abcd
Does current government policy
sufficiently incorporate the key
determinants when tackling inequalities
in older people’s health?
An examination of current Government policy to
tackle the inequalities older people experience
Michaela Willmott, Age Concern England
Determinants of health:
Dahlgren & Whitehead’s model
Key approaches
 Health inequalities
Saving Lives: our healthier nation
Tackling health inequalities
From Vision to Reality
 Improving quality and measuring change
National Service Frameworks
National Institute for Clinical Excellence
Policy context
The NHS Plan
Saving Lives: our healthier nation
The New NHS: modern, dependable
(The NSF for older People)
Inequalities agenda
 Definition of inequalities
 Increasing life expectancy and reducing
mortality
 Focus on early years
 Disease specific
The NSF for Older People
 Whole systems approach
 Health and social care services
 Standard on promoting an active
healthy life in older age
 Rooting out age discrimination
 Person-centred care
 Relationship to other NSFs
Age discrimination
“On my last visit, I was informed by a nurse
that my grandmother had been a ‘naughty
girl’ because she hadn’t eaten her dinner.
After the nurse had left, another patient took
me aside and informed me that they had
placed her food out of reach... without
enquiring whether she needed any
assistance”
Age discrimination
“It was only because I spoke out that I got the
treatment I needed. But most older people
won’t and that worries me a lot.”
“I didn’t become different - just older”
Ways forward
Consistency of policy and resources
 Hospital downrating
 Long term care
Involving older people
Quality measurement
Ways forward
Age discrimination
 Cultural change
 Policy audit
 Legislation
 Structural change
 Partnerships
Conclusion
 Age discrimination
 Involving older people
 Life course approach