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New Scottish standards for care of older patients

  • 3 Comments

A new set of standards for the care of older patients in Scottish hospitals has been published, with an emphasis on strengthening the involvement of patients and carers.

NHS boards are now expected to work towards meeting the standards, which have been published today by the regulator Healthcare Improvement Scotland.

The standards will be used to support future hospital inspections of the care of older people carried out by Healthcare Improvement Scotland.

“This new set of standards has been developed to support staff to provide the best care for older people in hospital”

Christine McApline

Each standard includes a statement of the level of performance that NHS boards are to achieve. They are built on previous standards from 2002, but with a greater focus on initial assessment on admission and more complex aspects of care.

The first three standards emphasise the principle of person-centred care. They state that older people should be given the opportunity to say what is important to them when they are cared for in hospital, treated with dignity and respect, and involved in decisions about their care.

These principles should be applied throughout the patient journey, said Healthcare Improvement Scotland.

Other standards cover the management of frailty, assessment of cognitive function, effective discharge planning and a standard to ensure that older people are cared for in the right place at the right time.

Project group chair Dr Christine McAlpine, geriatric medicine specialty advisor to Scotland’s chief medical officer, said: “This new set of standards has been developed to support staff to provide the best care for older people in hospital, wherever healthcare is delivered.

“Each standard details what patients, their representatives and the public can expect of healthcare services in Scotland,” she said. “We believe that the new standards once implemented will support continuing substantial improvement in the care that older people receive.”

Sara Twaddle, director of evidence for Healthcare Improvement Scotland, added: “The standards complement our ongoing programme of inspections for older people in hospital, and our national improvement programme focused on delirium and the identification and management of frailty.”

  • 3 Comments

Readers' comments (3)

  • michael stone

    'They state that older people should be given the opportunity to say what is important to them when they are cared for in hospital, treated with dignity and respect, and involved in decisions about their care.'

    I keep coming across this phrase - '... and involved in decisions about their care'.

    This 'involved in' is somewhere between unclear and legally wrong: the Montgomery case has made it crystal clear that patients DECIDE whether to accept of refuse any offered treatments [provided the patient is mentally capable]. Clinicians and 'the system' essentially decide which treatments to offer, and there can be some 'haggling about a non-offered treatment which the patient wants'.

    But patients are self-determining with respect to the acceptance of offered interventions, and they are not 'involved in' that decision: the patient makes that decision.

    Until clinicians are clear about who makes which decisions, these phrases about 'shared decision-making' and 'patients being involved in decisions about their care' are serving to shroud decision-making process and authority in a rather opaque 'veil'.

    I get very annoyed by this - you cannot 'describe the process' unless you are all clear and agreed about decision-making authority, and that lack of clarity then leads to unsatisfactory confusion and contradiction.

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  • The standards will only apply and be measured in acute hospital settings in Scotland. HIS does not have the remit to inspect care of the elderly/end of life care/complex care in community settings (where the majority of end of life care is provided).
    To be clear, there are NO external inspections of care of the elderly wards outwith the acute setting in Scotland.
    Scottish Government and HIS are "reviewing this", but will make no commitment to extend the remit in the foreseeable future. Meanwhile many, many vulnerable elderly patients are "being cared for" in unsuitable environments, with the lowest staff to registered staff ratios. With no external inspections this remains a hidden scandal.

    Unsuitable or offensive? Report this comment

  • The standards will only apply and be measured in acute hospital settings in Scotland. HIS does not have the remit to inspect care of the elderly/end of life care/complex care in community settings (where the majority of end of life care is provided).
    To be clear, there are NO external inspections of care of the elderly wards outwith the acute setting in Scotland.
    Scottish Government and HIS are "reviewing this", but will make no commitment to extend the remit in the foreseeable future. Meanwhile many, many vulnerable elderly patients are "being cared for" in unsuitable environments, with the lowest staff to registered staff ratios. With no external inspections this remains a hidden scandal.

    Unsuitable or offensive? Report this comment

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