. There are various ways in which the NSF can help actually promote the health of the older population. One of them is on putting a high priority on removing barriers to “active healthy life in older people, including poor housing, and social isolation, with performance by local government, the NHS and other stakeholders measured against positive indicators of health and well-being in older age” (Help the Aged, 2006). The NSF can also launch “campaigns among older people to promote greater physical fitness, reduced obesity, and better management of sensory impairment and incontinence” (Morris, 2006, p. 1166). Health promoting activities should take into account the structure and degrees of activity that older people can tolerate. “Health promoting activities at any stage in life should be sufficiently broadly based to take into account social and psychological elements in the design, conduct, and possible outcomes of the primary interventions that are chosen” (Andrews, 2001). Finally the NSF can help promote the health of older people by providing them “access to social services of the right quality in the right place and the right time” (Thomlinson, 2008, p. 10). The agencies involved in the implementation of the NSF for older people are: Primary Care Trust(s), Hospital Trust(s), Borough Councils, private sector, and voluntary organizations. The Primary Care Trust (PCT) is the centre of the National Health Services Programme. The PCTs are “expected to understand and respond to the needs of the community” (Johnson, et.al., 2005, p 648). The Hospital Trusts helps in achieving the goals of the NSF by making sure that the older patients have an input in their care. They make sure that this older population has access to “hospital procedures such as cataracts, hip replacements and knee replacements. Data is also available for accidental falls and fractured neck of femur hospital admissions” (Southampton City, 2007). The different Borough Councils help to achieve the goals of the NSF for older people by making sure that “older people have access to a range of information and high quality services to enable them to live as full and independent life as possible within the community” (Fareham Borough Council, 2008). With the help of the private sector, the different standards set by the NSF may be implemented. The government usually contracts out through private and voluntary institutions by providing the budget and getting the best possible bid for necessary services. The Primary Care Trusts help ensure that the different standards set by the NSF are met. Their activities include implementing measures to staff hospitals and community centres with nurses equipped in falls prevention training, and “educating older people on how to implement safety measures in their home that will reduce the chance of falls…” (Young, 2008). Their function also lies in “commissioning a comprehensive and equitable range of high quality, responsive and efficient services, within allocated resources, across all service sectors” for the older population (Department of Health, 2006). The private sector helps to implement the aims and objectives of the NSF for older people by serving as long-term residential homes for this older population. They provide “around 85% of all residential and nursing home places, 80% of which are subsidized by the NHS or social services” (Mackay, 2003). The private sector also works with the government in order to increase the capacity of health and social services for the older people. There are different factors affecting the implementation of the NSF for older people. Three of these factors include the economic factor, the workforce development factor, and the lack of implementation guidelines for some of the standards set by the NSF. This is seen in the area of improving the mental health of the older clients. While the NSF mentions different strategies to improve the mental health of older clients, “other than intermediate care, there is little new money — certainly none specifically for old age psychiatry — and that the performance targets are too distant” (Baldwin, 2003, p. 27). Also, the development of the local implementation teams has also been criticized and slow and patchy, and there has been no input derived from old age psychiatrists. No funds have been actually set aside to hire staff with more specialized training in caring for older patients. In providing for general hospital care and in preventing strokes and falls, mental health assessments have been mentioned; however no mention has been made of the possible models to be adopted in order to address the needs of the older patient. Patient risk and safety is also not given enough attention by the NSF. Consequently the role of the risk manager is not given enough notice by the NSF, and as a result various opportunities for improvement are lost in the process. In order to resolve these difficulties in the implementation of the NSF, there is a need to increase funding for the NSF program. The program will actually gain more ground if its financial aspect is adequately seen to. Also, another way of getting around these problems would be to ensure adequately trained staff to handle the implementation end of the project. The government and the private sector should coordinate with each other in order to provide specialized training for health care professionals caring for older patients. Older clients have health care needs different from their younger counterparts. Falls may not bring as much problem to the 20 something individual, but they bring such grave dangers to the older population. Hence, the focus of their care requires more specialized training on the part of the health care professionals. The National Service Framework for older people was established in response to the problems being encountered in the health maintenance and care of UK’s population. It provides for standards of care that must be adopted in providing health and social services for the UK’s older population. The Department of Health wishes to achieve better standards of care and to promote a healthy life for the older people by rooting out age discrimination, achieving person-centred care, providing intermediate care, provide general hospital care, prevent strokes and falls, and promote a healthy and active life for the older population. With the help of different agencies like the Primary Care Trusts, Hospital Care Trusts, the Borough Councils, and the private sector, the aims of the NSF will be implemented. The Primary Care Trusts are the main implementing agency for the NSF, and with the help of the private sector better housing provisions are made available for the client population. Financial concerns, inadequate workforce development, and lack of implementation guidelines are some of the problems being encountered in the implementation of the NSF programme. These problems would be resolved through increased funding, improved and highly specialized training for health care professionals working with the older population, and clear-cut implementation guidelines for the provisions of the NSF. Works Cited Andrews, G. 24 March 2001, Care of Older People: Promoting Health and Function in an Ageing Population, Find Articles.com, viewed 18 November 2008 from http://findarticles.com/p/articles/mi_m0999/is_7288_322/ai_73061972/pg_1?tag=artBody;col1 Baldwin, R. 2003, National Service Framework for Older People, Psychiatric Bulletin, 27: 121-122. 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Young, T. 2008, Primary Care Trust takes action to helps prevent falls in older people, Health Promotion in County Durham and Darlington, viewed 18 November 2008 from, http://www.health-promotion.cdd.nhs.uk/index.cfm?articleid=9737 Read More