Published by The King’s Fund in 2014, the report describes how the successes of modern medicine have created an ageing population and how many people stay healthy, happy and independent well into old age.

However, it also points out that as people get older they are more likely to be living with some degree of disability and long-term health problems, including frailty. This changing demographic profile is dramatically changing the health and care needs of our society and this report aims to provide a framework to help service leaders examine and improve the services they provide for older people.

The report describes and discusses ten components of good care for older people. It also highlights improving services for older people requires joint consideration of all these components since many older people use multiple services, and the quality, capacity and responsiveness of any one component will affect others.

The ten components of good care set out in the paper are:

  1. Healthy, active ageing and supporting independence;
  2. Living well with simple or stable long-term conditions;
  3. Living well with complex co-morbidities, dementia and frailty;
  4. Rapid support close to home in times of crisis;
  5. Good acute hospital care when needed;
  6. Good discharge planning and post-discharge support;
  7. Good rehabilitation and re-ablement after acute illness or injury;
  8. High-quality nursing and residential care for those who need it;
  9. Choice, control and support towards the end of life;
  10. Integration to provide person-centred co-ordinated care.

For each of these components, the report presents evidence and guidance for how to provide high-quality care, with examples of local innovations. Key issues include the appropriate use of comprehensive geriatric assessment and the effective provision of co-ordinated primary, community and social care services close to home.

The report concludes that transforming services for older people requires a fundamental shift towards care that is:

  • Co-ordinated around the full range of an individual’s needs and care;
  • Truly prioritises prevention and support for maintaining independence.

The report states that much more integrated working is needed to ensure that the right mix of services is available in the right place at the right time to meet an individual’s needs and that change to our systems of care need to be made rapidly and at a wide scale in order to achieve this.

Full report