Long term care of older people.

Abstract

Car manufacturers have responded radically to the challenge of global competition; they have revolutionised assembly through technology, just-in-time inventories, team working, and a focus on quality; they have optimised component supply by forging long term contracts based on mutual help and trust; they have introduced customer focus into relationships with car purchasers. This exemplifies how industry has recognised the need for effective strategic management when crisis looms. Why then, when Britain faces the unprecedented strategic challenge of the long term care of older people, is there increasing evidence of strategic drift? Two issues are of particular concern and may lead to increased costs: they are the poor assessment of eligibility of older people for long term care, and poor quality of care. Evidence of the present inadequacy of eligibility assessment in Britain is beginning to emerge.1 A recent audit report disclosed a disturbing level of inappropriate placement, even after poor …