Achieving high quality long-term care for elderly people: consumers' wishes and providers' responsibilities

The organisation of long-term care for older people has major implications for all hospital and community health services. However, even health professionals have a poor understanding of the structure and purpose of long-term care and national professional bodies are still not giving enough attention to the issues involved. In the wider context, care of disabled older people has received little public debate in the UK despite the ethical, social, and financial issues involved and despite the recent major organisational changes in the health service. The past ten years have seen a huge expansion in private residential and nursing homes with a concomitant fall in NHS long-stay beds. Currently, approximately 500,000 elderly people in the UK are living in some form of long-stay care facility, and many other elderly people with multiple disabilities are being supported at home and should also be included under the umbrella of long-term care. Ensuring appropriate, equitable, and high-quality care is a responsibility not only for health and social services but also for society as a whole. This conference, organised jointly by the Royal College of Physicians, the British Geriatrics Society, and Age Concern England, with support from the Department of Health, was a much-needed and welcomed initiative. Over 200 delegates attended, consisting of doctors (geriatricians, psychiatrists, general practitioners), nurses (public and private sector), social services representatives, Department of Health representatives, managers of nursing homes, and members of charities such as Age Concern and the Relatives Association.