In October 2014 the NHS Scotland published what I believe is a very important document: “Optimising Older People’s Quality of Life: an Outcomes Framework”.
The rather formal title belies its exciting content and potential to improve services across the board for older people in Scotland.
A development team of health and care professionals and voluntary groups set out a framework to measure and improve outcomes strategically, as well as in four specific example areas: eating well, falls prevention, age-friendly environment and palliative/end of life care.
Pushing to set and achieve outcomes
My experience in working in elderly care was of constantly pushing to set and achieve outcomes. Healthier eating, exercise, social activity and setting aspirations we found were ways to turn around people’s attitudes and enable oder people to lead fuller and perhaps longer lives. We had considerable success in terms of activities being taken up, and people setting activity targets for themselves. I remember one gentleman who took piano lessons at an advanced age, others who discovered ‘new’ foods, and regained what they thought were lost skills.
What I find exciting about this framework is that it sets out nationally, in strategic as well as in detailed terms for all professionals, where their work should be targeted. Rather than age being a static and declining condition, it presupposes that people have the potential to develop at all ages. This involves service commissioners and planners, all the way to the front line care assistants and managers.
The programme states the current position in each of four model areas, and then shows how we need to improve performance.
Useful guide to best practice in elderly care
It is a useful guide to best practice in elderly care. To take one of the ‘Nested models’, eating well, the paper identifies the shocking statistics of poor nourishment among older people and the public expense of treating the resulting hospital admissions.
The model encourages knowledge and awareness about healthy eating to be promoted, for food services (e.g. delivery, availability, diversity) to improve reach to older people, workforce knowledge to be enhanced, planners to be better informed, and older people themselves (a significant make up of voluntary services ) to spread the word about eating well.
Each of us working with older people can find where we slot into this framework, and proceed accordingly. I will certainly be promoting it myself, and I trust that the government, as well as all other partners, will have outcome targets to measure the actual improvement which this bold development can bring about.
