Opportunity Age – Opportunity and security throughout life
Annex 1 – Assessing the quality of life of older people: the outcomes we want and the indicators that matter
Purpose
Chapter 5 asks for your views on how we assess and track progress towards the objectives of this strategy.
We need to find a balanced way of assessing what constitutes quality of life for older people to further the principles of the strategy set out in its chapter. This provides the basis for identifying the outcomes and indicators of progress that matter most. We have to be selective, because the potential range of factors is so wide. The outcomes and their indicators will become the means of assessing periodically our overall progress towards enabling older people to achieve a higher quality of life. We see this as an important tool for central government and local authorities, voluntary bodies and the private sector. Its purpose is to assess directional progress, not set a basis for inspection or performance assessment procedures.
Our intention is not to add to the target regimes that already apply to central government, health services and local authorities. Indeed we expect to use those targets among the wider range of indicators of progress. Some will be indicators of service-delivery outputs, others of outcomes (eg health) and some will draw on subjective survey responses from older people.
Grouped under key headings, each of which constitutes a significant dimension of the quality of life, our aim is to provide:
- a balanced assessment of progress and gaps;
- a means of unifying a variety of different target and performance regimes around the objectives of the strategy; and
- a resource to enable different players to assess how the development of their own performance regimes can evolve to serve our common purpose.
The means
Following consultation with partner organisations, the following five domains were agreed as the most relevant to assessing progress in older people's quality of life:
- independence within inclusive communities;
- healthy, active living;
- fairness in work and later life;
- material well-being; and
- support and care.
The emphasis here is the quality of life. Trends in the employment of older people and the improvement of their skills will continue to be assessed separately within the regimes being developed by the Department for Work and Pensions (DWP) to assess the impact of their programmes to help unemployed and inactive people. The Department for Education and Skills will also develop their assessment of progress towards the objectives of the recent Skills White Paper.
Chart A1 under the heading of quality of life, provides an overview of the five domains and lists the key questions that need to be addressed to assess progress. These provide a straightforward basis for identifying the measurable dimensions that matter most. Overall, the chart provides a snapshot of the ground we should cover in assessing progress and the inter-relationship between domains, while minimising confusing overlaps.
Do respondents believe we have captured the key elements and questions?
Chart A2 illustrates how we intend to move from the key questions for each domain to an easy-to-follow template for measuring and assessing progress within each domain by applying it to 'independence within inclusive communities'. The 'what matters most' column identifies the main areas for assessment. Suggested indicators (we propose no more than about four) are logged against each area. And for each area we would propose to assess the trend overall. A balanced scorecard at the bottom of the page would sum up the overall picture.
Do respondents find this a transparent way of presenting assessments?
Do respondents have suggestions about the key areas for measurement and the best indicators/sources?
Charts A3 to A6 repeat that process for the other key domains identified in Chart A1, but without the illustrative indicators we have provided for 'independence within inclusive communities'.
We would welcome views on relevant indicators and the right balance necessary to measure progress nationally and locally. Clearly, some domains may be more relevant to one level than another when it comes to determining the development of responses – for example, although incomes may vary from area to area, national responses are likely be more effective.
Guidance on selection of data and indicators
Good data and indicators are:
- relevant to the success criteria against which this strategy will be measured, based on the Government's values and Public Service Agreements relevant to ageing (listed at the end of this annex) for ageing;
- specific to older people, or broken down by age groups that identify older people. The exception to this is data indicative of preparing for later life, such as better planning for retirement;
- focused on achieving outcomes, though outputs that contribute critically to those outcomes should be included (for example, the volume of recipients of Pension Credit has a bearing on the incomes of pensioners);
- based on information that is publicly available, including locally gathered information that should be available to the local community as well as for local authority, audit and inspection purposes; and
- sufficiently robust to demonstrate meaningful, convincing trends.
Next steps
We invite responses by 28 July.
In parallel, we will consider:
- how to develop this assessment model alongside other relevant exercises such as Opportunity for All, further work by DWP on measuring material well-being and pensioner poverty, and major academic research projects;
- how best to involve stakeholders in the development of the model and the periodic publication of assessments, building on the Minister of State's (Work and Pensions) Partnership Group; and
- the frequency of publication of assessments, taking account of the key phases of central and local authority performance regimes.
We will announce our conclusions in the autumn.
These proposals apply to England only. In Wales, separate dialogue will be undertaken by the Welsh Local Government Association on this issue, and there are different arrangements in Scotland.
Chart A1: Quality of life domains
| Quality of life | ||||
| Independence within inclusive communities | Healthy, active living | Fairness in work and later life | Material well-being | Support and care |
| Are older people exercising independence? | Is access to healthcare proportionate to older people's needs? | Are older people able to find jobs if they want them and are they treated fairly in employment? | Are retired people able to sustain key elements of their previous lifestyle? | Is the supply of care and support responsive to what people need? |
| Are older people able to exercise choices that give them control over key aspects of their lives? | Are people remaining in good health for longer? | Are older people involved equitably in the decisions that affect their lives? | Are extremes of poverty and deprivation being tackled? | Is support available in a variety of forms to meet diverse needs? |
| Are older people able to participate as much as they wish in their local community? | Are older people taking measures to maintain their health and fitness? | Are older people unfairly exploited? | Do older people have sufficient wealth to provide them with security in retirement? | Does the care available enable older people to maintain their independence and quality of life? |
| How can we reduce the damaging isolation of older people? | Are older people mentally and physically active? | Is there evidence of age discrimination in access to goods, services and employment? | Are older people able to use their resources to best effect? | Is care affordable? |
| Are people planning ahead for retirement? | Are care standards protecting older people from abuse? | |||
| Are informal sources of care, especially carers within the family, being facilitated and supported? | ||||
Chart A2: Independence within inclusive communities
| Key questions | What matters most | Possible indicators | What do the indicators show? | |||
|---|---|---|---|---|---|---|
Are older people exercising independence? Are older people able to exercise choices that give them control over key aspects of their lives? Are older people able to participate as much as they wish in their local community? How can we reduce damaging isolation of older people? |
Housing and the home. Quality of housing, suitability for older people's needs. Availability of suitable adaptations | 1. Decent homes - social and private sector | 2. Percentage of people in receipt of care who enter residential care; numbers supported to remain at home | 3. Choice over where people live | 4. | |
| Neighbourhood and security. Location of homes in safe and secure local environments | 1. Older people as victims of crime compared with the rest of the population | 2. Perceptions of safety | 3. | 4. | ||
| Social networks and involvement. Evidence of intergenerational interaction / isolation | 1. Frequency / type of contact with family and friends | 2. Examples of intergenerational engagement | 3. Use of local leisure facilities | 4. Ad hoc local transport surveys | ||
| Getting out and and about. Public and private transport, evidence of mobility, access to facilities and services | 1. Access to key places using local transport? | 2. Access to a car | 3. Take up of concessionary fares | 4. Ad hoc local transport surveys | ||
| Information and choice. Evidence of ease of access to the information older people need and evidence of the availability of real choices | 1. Older people's knowledge of key information sources | 2. | 3. | 4. | ||
| Perceptions of independence. Evidence that older people feel that they are independent | 1. Evidence of choices exercised by older people | 2 | 3 | 4 | ||
| Balanced Scorecard [Narrative assessment of the overall picture derived from the indicators] | ||||||
Chart A3: Healthy, active living
| Key questions | What matters most | Possible indicators | What do the indicators show? | |||
|---|---|---|---|---|---|---|
Is access to healthcare proportionate to older people's needs? Are people remaining in good health for longer? Are older people taking measures to maintain their health and fitness? Are older people mentally and physically active? | Living longer and healthier lives. Evidence of increase in healthy life expectancy and reduced morbidity, trends in debilitating mental illness | 1. | 2. | 3. | 4. | |
| Freedom from disease or injury. Evidence of incidence of illness or injury that inhibits activity and choice | 1. | 2. | 3. | 4. | ||
| Access to treatment. Availability of appropriate treatment at point of need and smooth transition into appropriate support and care | 1. | 2. | 3. | 4. | ||
| Keeping healthy and active. Evidence of healthier lifestyle choices being adopted throughout the life cycle. Evidence of takeup of learning and leisure opportunities | 1. | 2. | 3. | 4. | ||
| Balanced Scorecard [Narrative assessment of the overall picture derived from the indicators] | ||||||
Chart A4: Fairness in and out of work
| Key questions | What matters most | Possible indicators | What do the indicators show? | |||
|---|---|---|---|---|---|---|
Are older people able to find jobs if they want them and are older people treated fairly in employment? Are older people involved equitably in decisions that affect their lives? Are older people unfairly exploited? Is there evidence of age discrimination in access to goods, services and employment? |
Employment. Evidence of participation and equality of opportunity in the labour market | 1. | 2. | 3. | 4. | |
| Goods and services. Evidence that older people can access goods and services as required | 1. | 2. | 3. | 4. | ||
| Consultation. Evidence of opportunities for older people to have their say and make a difference, particularly when decisions affect their lives | 1. | 2. | 3. | 4. | ||
| Balanced Scorecard [Narrative assessment of the overall picture derived from the indicators] | ||||||
Chart A5: Material well-being
| Key questions | What matters most | Possible indicators | What do the indicators show? | |||
|---|---|---|---|---|---|---|
|
Are retired people able to sustain key elements of their previous lifestyle? Are extremes of poverty and deprivation being tackled? Do older people have sufficient wealth to provide them with security in retirement? Are older people able to use their resources to best effect? Are people planning ahead for retirement? |
Incomes. Evidence of trends in income relative to the median, and income disparities | 1. | 2. | 3. | 4. | |
| Expenditure. Evidence of consumption patterns which show that main needs are being met (eg ability to meet home maintenance costs and routine household expenditure) | 1. | 2. | 3. | 4. | ||
| Poverty. Evidence of trends in extremes of low income and take-up of entitlements to raise incomes | 1. | 2. | 3. | 4. | ||
| Wealth. Evidence of trends in capital assets, to provide people with security against unexpected financial demands, and their use (eg equity release) | 1. | 2. | 3. | 4. | ||
| Planning ahead and informed decisions. Measures taken early in the lifecourse can help ensure that income in retirement matches expectations. Increased financial awareness should lead to better planning for retirement | 1. | 2. | 3. | 4. | ||
| Balanced Scorecard [Narrative assessment of the overall picture derived from the indicators] | ||||||
Chart A6: Support and care
| Key questions | What matters most | Possible indicators | What do the indicators show? | |||
|---|---|---|---|---|---|---|
Is the supply of care and support responsive to what people need? Is support available in a variety of forms to meet diverse needs? Does the care available enable older people to maintain their independence and quality of life? Is care affordable? Are Care Standards protecting people against abuse? Are informal sources of care, especially carers, within the family, being facilitated and supported? |
Need for care. Evidence of availability of care to match need | 1. | 2. | 3. | 4. | |
| Intensive care at home, residential care, nursing homes and sheltered accommodation. Evidence of different types of care available | 1. | 2. | 3. | 4. | ||
| Provision of lower level care and home adaptations. Evidence of availability of low-level support at home | 1. | 2. | 3. | 4. | ||
| Informal care from carers (friends, relatives). Evidence of support available for carers | 1. | 2. | 3. | 4. | ||
| Effective care standards. Evidence of measures in place that are effective in preventing vulnerable people being abused | 1. | 2. | 3. | 4. | ||
| Balanced Scorecard [Narrative assessment of the overall picture derived from the indicators] | ||||||
Relevant Public Service Agreements – key departments
Department of Health
PSA 8: improve the quality of life and independence of vulnerable older people by supporting them to live in their own homes where possible by:
- increasing the proportion of older people being supported to live in their own home by 1 per cent annually in 2007 and 2008; and
- increasing by 2008 the proportion of those supported intensively to live at home to 34 per cent of the total of those being supported at home or in residential care.
Office of the Deputy Prime Minister
PSA 7: by 2010, bring all social housing into a decent condition, with most of this improvement taking place in deprived areas, and, for vulnerable households in the private sector, including families with children, and increase the proportion who live in homes that are in decent condition.
Department for Work and Pensions
PSA 4: as part of the wider objective of full employment in every region, over the three years to spring 2008, and taking account of the economic cycle:
- demonstrate progress on increasing the employment rate, jointly with HM Treasury;
- increase the employment rates of disadvantaged groups (lone parents, ethnic minorities, people aged 50 and over, those with the lowest qualifications and those living in the local authority wards with the poorest initial labour market position); and
- significantly reduce the difference between the employment rates of the disadvantaged groups and the overall rate.
PSA 6: by 2008, be paying Pension Credit to at least 3.2 million pensioner households, while maintaining a focus on the most disadvantaged by ensuring that at least 2.2 million of these households are in receipt of the Guarantee Credit.
PSA 7: improve working-age individuals' awareness of their retirement provision such that, by 2007/08, 15.4 million individuals are regularly issued a pension forecast and 60,000 successful pension traces are undertaken a year.
Department for Environment, Food and Rural Affairs
PSA 4: reduce the gap in productivity between the least well performing quartile of rural areas and the English median by 2008, demonstrating progress by 2006, and improve the accessibility of services for people in rural areas.
PSA 7: eliminate fuel poverty in vulnerable households in England by 2010 in line with the Government's Fuel Poverty Strategy Objectives.