Will improve only when there are national standards and explicit funding

For an elderly person discharged from hospital in Britain, gaining access to continuing health care is like queuing for a car parking place in a multistorey car park on a Saturday afternoon. A “one in, one out policy” operates; you can never be sure how long you will have to wait; when you do get a place it is usually furthest away from where you want to be; and, if you miscalculate your length of stay against the amount paid, you will incur a hefty fine.

This picture will sound familiar to most community practitioners, but earlier this year the Clinical Standards Advisory Group gave further credence to professional concerns and made explicit the deficiencies in the community care of older people.1Its report, Community Health Care for Elderly People, used the care of people discharged from hospital after treatment for fractured femur as a tracer condition for identifying the range, level, and quality of community health services for older …