Call for 'revolution' in care for older people

Community-based care is much more suitable for older people than the provision of care in hospitals, an expert has said.

Sir David Nicholson, the head of the new NHS Commissioning Board, believes hospitals are 'very bad places for old, frail people' and has called for alternatives to be found.

A revolution is needed in care for older people, he told the Independent newspaper, and he singled out community-based treatment centres as the key to that transformation.

Sir David likened the scale of the issue to the 'national scandals' surrounding the care of mental health patients during the 1960s and 1970s.

He told the newspaper that around 40% of patients in the average general hospital have dementia of some form.

The country has a patient base to care for that is 'changing rapidly' with an increasing number of older patients who are confused, he said.

He compared the change in care for older people to the shift in attitude towards mental health patients several decades earlier.

Sir David said: 'If you remember what happened in the 1960s and 1970s, there was a whole series of national scandals about care of mentally ill patients.

'The response was not just to say that the nurses who looked after these patients needed to be more caring, but actually there was something about the way we treated these patients and the model of care that needed to change.'

New role for the NHS Commissioning Board

Sir David has been speaking about how the new NHS Commissioning Board will work when it takes over responsibility for all NHS services from the Department of Health in April.

The Board will be accountable to Parliament and Sir David has stressed it will be frank in its dealings with politicians.

It will question ministers about NHS funding if necessary and will tell the public how much it believes the health service needs to spend to achieve certain outcomes, such as improving life expectancy and keeping waiting lists at a minimum.

'We will be saying 'If that's the amount of money which is available, these are the sorts of things we will be able to deliver and these are the sorts of things that we can't'. That's a big change,' he added.

Michelle Mitchell, Charity Director General at Age UK, commented: 'For too long older people have received second or even third rate care from the NHS, so it is good that David Nicholson is highlighting these issues, which Age UK has campaigned on for many years.

'This vision isn't simply about moving older patients out of hospitals and into the community - the treatment of older people needs a radical overhaul from the organisation of care to the training of staff, including GPs. It is crucial that there is also fair and lasting reform of social care working in partnership with the NHS and other essential services.

'We now look forward to seeing his words turned into action and the publication of a clear road map to making this change happen, with older people consulted throughout the process.'

Copyright Press Association 2013