OPAH standards

Inspecting the care of older people

Our standards will form an integral part of our current inspection programme into the care of older people in acute hospitals.

Visit the inspections section of our website to find out more about this programme of work.

What is a standard?

A standard is a statement of an expected level of service which demonstrates delivery of person-centred, safe and effective health care, and promotes understanding, comparison and improvement of that care.

Standards can be used for national consistency and/or for local improvement.

Care of older people in hospital standards

Everyone using healthcare services in Scotland is entitled to the same level of care regardless of their age, however, it is recognised that older people are admitted more often to hospital, and can face problems not experienced by other user groups.  

We have developed standards to support staff and ensure the highest standards for the care of older people in hospital presenting with an acute episode, wherever healthcare is delivered. 

These standards supersede the 2002 Clinical standards for older people in acute care.


Purpose and scope

The revised standards support acute episodes of care of older people in hospital. The scope focuses on initial assessment after admission and on more complex journeys of care (rehabilitation, care transitions and discharge planning). The standards have been developed in recognition of the integration of health and social care services.

The standards are equally applicable to all patients using NHS services in Scotland with regard to protected characteristics under the Equality Act 2010, including age.

Older people are the focus of these standards. However, we sought not to provide a definitive age cut-off point; treatment and care will be determined by a range of considerations, including functionality. It was not felt appropriate to state that these standards applied to all people aged over 65 or 75 years of age. Each patient will be assessed based on their individual needs and preferences, and not age alone. NHS boards will be asked to demonstrate processes for access to assessment, treatment and care, for example, comprehensive geriatric assessment and falls prevention, although in recognition of health inequalities across Scotland, this may vary by NHS board.

As a consequence, the standards should be reviewed pragmatically by service providers: not every criterion will apply to all older people in hospital.

Consultation report

The above additional report details the consultation process we followed to produce our final standards.

Overview of the standards

The sections below will give you an overview on each of the sixteen standards we have developed in relation to Care of older people in hospital

Detailed information including the rationale and criteria for each standard can be found by downloading the full publication.

Older people in hospital have the opportunity and are enabled to discuss their needs and preferences, including the people they wish to be involved in their care.

Older people in hospital will be treated with dignity and privacy, particularly during communication, physical examination and activities of daily living.

Older people in hospital have the opportunity and are enabled to discuss their needs and preferences, including the people they wish to be involved in their care.

Older people have an initial assessment on admission to hospital, which identifies:

  • their current health needs and any predisposing conditions which may heighten the risk of healthcare associated harm, and
  • where care and treatment can most appropriately be provided.

Older people presenting with frailty syndromes have prompt access to a comprehensive geriatric assessment and management by a specialist team.

Pharmaceutical care contributes to the safe provision of the care for older people in hospital.

Older people in hospital have their cognitive status assessed and documented.

Older people in hospital with a confirmed or suspected diagnosis of dementia receive high quality care.

Older people in hospital are assessed for their risk of falls within 24 hours of admission, and appropriate measures put in place to reduce that risk.

Older people in hospital have access to rehabilitation services that are timely, accessible and person-centred.

Effective discharge planning is a continual process and starts as soon after admission as possible, or before admission for planned admissions. Communication, including transfer of information between healthcare and social care professionals, is essential to a seamless process of transition.

Older people in hospital are supported during periods of transition or delays between care environments through co-ordinated, person-centred and multi-agency planning.

Older people in hospital are cared for in the right place at the right time.

Older people are cared for by knowledgeable and skilled staff, with care provided at a safe staffing level.

Published Date: 9 June 2015