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Wednesday, 09th November 2016
#futureofageing
The Future Of Ageing
ILC-UK Conference 2016
We are grateful to McCarthy & Stone for
their sponsorship of this conference.
Further support has kindly been received fro...
Welcome
Baroness Sally Greengross OBE
Chief Executive
ILC-UK
#futureofageing
ILC-UK Partners Programme
#futureofageing
An International Perspective
#futureofageing
Jonathan Stevens
Senior Vice President
Thought Leadership, AARP
#futureofageing
THOUGHT LEADERSHIP
IN LONGEVITY
Jonathan Stevens
Senior Vice President, Thought Leadership
November 2016
LONGEVITY
NATIONALLY
GLOBALLY
US Population, by Age, 1950 to 2050
Estimates of the Global Population, by Age, 1950 to 2050
THE LONGEVITY ECONOMY ON A GLOBAL SCALE, 2015*
THE LONGEVITY ECONOMY RIPPLE EFFECTS FROM SPENDING, 2015
“A thought leader is someone who looks at
the future and sets a course for it that
others will follow.
They foment change,...
I G F R E
https://www.youtube.com/watch?v=lYdNjrUs4NM
Dr Islene Araujo de Carvalho
Senior Policy and Strategy Adviser
Department of Ageing and Life Course
WHO
#futureofageing
Presenter’s name if needed
Islene Araujo de Carvalho
Senior Policy and Strategy Adviser
Department of Ageing and Life
Cour...
World report on ageing
and health
• Summarizes the best available
evidence
• Outlines a framework for action around
a new ...
Populations are getting older
2015 2050
Population ageing is happening much
more quickly than in the past
Time for percentage of population
older than age 60 to d...
People are living longer
How these extra 20 years can
be spent…
… It all depends on HEALTH
?
Health in older age is not random
There is no “typical” older person
Barriers to Healthy Ageing
• Outdated and ageist stereotypes
• Inadequate policies
• Lack of accessibility
• Inadequate or...
Healthy Ageing is an investment,
not a cost
The goal:
maximize
functional
ability
Public Health Framework
Priority areas for action
Align health systems
• Place older people at the centre of health
care
• Shift the care focus from managing
diseases to op...
Develop long-term care systems
• Establish the foundation for a functioning
system
• Develop the long-term care workforce
...
Create age-friendly environments
• Combat ageism
• Enable autonomy
• Support Healthy Ageing in all policies
Improve measurement,
monitoring, and understanding
• Agree on metrics, measures and analytical
approaches
• Improve unders...
Investing in Healthy Ageing
means creating a future that
gives older people the
freedom to live lives that
previous genera...
For more information
http://www.who.int/ageing
Full report: English and Spanish
Executive summary: Arabic, Chinese,
Englis...
An International Perspective
Discussion
#futureofageing
A Faith Perspective
#futureofageing
The Rt Rev. and the Rt Hon.
The Lord Carey of Clifton
Archbishop of Canterbury 1991-2002
#futureofageing
VALUING OLDER
PEOPLE
GEORGE CAREY
Four Ages of Man
You
believe in
Santa
Claus
You
don’t
believe
in
Santa
Claus
You look like
Santa Claus
You ARE Santa
Claus!
Growing Up in the East End
Extended family life in the East End
• Growing up in the East End of London.. Remarkable
symbiosis between the different a...
Thousands are dying alone and unloved.
• Britain is failing to meet its obligation to the elderly
because some people lead...
An Important Book
• THE POLITICS OF VIRTUE: POST-LIBERALISM AND
THE HUMAN FUTURE,
• By John Milbank and Adrian Pabst.
• “R...
The Spiritual Question
• How does our society today find language for those
things that are to be sought for what they are...
The Dangers of Utilitarianism
• Jeremy Bentham and John Mills contention that life must
be conducted on the consequences o...
The Consequences of Utilitarianism
• Think of a medical missionary in, say, India, with
a drug that is only sufficient to ...
What some Older People Fear
• Old people 'viewed as second-class citizens'
• Older people in Britain are viewed as second-...
‘Age discrimination within NHS leave
elderly neglected’
THE ROLE OF CHURCHES AND
OTHER BODIES
The Churches and Older People
• I want to draw attention to the Leveson Centre in the
diocese of Birmingham which exists t...
CHALLENGES FACING US
• Given the resources that voluntary groups like the
churches are able to offer, is it not time for s...
Old Age has its advantages!
WHAT MAKES A COUNTRY GREAT
• Is measured more simply by how we care for the most
vulnerable in our society. This transcend...
Think Positively
• ‘Grow old along with me!
• The best is yet to be,
• The last of life, for which the first was made.
• O...
A Faith Perspective
Discussion
#futureofageing
Break
#futureofageing
A Work and Retirement Perspective
#futureofageing
John Cridland CBE
Independent Reviewer of the State Pension Age
#futureofageing
State Pension Age
Independent Review
The Future of Ageing, ILC-UK Conference
9th November 2016
John Cridland CBE
State Pen...
67
State Pension age review: Three
Pillars
• Affordability
• Fairness
• Fuller Working Lives
68
Affordability
69
Pensioner spending over time
70
Dependency ratio over time
Source: ONS
Old age
Dependency
ratio data
based on
2014
Population
Projections
and OBR
Scena...
71
Life expectancy projections
Source:
ONS 2015
National
Population
Projections
Accuracy
Report
72
Fairness
73
Regional variations in life expectancy
Socio-economic variations in healthy life expectancy
74
Source: ONS
2016 Health
state Life
Expectancies
(general
health) a...
75
Fuller Working Lives
76
Position of older workers
Source: ONS
Data from
Labour Force
Survey
Please send us submissions to:
spa.review@dwp.gsi.gov.uk
Consultation closes 31st December
77
A Work and Retirement Perspective
Discussion
#futureofageing
An Evidence Perspective
#futureofageing
John Pullinger CB
National Statistician
UK Statistics Authority
#futureofageing
An Evidence Perspective
Discussion
#futureofageing
Close of morning session
Baroness Sally Greengross OBE
Chief Executive
ILC-UK
#futureofageing
Lunch Break
#futureofageing
Welcome
Lawrence Churchill CBE
Trustee
ILC-UK
#futureofageing
A Health and Care Perspective
#futureofageing
Dr Margaret McCartney
GP and regular contributor on Radio 4’s Inside Health
#futureofageing
Life, death, and
evidence based
medicine
London, November 2016
DOI• GP partner
• undergraduate tutor
• freelance writing /broadcasting
• whomadeyourpants
• chair RCGP overdiagnosis group
multimorbidity
The Lancet, Volume 380, Issue 9836, Pages 37 - 43, 7 July 2012
doi:10.1016/S0140-6736(12)60240-2
dementia screening
• 100 people, prevalence of 6%
• correctly identify 4/6
• incorrectly identify 23/100
• UKNSC have neve...
http://www.bmj.com/content/340/bmj.c2442
Rosa
• aged 72
• lung cancer
• medication for blood pressure, cholesterol,
osteoporosis, COPD (multimorbidity)
• breathles...
chemotherapy
• non small cell lung cancer
• not fit for surgery
• relapse after 1st cycle
• trials of chemo: 27% reduction...
which is also
• a change in 1 year survival from 15% to 25%
• median survival increase of 1.5 months
• (from 4 months aver...
unintended harms
• about 40% people dying from cancer have
palliative chemo within 4m of death
• die in ITU: 11% vs 2%
• l...
Early Palliative Care for Patients with metastatic non-small-cell lung cancer. NEJM, 19/8/10, DOI 1056/NEJoa1000678
An integrated palliative and respiratory care service for patients with advanced disease and refractory breathlessness: a ...
• Rosa might be better off with palliative care
• chemotherapy may not give her what she
wants
• how does she want to live...
fighting cancer
• no evidence that specific psychological coping
styles are helpful
• “for patients these responses meant ...
understandinguncertainty.org
http://www.nejm.org/doi/full/10.1056/NEJMoa0909087
CPR
• ER/Chicago Hope: 75% survive
• Holby City/Casualty: 46% survive
• older people in US rate chances of survival as
80%...
CPR in real life
• CPR outside hospital: 9.6% survive to
discharge home
• CPR inside hospital: 17% survive to discharge
ho...
CPR in people who
have cancer
• 243 patients with cancer had CPR
• no people with metastatic cancer survived to
discharge
...
CPR
• CPR is potentially life saving in the otherwise
reasonably well
• unlikely to work in people who are frail
• no evid...
death is inevitable
it is often hard to
predict
it is not a failure of
medicine
but bad death might
be
112
thank you
@mgtmccartney
margaret@margaretmccartney.com
Dwayne Johnson
Director of Social Care and Health
Sefton Metropolitan Borough Council
#futureofageing
Dwayne Johnson
Director of Social Care and Health
and Chair ADASS Older People
Network
Context
• 1 in 3 people in England rely on or have a close family member
that relies on social care
• £5bn was taken out o...
Care Act 2014
Care Act 2014 heralded a new era for social care and was
the most significant change in social care law for ...
Budget…. The true story
• By the end of the decade Adult social care will have a
funding gap of £1.259bn (ADASS) why…:
• D...
Adult Social Care Funding
Year
All figures in £m 2016/17
baseline
spend
2017/18 2018/19 2019/20
Adult social care –
forwar...
Care Market fragility
In the 6 months to July 2016:
• 48 Councils experienced at least 1 provider
ceasing trading in the h...
Opportunities
• Devolution ?
• Working with the provider market to quantify the pressures
• Work with the voluntary sector...
Mrs Sefton
Conclusions
• Local Government should be seen as a key
part of the system and solution
• The social care sector is a major...
A Health Perspective
Discussion
#futureofageing
Break
#futureofageing
A Financial Perspective
#futureofageing
Linda Woodall
Director of Life Insurance and Financial Advice
and Sponsor of the Ageing Population project
Financial Condu...
Ben Franklin
Head of Economics of an Ageing Society
ILC-UK
#futureofageing
The International Longevity Centre-UK is an independent, non-partisan think-tank
dedicated to addressing issues of longevi...
The International Longevity Centre-UK is an independent, non-partisan think-tank
dedicated to addressing issues of longevi...
The International Longevity Centre-UK is an independent, non-partisan think-tank
dedicated to addressing issues of longevi...
The International Longevity Centre-UK is an independent, non-partisan think-tank
dedicated to addressing issues of longevi...
The International Longevity Centre-UK is an independent, non-partisan think-tank
dedicated to addressing issues of longevi...
The International Longevity Centre-UK is an independent, non-partisan think-tank
dedicated to addressing issues of longevi...
The International Longevity Centre-UK is an independent, non-partisan think-tank
dedicated to addressing issues of longevi...
The International Longevity Centre-UK is an independent, non-partisan think-tank
dedicated to addressing issues of longevi...
The International Longevity Centre-UK is an independent, non-partisan think-tank
dedicated to addressing issues of longevi...
The International Longevity Centre-UK is an independent, non-partisan think-tank
dedicated to addressing issues of longevi...
The International Longevity Centre-UK is an independent, non-partisan think-tank
dedicated to addressing issues of longevi...
The International Longevity Centre-UK is an independent, non-partisan think-tank
dedicated to addressing issues of longevi...
The International Longevity Centre-UK is an independent, non-partisan think-tank
dedicated to addressing issues of longevi...
The International Longevity Centre-UK is an independent, non-partisan think-tank
dedicated to addressing issues of longevi...
The International Longevity Centre-UK is an independent, non-partisan think-tank
dedicated to addressing issues of longevi...
The International Longevity Centre-UK is an independent, non-partisan think-tank
dedicated to addressing issues of longevi...
The International Longevity Centre-UK is an independent, non-partisan think-tank
dedicated to addressing issues of longevi...
The International Longevity Centre-UK is an independent, non-partisan think-tank
dedicated to addressing issues of longevi...
The International Longevity Centre-UK is an independent, non-partisan think-tank
dedicated to addressing issues of longevi...
The International Longevity Centre-UK is an independent, non-partisan think-tank
dedicated to addressing issues of longevi...
The International Longevity Centre-UK is an independent, non-partisan think-tank
dedicated to addressing issues of longevi...
The International Longevity Centre-UK is an independent, non-partisan think-tank
dedicated to addressing issues of longevi...
A Financial Perspective
Discussion
#futureofageing
A Population Ageing Perspective
#futureofageing
David Sinclair
Director
ILC-UK
#futureofageing
The International Longevity Centre-UK is an independent, non-partisan think-tank
dedicated to addressing issues of longevi...
The International Longevity Centre-UK is an independent, non-partisan think-tank
dedicated to addressing issues of longevi...
The International Longevity Centre-UK is an independent, non-partisan think-tank
dedicated to addressing issues of longevi...
The International Longevity Centre-UK is an independent, non-partisan think-tank
dedicated to addressing issues of longevi...
The International Longevity Centre-UK is an independent, non-partisan think-tank
dedicated to addressing issues of longevi...
The International Longevity Centre-UK is an independent, non-partisan think-tank
dedicated to addressing issues of longevi...
The International Longevity Centre-UK is an independent, non-partisan think-tank
dedicated to addressing issues of longevi...
The International Longevity Centre-UK is an independent, non-partisan think-tank
dedicated to addressing issues of longevi...
The International Longevity Centre-UK is an independent, non-partisan think-tank
dedicated to addressing issues of longevi...
The International Longevity Centre-UK is an independent, non-partisan think-tank
dedicated to addressing issues of longevi...
The International Longevity Centre-UK is an independent, non-partisan think-tank
dedicated to addressing issues of longevi...
The International Longevity Centre-UK is an independent, non-partisan think-tank
dedicated to addressing issues of longevi...
The International Longevity Centre-UK is an independent, non-partisan think-tank
dedicated to addressing issues of longevi...
The International Longevity Centre-UK is an independent, non-partisan think-tank
dedicated to addressing issues of longevi...
The International Longevity Centre-UK is an independent, non-partisan think-tank
dedicated to addressing issues of longevi...
The International Longevity Centre-UK is an independent, non-partisan think-tank
dedicated to addressing issues of longevi...
The International Longevity Centre-UK is an independent, non-partisan think-tank
dedicated to addressing issues of longevi...
The International Longevity Centre-UK is an independent, non-partisan think-tank
dedicated to addressing issues of longevi...
The International Longevity Centre-UK is an independent, non-partisan think-tank
dedicated to addressing issues of longevi...
The International Longevity Centre-UK is an independent, non-partisan think-tank
dedicated to addressing issues of longevi...
The International Longevity Centre-UK is an independent, non-partisan think-tank
dedicated to addressing issues of longevi...
The International Longevity Centre-UK is an independent, non-partisan think-tank
dedicated to addressing issues of longevi...
The International Longevity Centre-UK is an independent, non-partisan think-tank
dedicated to addressing issues of longevi...
The International Longevity Centre-UK is an independent, non-partisan think-tank
dedicated to addressing issues of longevi...
The International Longevity Centre-UK is an independent, non-partisan think-tank
dedicated to addressing issues of longevi...
The International Longevity Centre-UK is an independent, non-partisan think-tank
dedicated to addressing issues of longevi...
The International Longevity Centre-UK is an independent, non-partisan think-tank
dedicated to addressing issues of longevi...
The International Longevity Centre-UK is an independent, non-partisan think-tank
dedicated to addressing issues of longevi...
The International Longevity Centre-UK is an independent, non-partisan think-tank
dedicated to addressing issues of longevi...
The International Longevity Centre-UK is an independent, non-partisan think-tank
dedicated to addressing issues of longevi...
The International Longevity Centre-UK is an independent, non-partisan think-tank
dedicated to addressing issues of longevi...
The International Longevity Centre-UK is an independent, non-partisan think-tank
dedicated to addressing issues of longevi...
The International Longevity Centre-UK is an independent, non-partisan think-tank
dedicated to addressing issues of longevi...
The International Longevity Centre-UK is an independent, non-partisan think-tank
dedicated to addressing issues of longevi...
The International Longevity Centre-UK is an independent, non-partisan think-tank
dedicated to addressing issues of longevi...
The International Longevity Centre-UK is an independent, non-partisan think-tank
dedicated to addressing issues of longevi...
The International Longevity Centre-UK is an independent, non-partisan think-tank
dedicated to addressing issues of longevi...
The International Longevity Centre-UK is an independent, non-partisan think-tank
dedicated to addressing issues of longevi...
The International Longevity Centre-UK is an independent, non-partisan think-tank
dedicated to addressing issues of longevi...
The International Longevity Centre-UK is an independent, non-partisan think-tank
dedicated to addressing issues of longevi...
The International Longevity Centre-UK is an independent, non-partisan think-tank
dedicated to addressing issues of longevi...
The International Longevity Centre-UK is an independent, non-partisan think-tank
dedicated to addressing issues of longevi...
The International Longevity Centre-UK is an independent, non-partisan think-tank
dedicated to addressing issues of longevi...
The International Longevity Centre-UK is an independent, non-partisan think-tank
dedicated to addressing issues of longevi...
The International Longevity Centre-UK is an independent, non-partisan think-tank
dedicated to addressing issues of longevi...
The International Longevity Centre-UK is an independent, non-partisan think-tank
dedicated to addressing issues of longevi...
The International Longevity Centre-UK is an independent, non-partisan think-tank
dedicated to addressing issues of longevi...
Professor Sarah Harper
Director
Oxford Institute of Population Ageing
#futureofageing
‘Future of an Ageing Population’ -
Making the UK more resilient to age-structural
change and longevity: translating academ...
GO-Science
UK demographics are changing.
Approximately 75% of UK projected
population growth between 2012-2040 is in
the 6...
GO-Science
Demographic trends
Right:
Population size
in millions to
2040, broken
down by age
groups
Populationsize(million...
As a result not only are individuals living longer, they are doing so within a UK
population which is in itself growing ol...
Societal Risks for Ageing Societies
The shift from predominantly young to predominantly older populations raises
concerns ...
GO-Science
Implications of demographic trends
Right: Projected
Population
change 2012-37
(million people)4
Populationsize(...
Work: fewer people of working age
per older person
Working & pensionable age population & old age dependency
ratio (‘worki...
Health: long term pressure on cost of care
Projected public expenditure on health and long-term care from
2014/15 to 2064/...
Connectivity: potential challenge from large
growth of older populations in towns and rural
areas
Projected Population cha...
Head of household in England by age,
estimations for 2012 and projections for 2037
211
Lead Expert Group
• Professor Sarah Harper (Chair) - University of Oxford
• Professor James Banks - University of Manchest...
The challenge in all regions is how
to sustain and enhance well-being
across an individual’s life, while at
the same time ...
GO-Science
Productivity and Employment
Lifelong Learning
Housing
Families
Health and Social Care
Connectivity
170
Main the...
GO-Science
Internet use by educational qualifications
215
Areas of the UK with the slowest internet
speeds have disproport...
GO-Science
How can technology address demographic challenges?
Frequency of loneliness by marital status, older adults4
%of...
GO-ScienceSources: 1. Dutton and Blank 2013; 2. Ofcom 2015 217
Barriers (1): sub-optimal technology uptake in the older
po...
GO-ScienceSources: 1. Dutton and Blank 2013; 2. ONS 2014 218
Barriers (2): Differences in uptake within cohorts (e.g. betw...
GO-ScienceSources: 1. Dutton and Blank 2013; 2. ONS 2014; 4. Resolution Foundation 2012 219
Implications of low technology...
GO-Science
• Skills: 79% of 65-74 year olds
had ‘low’ or ‘no’ internet skills in
2013.
• Perceived benefits/utility of
ICT...
GO-Science
• Choice, control, issues of privacy,
and fear of reduced social
interaction in certain technologies
(e.g. assi...
A Coherent Response to Ageing
The report combined evidence about today’s older people with future trends
and projections t...
A Coherent Response to Ageing
The report combined evidence about today’s older people with future trends
and projections t...
Oxford Institute of Population Ageing
Picture: Nasir Hamid/Oxford University
A Population Ageing Perspective
Discussion
#futureofageing
End of Afternoon session
Lawrence Churchill CBE
Trustee
ILC-UK
#futureofageing
09 November 2016
#futureofageing
The Future Of Ageing
ILC-UK Conference 2016
ILC-UK Future of Ageing Presentation Slides - 09Nov16
ILC-UK Future of Ageing Presentation Slides - 09Nov16
ILC-UK Future of Ageing Presentation Slides - 09Nov16
ILC-UK Future of Ageing Presentation Slides - 09Nov16
ILC-UK Future of Ageing Presentation Slides - 09Nov16
ILC-UK Future of Ageing Presentation Slides - 09Nov16
ILC-UK Future of Ageing Presentation Slides - 09Nov16
ILC-UK Future of Ageing Presentation Slides - 09Nov16
ILC-UK Future of Ageing Presentation Slides - 09Nov16
ILC-UK Future of Ageing Presentation Slides - 09Nov16
ILC-UK Future of Ageing Presentation Slides - 09Nov16
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ILC-UK Future of Ageing Presentation Slides - 09Nov16

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On Wednesday 9th November 2016, ILC-UK held it's second annual future of Ageing conference.

We welcomed over 180 delegates made up of business leaders; charity sector experts; public sector decision makers; local authority staff; academics; and senior journalists.

The one day conference was chaired by Baroness Slly Greengross OBE and Lawrence Churchill CBE, and we heard from the following speakers:

- Dr Islene Araujo de Carvalho, Senior Policy and Strategy Adviser, Department of Ageing and Life Course, WHO
- John Cridland CBE, Head of the Independent State Pension Age Review
- The Rt Rev. and the Rt Hon. the Lord Carey of Clifton, Archbishop of Canterbury 1991-2002
- Ben Franklin, Head of Economics of an Ageing Society, ILC-UK
- Professor Sarah Harper, Director, Oxford Institute of Population Ageing
- Dwayne Johnson, Director of Social Care and Health at Sefton Metropolitan Borough Council
- Dr Margaret McCartney, Author and Broadcaster
- John Pullinger CB, National Statistician, UK Statistics Authority
- David Sinclair, Director, ILC-UK
- Jonathan Stevens, Senior Vice President, Thought Leadership, AARP
- Linda Woodall, Director of Life Insurance and Financial Advice, and sponsor of the Ageing Population project, Financial Conduct Authority

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ILC-UK Future of Ageing Presentation Slides - 09Nov16

  1. 1. Wednesday, 09th November 2016 #futureofageing The Future Of Ageing ILC-UK Conference 2016
  2. 2. We are grateful to McCarthy & Stone for their sponsorship of this conference. Further support has kindly been received from:
  3. 3. Welcome Baroness Sally Greengross OBE Chief Executive ILC-UK #futureofageing
  4. 4. ILC-UK Partners Programme #futureofageing
  5. 5. An International Perspective #futureofageing
  6. 6. Jonathan Stevens Senior Vice President Thought Leadership, AARP #futureofageing
  7. 7. THOUGHT LEADERSHIP IN LONGEVITY Jonathan Stevens Senior Vice President, Thought Leadership November 2016
  8. 8. LONGEVITY NATIONALLY GLOBALLY
  9. 9. US Population, by Age, 1950 to 2050
  10. 10. Estimates of the Global Population, by Age, 1950 to 2050
  11. 11. THE LONGEVITY ECONOMY ON A GLOBAL SCALE, 2015*
  12. 12. THE LONGEVITY ECONOMY RIPPLE EFFECTS FROM SPENDING, 2015
  13. 13. “A thought leader is someone who looks at the future and sets a course for it that others will follow. They foment change, often causing great disruption. Thought leaders are people, not companies. Smart enterprises employ, encourage, and embrace individual thought leaders, and thus earn recognition as a thought leadership company.” Shel Israel, Forbes.com
  14. 14. I G F R E
  15. 15. https://www.youtube.com/watch?v=lYdNjrUs4NM
  16. 16. Dr Islene Araujo de Carvalho Senior Policy and Strategy Adviser Department of Ageing and Life Course WHO #futureofageing
  17. 17. Presenter’s name if needed Islene Araujo de Carvalho Senior Policy and Strategy Adviser Department of Ageing and Life Course World Health Organization @islene123
  18. 18. World report on ageing and health • Summarizes the best available evidence • Outlines a framework for action around a new concept of functional ability
  19. 19. Populations are getting older 2015 2050
  20. 20. Population ageing is happening much more quickly than in the past Time for percentage of population older than age 60 to double
  21. 21. People are living longer
  22. 22. How these extra 20 years can be spent… … It all depends on HEALTH ?
  23. 23. Health in older age is not random
  24. 24. There is no “typical” older person
  25. 25. Barriers to Healthy Ageing • Outdated and ageist stereotypes • Inadequate policies • Lack of accessibility • Inadequate or absent services • Lack of consultation and involvement
  26. 26. Healthy Ageing is an investment, not a cost
  27. 27. The goal: maximize functional ability
  28. 28. Public Health Framework
  29. 29. Priority areas for action
  30. 30. Align health systems • Place older people at the centre of health care • Shift the care focus from managing diseases to optimizing what people can do • Develop the health workforce
  31. 31. Develop long-term care systems • Establish the foundation for a functioning system • Develop the long-term care workforce • Ensure the quality of long-term care
  32. 32. Create age-friendly environments • Combat ageism • Enable autonomy • Support Healthy Ageing in all policies
  33. 33. Improve measurement, monitoring, and understanding • Agree on metrics, measures and analytical approaches • Improve understanding of the health status and needs of older populations • Increase understanding of ageing trajectories and what can be done to improve them
  34. 34. Investing in Healthy Ageing means creating a future that gives older people the freedom to live lives that previous generations could never have imagined.
  35. 35. For more information http://www.who.int/ageing Full report: English and Spanish Executive summary: Arabic, Chinese, English, French, Japanese, Portuguese, Russian and Spanish.
  36. 36. An International Perspective Discussion #futureofageing
  37. 37. A Faith Perspective #futureofageing
  38. 38. The Rt Rev. and the Rt Hon. The Lord Carey of Clifton Archbishop of Canterbury 1991-2002 #futureofageing
  39. 39. VALUING OLDER PEOPLE GEORGE CAREY
  40. 40. Four Ages of Man You believe in Santa Claus You don’t believe in Santa Claus You look like Santa Claus You ARE Santa Claus!
  41. 41. Growing Up in the East End
  42. 42. Extended family life in the East End • Growing up in the East End of London.. Remarkable symbiosis between the different age groups. • BUT IN 2015 The UK is one of the happiest countries in terms of family relationships but is among the least friendly to neighbours, according to an international study. • We are, however, one of the least friendly nations in terms of knowing our neighbours. Only Germany ranked as less sociable in the study. More than 90 per cent of Britons said they were either very happy or fairly happy with their family life, ranking the country fourth highest of developed nations.
  43. 43. Thousands are dying alone and unloved. • Britain is failing to meet its obligation to the elderly because some people lead such "busy, atomised lives" that they don't even know whether their relatives are dying. • Jeremy Hunt, the Health Secretary, said that it is "shocking" that thousands of people are dying alone in Britain. • Telegraph, July 2015
  44. 44. An Important Book • THE POLITICS OF VIRTUE: POST-LIBERALISM AND THE HUMAN FUTURE, • By John Milbank and Adrian Pabst. • “Reduction of democracy to market terms”
  45. 45. The Spiritual Question • How does our society today find language for those things that are to be sought for what they are – and mean- and not for their exchange value? • “What kind of world have we allowed to develop in which our most important values are now physical and material?”
  46. 46. The Dangers of Utilitarianism • Jeremy Bentham and John Mills contention that life must be conducted on the consequences of the greatest happiness for the greater number. • J. J. C. Smart (49) explains this difference by imagining the action of a person who, in 1938,saves someone from drowning. While we generally regard saving a drowning person as the right thing to do and praise people for such actions, in Smart’s imagined example, the person saved from drowning turns out to be Adolph Hitler. Had Hitler drowned, millions of other people might have been saved from suffering and death between 1938 and 1945. If utilitarianism evaluates the rescuer’s action based on its actual consequences, then the rescuer did the wrong thing.
  47. 47. The Consequences of Utilitarianism • Think of a medical missionary in, say, India, with a drug that is only sufficient to cure five people but she has twenty very ill people who would also benefit from the drug. She is clearly going to have to make a choice but upon what basis? • Will her choice depend upon the severity of illness? Those likely to get most benefit from the drug? A policy decision in favour of the young?
  48. 48. What some Older People Fear • Old people 'viewed as second-class citizens' • Older people in Britain are viewed as second-class citizens and face "blatant discrimination" in health, social care and other areas of everyday life, a new report claimed today. • The study, called Age Discrimination in Public Policy, said age is used to ration resources in the NHS and older people are being excluded from the job market. • A parallel Help the Aged/NOP poll of more than 2,000 people across the country also revealed that more than half believe the UK treats older people as if they are on the scrapheap. • Nearly 50% said that older people are viewed as a burden on society. • Help the Aged, which published the report with British Gas, said the findings showed that age discrimination was "endemic" in public institutions. MAIL ON SUNDAY. OCT 29th 2016
  49. 49. ‘Age discrimination within NHS leave elderly neglected’
  50. 50. THE ROLE OF CHURCHES AND OTHER BODIES
  51. 51. The Churches and Older People • I want to draw attention to the Leveson Centre in the diocese of Birmingham which exists to focus attention on the study of ageing, spirituality and care for the elderly. The centre is based upon the philosophy that life should be lived to the full and that age is merely a number, not a confession of decline. • The challenge for the churches at our present time where society is ageing, is to provide resources for the elderly where they feel welcomed and cared for.
  52. 52. CHALLENGES FACING US • Given the resources that voluntary groups like the churches are able to offer, is it not time for some joined-up thinking to include such groups in a national strategy for care for the elderly? Is it not time to draw upon the good will that exists in our society and put that compassion to work? But there is also a challenge to the churches and other voluntary groups and that is to reach out in their communities to those living alone, with health problems and other needs.
  53. 53. Old Age has its advantages!
  54. 54. WHAT MAKES A COUNTRY GREAT • Is measured more simply by how we care for the most vulnerable in our society. This transcends our religious affinities because it touches what it is to be human. If we do not value the elderly it suggests that we do not value the young either. • “What will become of us?” older people often ask. We should respond: ‘You matter because though vulnerable, you are valued and are of worth that transcends your economic status’.
  55. 55. Think Positively • ‘Grow old along with me! • The best is yet to be, • The last of life, for which the first was made. • Our times are in his hand who saith: • ‘A whole I planned, youth shows but half: • Trust God; see all, • Nor be afraid’. • Robert Browning, Rabbi Ben Ezra.
  56. 56. A Faith Perspective Discussion #futureofageing
  57. 57. Break #futureofageing
  58. 58. A Work and Retirement Perspective #futureofageing
  59. 59. John Cridland CBE Independent Reviewer of the State Pension Age #futureofageing
  60. 60. State Pension Age Independent Review The Future of Ageing, ILC-UK Conference 9th November 2016 John Cridland CBE State Pension Age Independent Reviewer 66
  61. 61. 67 State Pension age review: Three Pillars • Affordability • Fairness • Fuller Working Lives
  62. 62. 68 Affordability
  63. 63. 69 Pensioner spending over time
  64. 64. 70 Dependency ratio over time Source: ONS Old age Dependency ratio data based on 2014 Population Projections and OBR Scenarios
  65. 65. 71 Life expectancy projections Source: ONS 2015 National Population Projections Accuracy Report
  66. 66. 72 Fairness
  67. 67. 73 Regional variations in life expectancy
  68. 68. Socio-economic variations in healthy life expectancy 74 Source: ONS 2016 Health state Life Expectancies (general health) and Life Expectancy, 2010 to 2012
  69. 69. 75 Fuller Working Lives
  70. 70. 76 Position of older workers Source: ONS Data from Labour Force Survey
  71. 71. Please send us submissions to: spa.review@dwp.gsi.gov.uk Consultation closes 31st December 77
  72. 72. A Work and Retirement Perspective Discussion #futureofageing
  73. 73. An Evidence Perspective #futureofageing
  74. 74. John Pullinger CB National Statistician UK Statistics Authority #futureofageing
  75. 75. An Evidence Perspective Discussion #futureofageing
  76. 76. Close of morning session Baroness Sally Greengross OBE Chief Executive ILC-UK #futureofageing
  77. 77. Lunch Break #futureofageing
  78. 78. Welcome Lawrence Churchill CBE Trustee ILC-UK #futureofageing
  79. 79. A Health and Care Perspective #futureofageing
  80. 80. Dr Margaret McCartney GP and regular contributor on Radio 4’s Inside Health #futureofageing
  81. 81. Life, death, and evidence based medicine London, November 2016
  82. 82. DOI• GP partner • undergraduate tutor • freelance writing /broadcasting • whomadeyourpants • chair RCGP overdiagnosis group
  83. 83. multimorbidity The Lancet, Volume 380, Issue 9836, Pages 37 - 43, 7 July 2012 doi:10.1016/S0140-6736(12)60240-2
  84. 84. dementia screening • 100 people, prevalence of 6% • correctly identify 4/6 • incorrectly identify 23/100 • UKNSC have never recommended screening • functional impairment is necessary for a diagnosis of dementia
  85. 85. http://www.bmj.com/content/340/bmj.c2442
  86. 86. Rosa • aged 72 • lung cancer • medication for blood pressure, cholesterol, osteoporosis, COPD (multimorbidity) • breathless and in pain, frail • lives with husband in first floor flat
  87. 87. chemotherapy • non small cell lung cancer • not fit for surgery • relapse after 1st cycle • trials of chemo: 27% reduction death
  88. 88. which is also • a change in 1 year survival from 15% to 25% • median survival increase of 1.5 months • (from 4 months average to 5.5 months average survival) • “hope of progress, and suggest that chemotherapy has role....” Cochrane systematic reviews of treatment for lung cancer. Fong et al. Respiratory Medicine Vol 99 Issue 9 Sept 05 1071-1078
  89. 89. unintended harms • about 40% people dying from cancer have palliative chemo within 4m of death • die in ITU: 11% vs 2% • late hospice referral 54% vs 37% • die in preferred place: 65% vs 80% Associations between palliative chemotherapy and adult cancer patients’ end of life care and place of death: prospective cohort study. Wright et al, BMJ 2014; 348 doi http//doi.org/10.1136/bmj.g1219
  90. 90. Early Palliative Care for Patients with metastatic non-small-cell lung cancer. NEJM, 19/8/10, DOI 1056/NEJoa1000678
  91. 91. An integrated palliative and respiratory care service for patients with advanced disease and refractory breathlessness: a randomised controlled trial Higginson, Irene J et al. The Lancet Respiratory Medicine , Volume 2 , Issue 12 , 979 - 987
  92. 92. • Rosa might be better off with palliative care • chemotherapy may not give her what she wants • how does she want to live, where does she want to die? • treatment burden • ‘I really don’t want to be in pain’ • ‘shouldn’t I be fighting this more?’
  93. 93. fighting cancer • no evidence that specific psychological coping styles are helpful • “for patients these responses meant resisting the expression of emotional distress” Influence of psychological coping on survival and recurrence in people with cancer: systematic review BMJ 2002; 325 9/11/02 Patients’ experience of cancer; evidence of the role of ‘fighting’ in collusive clinical communication. Patient Educ Couns. 2002 Sept; 48(1) 15-21
  94. 94. understandinguncertainty.org
  95. 95. http://www.nejm.org/doi/full/10.1056/NEJMoa0909087
  96. 96. CPR • ER/Chicago Hope: 75% survive • Holby City/Casualty: 46% survive • older people in US rate chances of survival as 80% • 63% people with COPD rate chances survival > 40% CPR on television - Miracles and misinformation. 334:1578-1582 13/6/96, NEJM Resuscitation on TV: realistic or ridiculous. A quantatitive observational analysis of the portrayal of cardiopulmonary resucitation in television medical drama. Resuscitation 21/8/09 Journal of American Osteopathic Association 2006;106 (7) 402-404 Int J Chron Obstruc Pulmon Dis. June 08 3(2) 295-300
  97. 97. CPR in real life • CPR outside hospital: 9.6% survive to discharge home • CPR inside hospital: 17% survive to discharge home
  98. 98. CPR in people who have cancer • 243 patients with cancer had CPR • no people with metastatic cancer survived to discharge • 7 with localised cancer survived JAMA Internal Medicine 1991 Vol 151 No 2
  99. 99. CPR • CPR is potentially life saving in the otherwise reasonably well • unlikely to work in people who are frail • no evidence that it will work in people with metastatic cancer
  100. 100. death is inevitable it is often hard to predict it is not a failure of medicine but bad death might be
  101. 101. 112 thank you @mgtmccartney margaret@margaretmccartney.com
  102. 102. Dwayne Johnson Director of Social Care and Health Sefton Metropolitan Borough Council #futureofageing
  103. 103. Dwayne Johnson Director of Social Care and Health and Chair ADASS Older People Network
  104. 104. Context • 1 in 3 people in England rely on or have a close family member that relies on social care • £5bn was taken out of the social care system between 2011- 2015/16 (ADASS) • Care and support Alliance estimated that 500,000 people who had social care in 2009 no longer do so because of rationing • “were extra funding available, frankly we should be arguing that it should be going to social care” – CExec NHS England • 2016 CQC State of Care report…”pressures in social care “is approaching a tipping point” • No solutions to long term care funding…”deeper existential crisis of care” - Kings Fund 2016 • However……
  105. 105. Care Act 2014 Care Act 2014 heralded a new era for social care and was the most significant change in social care law for 60 years, its key aims: • people to have more control over their lives; • support should be less about firefighting and more about prevention; • goal of independence • By 2016 the final arrangements for the funding of care – including the £72,000 cap on care costs • However…..
  106. 106. Budget…. The true story • By the end of the decade Adult social care will have a funding gap of £1.259bn (ADASS) why…: • Demands…..inflation…..national living wage …unfunded Deprivation of Liberty safeguards…Council overspends • £200M in year cut to public health in 2015/16 and a further £330M reduction by 2020/21 • Some good news….: • Council tax precept for adult social care 2016/17 - £393M • Better care Fund - £105M 2016/17
  107. 107. Adult Social Care Funding Year All figures in £m 2016/17 baseline spend 2017/18 2018/19 2019/20 Adult social care – forward cost projection 14,380 15,444 16,629 17,833 Council tax: adult social care precept 393 821 1,290 1,804 Improved Better Care Fund 105 825 1,500
  108. 108. Care Market fragility In the 6 months to July 2016: • 48 Councils experienced at least 1 provider ceasing trading in the home care market and; • 77 Councils experiencing at least 1 provider in the residential/nursing care market • Continuing Health Care pressures and associated impact on the care system • Sustainability and Transformation plans STPs
  109. 109. Opportunities • Devolution ? • Working with the provider market to quantify the pressures • Work with the voluntary sector – they are the very heart beat of our communities • Prevention – obesity, diabetes….people looking after themselves • Digital and ICT solutions • Bring forward the £700M of the ‘up to £1.5bn’ additional funding to 2019/20 • Business rates?
  110. 110. Mrs Sefton
  111. 111. Conclusions • Local Government should be seen as a key part of the system and solution • The social care sector is a major employment area and providing good quality care should be the key part of the system • This is not a new agenda…..rather it is an agenda in new times and we should be promoting Inclusivity, cohesive communities and promoting life chances for all
  112. 112. A Health Perspective Discussion #futureofageing
  113. 113. Break #futureofageing
  114. 114. A Financial Perspective #futureofageing
  115. 115. Linda Woodall Director of Life Insurance and Financial Advice and Sponsor of the Ageing Population project Financial Conduct Authority #futureofageing
  116. 116. Ben Franklin Head of Economics of an Ageing Society ILC-UK #futureofageing
  117. 117. The International Longevity Centre-UK is an independent, non-partisan think-tank dedicated to addressing issues of longevity, ageing and population change. So near and yet so far: Striving for economic bliss Ben Franklin, ILC-UK follow us on twitter: @ilcuk @bjafranklin
  118. 118. The International Longevity Centre-UK is an independent, non-partisan think-tank dedicated to addressing issues of longevity, ageing and population change. “But it will be those peoples, who can keep alive, and cultivate into a fuller perfection, the art of life itself…who will be able to enjoy the abundance when it comes.” John Maynard Keynes, The economic possibilities for our grandchildren (1930)
  119. 119. The International Longevity Centre-UK is an independent, non-partisan think-tank dedicated to addressing issues of longevity, ageing and population change. What am I going to cover? - Revisiting Keynes’ vision of economic bliss. - In what ways have we reached this ideal world? - In what ways have we failed? - Is the vision slipping away?
  120. 120. The International Longevity Centre-UK is an independent, non-partisan think-tank dedicated to addressing issues of longevity, ageing and population change. Revisiting economic bliss • The end of the struggle for subsistence. • Shorter working weeks – 3 hour days. • Learning to enjoy leisure and abundance. The economic possibilities for our grandchildren, Essays in Persuasion (1930)
  121. 121. The International Longevity Centre-UK is an independent, non-partisan think-tank dedicated to addressing issues of longevity, ageing and population change. The end of the struggle for subsistence?
  122. 122. The International Longevity Centre-UK is an independent, non-partisan think-tank dedicated to addressing issues of longevity, ageing and population change. Great successes have been made in reducing pensioner poverty in particular
  123. 123. The International Longevity Centre-UK is an independent, non-partisan think-tank dedicated to addressing issues of longevity, ageing and population change. And the number of working hours has fallen
  124. 124. The International Longevity Centre-UK is an independent, non-partisan think-tank dedicated to addressing issues of longevity, ageing and population change. As has the proportion of time spent in the labour force
  125. 125. The International Longevity Centre-UK is an independent, non-partisan think-tank dedicated to addressing issues of longevity, ageing and population change. In fact…we are not far from the 15 hour working week if we include the whole of our adult lives • The number of hours worked has fallen. • The date of labour market exit has fallen. • But life expectancy has continued to rise. • As a result….
  126. 126. The International Longevity Centre-UK is an independent, non-partisan think-tank dedicated to addressing issues of longevity, ageing and population change. Source: ILC-UK calculations based on OECD data Big health warning: “work” in our calculations does not include caring for others or looking after the family home since comparable data was not available. Neither do our calculations account for changes in participation rate over time.
  127. 127. The International Longevity Centre-UK is an independent, non-partisan think-tank dedicated to addressing issues of longevity, ageing and population change. Are longer retirements the real world manifestation of Keynes’ vision? Yes • Current pension incomes are strong for many. • Significant time for leisure activities. • Proportion volunteering in retirement is initially high. No • People don’t spend their abundance but continue to save. • Health prevents people doing what they want. • Most leisure time is taken up watching TV and later on living at home alone.
  128. 128. The International Longevity Centre-UK is an independent, non-partisan think-tank dedicated to addressing issues of longevity, ageing and population change. Yes…Current pension income is strong Source: Eurostat
  129. 129. The International Longevity Centre-UK is an independent, non-partisan think-tank dedicated to addressing issues of longevity, ageing and population change. No…People don’t spend the abundance in retirement % and amount saved rises during retirement
  130. 130. The International Longevity Centre-UK is an independent, non-partisan think-tank dedicated to addressing issues of longevity, ageing and population change. Maybe these are the leisure activities Keynes had in mind or maybe not Percentage spending time on different activities in week
  131. 131. The International Longevity Centre-UK is an independent, non-partisan think-tank dedicated to addressing issues of longevity, ageing and population change. No…Health prevents people doing what they want To what extent does health stop you from doing the things you want to do Source: ELSA Wave 6 (2012/13)
  132. 132. The International Longevity Centre-UK is an independent, non-partisan think-tank dedicated to addressing issues of longevity, ageing and population change. What about the prospects for current and future generations? Signs of a return to subsistence? • Wage growth has slowed. • Hours worked have been rising. • Productivity growth has stagnated. Reasons to be optimistic • Technological change hard to predict. • A record number of educated and technically proficient people.
  133. 133. The International Longevity Centre-UK is an independent, non-partisan think-tank dedicated to addressing issues of longevity, ageing and population change. Wage growth has slowed Source: ILC-UK calculations and BoE
  134. 134. The International Longevity Centre-UK is an independent, non-partisan think-tank dedicated to addressing issues of longevity, ageing and population change. Much of which may be underpinned by lower productivity growth
  135. 135. The International Longevity Centre-UK is an independent, non-partisan think-tank dedicated to addressing issues of longevity, ageing and population change. And a slowdown in productive invention Source: ILC-UK calculations and BoE
  136. 136. The International Longevity Centre-UK is an independent, non-partisan think-tank dedicated to addressing issues of longevity, ageing and population change. Which means hours worked have been increasing Sources: ONS LFS BoE and ILC-UK calculations
  137. 137. The International Longevity Centre-UK is an independent, non-partisan think-tank dedicated to addressing issues of longevity, ageing and population change.  The product of labour has allowed us to live way above subsistence for many years.  Increased the amount of time for leisure primarily by longer periods in retirement.  But maybe people have not done the sorts of things with this leisure time that Keynes would have dreamt about.  And…our post-crisis economic fundamentals suggest a return to our longer run trend. Might this mean economic bliss will slip further from our fingers? Key conclusions
  138. 138. The International Longevity Centre-UK is an independent, non-partisan think-tank dedicated to addressing issues of longevity, ageing and population change. Many thanks Ben Franklin International Longevity Centre - UK 02073400440 Twitter: @ilcuk @bjafranklin
  139. 139. A Financial Perspective Discussion #futureofageing
  140. 140. A Population Ageing Perspective #futureofageing
  141. 141. David Sinclair Director ILC-UK #futureofageing
  142. 142. The International Longevity Centre-UK is an independent, non-partisan think-tank dedicated to addressing issues of longevity, ageing and population change. David Sinclair, ILC-UK “Necessity is the mother of invention” (and perhaps there is a silver bullet)
  143. 143. The International Longevity Centre-UK is an independent, non-partisan think-tank dedicated to addressing issues of longevity, ageing and population change. We are supported by.. thank you
  144. 144. The International Longevity Centre-UK is an independent, non-partisan think-tank dedicated to addressing issues of longevity, ageing and population change. Thank you
  145. 145. The International Longevity Centre-UK is an independent, non-partisan think-tank dedicated to addressing issues of longevity, ageing and population change. The future of ageing – A new golden age?  A new life-course: Grow up, have fun, spend, work, save, care, spend, learn, work, save, have fun, work, save, care, learn, work, be cared for..  Healthier, happier, more engaged older population  Keynes, Marx, Bertrand Russell - the shortening of work time as an important ingredient of a better life
  146. 146. The International Longevity Centre-UK is an independent, non-partisan think-tank dedicated to addressing issues of longevity, ageing and population change. Ageing is slow, change is sometimes slow iwaited96years.com A new social revolution: "social revolution means the reorganization of the industrial, economic life of the country and consequently also of the entire structure of society.” Alexander Berkman
  147. 147. The International Longevity Centre-UK is an independent, non-partisan think-tank dedicated to addressing issues of longevity, ageing and population change. We are at a tipping point Staff and skills shortages http://www.birmingha mmail.co.uk/whats- on/food-drink- news/brum-chef- opens-indian- restaurant-7190927 A "new normal" of low investment returns combined with low real wage growth is repressing savings levels and presenting a significant risk of long term pensioner poverty. “The financial cost of Britain’s ageing population will require a fresh £20bn wave of spending cuts or tax increases from 2020 to bring the national debt back to pre-recession levels in 50 years time” [OBR 2015] Eastern Europe labour shortage is so acute McDonald’s is offering free housing
  148. 148. The International Longevity Centre-UK is an independent, non-partisan think-tank dedicated to addressing issues of longevity, ageing and population change. There are some “known unknowns” Antibiotic Resistance could lead to the deaths of ten million people a year globally by 2050” “Pill to help us live to 120: 10p-a-day MIRACLE drug could slow the ageing process” “Alzheimer's cure at last: First drug to stop disease in its tracks”
  149. 149. The International Longevity Centre-UK is an independent, non-partisan think-tank dedicated to addressing issues of longevity, ageing and population change. But – we are miles from where we need to be We know the direction of ageing and we have made progress. We are miles from where we need to be Ensuring our economy is ready for ageing Ensuring Health and Care is ready for ageing Ensuring our communities are ready for ageing
  150. 150. The International Longevity Centre-UK is an independent, non-partisan think-tank dedicated to addressing issues of longevity, ageing and population change. Ensuring our economy is ready for ageing ONS annual survey of hours and earnings, pension tables
  151. 151. The International Longevity Centre-UK is an independent, non-partisan think-tank dedicated to addressing issues of longevity, ageing and population change. Today’s older population are wealthier than previous generations The remarkable catch-up in pensioner incomes Chart shows median after housing costs incomes of pensioner households as % of median for non-pensioners (HBAI income definitions) But still 1.6 million ish in poverty
  152. 152. The International Longevity Centre-UK is an independent, non-partisan think-tank dedicated to addressing issues of longevity, ageing and population change. Ensuring our economy is ready for ageing  Savings levels remain far too low  Real wage growth is low  Returns on investments are at historic lows  House prices continue to be high  Our economy still loses billions due to the underemployment of older people  The private sector is not maximising the economic spending power of older people
  153. 153. The International Longevity Centre-UK is an independent, non-partisan think-tank dedicated to addressing issues of longevity, ageing and population change. Ensuring our communities are ready for ageing
  154. 154. The International Longevity Centre-UK is an independent, non-partisan think-tank dedicated to addressing issues of longevity, ageing and population change. Ensuring our communities are ready for ageing  Isolation and loneliness remain blights on our society  Spending cuts have hit services for older and younger people  We have a huge undersupply of retirement housing. New mainstream housing is not adaptable enough.
  155. 155. The International Longevity Centre-UK is an independent, non-partisan think-tank dedicated to addressing issues of longevity, ageing and population change. Ensuring Health and Care is ready for ageing Prevalence of serious illness among those aged 50+ has been slightly decreasing over time, from 15.8% in 2002 to 13.6% in 2012. – the overall % of older people reporting a cardiovascular event fell – lower % of people in each age group from 50-79 experiencing heart attacks in 2012 compared to 2002
  156. 156. The International Longevity Centre-UK is an independent, non-partisan think-tank dedicated to addressing issues of longevity, ageing and population change. Excess winter deaths have been falling
  157. 157. The International Longevity Centre-UK is an independent, non-partisan think-tank dedicated to addressing issues of longevity, ageing and population change. Ensuring Health and Care is ready for ageing  Urgent action is needed to ensure our health service keeps up with the demands of demographic change.  Social Care funding reform seems to have been put in the “too difficult” box.  Health and care face major staffing shortages “A disaster for older people today and tomorrow”. Ready for Ageing Alliance
  158. 158. The International Longevity Centre-UK is an independent, non-partisan think-tank dedicated to addressing issues of longevity, ageing and population change. “NHS spending will drop per head despite ageing population and growing demand, says chief executive” “The NHS last year recorded the biggest deficit in its history, at £2.45bn”
  159. 159. The International Longevity Centre-UK is an independent, non-partisan think-tank dedicated to addressing issues of longevity, ageing and population change.  1.86 million people over the age of 50 in England (1 in 10) have unmet care needs – an increase of 120,000 people (or 7%) since 2008/9.  There are 4.3 million people aged 50+ in England who are living alone (1 in 5).  The numbers accessing care services have fallen by half a million since 2008/9 (30%).  The number of over 80s have risen by 800,000 in the last decade.  There are already around 1.5 million people providing over 50 hours per week of unpaid care.
  160. 160. The International Longevity Centre-UK is an independent, non-partisan think-tank dedicated to addressing issues of longevity, ageing and population change. Ensuring Health and Care is ready for ageing Prevalence of five serious illnesses among people aged 50+ in England, 2002-2012
  161. 161. The International Longevity Centre-UK is an independent, non-partisan think-tank dedicated to addressing issues of longevity, ageing and population change. Is there a magic bullet (or perhaps 6)?
  162. 162. The International Longevity Centre-UK is an independent, non-partisan think-tank dedicated to addressing issues of longevity, ageing and population change. The 6 magic bullets  Maximising the economic contribution of older people  Getting us healthy  Maximising the potential of technology and big data  Stop patronising old age. Treat adults as adults  Start talking about end of life  Let’s make ageing fun
  163. 163. The International Longevity Centre-UK is an independent, non-partisan think-tank dedicated to addressing issues of longevity, ageing and population change. Maximising the economic contribution – Ensuring older people spend more.. We calculate total per annum savings made by those in retirement in the UK today of around £48.7bn. This equates to 2.8% of GDP. The majority of savings made by older people are sitting in low interest current accounts. (UK)
  164. 164. The International Longevity Centre-UK is an independent, non-partisan think-tank dedicated to addressing issues of longevity, ageing and population change. Maximising the economic contribution – more of us working longer Unless a higher proportion of older people remain in the workforce, we estimate that total Eurozone employment could fall by up to 17% over the next 35 years. (ILC-UK)
  165. 165. The International Longevity Centre-UK is an independent, non-partisan think-tank dedicated to addressing issues of longevity, ageing and population change. Maximising the economic contribution – More of us working longer
  166. 166. The International Longevity Centre-UK is an independent, non-partisan think-tank dedicated to addressing issues of longevity, ageing and population change. But employment rates are lower than 1960s Source: Family Expenditure Survey (1968– 1982), Labour Force Survey (1983–2013). Figure 2.1 in Retirement in the 21st Century Employment rates of older men, 1968–2013
  167. 167. The International Longevity Centre-UK is an independent, non-partisan think-tank dedicated to addressing issues of longevity, ageing and population change. How do we get people to work a little more and spend a little more? (we just need the political will)  Can we use the tax system to discourage hoarding?  Can we have products which give people certainty of income so they know how much they have to spend? (oops)  Can we give people certainty of future care costs?  Can we ensure the tax system supports working longer?  Can employers better recruit/retain/retrain older workers?  Universal income?  Can we make workplaces healthier?  Can we help industry better understand the older consumer?
  168. 168. The International Longevity Centre-UK is an independent, non-partisan think-tank dedicated to addressing issues of longevity, ageing and population change. Getting us healthy BHF Physical Activity Stats 2015
  169. 169. The International Longevity Centre-UK is an independent, non-partisan think-tank dedicated to addressing issues of longevity, ageing and population change. How might we get people to exercise more?.. (we just need the political will) We need to move the “social norm”. Active workplaces and active travel are key.  Educate and inform (e.g. leaflets, information, posters)  Nudge (e.g. make healthy choices easier or the default, move the social norm, small financial incentives for “goods”)  Compel (e.g. taxation/fines of “bads”, parking bans)
  170. 170. The International Longevity Centre-UK is an independent, non-partisan think-tank dedicated to addressing issues of longevity, ageing and population change. Maximising the potential of new technology - automation BBC News - RBS, NatWest and SEB banks employ virtual staff
  171. 171. The International Longevity Centre-UK is an independent, non-partisan think-tank dedicated to addressing issues of longevity, ageing and population change. Technology can help us with our daily activities
  172. 172. The International Longevity Centre-UK is an independent, non-partisan think-tank dedicated to addressing issues of longevity, ageing and population change.  But innovations have often made the world more difficult rather than simpler  Most of the need comes at 75+ (i.e. the market isn’t big enough to deliver innovations)
  173. 173. The International Longevity Centre-UK is an independent, non-partisan think-tank dedicated to addressing issues of longevity, ageing and population change. Do we really want robots? “Sexbots, though not yet exactly flying off shelves, have stoked enough cultural interest to inflame a widely covered campaign to ban them. Meanwhile, care robots for the elderly remain stuck in sociocultural purgatory.” …The Guardian: being left with a carebot is just “another way of dying even more miserably”.
  174. 174. The International Longevity Centre-UK is an independent, non-partisan think-tank dedicated to addressing issues of longevity, ageing and population change. 1997: ..harness the enormous potential benefits of IT to support the drive for quality and efficiency in the NHS.. Electronic patient records 2005: Technology has the capacity to transform the way we offer services and the support that is available to help people with dementia stay in their own homes. (DH) 2005: We need to seize the full potential of the advanced application of science and technology to help deliver better later lives. (DWP) 2006: New service models and technology have an important role in enabling older people to remain in their own homes” (The Wanless social care review, 2006)
  175. 175. The International Longevity Centre-UK is an independent, non-partisan think-tank dedicated to addressing issues of longevity, ageing and population change. 2009: Using technology to enable delivery of high-quality support will be a vital element of the future care and support system. DH 2009: New technology opens up new horizons for care. From community alarms to sophisticated communication systems. DH 2013: Technologies, including telecare and telehealth, also have the potential to save money and improve the quality of care that older people experience. (House of Lords) 2014: Technology can improve connectivity, address health, work and care challenges, and help people unlock the potential benefits of living longer. DH
  176. 176. The International Longevity Centre-UK is an independent, non-partisan think-tank dedicated to addressing issues of longevity, ageing and population change. So how can we maximise the potential of technology? (we just need the political will)  Ensure social care is adequately funded  Design products better (inclusive design)  Tackle digital exclusion  Better engage with older people about what they want and need  Have a proper public debate on data sharing, protection and ownership  Have regulation which protects consumers but does not stop innovation  Build a culture of private purchase for health products
  177. 177. The International Longevity Centre-UK is an independent, non-partisan think-tank dedicated to addressing issues of longevity, ageing and population change. Is the sharing economy part of the solution?
  178. 178. The International Longevity Centre-UK is an independent, non-partisan think-tank dedicated to addressing issues of longevity, ageing and population change. It might work for some but…  It’s not a new economy  Flexible working will work for some (but how can the gig economy deliver retirement savings?)  Most of us don’t work in the gig economy
  179. 179. The International Longevity Centre-UK is an independent, non-partisan think-tank dedicated to addressing issues of longevity, ageing and population change. Stop patronising old age. Treat adults as adults  Let’s embrace, not ignore ageing  Let’s all stop denying ageing  Don’t treat us like infants as we age  Give people rights & responsibilities for their whole adult life
  180. 180. The International Longevity Centre-UK is an independent, non-partisan think-tank dedicated to addressing issues of longevity, ageing and population change. Start talking about the end of life  Focus on living better rather than longer  We have to die of something  Stop competing disease against disease  Let people be involved in their death  Let’s help people die well  We cant say we believe in self determination for older people but not on end of life issues
  181. 181. The International Longevity Centre-UK is an independent, non-partisan think-tank dedicated to addressing issues of longevity, ageing and population change. Let’s make ageing fun
  182. 182. The International Longevity Centre-UK is an independent, non-partisan think-tank dedicated to addressing issues of longevity, ageing and population change. Swings at bus stops… listening to One Direction (or Metallica)
  183. 183. The International Longevity Centre-UK is an independent, non-partisan think-tank dedicated to addressing issues of longevity, ageing and population change. (although ageing is hitting condom sales!) http://www.bloomberg.com/news/articles/2016-01-24/china-s-foreign-condom-frenzy-gives-low- libido-japan-a-boost
  184. 184. The International Longevity Centre-UK is an independent, non-partisan think-tank dedicated to addressing issues of longevity, ageing and population change. But we are at least getting our swings..
  185. 185. The International Longevity Centre-UK is an independent, non-partisan think-tank dedicated to addressing issues of longevity, ageing and population change. We can have a new golden age. Delivering the utopian lifecourse vision? Grow up, have fun, spend, work, save, care, spend, learn, work, save, have fun, work, save, care, learn, work, be cared for..
  186. 186. The International Longevity Centre-UK is an independent, non-partisan think-tank dedicated to addressing issues of longevity, ageing and population change.  Public policy and financial services should better help us smooth our income (and expenditure) across our lives?  Universal income?  Access to learning across our lives?  Access to care and support for young and old?  A more equal society?  What do you think?
  187. 187. The International Longevity Centre-UK is an independent, non-partisan think-tank dedicated to addressing issues of longevity, ageing and population change.  Ageing is a social revolution whose time has come  We have made some progress  There are a few uncertainties  But we know that we are miles from where we need to be  There are no silver bullets – Or perhaps there are?  Getting to a new golden age is possible  We just need the political will http://www.flickr.com/pho tos/48039948@N02/607 0071650/sizes/m/in/pool- 92307085@N00/
  188. 188. The International Longevity Centre-UK is an independent, non-partisan think-tank dedicated to addressing issues of longevity, ageing and population change. See you in 2017 @sinclairda @ilcuk davidsinclair@ilcuk.org.uk International Longevity Centre-UK
  189. 189. Professor Sarah Harper Director Oxford Institute of Population Ageing #futureofageing
  190. 190. ‘Future of an Ageing Population’ - Making the UK more resilient to age-structural change and longevity: translating academic evidence into policy Professor Sarah Harper University of Oxford ILC 9th November 2016
  191. 191. GO-Science UK demographics are changing. Approximately 75% of UK projected population growth between 2012-2040 is in the 60+ group. Meeting the challenges of the ageing population will have policy implications for housing, work, education, families, health and care, and technology. Population size in millions to 2040, broken down by age groups1 Projected percentage of the population aged 65+, 2037 202 Context and background
  192. 192. GO-Science Demographic trends Right: Population size in millions to 2040, broken down by age groups Populationsize(millions) Sources: [to add] 203 Left: historic & projected period life expectancy at birth (years) Life expectancy increasing Population age structure changing Left: the population distribution of UK according to age, males, 1925, 1950 and 2015 Livebirthsperwoman Fertility below replace level of 2.1 live births/woman Right: total fertility in the United Kingdom, 1960-2011 75% growth in 60+ age group whilst other age groups remain fairly constant Lifeexpectancyatbirth(years)
  193. 193. As a result not only are individuals living longer, they are doing so within a UK population which is in itself growing older. To grow old in a society where most people are young is fundamentally different from doing so in a society where most people are old. In demographically young populations, there are high proportions of economically active individuals who may produce the wealth needed to support dependents, old and young. However, these societies may not place much emphasis on the wellbeing of older people as they comprise a small minority of the overall population. Conversely, demographically old populations have a lower proportion of economically active individuals and thus the responsibility of providing for old age dependency may be increasingly fall to the older person themselves. 204
  194. 194. Societal Risks for Ageing Societies The shift from predominantly young to predominantly older populations raises concerns over 1. The ability of nations to finance the social security and long term health and social care which are required to support a growing number and percentage of older dependents, at a time when the number and percentage of those who are economically active is declining. 2. The ability to reconfigure health and long term care provision. 3. The reconfiguration of social institutions to address issues of intergenerational and intergenerational fairness, that is fairness and equity within and between different generations as population age and the support of individual well-being across the life course Inequalities in access to resources, health, economic and social, is likely to remain a pressing concern over the coming decades. 205
  195. 195. GO-Science Implications of demographic trends Right: Projected Population change 2012-37 (million people)4 Populationsize(millions) Sources: 1. ONS (2014) 2. OBR Fiscal Sustainability Report 2015 ;3. DCLG 2012-based household projections; 4. Champion, T (2015) 206 Left: working & pensionable age population & old age dependency ratio (‘working age’ person per ‘pension age’ person)1 Work: fewer people of working age per older person Housing: demand growing in older age groups Livebirthsperwoman Health: long term pressure on cost of care Connectivity: potential challenge from large growth of older populations in towns and rural areas People(thousands) Left: Head of household in England by age, 2012 and 2037 (thousand people)3 People(millions) Right: Projected public expenditure on health and long- term care from 2014/15 to 2064/65 as a % of GDP2
  196. 196. Work: fewer people of working age per older person Working & pensionable age population & old age dependency ratio (‘working age’ person per ‘pension age’ person)
  197. 197. Health: long term pressure on cost of care Projected public expenditure on health and long-term care from 2014/15 to 2064/65 as a % of GDP
  198. 198. Connectivity: potential challenge from large growth of older populations in towns and rural areas Projected Population change 2012-37 (million people)
  199. 199. Head of household in England by age, estimations for 2012 and projections for 2037
  200. 200. 211
  201. 201. Lead Expert Group • Professor Sarah Harper (Chair) - University of Oxford • Professor James Banks - University of Manchester and Institute for Fiscal Studies • Professor Paul Boyle CBE - University of Leicester • Professor Tom Kirkwood - Newcastle University and University of Copenhagen • Professor Martin Knapp - London School of Economics and Political Science • Professor Jeremy Myerson – Royal College of Art • Mrs Mary Sinfield OBE - Former Chairman of the New Dynamics of Ageing Programme’s Older People’s Reference Group • Professor Alan Walker CBE - University of Sheffield • Mr Oliver Wells - Devices for Dignity Healthcare Technology Co-operative 212
  202. 202. The challenge in all regions is how to sustain and enhance well-being across an individual’s life, while at the same time reducing the inequalities within each generation, and ensuring an equitable reallocation of resources between the generations 213
  203. 203. GO-Science Productivity and Employment Lifelong Learning Housing Families Health and Social Care Connectivity 170 Main themes of the project
  204. 204. GO-Science Internet use by educational qualifications 215 Areas of the UK with the slowest internet speeds have disproportionately higher populations of older people. There is a “digital differentiation” in uptake in the population associated with age, income, gender and disability. Overall broadband performance by administrative authority Technology can provide the solutions to challenges of an ageing population
  205. 205. GO-Science How can technology address demographic challenges? Frequency of loneliness by marital status, older adults4 %ofeachagegroup Sources: 1. ONS (2014) 2015 ; 2. Monitor/HMG (2015) 3. Torrington (2015) / BRE; 4. ILCUK / ONS (2015) * Fixed costs include larger structures such as wards; semi-fixed include bed bays; variable costs are based on basic ward staffing requirements 216 Left: % of each age group of workers who work from home (with total numbers above each bar)1 Work: Extending working lives through smart & connected homes, workplace adaptations Housing: Improving homes through low-fi solutions (stairs, footing, lighting) Health: Remote/home-based care can provide cost efficiencies & services tailored to individual circumstances Right: Cost of a patient spell on a community- based scheme in its fifth year compared to a spell for an equivalent patient in the acute hospital Connectivity: ICT can help social connectivity, alleviating loneliness Cost(£billions) Left: Head of household in England by age, 2012 and 2037 (thousand people)3 People(millions) Percentage Left: cost of common health hazards to NHS)3 *
  206. 206. GO-ScienceSources: 1. Dutton and Blank 2013; 2. Ofcom 2015 217 Barriers (1): sub-optimal technology uptake in the older population Internet use by lifestage1 • The older population has lower technology uptake levels. • ‘Catch-up’ of existing technology is likely to occur over time as cohorts who learnt technologies earlier in life grow older. • However, this phenomenon is balanced by the pace of technological change. The older population is always likely to be ‘left behind’ to some extent (without intervention). * Technology readiness is a concept developed by Professor A. Parasuraman in 2000 and refers to the propensity to embrace and use new technologies for accomplishing goals in home life and at work. Full reference: Parasuraman, A. (2000) Technology Readiness Index (Tri) A Multiple-Item Scale to Measure Readiness to Embrace New Technologies Journal of Service Research 2(4) 207-320 Proportion of adults who own a smartphone, by age2 %ofUKadults
  207. 207. GO-ScienceSources: 1. Dutton and Blank 2013; 2. ONS 2014 218 Barriers (2): Differences in uptake within cohorts (e.g. between different socio-economic groups) will widen as cohorts age • Digital ‘divide’ or differentiation in uptake in the population associated with income, gender and disability, as well as age. • Technology readiness also depends on wealth, social context and culture. • In summary: wealthier, socially active individuals possess & maintain a higher level of ‘technology readiness’ longer than poorer, socially excluded individuals. This is exaggerated into older age. Internet use by educational qualifications (2013)1 Internet non- users % of population (2014)2
  208. 208. GO-ScienceSources: 1. Dutton and Blank 2013; 2. ONS 2014; 4. Resolution Foundation 2012 219 Implications of low technology uptake in ageing population Wellbeing: individuals will not gain full benefits of technologies in terms of wellbeing or independence. Society does not get full benefits in terms of reduced dependency and cost effective public services. Survey for +50 group: what 2 or 3 things are you most worried about as you age?2 Employment status of people living in low to middle income households for carers and non-carers4
  209. 209. GO-Science • Skills: 79% of 65-74 year olds had ‘low’ or ‘no’ internet skills in 2013. • Perceived benefits/utility of ICT: Older adults are currently deeply ambivalent towards ICT, use it for limited purposes and only when it does not interfere in their daily lives2. • Affordability and perceptions of affordability are often rooted in long- established spending patterns and consumer behaviour. Specific internet skills by lifestage6 What are the barriers to technology adoption? Sources: [to add] 220 % of participants in one study who agreed that “technologies are very useful”7
  210. 210. GO-Science • Choice, control, issues of privacy, and fear of reduced social interaction in certain technologies (e.g. assisted living technologies3 and telecare4). • Technology can be hard to access of perceived as hard to access, including: • Fonts, layouts of web-based applications including some telemedicine systems • Insufficient ‘reach’ of monitoring & community alarm systems • Bulky, cumbersome, awkward wearables • Poor sound quality of audio equipment Specific internet skills by lifestage6 What are the barriers to technology adoption? Sources: [to add] 221 % of participants in one study who agreed that “technologies are very useful”7
  211. 211. A Coherent Response to Ageing The report combined evidence about today’s older people with future trends and projections to identify the most critical implications of the ageing population for government policy and the socio-economic resilience of the UK. The following principles were followed to ensure a coherent response to ageing: • The future success and resilience of the UK will be determined in a large part by its ageing population. • Issues cannot be addressed in silos. A co-ordinated response is likely to be more successful than addressing issues in isolation. • Most domestic policy areas will be affected by the ageing population. Beyond the expected (Health and social care/pensions) are housing, education, family, transport, infrastructure and technology. 222
  212. 212. A Coherent Response to Ageing The report combined evidence about today’s older people with future trends and projections to identify the most critical implications of the ageing population for government policy and the socio-economic resilience of the UK. The following principles were followed to ensure a coherent response to ageing: • Factors throughout an individual’s lifetime affect how they age. To improve outcomes for people as they age – whether in skills, health, employability, housing or financial assets - requires interventions from an early age, and an understanding of the impact of policies through the life course. • Regional and local variation must be understood. There are also important differences between how the devolved administrations will experience ageing. 223
  213. 213. Oxford Institute of Population Ageing Picture: Nasir Hamid/Oxford University
  214. 214. A Population Ageing Perspective Discussion #futureofageing
  215. 215. End of Afternoon session Lawrence Churchill CBE Trustee ILC-UK #futureofageing
  216. 216. 09 November 2016 #futureofageing The Future Of Ageing ILC-UK Conference 2016

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