Long term care of older peopleBMJ 1996; 312 doi: https://doi.org/10.1136/bmj.312.7035.862 (Published 06 April 1996) Cite this as: BMJ 1996;312:862
- Edward Dickinson
- Senior clinical research fellow Research unit Royal College of Physicians, London NW1 4LE
Strategic management would stop people going too early to the wrong place
Car manufacturers have responded radically to the challenge of global competition; they have revolutionised assembly through technology, just-in-time inventories, team working, and a focus on quality; they have optimised component supply by forging long term contracts based on mutual help and trust; they have introduced customer focus into relationships with car purchasers. This exemplifies how industry has recognised the need for effective strategic management when crisis looms. Why then, when Britain faces the unprecedented strategic challenge of the long term care of older people, is there increasing evidence of strategic drift? Two issues are of particular concern and may lead to increased costs: they are the poor assessment of eligibility of older people for long term care, and poor quality of care.
Evidence of the present inadequacy of eligibility assessment in Britain is beginning to emerge.1 A recent audit report disclosed a disturbing level of inappropriate placement, even after poor …