Sixty Second Interview with Gordon Lishman
By Maria Ahmed
Gordon Lishman is director general of Age Concern.
The government’s revised national service framework for older people aims to raise the standard of care for older people. What do you think about the aims of the new NSF and are they achievable?
We welcome the emphasis given to essential standards of care for older people, which have been sadly lacking for quite some time. The commitment to improve older people’s mental health and services such as footcare and oral health are welcome but will need to be backed up with resources. The aims are achievable but will require strong leadership and a change of culture across social care and the NHS. Neither leadership or cultural change are entirely the responsibility of managers. Professional groups need to place a much stronger emphasis on respect for service users and for their human and other rights.
The government’s rhetoric around improving standards of care is centred on promoting dignity for older people – what do you think this should mean in practice?
Dignity is a theme which resonates very strongly with older people. The Dignity and Older Europeans project, which the ‘Next steps’ report refers to, gives some very clear ideas about what this means in practice – including getting to know a person before delivering care, using respectful language and gestures, and respecting individuals’ habits and values. One of the most important insights in this paper is the importance that older people place on maintaining their personal identities as one of the foundations of dignity. Services provided to older people need to reflect this basic human need. In short it means thinking of older people as equal citizens and acting accordingly.
What kind of resources are needed to ensure the revised NSF can be implemented properly?
There is a clear need for additional financial resources for social care. The scale of those resources and how they should be met will be part of the remit of the Minister’s review group which I have agreed to serve on. The main resources however will continue to be the workforce who deliver health and social care to older people – at the moment the training and development of staff simply does not prepare them adequately for the fact that older people are the main group using services. We need a major change in training and workforce development to match skills with older people’s needs and aspirations.
What progress has been made since the first NSF for older people was published in 2001?
The standards which very clearly focused (such as those for intermediate care and stroke care) have seen the best progress. Older people have not been well served by some of the other standards, such as those for mental health services and care in general hospitals, where greater priority has been given to other targets. Although many age discriminatory policies have amended, there remains much to do in terms of cultural change.
How do you think the Wanless recommendations could help the government achieve the aspirations of raising standards of care for older people?
The funding issues clearly need to be worked through. But the concept of ‘partnership in care’ is attractive in helping to emphasise the equal contribution that older people can and do make to the provision of care.