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Better coordination is needed in services for older people

BMJ 2003; 326 doi: http://dx.doi.org/10.1136/bmj.326.7391.680/e (Published 29 March 2003) Cite this as: BMJ 2003;326:680
  1. Susan Mayor
  1. London

    Services for older people in England need to be better coordinated to make them easier to access, the National Audit Office has recommended.

    In a report published this week, the National Audit Office suggested that, although the government has made progress towards improving services for older people, scope exists for further improvement in coordination, consultation, and the use of evidence in formulating policy.

    John Bourn, the comptroller and auditor general, pointed out: “Older people are major users of public services, and many of them find the divisions between service providers confusing. Often, those most in need have to deal with the largest number of different agencies.”

    The National Audit Office, an independent body that scrutinises public spending on behalf of the English parliament, examined service development relevant to older people over the past few years. It found that the government had recognised the needs of older people in a wide range of initiatives, such as the better government for older people programme, which aimed to “improve public services for older people by better meeting their needs.”

    The national service framework for older people defined eight areas of standards in health and social care for older people. “These initiatives have all had major beneficial impacts but there are also important elements of unfinished business,” the report said. It recommended that policies outlined in the initiatives should be implemented promptly.

    Some progress had been made towards better coordination of services for older people, with the setting up of a Cabinet Committee on Older People, appointing a Cabinet champion for older people and designating the Department for Work and Pensions to take the lead on older people's issues.

    However, the report suggested that action is needed to provide an overall framework for action across different government departments. It suggested that the Department for Work and Pensions should publish a strategy for older people as soon as possible. “This would help to make it clearer how the work of different departments in different areas relevant to older people fit together,” the report said.

    The audit office also suggested that the Department of Health should clarify the roles of older people's champions—people working to drive and integrate services for older people—in the NHS. This will help them to discharge their responsibilities more effectively, provide stronger leadership on older people's issues, and dispel confusion identified in previous research.

    Finally, the Cabinet Office should consider requiring every government department to appoint an older people's champion to work with the Department for Work and Pensions in coordinating work across different departments.

    Developing Effective Services for Older People can be found on the National Audit Office's website at http://www.nao.gov.uk/. Copies can be obtained from the Stationery Office (tel 0845 702 3474).

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