The Healthy Ageing Strategy was launched in Parliament on 13th December as the replacement for the 2002 Health of Older People Strategy.
Associate Health Minister Sam Lotu Iiga speaking at the launch in his final official act as Minister before standing down, praised all those involved in developing the new Strategy over the past two years. He also explained the reason for re-naming the Strategy, saying it represented a change in focus. The new Healthy Ageing Strategy has a strong emphasis on prevention, wellness and support for independent living, and a greater focus on the most vulnerable, including people with high and complex needs and those in the final stages of life.
The final version of the Strategy includes a number of changes from the draft version that NZCCSS commented in on in the October Kete Kupu edition, but the overall vision remains unchanged:
“Older people live well, age well and have a respectful end of life in age-friendly communities”
A stronger focus on equity in the vision section is a welcome change (p.20 Healthy Ageing Strategy). This recognises that some population groups have markedly poorer health outcomes than others, such as Māori, Pacific peoples as well as people living with intellectual disabilities or those who are living in social and economic hardship. The vision is to remove barriers that prevent different groups achieving better health outcomes, actively enabling equal opportunity through directing resources to where they are most needed and working across government on the social and economic factors (such as housing, discrimination, elder abuse, and social isolation) that contribute to poorer health outcomes.
The Strategy emphasises the importance of the health workforce (p.35) in achieving the vision and there is a commitment to invest in the home and community workforce, and develop service and funding models that are sustainable, culturally appropriate, equitable and person-centred. Similarly the role of family/whānau and community carers and support is identified (p.40), including paying attention to the training needs of those in the carer role as well as recognising carers’ own physical and mental health needs.
The most important part of the Strategy is of course the Action Plan, which sets out the steps that will be taken over the next two years and beyond to progress towards the five outcome areas of the plan. Five outcome areas make up the substance of the plan and there are 26 specific actions identified across those outcomes, with some actions identified as priorities for the first two years of the Strategy:
- Ageing well
- Acute and restorative care
- Living well with long-term conditions
- Support for people with high and complex needs
- Respectful end of life
Building age-friendly communities and addressing the socio-economic determinants of health feature strongly in the actions in the first two years. A cross-government working party aimed at improving housing options for older people will be established, but this not included in the priorities for the first two years.
Under acute and restorative care, all the action areas are prioritised for the next two years. Reducing acute admissions, improving assessment processes and supporting rehabilitation closer to home are all set to be implemented or continue existing programmes.
An additional action area aimed at improved models of care for home and community services has been added in the final strategy under living well with long-term conditions. Improving oral health for older people in all care and support settings is now under this action area, having been previously included under ageing well.
Most of the action areas relating to support for people with high and complex needs are not identified as being implemented in the next two years. In fact, developing a “frailty idenitficaton tool” and standard referral and discharge protocols between different health providers, including aged care, are the only actions receiving short-term priority. A review of the quality of home and community support and aged residential care is however clearly signaled under Action 16.
Actions relating to end-of-life care in the next two years are aimed at implementing the actions from the review of Palliative Care Services and the Te Ara Whakapiri: principles and guidance for the last days of life document. A national survey of of patient, family and whānua carers’ experience of end-of-life care is also signaled.
The next step for the Strategy is producing an implementation plan for the various actions identified. A deadline of four months after the release of the Strategy is set for this work, which means mid-March 2017. The Ministry has signaled that it will be working with a wide range of partners to develop this. This includes a commitment to evaluate and regularly review the implementation progress, something that was not achieved under the previous Strategy.
Read more about the Healthy Ageing Strategy on the Ministry of Health website: http://www.health.govt.nz/publication/healthy-ageing-strategy/