We need a new culture of care for older people

As the population ages, we need to end the tug of war between funding and innovation.

As the population ages, we need to end the tug of war between funding and innovation

Audio editorial


With the proportion of the population over 65 years set to rise to one in five people by 2030, the need and demand for skilled health and social care practitioners is expected to rise too.

An effective future workforce must promote health, well-being and self-care in later life, while managing the consequences of frailty, long-term conditions and co-morbidities in an ageing population.

Working with older people should be one of the main career development opportunities for nurses over the next three decades. However, the status of nursing older people is mixed, and is likely to remain so until there is a shift in culture towards older people themselves.

In this month’s issue our analysis of recent high-level reviews of the status and future of health and social care reveals some of the tensions in the system, with funding pressures and innovative practice at either end of a tug of war.

Picture: iStock

There are pockets of progress in the integration of care sectors, but a stranglehold on funding for social care.

Workforce factors, such as low pay, low status and lack of future progression, are contributing to demoralisation, and high nursing vacancy and turnover rates in the social care workforce.    

Health and social care services must embrace ways to value, retain and reward nurses working with older people. This will involve not only pay increases, but also sectors working together to foster a new culture of care for older people.

In this culture the intrinsic rewards of such care will be recognised. There should be universal adoption of a professional model of service and care, opportunities for specialist knowledge and skills development, established career pathways from assistant to advanced practitioner, and systems of mentorship and peer support with feedback involving managers, peers and patients.

This is not a speculative vision; it must be the future.

About the author



Nicky Hayes is nurse consultant for older people at King’s College Hospital NHS Foundation Trust, London, and consultant editor of Nursing Older People