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The care of frail older people with complex needs: time for a revolution


The Sir Roger Bannister Health Summit, held at Leeds Castle, Kent in November 2011, offered The King’s Fund an opportunity to invite academics, practitioners, policy-makers and representatives from patient and voluntary organisations to discuss the care of frail older people with complex health problems.

The summit included discussion of a study The King’s Fund had undertaken into the care of older people in hospital ­– Continuity of care for older hospital patients: A call for action ­– but also included home care.

Key points

The Care of Frail Older People with Complex Needs: Time for a revolution summarises the discussion, looking at the challenges of caring for frail older people:

  • the model of acute care is geared to treatment and cure and is not well suited to patients with complex needs

  • older people’s care lacks social and professional status

  • working conditions of nurses, care assistants and home care workers are poor

  • as older people account for the majority of patients, all staff working with adults should have basic training relevant to their care including awareness and skills in working with patients who are cognitively impaired

  • caring for older people with complex needs is physically and emotionally demanding and staff need support.

The summit concluded that the quality of interactions and relationships between frail older people and professional caregivers is shaped by the team and the organisational ‘climate’ of care.  Effective managers and staff working in a supportive organisational context could remedy many of the problems encountered by patients and carers in both their own homes and hospital. The summit recommended that responsibility for quality of care and outcomes for patients should rest with the ward manager or community team leader, who should also have control over their resources. The main purpose of decisions and actions taken at other levels of the system should be to enable frontline staff to do their work.