Engage Programme

Salisbury NHS Foundation Trust


There are around 9.7 million people over the age of 65 years old in the United Kingdom. With one in five UK citizens estimated to be over 65 years old by 2020, providing health care appropriate to the needs of older people is becoming a major concern for health care systems.

In the National Health Service (NHS), around 66% of inpatients are over 65 years of age and despite having additional and complex care needs, the care of older adults still has major deficits. For example, the Dignity in Practice Report highlighted several shortcomings in care which included a loss of independence, dignity and autonomy alongside personal identity. A lack of staff time can also be a cause of additional difficulties including a detrimental effect on wellbeing.

In particular, depression has become an increasing concern in older adults in hospital with over twice as many people experiencing depression in hospital than in the community. The implications for older adults in hospital with depression are serious, as many of its symptoms, including poor motivation and changes in sleep and appetite, have a negative impact on physical recovery. Anxiety is often comorbid with depression because it reduces quality of life and delays healing.

After examining the literature in this area alongside gathering qualitative data from our patients, we put together the Engage programme in order to improve the psychological care that older adults receive in hospital. By utilising volunteer skills, we were able to develop and implement specialist volunteer interventions that aimed to target specific areas of concern such as rising levels of anxiety, depression and social isolation.

The programme has been successfully run across all mixed and older adult wards across the hospital. Its evaluation has shown a positive impact on levels of depression, anxiety and also length of hospital stay.