Priorities for older people

As Minister with responsibility for the health and social care of the people of Northern Ireland, I am delighted to have this opportunity to offer the readers of agendaNi some thoughts on my key priorities in relation to our older population.


Since taking up post as Health Minister in May 2015, I have been involved in a number of initiatives, discussions and debates relating to the care of our elderly community and indeed a lot of good work in this area had already being undertaken by my predecessors, including the valuable work now being done as a result of Transforming Your Care.

It is widely recognised that Northern Ireland, like many other countries around the world, has an ageing population and projections from the Northern Ireland Statistics and Research Agency indicate that the population aged 65 and over will increase by 26 per cent – some 71,000 people – by 2022.

Transforming Your Care identified, in a single comprehensive document, the serious pressures facing the health and social care system going forward. The review set out a very strong case for change, recognising that ‘no change’ was simply not an option, and made proposals on where service change would have most impact on those challenges.

At the heart of the Transforming Your Care vision is the core belief that preventative approaches deliver better outcomes and that care should be provided closer to home, avoiding unnecessary hospital visits. Transforming Your Care sets out proposals on supporting older people, including:

•   home as the hub of care for older people, with more services provided at home and in the community;

•   a major reduction in statutory residential accommodation for older people, over the next five years as a result of a focus on promoting healthy ageing, individual resilience and independence;

•   a diverse choice of provision to meet the needs of older people, with appropriate regulation and safeguards to ensure quality and protect the vulnerable.

Projects directly addressing the need for services designed to meet the needs of older people include:

•   the adoption of a regional approach to the delivery of reablement services that helps people remain independent, at home, for longer;

•   reviewing domiciliary care provision (that is linked to the work on reablement), with the aim of providing a consistent service across Northern Ireland;

•   promotion of self-directed support, which empowers service users and carers to exercise more control over their social care services by giving them as much control as they want over their personal budget, the amount of money that is identified and allocated by Health and Social Care Trusts to meet their assessed needs. This enables service users to make informed choices about how and when services are provided;

•   the establishment of 17 Integrated Care Partnerships (ICPs), which all have agreed action plans in place and funding for a range of service change initiatives.

Recently, I was delighted to announce an investment of £1 million to support the delivery of the Enhanced Care at Home Service in the Ards and North Down area. The £1 million investment is coming from the recently launched £30 million Transformation Fund which is designed to be invested in projects and initiatives which are focused on innovation and prevention.

The Enhanced Care at Home Service (EHAC) will provide support at home for older people suffering acute episodes of illness, with the support of a community geriatrician, GPs and other health and social care professionals. Since 1 September 2015, 125 patients have benefited from the service, which equates to 1,450 saved bed days. This investment will help provide the service for up to 20 clients per week. Similar schemes are already running in the Belfast LCG and Southern LCG areas.

The EHAC service demonstrates my commitment to making every effort to ensure that the care of older people and the vulnerable in our society is the best it can be.

There are big challenges ahead and it will mean taking some tough decisions, but we cannot stand by and watch the system that cares for the vulnerable in our society falter and fail.

Earlier this year, I appointed an expert panel, led by Professor Rafael Bengoa, to consider, and lead the debate on, the best model for Health and Social Care services in Northern Ireland.

It is of course good news that life expectancy in Northern Ireland is rising but a growing and ageing population presents challenges to our system. Our current health and social care model was designed in and for a different era and, as currently configured, it simply isn’t sustainable in the face of these new challenges. We need to make sure that our NHS is able to meet the whole population’s needs in the long-term and, to do so, it must change.

This is not a simple assignment and I wish the panel the very best in their work to design a model that will meet the challenges we face now and in the future.

It is only right that a similar focus is given to adult care and support. To that end, I recently announced my intention to establish a new Commission on Adult Care and Support to provide expert, independent analysis of the challenges facing the system and to think radically about what changes must be made to safeguard it for future generations.

This new Commission will consider all available evidence to assess the ability of the adult care and support system to continue to meet demand for support into the future and to consider what could and should be done to ensure it is fit for purpose. Recommendations made by the Commission will be used by my department to develop proposals for change and these will be consulted on in due course.

It is essential that we take this opportunity to put in place the reforms needed to make sure the system of the future can deliver the best care possible for our population. In doing so, we will ensure that the people of Northern Ireland can benefit from a truly world class health and social care system.

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