Health services – an introduction for the older person


Updated July 2006

As people age their use of the health service is likely to increase. Concern has been raised in recent years over the de-medicalisation of healthcare issues of the elderly by the movement of patients into care homes where their healthcare has been substituted by social care. Despite this, there is evidence that providing greater access to medical care for older people will result in reductions in disability and mortality.[see reference 1]

In response to increasing demand for healthcare services, the Department of Health has established a National Service Framework for Older People. The aim is to provide better health and social care services to older people.[see reference 2] Living Well in Later Life (2006) describes the progress that has been made since the National Service Framework was published. In addition, the Government's White Paper Our health, our care, our say (2006) aims to ensure that there is greater integration between health and social care in order to meet the needs of patients.[see reference 3] For example, there will be greater coordination between health and social care services, and everyone who needs or wants one has a personal health and social care plan.

The need for greater integration between health and social care in order to prevent ‘bed blocking’ and ‘delayed transfers’ was highlighted in the Wanless Review.[see reference 4] The main causes of delayed discharges include patients waiting for assessment or funding for a care home. Greater integration will mean the health and social care needs of older people are met more effectively and efficiently.[see reference 4] Finally, the introduction of the Expert Patient Programme (link to BMA Patient Liaison Group discussion paper) is likely to impact on the delivery of healthcare to older people as it encourages people with chronic diseases to take an active role in their own care.[see reference 5]

The elderly are entitled to specific health services including annual health checks for people aged over 75, which will assess mental and physical health, mobility, continence, hearing, eyesight, accommodation, family support, social links, diet and use of medicines. People over the age of 60 should be offered eye tests and prescriptions for medicines free of charge.[see reference 6] Some other services that may be available to older people, if eligibility criteria are met, include free nursing care in all settings including nursing homes, continuing in-patient care in hospital, fully NHS-funded care in nursing homes, rehabilitation and recovery services including intermediate care, short-term breaks and specialist transport.[see reference 7]

Whilst the above details broadly reflect the situation throughout the UK, there are some differences in service provision between England, Scotland, Wales and Northern Ireland. For information on specific areas visit the NHS website.

References:
  1. Ebrahim S (2002) The medicalisation of old age. British Medical Journal 324: 861-863.
  2. Department of Health (2006) Our health, our care, our say: a new direction for community services. London: Department of Health.
  3. Department of Health (2001) Shifting the balance of power within the NHS: Securing delivery. London: Department of Health.
  4. Wanless D (2002) Securing our future health: Taking a long-term view. London: HM Treasury
  5. Department of Health. (2001) The Expert Patient: A new approach to chronic disease management for the 21st Century. London: Department of Health.
  6. Age Concern (2006) Concessions for older people information sheet. London: Age Concern England.
  7. Age Concern (2005) Continuing NHS care, NHS funded registered nursing care and intermediate care. London: Age Concern England.
Further information:

© British Medical Association 2008

Log in to your BMA here