3 mitchell new mm ifa 2012 v3 120529

Pathways to better health for older

people: Focusing on the person

Michelle Mitchell, Director General

Age UK

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?

Health in later life

His risk of dementia will rise dramatically over the next 10

years

Source: Health Survey for England 2005

Prevalence of disease, 65 +

Life expectancy and healthy

life expectancy

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

Even between comparable,

countries, variation persists

Colorectal cancer 5 year survival rates

0

10

20

30

40

50

60

70

Australia Canada Denmark Norway Sweden UK

Re

lati

ve s

urv

iva

l est

ima

tes

(%)

Colorectal Cancer

55-64 years 65-74 years 75-99 years

Source: Coleman et.al. 2010

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

Unfinished business

Dramatic drops in mortality a major success

BUT Care needs change rather than disappear

-

100

200

300

400

500

600

700

800

900

1,000

1911 1921 1931 1941 1951 1961 1971 1981 1991 2001

Rate

s per

100,0

00 p

opula

tion

Year

MEN Respiratory

Circulatory

Infectious

Cancers

Source: ONS, 2011

Public spending on older people 2010/11

Social security benefits

Social care

NHS

£0bn

£50bn

£100bn

£150bn

Dilnot et al: Conclusions and recommendations of the Commission on Funding of Care and Support, 2011

Meet James

Pathways

Now In the future

•Shared decision-making

•Community and individual

needs understood

•Care planned against

agreed outcomes

•Social care support fully

incorporated

•Reduced need to use

health services

• Decisions are made for

James

•No comprehensive

assessment of need

•Conditions addressed in

isolation

•Social circumstances

ignored

•Information not available to

care for himself

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

Thank you