Improving care for older people

Why is this important?

Advances in health care have helped people in England to live longer than ever before.  As a result, the number of older people in England is growing significantly and this rate of growth is projected to speed up over the next 20 years.  This is good news for all of us but it creates a challenge for the NHS – as we get older we tend to get long term conditions and need more health and social care.

Our ageing population

  • More than one in five of us are already over 60, and the number of people over 60 is expected to increase from 14.9 million in 2014 to 18.5 million in 2025 (ONS, 2015).
  • 75% of 75 year olds in the UK have more than one long term condition, rising to 82% of 85 year olds (Barnett et al, 2012).
  • Between 2007/08 and 2013/14 the numbers of A&E attendances by people aged 60 or over increased by two-thirds, a steeper increase than is expected by demographic change alone (NHS England data, 2015).

If we don’t improve the way we provide support to older people then the NHS will struggle to meet the increasing demand for resources as well as changing patient needs. 

How old is an older person?

Generally, someone over the age of 65 might be considered an older person.  However, it is not easy to apply a strict definition because people can biologically age at different rates so, for example, someone aged 75 may be healthier than someone aged 60.  Instead of simply age, ‘frailty’ has a bigger impact on their likelihood to require care and support.

How is NHS England making it happen?

NHS England is working with partners to support people in England to age well.  There is always something we can do to improve our health and wellbeing. For older people who may be starting to find things more difficult, it is particularly important to take active steps to slow down or reverse some of the health challenges we are all likely to face. It is essential that older people are supported to remain as healthy and independent as possible for as long as possible and they receive the highest quality care when they need it.  To do this we are working with partners across health and social care to:

  • Reframe frailty as a long term condition to be identified and managed alongside other long term conditions;
  • Reduce the amount of time someone spends in long term ill health in later life through early identification and offering support and self-management through, for example, healthy ageing and healthy caring guides;
  • Supporting public services to work together to support people. This includes safe and well visits carried out by the fire and rescue service, who also work with people to identify common health and fire risks;
  • Identify and support implementation of best practice interventions for key stages of frailty;
  • Promote proactive frailty case finding (identifying people at risk of frailty) to target prevention strategies among those most at risk of ageing with multiple long term conditions, for example Toolkit for General practice in supporting older people living with frailty;
  • Promote personalised care planning which documents people’s preferences and supports choices about key aspects of care towards the end of life for people with advanced frailty.

Many of these approaches are being put into practice by the Vanguard sites who are developing new care models that include supporting older people and those with long term conditions to have better, joined up health and care services. NHS has also worked with stakeholders to develop a Practical Guide to Healthy Ageing and a Practical Guide to Healthy Caring.

For more information contact us at england.longtermconditions@nhs.net