Matching services to needs in the health care of elderly people

This paper is based on the results of a postal enquiry to health care professionals working in the care of elderly people in a Scottish Health Board. Responses fall into three main categories. The first refers to issues of process, where lack of information or delays in response create problems. Second, there are problems of scarcity, with both lack of provision and pressures on existing provision. Third, the responses relate to the impact of constrained choices, which are the consequences of that scarcity: either people are sent to existing services because of a lack of alternatives, or people cannot be referred on appropriately because of the lack of alternatives. The process of referral is, then, affected directly by the options that are available. In the process, compromises have to be made, and this produces mismatches between needs and services.