Ageing Society
Content
An ageing society – are our health and social care systems fit for purpose?
Philip Hurst National Development Manager - Health LEIGHS seminar – 17 May 2010
Overview of seminar
The demography – an opportunity The challenge and the promise Age discrimination and human rights today The f t Th future – what might help? h t i ht h l ?
Life expectancy continues to rise
Assuming continued improvements in mortality, life expectancy for those aged 65 in 2008 is 21 years for males and 23 6 years for 23.6 females.
Over 85s are the fastest growing population group
Older people – main adult users of health and care services
People aged 65+: Two thirds of acute hospital b d ( t 60% T thi d f t h it l beds (up to also with mental health needs) Average 7 visits p.a. to GP (compared to 4 visits by y y younger adults) g ) 65% of NHS spend 60% of gross social care spend f
By 2017 in England the population of older people will include
Nearly 1 million with dementia 1.5 illi 1 million with d i h depression i Over 4 million with major hearing problems Between 4-7 million with urinary incontinence y p g Nearly 7 million who cannot walk up one flight of stairs without resting Multiple morbidity is the already the norm
A( (not so) New Ambition )
In the next phase of health and social care reform we must place older people’s needs at the centre and i d involve th l them and th i representatives i care d their t ti in planning. Within fi Withi five years our ambition i t ensure th t older biti is to that ld people and their families will have confidence that in all care settings older people will be treated with settings, respect for their dignity and their human rights.
AN New A biti Ambition f Old A for Age: D Department of H lth 2006 t t f Health,
Mismatch with current systems Mi t h ith t t
Workforce training and development / specialisation Incentives and levers based on single conditions / neat episodes of care Choice and control as main approach to quality improvement Broken social care system – under-funded, tight eligibility criteria Personal budgets – evaluation ignored Little Littl emphasis on re-ablement h i bl t Age discrimination persists
Age discrimination – report of national review
Despite recent progress, and the good service received by many people of all ages, age discrimination remains an issue for the health and social care system which all organisations need to address. Many of the examples of age discrimination that have been shared with us are of indirect discrimination but these have just as detrimental an impact on patients, service users and carers and on public confidence in the system as direct discrimination. Negative attitudes and narrow assumptions about age but particularly about older people, are an important cause of age discrimination. Action to shape attitudes through training and professional standards is therefore critical. Discriminatory behaviour is often bound up with other factors contributing to poor quality care: leaders within the system need to take responsibility for tackling age discrimination as part of achieving high quality care.
Age discrimination – mental health
‘There is indisputable evidence that older people experience widespread discrimination at all levels of mental health care: from primary prevention, prevention identification and treatment through to standards of care and access to treatments for those with acute mental ill health ’ health. New Horizons – A Shared Vision for Mental Health, H lth 2010
Age discrimination – mental health consequences
In primary care In I social care i l In acute hospitals p In specialist mental health services
Human rights of older people in healthcare
Malnutrition and dehydration Abuse/rough treatment g Neglect, poor hygiene Bullying, infantilising attitudes y g g Fear of complaining Mixed sex wards Lack of confidentiality y Medication/other restraint Hasty discharge y g Eviction from care homes
Discrimination on grounds of age, disability and race Communication problems (esp dementia or language other than English)
Joint Committee on Human Rights, 2007 J i tC itt H Ri ht
Human rights of older people in healthcare
‘We consider that the power imbalance between service providers and service users and the strong evidence that we have received of historic and embedded ageism within h l h f hi i d b dd d i i hi healthcare f older for ld people are important factors in the failure to respect and protect the human rights of older people. These problems require more than simply action at the local level, but an entire culture change in the way that healthcare services for older people are run, as well as strong leadership from the top.’ g p p
Joint Committee on Human Rights, 2007
Human rights abuses - consequences
‘In hospital, despite being blind, her meals and drinks were left on a trolley – in most cases without her being y g alerted. For the most part, staff did not offer any assistance with eating and drinking. When she asked for a commode, she was told by a nurse that she could use her incontinence pad.’
On the right track? Age Concern 2008
A long and sorry saga
Stoke Mandeville Maidstone and T b id W ll M id t d Tunbridge Wells Mid Staffordshire Basildon & Thurrock ………
……..
‘….at visiting time with no blankets over him and no trousers on...just a pad stuffed between his legs and some net pants loosely h ldi i i place...it was a mixed ward and visitors l l holding it in l i i d d d i i were all walking past his bed’ Comment on NHS Choices, 2010 Choices ‘Left unwashed and fed by fellow patients…yet another life Left ends without dignity’ Newspaper headline – 6 May 2010
Equality Act 2010
Protection against discrimination, harassment and victimisation on grounds of h t d i ti i ti d f age Outlaws age discrimination in provision of goods, facilities and services – from 2012 Objective justification and exemptions Public P bli sector equality d t – f t lit duty from April 2011 A il
Levers and leaders
Unambiguous standards Professional education and training P f i l d ti dt i i Opportunities for a voice – inc regulation and pp g inspection Politicians and non execs challenging and non-execs testing Local heroes
Questions? Q ti ?
Philip Hurst National Development Manager - Health LEIGHS seminar – 17 May 2010
Overview of seminar
The demography – an opportunity The challenge and the promise Age discrimination and human rights today The f t Th future – what might help? h t i ht h l ?
Life expectancy continues to rise
Assuming continued improvements in mortality, life expectancy for those aged 65 in 2008 is 21 years for males and 23 6 years for 23.6 females.
Over 85s are the fastest growing population group
Older people – main adult users of health and care services
People aged 65+: Two thirds of acute hospital b d ( t 60% T thi d f t h it l beds (up to also with mental health needs) Average 7 visits p.a. to GP (compared to 4 visits by y y younger adults) g ) 65% of NHS spend 60% of gross social care spend f
By 2017 in England the population of older people will include
Nearly 1 million with dementia 1.5 illi 1 million with d i h depression i Over 4 million with major hearing problems Between 4-7 million with urinary incontinence y p g Nearly 7 million who cannot walk up one flight of stairs without resting Multiple morbidity is the already the norm
A( (not so) New Ambition )
In the next phase of health and social care reform we must place older people’s needs at the centre and i d involve th l them and th i representatives i care d their t ti in planning. Within fi Withi five years our ambition i t ensure th t older biti is to that ld people and their families will have confidence that in all care settings older people will be treated with settings, respect for their dignity and their human rights.
AN New A biti Ambition f Old A for Age: D Department of H lth 2006 t t f Health,
Mismatch with current systems Mi t h ith t t
Workforce training and development / specialisation Incentives and levers based on single conditions / neat episodes of care Choice and control as main approach to quality improvement Broken social care system – under-funded, tight eligibility criteria Personal budgets – evaluation ignored Little Littl emphasis on re-ablement h i bl t Age discrimination persists
Age discrimination – report of national review
Despite recent progress, and the good service received by many people of all ages, age discrimination remains an issue for the health and social care system which all organisations need to address. Many of the examples of age discrimination that have been shared with us are of indirect discrimination but these have just as detrimental an impact on patients, service users and carers and on public confidence in the system as direct discrimination. Negative attitudes and narrow assumptions about age but particularly about older people, are an important cause of age discrimination. Action to shape attitudes through training and professional standards is therefore critical. Discriminatory behaviour is often bound up with other factors contributing to poor quality care: leaders within the system need to take responsibility for tackling age discrimination as part of achieving high quality care.
Age discrimination – mental health
‘There is indisputable evidence that older people experience widespread discrimination at all levels of mental health care: from primary prevention, prevention identification and treatment through to standards of care and access to treatments for those with acute mental ill health ’ health. New Horizons – A Shared Vision for Mental Health, H lth 2010
Age discrimination – mental health consequences
In primary care In I social care i l In acute hospitals p In specialist mental health services
Human rights of older people in healthcare
Malnutrition and dehydration Abuse/rough treatment g Neglect, poor hygiene Bullying, infantilising attitudes y g g Fear of complaining Mixed sex wards Lack of confidentiality y Medication/other restraint Hasty discharge y g Eviction from care homes
Discrimination on grounds of age, disability and race Communication problems (esp dementia or language other than English)
Joint Committee on Human Rights, 2007 J i tC itt H Ri ht
Human rights of older people in healthcare
‘We consider that the power imbalance between service providers and service users and the strong evidence that we have received of historic and embedded ageism within h l h f hi i d b dd d i i hi healthcare f older for ld people are important factors in the failure to respect and protect the human rights of older people. These problems require more than simply action at the local level, but an entire culture change in the way that healthcare services for older people are run, as well as strong leadership from the top.’ g p p
Joint Committee on Human Rights, 2007
Human rights abuses - consequences
‘In hospital, despite being blind, her meals and drinks were left on a trolley – in most cases without her being y g alerted. For the most part, staff did not offer any assistance with eating and drinking. When she asked for a commode, she was told by a nurse that she could use her incontinence pad.’
On the right track? Age Concern 2008
A long and sorry saga
Stoke Mandeville Maidstone and T b id W ll M id t d Tunbridge Wells Mid Staffordshire Basildon & Thurrock ………
……..
‘….at visiting time with no blankets over him and no trousers on...just a pad stuffed between his legs and some net pants loosely h ldi i i place...it was a mixed ward and visitors l l holding it in l i i d d d i i were all walking past his bed’ Comment on NHS Choices, 2010 Choices ‘Left unwashed and fed by fellow patients…yet another life Left ends without dignity’ Newspaper headline – 6 May 2010
Equality Act 2010
Protection against discrimination, harassment and victimisation on grounds of h t d i ti i ti d f age Outlaws age discrimination in provision of goods, facilities and services – from 2012 Objective justification and exemptions Public P bli sector equality d t – f t lit duty from April 2011 A il
Levers and leaders
Unambiguous standards Professional education and training P f i l d ti dt i i Opportunities for a voice – inc regulation and pp g inspection Politicians and non execs challenging and non-execs testing Local heroes
Questions? Q ti ?
