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Clearer vision is required to safeguard care of the elderly

THE ambition for the future of NHS Scotland is perfectly clear.

community CARE: Freedom of information requests revealed a wide disparity in waiting times for community rehabilitation care between authorities.
community CARE: Freedom of information requests revealed a wide disparity in waiting times for community rehabilitation care between authorities.

Politicians from all sides have signed up to the 2020 Vision which paints a reassuring picture of everyone living longer, healthier lives in their own homes. The focus, it says, will be on helping people to manage their own conditions and preventing the need for emergency spells in hospital.

With less than four years to go, The Herald has investigated how quickly elderly people whose health has deteriorated can be seen by community rehabilitation teams which are intended to help people live independently and avoid repeated hospital admissions.

These teams bring together nurses, occupational therapists, physiotherapists and sometimes geriatricians.

When patients are referred to them, perhaps because their GP is concerned about their growing instability, these professionals visit people in their own homes.

They assess the individual's needs, may seek aids and equipment to help them get about the house, recommend a programme of exercise to help address muscle weaknesses and look for hazards which might cause the patient to fall.

Our freedom of information request, which asked how long people wait for a first visit from the community rehabilitation team, showed a muddled picture.

Some health boards boast excellent response times. NHS Ayrshire and Arran said they have no waiting lists - people are seen as quickly as required. Parts of NHS Lanarkshire also have Integrated Community Support Teams which visit everyone, including low priority "routine" patients" in under five days.

In other areas, the delay between the person being referred to their first visit could stretch to months. Borders recorded a maximum wait of 111 days in the Cheviot region, Dundee 12 weeks.

In addition, a number of health boards, including NHS Dumfries and Galloway, NHS Tayside outside of Dundee and NHS Highland said they were unable to answer the questions.

Council social care services have been merged into the NHS in the Highlands. It was a pilot site for the Scottish Government's much trumpeted policy for integrating the NHS and social care -the mechanism by which ministers expect prevention services to improve, relieving the growing pressure on hospitals.

Despite this, NHS Highland said: "Information about referrals to community teams is not recorded in a way that can be interrogated to produce the information you are seeking."

Professor Paul Knight, president of the British Geriatrics Society and a community geriatrician at Glasgow Royal Infirmary, said: "It is actually very difficult to get a coherent sense of the pattern of care in the community for older people on a national basis. In some places it might be excellent, in some places it might not be so good, but it is actually very difficult to tell."

He called for comparable figures to be available nationwide to make it clear how effective services are. Professor Knight said: "It is vital that we have a standard data set. Otherwise we risk learning by anecdote and given the amount of resource that has been put into teams we really need to know what works."

A government spokesman said: "Through the Allied Health Professional National Delivery Plan we're aiming that by March 2016 all patients with musculoskeletal problems will wait no longer than four weeks - over £600,000 of additional Scottish Government funding has been provided to boards to achieve this.

"We are also working to ensure that the wait for other Allied Health Professional services will be no longer than 18 weeks."

Contextual targeting label: 
Health

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