Sixty may be the new 40, but will 80 ever be the new 60? It will need to be, if the NHS is to support a changing population.
When the NHS was founded in 1948, nearly half the population died before the age of 65. Now only 14 per cent do. By 2035, the over-65s will make up 23 per cent of the population. 鈥淔or the vast majority of chronic diseases, age is the single biggest risk factor,鈥� says at Newcastle University鈥檚 Institute for Ageing.
The main problem is that the health service is designed to treat single-organ diseases, but most elderly people have more than one medical condition. Work by Kirkwood鈥檚 group 鈥� 鈥� found that 75 per cent of people in this bracket have four or more age-related diseases. However, almost all guidelines are disease specific and based on clinical trials involving younger people with a single condition, says at the University of Exeter, which means that treatments might not work as expected. The lack of 鈥渏oined-up鈥� care for combinations of conditions is also a problem, says Kirkwood.
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The NHS is aware that change is needed. 鈥淲e鈥檝e got to move away from health services that are predominantly reactive and waiting for something to go wrong,鈥� Simon Stevens, chief executive of NHS England, told a conference on ageing and health at Chatham House in February. He said that GPs are well placed to plan and coordinate the kinds of care needed before things go wrong. Pharmacists could play a role too. 鈥淭hings never tend to get taken off the prescription list, which just gets added to,鈥� says Kirkwood. If pharmacists were empowered to review and manage a person鈥檚 drug cocktail, health and budgets could both benefit.
To ensure the future health of the NHS, younger generations need to age more healthily than previous ones. This means focusing on the lifestyle risk factors that we know have a strong effect on health, such as smoking, poor diet, being overweight and low physical activity, says Elaine Rashbrook of advisory body Public Health England. 鈥淚f you鈥檙e active earlier in life, you鈥檙e above the disability threshold for longer because you鈥檝e built up that strength earlier on,鈥� she says.
Kirkwood believes we can do a lot to contain rising costs by being more effective in the way we deliver care. 鈥淚t鈥檚 a challenge, but it鈥檚 not something that should have us quaking in our boots.鈥�
Read more: 鈥�NHS game-changers: The key challenges to healthcare鈥�
This article appeared in print under the headline 鈥淲e鈥檙e living longer 鈥� but are we fit enough?鈥�
