This document summarizes key findings from a new report by Age UK on pathways to better health for older people in England and the UK. [1] It examines how successful the countries have been in preventing later life disease and disability and delivering high quality medical treatments. [2] While life expectancy has increased, healthy life expectancy has not kept pace. There are also major gaps in integrated care delivery and public health priorities for older adults remain low. [3] The report calls for a shift towards shared decision making, comprehensive needs assessments, and support for older people to manage their own conditions and stay independent.

1. Pathways to better health for older
people: Focusing on the person
Michelle Mitchell, Director General
Age UK

2. Our new report
I’m pleased to introduce our
new report
It examines two key questions:
1. As a country, how successful has
England and the UK been in
preventing later life disease and
disability?
2. How well are we delivering high
quality medical treatments for the
common disabling diseases of later
life?

3. Health in later life
Prevalence of disease, 65 +
Source: Health Survey for England 2005
His risk of dementia will rise dramatically over the next 10
years

4. Life expectancy and healthy
life expectancy

5. What’s wrong with the current system
• Major gaps in variation of care
• Care insufficiently integrated or centred
on needs
• Cannot meet efficiency challenges of
system
• Public health in later life and maintaining
wellbeing across the life course a low
priority

6. Even between comparable,
countries, variation persists
Colorectal cancer 5 year survival rates
70
Colorectal Cancer
Relative survival estimates (%)
60
50
40
30
20
10
0
Australia Canada Denmark Norway Sweden UK
55-64 years 65-74 years 75-99 years
Source: Coleman et.al. 2010

7. A poor deal for older people
In men over 75 (England):
– Around 40% have untreated or uncontrolled
hypertension
– Around 40% have high cholesterol
– Around 20% have diabetes
• 80% have not received training in self-
management
• 20% do not get their feet checked
– 73% are not helped to prevent their arthritis getting
worse and 67% do not have pain management
options discussed

8. Unfinished business
Dramatic drops in mortality a major success
BUT Care needs change rather than disappear
1,000
MEN Respiratory
900
Rates per 100,000 population
Circulatory
800 Inf ectious
700 Cancers
600
500
400
300
200
100
-
1911 1921 1931 1941 1951 1961 1971 1981 1991 2001
Year
Source: ONS, 2011

9. Public spending on older people 2010/11
£150bn
Social care
NHS
£100bn
£50bn
Social security
benefits
£0bn
Dilnot et al: Conclusions and recommendations of the Commission on Funding of Care and Support, 2011

10. Meet James

11. Pathways
Now In the future
• Decisions are made for •Shared decision-making
James
•No comprehensive •Community and individual
assessment of need needs understood
•Conditions addressed in •Care planned against
isolation agreed outcomes
•Social circumstances •Social care support fully
ignored incorporated
•Information not available to •Reduced need to use
care for himself health services

12. Principles for care
• Huge opportunities to improve treatment
quality and achieve better outcomes
• Healthcare must be designed with older
people and support shared decision making
• Invest in managing long-term condition
management
• Invest in prevention
• Unlock potential for older people to care for
themselves
• Shift in cultural attitudes

13. Thank you