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National service frameworks and strategies

National service framework for older people

People are living longer than ever before, and the proportion of older people in our society is growing.

This is rightly a cause for celebration. However, population ageing, with the fastest rise in the ‘oldest old’, means that the overall number of people in our society with health or care needs has risen. In turn, this has altered the very nature of our health and care services, with older people now the biggest users. This trend holds new responsibilities for the NHS and social care in helping older people stay healthy, active and independent for as long as possible.

Since its launch in 2001, the National Service Framework (NSF) for Older People (PDF, 510kb) has helped the NHS, social care and other organisations move significantly closer to this vision. By building stronger partnerships between NHS organisations, local councils, the private sector and older people themselves, the NSF for Older People helped bring about faster, more integrated care for older people.

Designed as a 10-year programme, the NSF contains eight standards relating to older people’s services covering the full range of care older people need. The standards embody fundamental principles ensuring care is based on clinical need, not age, and that services treat older people as individuals, promoting their quality of life, independence, dignity and their right to make choices about their own care.

The NSF also set out specific goals for tackling some of the most common conditions and problems in older people, eg falls. It also made the improvement of intermediate care a priority. Intermediate care speeds up hospital discharge and helps people get better in their own homes or in supported community settings. It also helps older people avoid crisis and emergency hospital admissions through timely and more personalised care.

The NSF for Older People provided direction and a focus on improvement in older people's services. All of the original standards in the NSF have ongoing relevance and are still clinically valid. However, in some areas, these standards have been developed much further, an example being the national dementia strategy. Also, many of the standards are now the subject of specific policy including the implementation of the Equality Act 2010 and the National Stroke Strategy (PDF, 1.04Mb).

What does the NSF mean for you?

The goal is to keep you healthier in older age. The NSF promoted more proactive and systematic health checks for older people, and challenged against attitudes about what older people can and want to do to stay healthy and more active.

What else has the NSF achieved?

  • Increased the numbers of older people that are benefiting from the seasonal flu vaccination programme. In 2011, 6.6m older people have received the vaccine (73.6%), out of a total of 9m.
  • Older people can expect to receive help with early diagnosis of dementia and other mental health problems.
  • Older people wanting to improve their fitness are increasingly likely to find innovative community programmes promoting physical exercise. Programmes such as Champions Show the Way by Bradford District Care Trust, which encourages over-50s to become community health champions. The project sees these community health champions increase their knowledge about the benefits of healthy eating, physical activity and the importance of looking after mental wellbeing. This enables them to develop and lead activities in their community that benefit the health and wellbeing of participants (mainly people who’ve recently been discharged from hospital or who suffer from a long-term health condition).

Better care, closer to your home

In the past, if you had hospital treatment, the lack of appropriate support, care and equipment available could often delay your discharge and stop you returning home to recover. The NSF has been a driving force in reversing this trend, with the number of delayed discharges no longer rising.

Major investment in intermediate care (bridging the gap between hospital and home) was a key goal of this transformation. This included:

  • Funding for extra care housing. This led to imaginative schemes across the country and more choice for older people needing flexible, longer-term support from health and social care teams.
  • Families caring for older people can expect better financial support, with a greater impetus on getting community services to attract older volunteers.

Watch this video about local community support schemes.


Joining up your care

Many older people cope with more than one illness and need more than one type of care. The NSF said connecting these complex services and creating a single, tailored care package is a priority for teams working across hospital, primary and community care services.

For older people suffering from the conditions that commonly affect their age group (including stroke, falls and incontinence), care is increasingly being delivered by specialist networks of professionals working across primary, community and hospital settings.

Keep on the road for longer

Keep on the road for longer (PDF, 1.28Mb) is a leaflet about health and social care prevention services for people aged 50 and over and aims to help maintain good health, wellbeing and independence. The leaflet gives details of current 'entitlements' for heatlh and social care services that may be accessed. Bringing together this information is part of the Department of Health's contribution to the ageing strategy.

Older people’s prevention services offer advice, support or interventions to help older people to live independently for longer, or if unwell to regain their independence and to prevent or delay the onset of further health problems. 


Page last reviewed: 11/05/2012

Next review due: 11/05/2014

Key facts

People over 65 account for the highest activity and spend across primary, secondary and social care.

The Department of Health (DH) is actively monitoring the numbers of delayed transfers of care between acute and other care settings across the country, and is working to identify any trends or outlying organisations. On January 3 2012, the DH announced that there would be an extra £150m available to help manage winter pressures and help bring down numbers of delays.


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