British Geriatrics Society

BGS Northern Ireland Manifesto - 2011

Old Age Concerns

BGS Northern Ireland (BGS NI) Election Priorities for 2011

Good quality care costs, poor quality [care] costs society more. ¹

Your Health Matters, The Annual Report of the Chief Medical Officer for Northern Ireland 2009

The British Geriatrics Society (BGS) seeks to promote better health and care for older people. Its membership includes the vast majority of health professionals who shape and deliver healthcare to older people in Northern Ireland.

This manifesto sets out the Northern Ireland Branch of the BGS’s key priorities for the 2011 election.

Context: Ageing Northern Ireland

There are around 1.75 million people in Northern Ireland² of whom 249,900 are aged 65 and over³ . Similar to most European countries, we are an ageing society. Currently about 14% of our population is 65 and over, but by 2041, individuals aged 65 and over will comprise about 25% of our population⁴.

As we age our risk of illness and disability increases. With disability and illness our use of health and social care resources increases.

Health and social care services are facing unprecedented financial challenges at a time of increasing demand. For older people health and social care needs are inextricably linked. Short term attempts to reduce social care costs are likely to result in increased health care costs as a consequence of individuals being unnecessarily delayed in hospital beds while waiting for social care packages at home to be arranged and financed. Rising to meet these challenges will be complex and difficult, but Northern Ireland has the unique advantage of a fully integrated health and social care system.

BGS NI believes that we need to prioritise healthier ageing strategies and work hard to ensure the most efficient, effective use of health and social care resources.

The patient and Client Council has identified the care of older people as one of three health priorities for people in Northern Ireland, while the Chief Medical Officer for Northern Ireland pointed out: ‘Good quality care costs, poor quality care costs society more’.⁵

Principles of Care

The BGS believes that to treat and care for people effectively, respect their dignity and treat them as equal citizens, healthcare must be structured and delivered on the following principles. The BGS believes that care should:

• promote independence and, as far as possible, respect older people’s choices to live the lives that they choose and to die where they choose;
• be holistic and person centred;
• be evidence-based and focused on outcomes, not outputs;
• be based on a full and complete assessment and diagnosis;
• be compassionate and caring;
• be based on need, not age, and promote fair and equal treatment for older people;
• be multidisciplinary, regardless of setting, and integrate the services of health, social and community care professionals to provide a seamless service.

Priorities for Action

Older people will always be the principal users of health and social care services and should therefore be central to the design and delivery of these services.

1. Health promotion activity should support people to remain as physically active and as socially engaged as possible, as they age

This approach will deliver benefits for the individual, their wider family circle and to society in general, by reducing the burden of chronic disease (e.g. heart disease, cancer, and depression), promoting independence and reducing dependency and social isolation.

2. Most health and social care provision should be available through community based services

These services should be delivered by a range of professionals / individuals who have appropriate skills in assessment, diagnosis and treatment. The service should be delivered in a timely fashion to enable individuals to remain independent for as long as is possible, ideally in their own homes.

3. No individual should enter long term care (residential or nursing) without being offered a comprehensive assessment and rehabilitation by skilled professionals

Evidence suggests that comprehensive assessment offers an individual a chance to improve independence, reduce their risk of admission to hospital or long term care and improves their quality of life. Currently there is no provision for universal comprehensive assessment prior to placement in residential or nursing home care. Figures show that Northern Ireland has higher rates of institutional care than other devolved nations. The move to institutional care is often regarded as a devastating event for the person and can be an extremely costly way of caring for people if it is not required.

4. Individuals living in care homes must have better access to appropriate health care

People living in care homes are highly vulnerable through complex disease patterns and high prevalence of dementias but evidence suggests that these individuals often have the poorest access to medical care. The BGS NI believes that new patterns of working between GPs, other primary care clinicians, specialist nurses and older people’s medical specialists should be developed to improve medical care for care home and nursing home residents. New models of care should promote opportunities for residents or their families (where appropriate) to consider future care wishes, including end of life and palliative care, and have these recorded and respected.

5. Palliative care services

Palliative care services for older people should be extended to cover equally a full range of conditions, notably dementia. It should not just be cancer focused.

6. Hospital services provided on the basis of need, not age

When older people require services in hospital they must have equitable access to the whole range of services they are likely to gain benefit from. Individuals should not be delayed in hospital if their needs can be better met in their own homes.

7. Dignity and respect for individual service users should be the central tenet of all Northern Ireland health and social care services

We all identify with the need to be respected and treated with dignity. This need is critical when we are vulnerable through illness.  Treating people with dignity and respect is a hallmark of quality care.6  Unfortunately older people report instances where they have been treated with less dignity and respect than is their due, by health and social care professions, because of their age.⁷ The BGS is committed to improve quality care through public campaigns: the 2007 Behind Closed Doors⁸ campaign and last year’s Don’t Forget the Person campaign.⁹ BGS NI will continue to work with all statutory and voluntary bodies to promote dignity in care.

ABOUT THE BGS

The British Geriatrics Society is a membership association for medical professionals specialising in the care of older people.

The British Geriatrics Society (BGS) was founded in 1947 for “the relief of suffering and distress amongst the aged and infirm by the improvement of standards of medical care for such persons, the holding of meetings and the publication and distribution of the results of research”. It has branches throughout the United Kingdom and has over 2,500 members including doctors practising geriatric medicine, old age psychiatrists, general practitioners, nurses, therapists and scientists. For more information on the BGS please contact Tom Thorpe MCIPR, Press, PR & Parliamentary Affairs Officer on 07779 269 182 or This email address is being protected from spambots. You need JavaScript enabled to view it.

Download facts and figures about ageing and health in Northern Ireland (MSWord format)

References

1. Your Health Matters, The Annual Report of the Chief Medical Officer for Northern Ireland 2009, Department of Health, Social Services and Public Safety, 2010, 4.
2. Ibid., Table 1A Northern Ireland: Sex and Age Distribution of Population and Percentage of Total Population in Each Age Group (2008).
3. Ibid.
4. Office of the First Minister and Deputy First Minister, Examining the Case for a Commissioner for Older People – Final Report, May 2008, 5.
5. Department of Health, Social Services and Public Safety, 2010, op. cit., p. 4.
6. Age NI, Strategic Plan, 2010, 4.
7. Age NI (Age Concern and Help the Aged NI), One Voice, Shaping our ageing society in Northern Ireland, 2009, 6-7.
8. BGS 2006 Behind Closed Doors - Dignity Campaign
9. BGS 2010 Don't Forget the Person - Dignity Campaign