Policy and Initiatives Focused on the Older Population

Welcome to Older People section of Physiopedia

This section is being created as part of a project undertaken through AGILE (Chartered Society of Physiotherapy Clinical Interest Group of Physiotherapists working with Older People in the UK).  Please do not edit these pages until the project is complete, but feel free to contact the author with any comments. 

Original Editor - Bhanu Ramaswamy as part of the AGILE Project.

Lead Editors - Your name will be added here if you are a lead editor on this page.  Read more.

Policy[edit | edit source]

The topic of 'Policy' is of relevance to physiotherapy. Agreeing and establishing policy requires an outline of expected outcome. This primes services to implement policy detail through chosen frameworks. Physiotherapy representation in relevant health and educational policy is achieved only by understanding how to ensure our value is recognised. When major policy is due to be drafted, we need to provide information of relevance to the drafts and attempt to be included in the process first hand.

The term ‘policy’ relates to a plan of action adopted by an individual or social group to guide decisions. Policy might be produced to determine foreign, health, insurance, monetary and security policies to name but a few.

Older people are more individually distinct than other segments of the population. Diversity exists in respect of social class, race, ethnicity and culture; differences are reflected in values, customs and beliefs, political affiliation, levels of education and material well-being. It is important that policy reflects these variations.

As with any ‘user group’, older people are helping to shape policy and practice. The Joseph Rowntree Foundation (an independent development and social research charity) conducted research by running 18 projects to review older people experiences, service responses and involvement in setting agendas. Some of the issues they defined as central to their lives included advocacy, quality, views on ‘modern’ healthcare and money. The project highlighted hitherto unrecognised needs of this population.

Health care policy has undergone change progressing from a model of treating ‘illness’ to a model of maintaining and promoting health. There is greater emphasis on the integration of health and social services, something of particular relevance to the care of older people. Although health provision differs according to each of the devolved UK nations, the trend in all countries in the UK is to increase the quality of clinical practice and service delivery through clinical governance (CG) and evidence-based practice, with the establishment of organisations such as NICE (National Institute of Clinical Health and Excellence), Care Quality Commission (CQC) in England, Quality Improvement Scotland, the Regulation and Quality Improvement Authority in Northern Ireland and the Healthcare Inspectorate in Wales. Reform is aimed towards making the health service less bureaucratic through continued decentralisation, accountability and transparency

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Internationally, the World Health Report, first published in 1995, is the World Health Organization’s leading annual publication. It provides expert assessment focusing on a global health subject plus provides country-specific statistics. It also provides countries, donor agencies, international organisations etc with information to permit policy and funding decisions, as well as providing professionals or those with personal interest in international health data.

The latest World Health Report (2008) reviews the necessity of primary health care (PHC) renewal. It cites globalisation as putting the social cohesion of many countries under stress, affecting health systems. As they are not performing as well as they could, it also notes peoples’ increasing impatience with the inability of health services to deliver efficient care.

Below are some sites containing UK-relevant health policy.

Scotland

Wales

England

Ireland


Discussion Point

Look up the most recent health policy of relevance to the country you are in as well as local policy where you are working or are on placement. Does the document tackle issues of relevance to the older population? With regards the local policy, does the final Business Plan specifically include physiotherapists specifically, or just medical and nursing colleagues?



Further Reading

Landry et al (2007). Shifting the Public-Private Mix: A Policy Analysis of Physical Therapy Funding in Ontario. Physiotherapy Canada;59; 255 - 265
The paper uses Policy Case Study as part of the methodology to develop a conceptual framework for analysing the public-private mix of funding of physiotherapy in Ontario.