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Abstract
The National Service Framework for Older People (NSFOP) highlights the need for comprehensive assessment of the health and social needs in the community. The system of 75 and over checks at the four doctors' practices in Trowbridge, Wiltshire was reviewed and recommendations made in the light of the NSFOP People aged 75 and over not seen by a health or social care professional for two years were identified and offered an assessment. This targeted case finding approach, although identifying fewer people than anticipated, generated considerable work. Significantly, a third of the people visited had undiagnosed hypertension. It was hoped that 'at risk' groups would be identifiable from GP electronic records: that this was not possible has serious implications for primary care group/trusts (PCG/Ts) who will need to produce accurate statistics for effective targeting of services in response to the NSFOP The profile of carers was examined and accurate data on carers was not available from general practice records. Finally, older peoples' views on the assessments were obtained, and show that dialogue with older people to prioritise services needed for them in their community is important and should be on-going.
Key words: NSF for Older People, primary care, targeting services
Community practitioner 2002; 75, 6: 211-213
Introduction
It is predicted that between 1995 and 2025, the number of people over the age of 80 will increase by almost half.1 The National Service Framework for Older People sets out standards on stroke and falls prevention, the rooting out of age discrimination, and the promotion of good mental health and active life in older people. Carers' needs are to be considered integrally with those of older people, and standards have been set with a series of national milestones to ensure progress.
The 75 and over annual health checks, introduced in 1990, were part of the new contract for GPs.2 They were intended to assess physical, mental and social functioning, and, where possible, were to be carried out in the home. The contract, however, lacked clear guidelines and GPs found difficulty with its implementation. Rigorous evaluation of different approaches was advocated but not carried out.3 Early findings of massive unmet need had not been confirmed by later research, which showed that older people were no longer...