NICE Guidance Calls for Better Integration of Social and Medical Care for Older People

A more person-centred approach to the provision of care for older people with complex social and medical needs has been called for by NICE.

The number of people with long-term conditions, such as dementia, diabetes, heart disease, and cancer, is set to rise by around 1 million in the next 3-5 years (in line with a rise in the number of older people in the population) and pressure on existing services is set to grow.

There has been much debate within the NHS, social care and the wider public, over how best to serve both the social and medical needs of this group and now NICE has joined the debate, publishing new guidance on the management of older people with multiple chronic condition and social care needs.

The guidance is aimed at social care providers as well as health practitioners, managers and commissioners and aims to improve quality of life, increase independence, choice, dignity and control, through a more person-centred approach

Key recommendations include:

·         Ensuring that each patient is treated as whole, rather than on a symptom by symptom basis, and that they are treated with dignity and respect at all times.

·         Having a single, named care coordinator for each patient, who acts as their first point of contact.  Leading the assessment process, liaising and working with all health and social care services (public, private and voluntary services).  Ensuring referrals are made and actioned appropriately.

·         Ensuring that care plans are updated regularly, to recognise the changing needs of the patient, recognising the progressive nature of many conditions.

·         Ensuring that patients are given choice and control over decisions made about their care.

·         Bringing together specialist teams to review and manage care, including community pharmacists, physiotherapists or occupational therapists,  mental health social workers or psychiatrists, and  community-based services liaison workers as appropriate.

Bernard Walker, Independent Consultant in social care, health and management, and Chair of the guideline development group, said: “When social care and health practitioners work together well, it helps both people using services and their carers to have choice and control over their care. It also avoids unnecessary duplication of services.

“As a committee, which brought together a knowledgeable group of experts including practitioners, carers and people who use services, we recognised how critically important this issue is. Better integration of health and social care services is best practice to which everyone involved in the care of older people with complex care needs and multiple long-term conditions should aspire.” 

Professor Gillian Leng, Deputy Chief Executive for NICE, added: “An estimated 6 million people in England aged 60 and over are living with more than one long-term health condition.

“As the number of older people in society increases, this figure is expected to rise too. A recent report by Age UK warned that a further one million older people in England could be living with multiple long-term conditions by 2020. This will inevitably put pressure on health and social care services and our new guideline highlights ways to best address the growing needs of this group.”