Care for older people – keep it local, keep it simple, keep it affordable

Melanie Henwood in Community Care (wwwcommunitycare.co.uk) today reports on the findings of the Partnerships for Older People Projects (Popp) initiative.

This scheme was funded by the Department of Health to the tune of £ 60m to develop services for older people to promote their health, well-being and independence, and prevent or delay their need for higher intensity or institutional care. Twenty-nine councils in England were involved as sites for the pilots.

Popp was focused on improving health and well-being for older people through local projects and services. These were to be ­person-centred and integrated, featuring strong partnerships between local organisations such as Age Concern and involving older people. Some 264,000 people using services were involved with the pilots over the course of three years.

Overall, 81% of respondents agreed that improvements had been delivered in the quality of life and well-being of older people using services, and a similar proportion agreed that a greater range of services was being offered to older people as a result of Popp.

Interestingly, the greatest improvements were reported by older people receiving practical help. Services providing practical support, often viewed pejoratively as ‘low level’, were found to significantly affect health and well-being.  These included providing simple aids and adaptations to make self-care easier such as a grab-rail attached to a lavatory, bath or shower.  Similarly, providing gardening services or making simple repairs was found to reduce anxiety.

Considered as a whole, the report found that there was a high probability (86%) that the Popp programme was cost-effective compared with usual care. Projects focused on practical help, small housing repairs, gardening, limited assistive technology or shopping indicated a 98% probability of cost-effectiveness for an extra spend of £5,000 a person (£96.15 a week).

Melanie Henwood notes that policy in health and social care for older people has, for some years, emphasised the importance of :

• partnership working
• integration
• prevention of ill-health
• promotion of wider well-being and independence
• development of social capital
• engaging local people in the design and operation of local services.

Although there has been “an underlying assumption that such a service shift would eventually bring cost savings” there has been, until now, little evidence to back this up. The findings of the Popps programme, however, provide valuable evidence that early interventions can deliver improved outcomes and greater satisfaction and reduce the need for hospital and other higher dependency services.

As Melanie Henwood says, providing this new government understands and embraces the potential for system-wide change that the report suggests, this could be a win-win both to the health care system and, above all, to the lives of older people.