Provision of specialist continuing care services for older adults across the UK

Background: Older people with mental health problems who meet needs based criteria for National Health Service (NHS) continuing care funding may be cared for in a variety of settings. These services have evolved due to socio-economic and political pressure, with the extent of movement of care from traditional NHS run long stay units into the private sector being unclear. Little attention has been paid to the best model of service provision for this group in terms of quality of care, patient outcomes, and cost effectiveness. Methods: A literature review was conducted in order to explore what is known about service models for long-term psychiatric care for older people and their cost effectiveness. Following this review, an online survey was conducted in order to establish current specialist continuing care service provision by provider organizations, as well as any planned developments in services. Results: The way specialist mental health continuing care services are provided in the United Kingdom (UK) varies, with just 45% (33) of NHS providers still operating their own services. Specialist mental health continuing care is an area of current service review for a number of organizations. Conclusions: Specialist care services for older adults with mental health problems in the UK are changing, but there is a lack of research on models of service delivery for this group of vulnerable individuals with complex needs. In the context of financial pressures within the NHS, and an increasing awareness of the need to develop and improve quality of services both for those with dementia and other mental illnesses, an urgent need for further research in this area is identified.