Ageism in NHS care?

Doctors highlight need for better NHS care for elderly
Ageism in healthcare is in the news after Help the Aged published research showing that many geriatricians consider the NHS to be institutionally ageist:

* 72% of 200 doctors said older people were less likely to be considered and referred on for essential treatments

* More than half the doctors said they themselves would be worried about how the NHS would treat them in old age

Respect, dignity and reducing health inequalities.

  Whilst many clinical teams - and their counterparts in social and community care - do a fantastic job, this research will come as little surprise to those who look after the elderly. As patient-centred care gains momentum and a priority across the NHS, with improved systems being put in place to measure and understand the experience of patients, it is vital that such systems truly harness the experience of all our patients - especially those for whom we need to strive hardest. Fully representing the views and experience of elderly patients and other "hard to reach" groups is an area in which iWantGreatCare has special interest and expertise, this new research reminds us all why such focus is so badly needed from all those providing or commissioning care.

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NHS constitution 1: meaningful engagement

"PCTs are required to demonstrate that they are proactively leading continuous and meaningful engagement with the public and patients to shape services and improve people's health."

The NHS constitution puts expectations on both patients and those providing healthcare. PCTs are expected to be "proactive" and "meaningful" in their engagement. Of course, these are already competencies required for World Class Commissioning and it is interesting to watch the range of ways in which PCTs are trying to meet (and in some cases exceed) these expectations.
It is clear that "meaningful engagement" is going to require a lot more than a few focus groups and production of a newsletter!

Measuring experience of care homes

As the Times launches its series and survey on care homes it is a good time to remind ourselves of the challenges in ensuring the voice and experience of care home residents is harnessed. But also, of the massive opportunity to improve the quality of care that could result.

The article highlights not only the scale of the challenge - but also the appalling human cost of getting things wrong. Proxies (relatives and friends) are known to be accurate reporters of healthcare experience, particularly for the elderly and those with long-term conditions. Capturing this information presents a powerful and valid way to ensure that the quality of care delivered in homes is visible and transparent - something that should be important to all of us.

Capability of PCTs and acute trusts

The HSJ reports the health select committee opinion that "Primary care trusts are incapable of implementing the next stage review due to "striking and depressing" management weaknesses."

Whilst this was a broad and sweeping statement, few would argue that PCTs (and indeed acute trusts) face a rapidly changing and highly demanding set of expectations, requiring skills and experiences that are in short supply in both the public and private sectors. When one considers the challenge of improving patient experience (not just measuring it) across the whole of the NHS, then it is likely that similar challenges will be faced. Delivering a better experience to our patients requires a thorough understanding of the issues that exist and what matters most to patients; continuous, accurate, granular, real-time data of local experience; and a carefully designed improvement programme to act on this data. A challenge for even the best organisations!

NHS Digital Dreams

"...a policy that emphasises choice needs to put information at its very core"
Although not brand new, it is worth reviewing this HSJ article from August 2007, to see how much progress has been made (or not) in supporting patients in making informed choices over their healthcare.
Is the view of Angela Coulter (former Chief Executive of Picker Europe) that "information on sites such as NHS Choices and NHS Direct online tends be 'didactic, rather old-fashioned and paternalistic' rather than recognising patients' roles in making decisions about their healthcare" a fair view of today's service? Or is the NHS now making the digital dreams of patients reality?

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