Following the consultation on a new health and social care strategy for older people, Debbie Horne reflects on what needs to change.

At Independent Age, our vision is that we can all live a happy, connected and purposeful later life. As we grow older, we should all be able to live well with dignity, choice and purpose. Central to this, is ensuring that older people can access the health and social care they need, as soon as they need it.

Earlier this month we responded to the Scottish Government’s consultation (this link will take you away from our website) on a Health and Social Care Strategy for Older People. As we emerge from the COVID-19 pandemic and the disruption caused to health and social care access and services, a renewed focus and ambition to improve the health and social care older people in Scotland receive is essential. The Scottish Government have committed to making Scotland the best place in the world to age. We believe the forthcoming health and social care strategy for older people provides the opportunity to take the first steps towards making this ambition a reality.

Through surveys and in person group discussions we heard what is working well for people in later life, what is not working and the areas that need urgent improvement to ensure the health and social care needs of older people are being met. The experiences we heard about shaped our response and recommendations to the Scottish Government.

Access to mental health support

We believe that growing older can, and should, be a positive time in someone’s life. But we know that many people face a range of challenges as they age. From lacking the care and support needed to complete everyday tasks, to not having enough money for the essentials, experiencing bereavement or feeling isolated and lonely. All these challenges can have an impact on mental health and wellbeing. We think everyone should have access to mental health support when they need it.

The Government should do more to end mental health stigma for people in later life by running public health campaigns to raise awareness of the fact that mental health problems can affect people in later life and help is out there. We also want them to represent older people in these campaigns. We’re also recommending that the Scottish Government publish data broken down by age for those waiting for and accessing talking therapies to help monitor and improve access to mental health support for people in later life.

GP access and health checks

Being able to access GPs for face to face, personalised and flexible appointments is a priority for many older people. Many of the people we spoke to shared their experience of finding it difficult to make and access GP appointments. The older people we spoke to told us:

“I think the worst thing now is if you want an appointment with the doctor you’ve got to phone at half past 8 in the morning, if you can. If I’m up at the health centre I can’t go round and make an appointment, I’ve got to go out to my car to phone for an appointment – and the phone can ring for half an hour.”

“It’s a nightmare – you actually don’t phone the doctor because of the hassle.”

We know there’s been huge pressure on the NHS throughout the pandemic, but we also know that patient satisfaction with GP surgeries has declined in recent years. We heard that many people in later life are not receiving annual health checks from GPs, which can be important in helping monitor and maintain health and wellbeing.

We want to see the Scottish Government do more to support GPs meet the needs of older people. We’re recommending that the Government work to improve access and monitor satisfaction with GP surgeries, whilst ensuring that everyone eligible can access an annual health check.

Waiting times and cancellations

We heard that many people are on a waiting list for treatment and have faced cancellations for surgeries, including hip and knee replacements. Our polling of older people in Scotland found over 40% of people waiting for surgery and treatment are experiencing daily pain. One woman waiting on a hip replacement told us:

“Three times it’s been cancelled. I’ve had the letters to go and then two days before it’s been cancelled. Then I got a phone call on the Wednesday when I was supposed to be in for it and she said ‘do you still want it’ (talking about the operation) and I said well unless I’ve got a miracle cure of course I want it.”

In our YouGov polling of all Scottish adults aged 50+ who are waiting for surgery on NHS, 29% had considered paying privately for the operation they are waiting for. We know a rise in private healthcare use will exacerbate and entrench existing health inequalities among those in later life.

We’re calling for the Government to reduce waiting times, improve communication around waiting for surgery and treatment, and ensure that everyone can wait as well as possible by receiving support and advice on things like pain management.

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