In November 2013, Healthcare Improvement Scotland was requested by the Scottish Government to update the Clinical Standards for Older People in Acute Care (2002) and to expand the scope of the standards to include both acute and community hospitals.
The standards should be read alongside related national work and policy including Standards for Dementia Care and Standards for Food, Fluid and Nutritional care. As a result of national work relating to hip fracture since the publication of the 2002 standards, hip fracture as a tracer condition has not been included in these standards. A tracer condition has been included for falls management (Standard 10) and further information regarding its selection is available in Appendix 1.
The revised standards supersede all previous older people in acute care standards provided by Healthcare Improvement Scotland’s predecessor organisations.
A project group, chaired by Dr Christine McAlpine (Geriatric Medicine Specialty Advisor to the Chief Medical Officer, NHS Greater Glasgow and Clyde) was convened in January 2014 to consider the 2002 standards and other documents, to help identify key themes for standards development. Sub-groups of the project groups were established to take this work forward under relevant themes.
For information, membership of the project group is set out in Appendix 2.
A project reference group was established which included members of the Whittle Group who were tasked to report on the review of the methodology and process for the inspection and the care of older people in acute hospitals and other subject experts; see Appendix 3 for membership.
Scope of the draft standards
The revised standards are relevant to all patients and members of the public, and apply to all healthcare organisations and practitioners, including independent healthcare providers.
Standards have been developed on involving patients (Standard 1) and consent and decision-making (Standard 2). Some of the criteria presented under these standards apply to all standards for older people.
Although the standards apply specifically to healthcare settings, they have been developed in recognition of the integration of health and social care services and the principles that apply to standards in both areas.
Information for patients and members of the public
It should be noted that this is a technical document, developed to support staff to ensure the highest standards of care of older people in hospital wherever healthcare is delivered. Each standard details what patients and the public can expect of healthcare services in Scotland following implementation.
Format of the draft standards
The revised standards cover the four themes indicated below:
- Person-centred care
- Safe and effective care
- Cognitive impairment, and
- Care transitions.
All our standards follow the same format. Each standard includes a statement of the level of performance to be achieved, a rationale providing reasons why the standard is considered important, and a list of criteria describing the structures, processes and outcomes. Within these standards, all criteria are considered to be ‘essential’ or required in order to demonstrate that the standard has been met.
