New proposals to improve care for vulnerable older people

The health secretary has announced he is seeking views on a set of proposals to radically improve care for vulnerable older people.

The proposals set out improvements in primary care and urgent and emergency care. They look at establishing ways for NHS and social care services to work together more effectively for the benefit of patients, both in and out of hospital.

Comments are being sought from NHS, social care and public health staff, carers and patients. People can discuss and comment on the proposals through the better health and care site.


The proposals include every vulnerable older person having a named clinician responsible for their care outside of hospital, ensuring accountability is clear and care packages are personalised and tailored around individual needs.

The other proposals include:

  • better early diagnosis and support to stay healthy by improving the role GPs play in supporting people to stay healthy and taking an active role in managing the health of their local populations
  • improving access to primary care through new types of services such as rapid walk-in access services, helping patients connect with their GP in different ways through new technology, making booking appointments easier and building on existing services and opening hours
  • providing consistent and safe out-of-hours services
  • enhancing choice and control by rolling out the friends and family test to general practice by December 2014, giving more choice about location and type of service such as seeing a preferred GP or nurse and the option of doing this face-to-face or by email and telephone
  • better sharing of information and joining up services so care can be provided in a coordinated way

Health Secretary Jeremy Hunt said:

In 65 years, the NHS has quite simply done more to improve people’s lives that any other institution in our history. But too often the people it fails are its heaviest users – our most vulnerable and elderly. Too often these people end up in hospital not by design, but simply because they can’t get the care they need elsewhere.

We need radical improvements to make sure our most vulnerable and elderly have the support they need to keep them in better health and out of hospital. With one clinician responsible for their care in the community, just as there is a consultant responsible for them in hospital.

Our immediate focus is on our most vulnerable and elderly. But this is only the starting point of a much broader transformation in out of hospital care – one which will help every single patient and make sure the NHS stays true to the values that underpinned its founding in 1948.

Over the summer, the Department of Health will seek views on the proposals, test them and the best ways to implement them. It will work with NHS England to set out a plan for improving out-of-hospital care for vulnerable older people.

The final plan will be published in October and will be reflected in the refreshed Mandate to NHS England for 2014 to 15.


  1. Jitendra S Malde says:

    I feel that some of the GP’s need training on this subject as from my experience many elderly people are ignored and GP’s say they are old which is outrageous.

  2. Clive Bowman says:

    It’s time to seriously consider what is mean’t by vulnerable, I respectfully suggest that the term has as little precision in meaning as, “frequent flyer” or “bed blocker” it is a term that stigmatises rather than create an ownership of responsibility.
    What vulnerable really means is highly dependent physically and or medically unstable in the latter phase of life where poor care and management lead to indiscriminate and inappropriate care and an extremley poor experience for the individual. .
    For the DH the challenge is to integrate health and care to move thinking on for this emerging population who are simply not served by the present NHS or social care approach’s of prevention (it’s happened) / reablement (it’s not going to happen) and telecare (not so sharp on heavy lifting). It’s also important to recognise that internationally as a country we have pushed eligibility thresholds for services very hard so that some of the present pressure on the NHS is because care and support is not enough.
    It may be creative to think about Geriatric care and Public Health coming together in local authorities and reconsider whether Ger Med and GP are configured or appropriate in their present format.