Making integration “core business”

Guest blog post by Professor David Oliver.

David is Consultant Physician, Royal Berkshire NHS Foundation Trust; Visiting Professor of Medicine for Older People, City University, London; Visiting Fellow, the Kings Fund; President-elect, British Geriatrics Society; and Recently of the Department of Health National Clinical Director for Older Peoples Services (England).

Population ageing is surely a cause for celebration not catastrophising. It represents a victory for societal conditions, for preventative medicine and public health and for advances in medical treatment. And it gives all of us a higher chance to live well in to older age. Just after the Second World War, nearly half the UK population died before 65. It’s now only 14%, with the over 80s the fastest growing demographic. By 2030 a UK man of 65 will live on average to 88 and a woman till 91.

Although older people generally report high levels of wellbeing and happiness and many remain remarkably independent and connected, we can’t duck the fact that more older people has inevitable consequences: more people with multiple Long-Term Conditions, with frailty syndrome, with Dementia and with a degree of disability or dependence. These same individuals are often reliant on multiple services and practitioners and on informal care from family and friends.

Our current service model needs to shift far more towards prevention, towards co-ordinated care focussed around the needs of individuals rather than single disease and to recognise that the care of such older people is now “core business” for health and care systems. If we don’t get care right for older people with complex needs, we won’t get it right for any group. This has radical implications for workforce, education and training and for collaborative and integrated working between organisations. Wales already has some of the building blocks in place to help realise these goals and many current examples of good services for older people. But we need to spread and implement good practice at scale and pace to get “the rest as good as the best” and be prepared to look to other health systems for other examples of “what good looks like”.

We hope these events and the “community of good practice” which follow on from them will help facilitate the public conversation, improve collaboration and encourage the dissemination of good ideas. Ultimately, we hope it will result in services that go beyond “mission statements” and really are built around the needs of our ageing population.

Here is a snapshot of the key messages from a recent report by Professor Oliver and his colleagues, ‘Making our health and care systems fit for an ageing population’.

Leave a Reply