Prevention Package for Older People

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Prevention Package for Older People

• Footcare Review

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• Context
• Prevention Programme
• Footcare Review
• Models
• Local examples
• Discussion

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How big a problem?

• Unable to cut toe nails alone
• over 65 men 22 women 36
• over 85 men 51 women 64

The fastest growing age group in the population
are those aged 80 years and over who currently
constitute 4.5 per cent (2,749,507) of the total
population. This age group has increased by
over 1.1 million between 1981 and 2007. 65 20
- more than under 16s
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Drivers
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Policy
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Old age is the new middle age!

• Older people are already entitled to a range of
  preventative services, including flu vaccinations
  and eye care, cancer screening services are
  coming on line.. But we need to do more and my
  intention is to develop a prevention package to
  improve the support we give to older people
• Rt Hon Alan Johnson MP, Secretary of State for
  Health 21st May 2008

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New Commitments

• As a first step in developing the package we
  will..
• Review the provision of footcare services to
  ensure that particularly toenail cutting is made
  more accessible to older people and delivered in
  an integrated way across all providers of such
  services

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Also in Prevention Package

• New focus on innovative healthcare such as
  telecare
• Reduce waiting times for assessment and treatment
  of adult progressive hearing loss
• Use an expert group to help the NHS to better
  commission services for falls, fractures and
  osteoporosis

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Footcare ReviewWhat's been happening?

• Ministerial announcement May 21st 2008
• Consultation event - June
• Stakeholder event - July 30th
• AHP Bulletin - August
• Commissioner event - Sept 15th
• Review team Nov, Feb, March
• NHS Operating Framework - December
• SHA AHP Leads - Jan
• Chiropody Concern Feb
• Documentation through DH process - March
• Announcement launch April 2009

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Review team

• Three meetings
• DH Project Lead
• AHP Advisor
• Pod Managers - MT/CB/AW
• SCP rep Joanna Brown

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Objectives

• Promote an increased range of models that will
  increase access to safe footcare services..
• Improve the health and wellbeing of older people
  and increase mobility
• By increasing mobility ensure older people have
  access to physical and other activity
• Improve quality of life

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Scope

• Client group low/reduced medical risk 50
• Footcare defined as
• Toe nail cutting
• Skin care
• Footwear advice
• Prevention advice
• Signposting

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Work streams

• Producing a communication strategy
• Guidance to individuals, families carers
• Commissioning guidance
• Good practice models
• Evidence base
• Impact and equality assessment
• Core competencies

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1. Communication Outputs

• Your health, your choices
• DH guidance document
• Launch material

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2. Guidance for public

• Material
• Websites
• Raised profile

Footcare for Ageing Feet A self help guide for
the over 50s
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3. Commissioning

• WCC model
• Health Impact
• Policy drivers
• Review local situation
• Choice
• Personal budget holders
• Quality and performance management

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4. Models a resource pack

• Innovative Local Solutions
• NHS Podiatry Funded
• Social Care - Funded
• Private Podiatry Practice - Fee
• Voluntary Orgrs Age Concern Fee
• Independent Orgs Social Enterprise,
  funding streams
• Training

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Key Issues

• Governance professional links
• Training
• Low risk
• Employment status
• Funding streams
• Management
• Sustainability

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5. Evidence Base

• Evidence of need
• Safe Services
• Improve health and wellbeing
• Cost savings

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6. Impact Assessment

• Impact on equality?
• Services?
• NHS service? Free at the point of care?
• Training
• Myth busting
• Funding

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7. Workforce Competence

• AHP20 Footcare Support Worker
• Communication
• Equality Diversity
• Health Safety Security
• Safeguarding protect individuals
• Planning/preparation for and addressing of health
  inequalities
• Provision of facilities, estates and logistics
  for healthcare
• Management Administration of health care
• Education and learning around health

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Elements of the career framework
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Assistant Practitioners/Associate Practitioners
Level 4 Probably studying for foundation degrees,
BTEC higher or HND. Some of their remit will
involve them in delivering protocol-based
clinical care that had previously been In the
remit of registered professionals, under the
direction and supervision of a state registered
practitioner.
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Senior Healthcare Assistants/Technicians Level
3 Have a higher level of responsibility than
support worker, probably studying for, or have
attained NVQ level 3, or Assessment of Prior
Experiential Learning (APEL).
Support Workers Level 2 Frequently with the job
title of Healthcare Assistant or Health Care
Technician probably studying for or has attained
NVQ Level 2.
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Issues

• Be careful what you wish for!
• Who is driving the change in your area?
• What are the implications for services?
• What are the patient safety risks?
• What do we need to know now?
• What do we need to do next?