General service improvements mask neglect of mental health provision

Claims by the Department of Health of progress in implementing the
National Service Framework for Older People have been challenged by
professionals who say some services are still being

A report by the DoH on the second anniversary of the NSF shows an
increase of 3,300 intermediate care beds and 2,000 fewer delayed

But delegates at the report’s launch, many of whom were older
people’s champions, raised concerns about mental health services
for that group of people.

One north London psychiatrist described older people with mental
health problems as “doubly stigmatised”. She said services for them
were taking second place to those for young people with mental
health problems and those for older people with physical

“Older people who are mentally ill are at the bottom of the pecking
order when it comes to services and attitudes,” she said.

There were also concerns about the NSF’s focus on the dental care
of older people.

The British Dental Association said that, although the NSF briefly
mentioned dental care, the lack of emphasis represented a missed

“We don’t see dentistry as stand alone or apart from general
health,” said Janet Clarke, chairperson of the BDA’s committee for
community and public health dentistry.

“Oral and dental services for older people need to be integrated
with other health and social care services and be joined up so that
they are not an add-on and so that when older people receive
services, dental services come automatically.”

The positioning of the standard of the health and well-being of
older people at the end of the NSF was also questioned.

But national clinical director for older people’s services Ian
Philp insisted this was due to the emphasis on age discrimination
and did not mean health and well-being was a low priority.

Other key findings from the progress report show that 98 per cent
of NHS trusts now provide single sex sleeping accommodation, 5,100
more people receive intensive home care and the number of direct
payments has doubled.

Health minister Jacqui Smith said “much progress” had been made and
that those involved could be proud of their achievements.

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