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World Health Day

Is the NHS equipped to deal with the ageing population?

We explore the challenges our health system is facing with the increasing number of older people in the UK.

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On the 7 April we celebrated World Health Day. When the World Health Organisation (WHO) launched World Health Day in 1948 the aim was to encourage focus on a single global health issue – this year's focus is access (or lack of) to universal health coverage. 

World Health Organisation Infographic
WHO created posters to promote health for all.
World Health Organisation Infographic
WHO created posters to promote health for all.

What's meant by universal health coverage? Well, WHO describe it as when 'all people have access to the quality health services they need, when and where they need them, without financial hardship.'

However, the worldwide population is ageing, and without considering the health and social care needs of the ever-increasing numbers of older people, achieving universal health coverage isn't going to be easy.

In the UK, we're lucky that 70 years since its inception the NHS remains free. It plays a vital role in maintaining our health and wellbeing but it faces a number of challenges – the ageing population being one of them. As we all get older, we're more likely to have health needs that require the NHS with a large proportion of our lifetime costs occurring in the last year of life. However, the way health and care services are organised means that there are often many missed opportunities to make sure older people stay as well as possible for as long as possible

Promoting healthy ageing

The health system currently places a strong emphasis on curative care as opposed to preventative care, meaning there's greater focus on treating people after a health need or conditions develops instead of supporting people to make it less likely they'll develop these conditions in the first place.

Why is this? Simply, it's a combination of how the system was built 70 years ago – the focus then very much being on medical treatment. Also, in the short-term, the number of people treated is much easier to quantify than the number of people who have decreased their risk of certain chronic conditions. These effects tend to be felt further down the line.

As the population ages, the number of people with disabilities, long-term conditions and multiple health conditions typically increases. But that doesn't mean there's nothing we can do about it. We can decrease the likelihood of developing health issues in later life by adopting some of the preventative measures now, like giving up smoking, eating more fruit and vegetables and staying physically active.

On top of the health benefits we'd enjoy, prevention can be the most cost-effective way to maintain the health of the population and keep the NHS free at point of delivery.

10 tips for ageing better

Follow our quick advice on the things you can do to keep yourself feeling healthier for longer.

Accessing health services

However, while we can decrease the likelihood of developing health conditions, we can't guarantee our health as we get older. People will still need to access health services in later life.

The natural effects of getting older, such as growing frailer, can make ordinary everyday tasks that little bit more difficult. As a result, older people require certain considerations from health and care services.

Conditions that predominantly affect older people, such as difficulties with hearing, seeing, walking or performing daily or social activities, are often overlooked by GP services. The increase in demand for support for older people has been poorly planned and has resulted in many finding it difficult to secure health appointments when they need them. This can result in older people disengaging from health care provision as a result of them feeling uncatered for.

Care in the community

Providing focused social and community health services may well be the answer, rather than relying on charities and family carers to fill in the gap in care provision. These services can support older people and enable them to stay independent for as long as possible.

These services can also help them manage their conditions day-to-day, making it less likely they'll need to access health services at a point of crisis.

A call in time

More than 1 million older people go over a month without speaking to a friend, neighbour or family member. And when you consider that loneliness is said to be as harmful for our health as 15 cigarettes a day, this isolation only compounds the other health problems many older people are living with, which again is felt by the health and care services.

Befriending services, such as the Call in Time service we offer at Age UK, ensure that older people's social needs are recognised and addressed, but this still requires the NHS to signpost those in social need to such services and help prevent problems down the line. An overstretched NHS and a lack of joined up thinking can result in services such as these being sidelined and wrongly perceived as unconnected to the health system.

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Health professionals must recognise these opportunities and point older people in the direction of non-medical services and support as they could enrich the lives of many older people. 

The NHS Long Term Plan

To address these challenges the Government needs to invest in better health and social care. Earlier this year, the NHS Long Term Plan was announced and in it were a number of positive developments for older people's care: enhanced care in care homes, urgent rapid response care closer to home and services aimed to support people to age well. If these are achieved, it will transform how the NHS cares for older people, with a focus on keeping them living comfortably for longer.

This is the perfect opportunity to carry out much-needed reform to how the NHS operates, to place greater emphasis on preventative measures that will reduce ill health and meet the demands of people that have health needs now, a large proportion of which will be older people.

As people live longer, it's important not only that they can access health services, but also that they can access quality services. The NHS needs to adopt a person-centred approach to care that manages the health needs of older people in a coordinated way rather than simply reacting to specific diseases individually, as and when they occur. This requires teams in physical and mental health, social care, public health and the wider public, private and voluntary sectors working together in partnership.

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Last updated: Apr 29 2019

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