Chief
Medical Officer Chief
Medical Officer
Publication of this report fulfils a commitment given in the Scottish Health Plan, Our National Health - a plan for action, a plan for change. It was commissioned because of serious concerns about the healthcare of older people.
The first step in tackling this task was to constitute the Expert Group itself, ensuring that as far as was possible, it drew on the skills, knowledge and opinion of as wide a spectrum of patients' groups, carers, voluntary and professional groups as was available in Scotland. It has been a real privilege to chair this diverse and lively assembly who have tackled the work with vigour and enthusiasm. The group met first in April 2001 and subsequently for five further full days of discussion and debate, including a meeting of the group and over a hundred invited participants. The agenda for each meeting was agreed in advance with the group itself providing structured papers, evidence and debate both from its own experience and by bringing in further advice as required. Group members were asked to report regularly on progress to their parent bodies and to ensure that all issues of concern were covered. The public was invited, via newspaper advertisements, to complete a structured questionnaire. A specially commissioned MORI poll sought the views of 500 older people on their recent experiences of the NHS. The results are summarised in this report.
The Group has examined specific concerns raised by older people themselves. Like ageism - discriminating against people because they are old. Like sharing mixed-sex wards, a particular issue for ethnic minority patients. Like nutrition and the quality of food in our hospitals. Concerns, too, about what was happening to older people whose discharge from hospital had been delayed because suitable care, in their own homes, or in care homes, could not be arranged.
All of these issues are addressed in this report and action is already in hand within the NHS to deliver improvements. The report has identified much to be proud of in terms of services for older people in NHSScotland. But, rightly, it also points out where the NHS needs to improve. There is clearly much work still to do.
But there are also wider concerns about the long-term needs of older people as patients in NHSScotland. Scotland's population is stable but we are growing older. As a nation we should be planning now for increasing numbers of older people in future. Although most older people are healthy, health problems increase with age and our NHS must be there to deal with them. Already older people are - quite rightly - the main users of many of our community and hospital services.
There has been a failure, over the last three or four decades, to adapt our health services to a gradual but very substantial increase in the numbers of older patients being treated.
This report sets out to put that right, and to go further, by pointing out what must be done now to meet the challenges that lie ahead. It puts older people and their care right at the top of the NHSScotland agenda, and challenges the Scottish Executive, the NHS, health professionals and patients themselves to play their part in responding to that challenge.
It is a report that has been developed, tested and written from the patient's point of view. It has messages for every part of the NHS: primary care, community services, acute care and longer-term care. The message from Scotland's older people is clear: involve patients, listen to patients, work with patients.
Its recommendations build on much that the Executive has already done to improve the lives and care of older people, such as the Scottish Health Plan, the Joint Future Group and the Care Development Group. As with these other key reports, the task now is to ensure that words are translated into action.
DR E M ARMSTRONG
January 2002