Older people in acute hospitals inspections and older people in acute care improvement programme

Review report

The following reports highlight the review process and recommendations arising from a review of the ‘older people in acute hospitals inspections and older people in acute care improvement programme’ carried out between May 2016 and May 2017. 

Healthcare Improvement Scotland supports two programmes of work focused on improving the care of older people: the Older People in Acute Hospitals Inspection Programme (OPAH) and the Older People in Acute Care (OPAC) Improvement Programme, both of which are commissioned by the Chief Nursing Officer Directorate at Scottish Government.
Whilst both programmes are based in acute care, their work programmes have developed over the years to support a range of different priorities.

In May 2016, a multi-agency strategic review group was established by Healthcare Improvement Scotland to review both programmes with the support of the Scottish Government. The aim of the review was “to explore how Healthcare Improvement Scotland can most effectively continue to support improvement and provide assurance in older peoples care.”

The strategic review group was co-chaired by Heidi May, Executive Director Nursing, Midwifery and Allied Health Professionals, NHS Highland, representing the Scottish Executive Nurse Directors and Pam Whittle CBE, Chair, Scottish Health Council and Healthcare Improvement Scotland non-executive director. Membership of the group included representatives from NHS boards, third sector organisations, public partners, national bodies and Scottish Government.

The aim of the review process was to understand how effective the current OPAH and OPAC programmes are at enabling improvements in older people’s care. Over 200 NHS staff were interviewed as part of an independent review process and the findings from this have been used to inform the thinking of the strategic review group and its recommendations.

During the timespan of this review, a number of significant changes and developments have taken place in health and social care which have influenced thinking and helped to shape the review, including the development of Healthcare Improvement Scotland’s Quality of Care Approach.

At present, the OPAH and OPAC programmes have focused on acute hospital care. To better reflect the experience of older people in different hospital settings across Scotland, the Chief Nursing Officer has requested Healthcare Improvement Scotland to consider expanding both programmes to community hospitals and specialist dementia units. It was, therefore, decided that a review of the OPAH and OPAC programmes for expansion beyond acute care should be conducted at the same time rather than independently. Work has already started on a programme of improvement support for specialist dementia units as part of the Focus on Dementia portfolio. Work to consider the models and resources required to expand the programmes will be taken forward in collaboration with the Chief Nursing Officer Directorate and a range of stakeholders.

A series of 15 recommendations are outlined on pages 32 and 33 of the strategic review group report which will be taken forward by Healthcare Improvement Scotland in collaboration with a range of stakeholders. Progress against the recommendations will be overseen by Healthcare Improvement Scotland’s Quality Committee.

Published Date: 13 October 2017