Too many older people are not receiving the right care at the right time and in the right place, according to a leading social care expert from the University of Birmingham.

Despite government spending of £900 million to promote care closer to home, this week’s health White Paper fails to build on this investment, says Dr Jon Glasby from the University’s Health Services Management Centre (HSMC).

“The White Paper is strong on rhetoric but needs more practical detail” says Dr Glasby.  “At present, people are queuing for services in the community, queuing to get into A&E, queuing to get from A&E into a hospital bed and queuing to get out of hospital again at the other end.  Tackling this requires a long-term commitment, and it’s not clear if the White Paper is sufficient to deliver.”

Dr Glasby continues: “In 2000, the government announced an extra £900 million for intermediate care and commissioned several large-scale national evaluations.  They now seem to have moved on to the next ‘big idea’ without seeing the first one through – this is a long-term agenda and one that needs ongoing commitment and leadership”.

The White Paper was published on the same day as the launch of a three-year evaluation of intermediate care – half way house services between hospital and the community - carried out by the Universities of Birmingham, Leicester and Sheffield. 

This and other recent national studies found that new intermediate care services have the potential to make a crucial difference to the lives of older people and to be a key element of current government attempts to promote services in community settings. 

Despite this, the White Paper made very little reference to intermediate care and did not draw on key messages from the emerging evidence, such as:

The positive impact that intermediate care can have on older people’s confidence, quality of life and independence.

The opportunity to act as a bridge and to provide a transition between different locations (from home to hospital and vice versa).

Tensions that can develop between health and social care, and between intermediate care, primary care and hospital services.

The ad hoc nature of many intermediate care projects, which have often evolved over time as separate initiatives with time-limited funding.  As a result, intermediate care is often seen as an add-on option to existing services, rather than a core part of NHS business.

Greater scope to develop support for older people with mental health problems, to work with the voluntary sector and to develop housing-based services.


Notes to Editors:

Dr Jon Glasby is head of health and social care and a senior lecturer at the Health Services Management Centre, University of Birmingham.

He is also a member of the national evaluation of the costs and outcomes of intermediate care commissioned by the Department of Health and the Medical Research Council (2002-2005).

A summary of the research report by the Universities of Birmingham, Leicester and Sheffield, entitled A National Evaluation of the Costs and Outcomes of Intermediate Care for Older People, is available on the HMSC website. Click here to view the PDF

Intermediate care is a key government priority and a central feature of the current reform of older people’s services.  In 2000, the government’s NHS Plan announced an additional £900 million investment in new intermediate care services to prevent unnecessary hospital admissions, facilitate swift and timely hospital discharges and prevent premature admissions to permanent residential and nursing care.

The government’s health and social care White Paper, Our Health, Our Care, Our Say, was published on 30th January 2006 and is available online, visit:

Further information / interview requests:

Rachel Robson – Head of News Team, University of Birmingham

Tel: 0121 414 6681 / email: / mob: 07789 921165