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Survey reveals healthcare ‘postcode lottery’ for older people in Scotland

The SCOoP audit revealed an inequality of services for older patients. Supplied via Shutterstock.
The SCOoP audit revealed an inequality of services for older patients. Supplied via Shutterstock.

A survey carried out by Aberdeen University has suggested older people face a “postcode lottery” for healthcare.

The Scottish Care of Older People (Scoop) national audit project, was carried out in 2019 to assess whether and to what extent the provision of geriatric care, known as Comprehensive Geriatric Assessment (CGA) varied across the country.

The audit included 26 out of the 28 hospitals that provide acute care for older people in Scotland, including rural locations in the Highlands.

Now the research, led by Aberdeen University, has been published in the Healthcare journal.


One of the primary findings of the report was that the largest health boards have proportionately higher provision and availability of care, which did not always correlate to the size of the population, meaning there is a disparity between regions.

The variations were found in staffing, physiotherapy, occupational therapy, psychiatry, pharmacy and social work as well as multidisciplinary team input.

Christine McAlpine, co-chairwoman of the Scoop Steering group said: “This is an important finding.

“CGA is effective in producing better outcomes in older people and in the context of an increasing ageing population with multi-morbidity and frailty, it is important that hospitals evaluate their CGA provision to ensure the highest standard of care for older people admitted to hospitals and optimal outcome.”

The report provides insight to understand the standards of care, improvement and the factors needed for the best possible care in older people.

Issues among staffing were also included, underlining difficulties for recruiting staff to “rural and remote” areas.

Research should be used to improve services

Phyo Myint, professor of medicine of old age and co-chairman of the steering group, added: “Our findings provide essential information for clinicians, service providers, policy makers and the public to improve their local services.

“Our results should offer a basis for opening discussion between services to learn from each other’s expertise as we aim to work collaboratively to improve acute care for frail older adults in Scotland and shape Scottish Geriatric Medicine into a world-leading service.”

The audit shows the need for health boards across the country to collaborate and share expertise from regular audits.

Rowan Wallace, chairman of the British Geriatrics Society Scotland welcomed the findings and said: “BGS Scotland fully supports the ScooP report findings and how they powerfully highlight the variations in how CGA can be accessed, structured and staffed in acute care across Scotland by our older population.”

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