Ageing society demands a 'fundamental shift' in how health and care are delivered

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A fundamental shift is urgently needed in the delivery of health and care to meet the challenges of a rapidly ageing society, say the authors of a new report from The King's Fund.

The report, Making our health and care systems fit for an ageing population, argues that health and care services have failed to keep up with dramatic demographic changes, which will see one in five people in England over the age of 65 by 2030. It finds that transforming services for older people will require a fundamental shift towards care co-ordinated around individual needs rather than single diseases, and that prioritises prevention and support for maintaining independence.

The authors identify nine individual components of care that need to improve with goals which include:

  • enabling older people to live well with stable long-term conditions, avoiding unnecessary complications and acute crises
  • improving collaboration between the NHS and social care to ensure that patients can leave hospital promptly once their treatment is complete, with good support available in the community
  • ensuring that in times of crisis, older people have rapid access to urgent care, including effective alternatives to hospital.

However, to make all this happen, the key component is integrated working across teams, to ensure that the right mix of services is available in the right place at the right time.

The report offers practical advice, evidence and guidance for service leaders to provide high-quality care in each area. It also highlights examples of local innovation, including:

  • the Gnosall GP surgery in Staffordshire provides patients over 75 with an annual health review, and uses experienced ‘elder care facilitators’ to support patients, help them navigate the system and draw up care plans. This model has been positively received by patients, has reduced length of stay in hospitals and has released savings
  • the University Hospitals Birmingham Dignity for Older Patients Project, where 506 ‘dignity champions’ from different teams work to promote dignity in care, with support from regular workshops and a series of annual events
  • Newcastle West CCG, working with Newcastle City Council, has developed an ageing well strategy that includes targeted health checks aimed at identifying risk factors in those aged 40–74, and engages older people as volunteers and health champions.

David Oliver, Visiting Fellow at The King's Fund, said: 'The health and care systems have a long way to go to adapt to the twin challenges of an ageing population and tighter funding. Many local service leaders are transforming services for older people, but we urgently need to see their experiences spread more widely.

'But marginal change will not be enough; transformation is needed at scale and at pace.'

See more on this report

Notes to editors: 

For further information or to request an interview with one of the authors, please contact the Press and Public Affairs team on 020 7307 2582 (if calling out of hours, please ring 07584 146 035).

The ten components of care outlined in the report are: healthy active ageing and supporting independence; helping people to live well with simple or stable long-term conditions; helping people live with complex co-morbidities, including dementia and frailty; rapid support close to home in times of crisis; good acute hospital care when needed; good discharge planning and post-discharge support; good rehabilitation and re-ablement (outside acute hospitals) after acute illness or injury; high-quality, long-term nursing residential care for those who need it; choice, control, care and support towards the end of life; and integrated care to support older people and their families.

The King's Fund is an independent charity working to improve health and health care in England. We help to shape policy and practice through research and analysis; develop individuals, teams and organisations; promote understanding of the health and social care system; and bring people together to learn, share knowledge and debate. Our vision is that the best possible care is available to all.

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