An ageing population: getting it right

Abstract

Across all four UK countries, from a health and social care perspective, we have seen a number of serious cases where lessons need to be learnt for all organisations in relation to the ageing population. In my experience, most organisations are able to describe improvement work or plans they have in place to improve how their care. A key principle is the application of a standard that is delivered in an individualised, person-centred way. Improvement and development in the care of the ageing population will continue to be scrutinised and monitored by all inspectorates in the four UK countries. Some inspections will be announced, some unannounced. But does all this monitoring and inspecting really work? Some of the key elements we need to improve in our care of an ageing population are: ■ Dementia/cognitive impairment ■ Dignity and respect ■ Food, fluid and nutrition ■ Pressure area care ■ Falls. Training, development and awareness in the nursing teams are critical. Only with these in place can the teams that care for patients and their families with dementia across primary, secondary and social care provide services that are safe, effective, and personand carer-centred. Across NHS Scotland, we have seen the development of a National Dementia Champion Programme to which all NHS Boards in Scotland have contributed positively. I see too that some organisations have created a ward specially for the ageing population so that they can build up an evidence base as to whether this approach can improve outcomes for patients and their carers. Some organisations have developed specific policies, such as Right Patient, Right Meal, Right Time (RPRMRT). The purpose of this policy is selfexplanatory. Its aim is to put the patient at the centre of the mealtime experience. Importantly, policy implementation involves the display of a visible up-todate RPRMRT ward protocol. As part of the RPRMRT policy, some organisations use the ‘red mat/tray’ system to identify patients who require assistance at mealtimes. Other systems include the use of the kitchen whiteboard and the ward safety brief to communicate special requirements. According to the NHS Trust/Board Director of Nursing Papers on Quality, accessible via all NHS Trust/ Board websites, there are high levels of compliance in most areas in relation to protected mealtimes, correct meal choice and assistance with eating. The Clinical Quality Indicator (CQI) for Food, Fluid and Nutrition (FFN) can measure the process and outcome and is used as evidence to check compliance against the relevant policies and standards. However, the evidence Rory Farrelly NHS Greater Glasgow and Clyde Director of Nursing Acute Services Division suggests that all organisations find that delivering these policies can be challenging. Across the UK, the Releasing Time to Care (RTTC) meals module was developed to improve the mealtime experience for patients. These tools include observations of mealtimes, questionnaires for staff and patients, and the introduction of the mealtime coordinator role.