Assessment of Older People's Health and Social Care Needs and ...

Discussion Points from theFinal Session_r--------------------------------In the time for discussion following the final session of the Conference, the points raised related to:• the need to focus first on infrastructural deficits and inequalities.assessment, Care Plans and the ambulance service.Focus on Infrastructural Variations and InequalitiesThe view was expressed that the issue for people in the health services is not lack of clarity aboutfuture directions, but a reluctance on the part of the Irish people to pay for what is needed. It waspointed out that there is a plethora of strategies, goals and gUidelines, none of which are beingimplemented. The immediate focus should be on addressing infrastructural variations within andbetween different counties. More beds and personnel are needed and when that deficit is addressed,perhaps people could begin to talk about a national assessment framework.Assessment, Care Plans and. Ambulance ServicesExperiences of difficulties created for patients and staff when ambulance drivers refuse to crossboundary lines in the greater Dublin area were presented. This applies in the case of patients whoseneeds and preferences have been assessed, following which Care Plans are devised, involving a rotaof visits to different family members. If, on a stay with one relative, the patient has an extension of acondition such as a stroke and needs to go to hospital by ambulance, patients are taken to thehospital on call in the relative's catchment area, which may not be the hospital where the patient hasoriginally been assessed and treated and which holds all of the relevant records. Records are notshared between the hospitals and the outcome is that all of the completed needs assessments areinvalidated.Assessment of Older People's Health and Social Care Needs and Preferences