Ageing positively

Dear editor,

I read with interest the well written editorial piece by Dr Currie¹ which highlighted the need to tackle the challenging issue of ageing positively head on. Here in the United Kingdom, we have perhaps not been as proactive to meet the challenges brought on by the changing ageing demographic. We are now witnessing how an increasing ageing population has had an impact on the way we provide, commission and deliver health care. In 1985, only 15% of the UK population were over the age of 65 years. This increased to 17% in 2010 but by 2035, it is projected to account for 23% of the total population.² An unwanted consequence of living longer is that older people are more likely to live with complex co-morbidities, disability and frailty. This has impacted on our health and social care expenditure where those over 65 years account for 51% of social care spending,³ two-thirds of primary care prescribing budget;⁴ and 70% of total health and social care budget is spent on those with long-term conditions.⁴ Whether attributed to a restricting health care budget or not, the quality of care that we have provided to our older people has at times been lacking too. The King's Fund, a highly respectable and influential independent body working to improve health care in England, describes an integrated health service model which places an older person at its centre. It begins with ageing well (or ageing positively); living well with provision of support for long-term conditions; high-quality acute care with good post-discharge support; effective rehabilitation; and in the end, supportive palliative care.⁴ The success of such a model, or indeed any health care model for older people, will only be achieved through integration of primary and secondary care; health and social care; and with a health policy that is willing to tackle the challenges of an ageing population.