Our population is ageing. The need to pay for decent care for older people becomes more pressing, and last month's Wanless report recommended how to provide long term care fairly.1 But what is decent care? The national standards for the health, treatment, and social care of older people in England—set in 2001 in the national service framework (NSF) for older people—provide a good grounding. Last week the UK national director for older people, Professor Ian Philp, presented the next steps for the framework in the report A New Ambition for Old Age, which examined how the framework is being implemented and announced new aims and targets.2

The national service framework for older people set out eight standards to improve the experiences of older people and their carers who are using health, social care, and other services (box 1). A standard on medicines management followed later. Last week's report added a further 10 programmes for implementing the framework, under three important and timely themes: dignity in care, joined up care, and healthy ageing.

What has improved since the framework was launched five years ago? A third of older people needing intensive daily help in England now receive this in their own homes rather than in residential care; delayed discharge from acute hospitals has been reduced by more than two thirds; …