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The National Service Framework for Older People (DoH, 2001) is a ten‐year plan which aims radically to improve health services for older people. Central to the plan is the belief that older people should be involved as ‘genuine partners’ in the implementation process. In this article we describe how regional and local implementation teams in the North West of England are working in partnership to develop a coherent and sustainable strategy for engaging with older people.

In this article we report findings from a small scale user‐controlled study which explores involvement and engagement in terms of the legacy of the National Service Framework for Older People (NSFOP) and the new opportunities that are opening up around community well‐being and active citizenship. A key finding of the study is that, when participating in implementation of a major policy initiative, older people's reference groups and forums require good support: practical help with administrative tasks and more professionalised support to help develop members' skills as activists and campaigners. We distill what this means for practice in a commissioning framework which can be used to specify support services that may be provided to older people's groups by external organisations such as the voluntary and community sector. Here, involvement and engagement are understood as a dynamic relationship between three stakeholder groups (older people, the statutory sector, and the voluntary and community sector). We pinpoint likely tensions in these relationships and how they might be addressed.

This rapid assessment aims to focus on the perceptions of healthcare staff from Welsh Health Boards on the National Service Framework (NSF) for Older People.

A questionnaire was sent by email to key colleagues in each of the seven Health Boards. This was crucial for this rapid assessment and conferred the additional advantage of also allowing for correspondence to be undertaken. Anonymity was crucial to allow colleagues to score their returns honestly.

Overall, the position was equivocal and the impact of the NSF was perceived as too difficult to assess. The most promising element of the NSF appeared to be a perception on the impact on joint health and social care working.

A rapid assessment exercise, using existing networks that are built on trust, can yield valid and useful information which can help policy development.

The NSF urgently needs to provide evidence of positive impact. The next stage, based on a focussed approach, offers an opportunity to progress this.

For the first time, a rapid assessment has been undertaken on the Welsh NSF. This inexpensive and readily achievable approach has advantages.

English governance has repeatedly had a tendency to veer between national, regional and local centres of power and influence. This has often led to profound disagreements, sometimes even open conflict. National policy guidance is usually helpful, if developed through consultation, to steer a clear, coherent direction for the system. But a narrow, excessively top‐down, mechanistic target‐driven approach can lead to a prevailing culture of ticking boxes at the expense of real patient priorities. Government ministers and civil servants, however, are often caught in a tension between being too dogmatic, or alternatively too flexible and giving responsibility to local agencies, whereupon people may complain about a ‘postcode lottery’ in services. Balancing perspectives and narratives in a coherent way for policy development and implementation and service improvement is a major challenge of leadership. The creation of the National Institute for Mental Health in England (NIMHE) was designed to bring together the local, regional and the national in a form that would see policy and practice mutually developed and nurtured at all levels of governance.

This paper explores how Standard 8 of the NSF for Older People can help local services and communities address the health inequalities agenda. We introduce the initiatives being undertaken by eight pilot sites participating in the Pre‐Retirement Health Check Pilots Initiative managed by the Health Development Agency, and share some of the emerging themes from their work. Finally, we reflect on the links between the work of the pilots and the requirements of Standard 8, as well as the wider policy and practice implications for sustaining this work beyond the life of the project.

Joint reviews are an approach to partnership working between those involved in inspection and regulation. They provide great opportunities and some challenges. This article describes a case study of the review of the National Service Framework for Older People. It discusses culture and commitment, organisational imperatives and governance.

This article reports on a national project being developed by the Royal National Institute of the Blind. It is aimed at improving health and social care for older people with sight problems, by focusing on some of the standards of the National Service Framework for older people and applying them to older people with sight problems. The project will identify, develop and disseminate good practice by establishing two pilot sites and conducting desk research.

The evaluation of primary and other care services for older people remains difficult due to the challenges of cost‐effective sampling and assessment of older people's views. The internet is an increasingly attractive option for evaluation due to its low cost and flexibility of use. The purpose of this paper is to report on a pilot study into the use of a web‐platform with older people.

A sample of 552 community dwelling men and women, aged at least 50 years, participated in an epidemiologic study conducted entirely remotely which included questions on the provision of services for older people.

The sample was heterogeneous being 52 per cent male, an age range of 50‐95 years (x¯=64 years) and with 13 per cent being in the two most deprived categories of social deprivation. Awareness of the National Service Framework for older people was low (14 per cent). For areas covered by the policy satisfaction with the availability of services was generally high (>70 per cent), whilst satisfaction with level of consultation was low (≤30 per cent).

This study shows that the internet is a viable technology for the evaluation of primary and other care services in older people.

Examines the issues faced in the implementation of the National Service Framework for Older People from the perspective of the risk manager in secondary care. It suggests that a paucity of published data about clinical risks and incidence of errors in this age group make it difficult to gauge the level of risk to older people within the UK’s health‐care system. The themes of patient safety and risk management are given insufficient emphasis in the NSF. By neglecting the role of the clinical risk manager in the safe implementation of the NSF, many opportunities for learning from adverse events could be lost. An efficient means to assess, disseminate, learn and progress from the problems encountered in caring for older people is called for.