1. The Future of Ageing – Yours and Mine! Longer lives – how can all of us benefit? Yorkshire Grant Makers Forum 18 November 2015 Geoffrey Filkin

2. Ready for Ageing? A lot more discussion, not a lot more action We have not all understood that: We will live much longer Later life can be a time of happiness It requires big shifts in our attitudes and how we plan and prepare And that what we do before we are older affects our later life Many will enjoy great benefits but others risk a poorer later life

3. Society has not recognised the opportunity: See it as a crisis not a great gift We under-estimate the asset of older people And the potential for more collective action Government has so far: Not gripped the significance or benefits Seen it mainly as a fiscal threat Been short term, silo’d and reactive Not set out the changes we all must make We await tomorrow’s settlement

4. The Opportunity Living longer – the greatest gift of our lives: Life expectancy has risen greatly and is still rising Men live 7 years longer than 30 years ago 50% of girls born in 2011 will live to 97 or more A later life can be a very good one In ten years there will be many more older people: 17% more people 65+; 40% more people 85+ A profound, certain and persistent change Affects society, the economy and every one of us.

5. Longer lives offer great benefits but require change, yet: Individuals struggle to prepare for a longer life Government is not coping with today’s ageing challenges! We are still not Ready for Ageing and it matters. A new settlement is needed to address the opportunities and challenges. Action by individuals, communities, business and the state will be needed to make for better later lives.

6. What do we want for a better later life? Good enough health and financial security These are necessary but not sufficient We also want to sustain our identity and independence To live in a home and neighbourhood good for later life And critically, to have relationships, meaning and purpose Despite challenges, many can get great value from later life Ageing Better will report on who is “happy” or not in their later lives. What people want for a better later life should set our societal goals.

7. Who is missing out now? Many will benefit from longer lives; many risk not doing so Fewer pensioners in poverty Average pensioner incomes now above the average for the working population. But: - Big inequalities in life and healthy life expectancy and frailty -11 million people are not saving enough into a pension -Only 3% of homes are mobility accessible -Striking differences in people’s well-being These define where we need to act for better longer lives Ageing Better will review what is known about these inequalities

8. Who may be at risk in the future? People at risk of a poorer later life in future include those: -without decent employment pensions -unable to save sufficiently -who cannot sustain employability -have not adopted healthy life-styles -have premature chronic long term conditions -are unable to get the care and support they need -are socially isolated How can we reduce these risks to help better later lives?

9. What can we do ourselves? What we do before we are old greatly influences later well-being: Planning and preparation Keeping in employment Saving enough Keeping active, nutrition, weight, smoking, alcohol Our relationships and meaning in our lives Resilience to face major life changes

10. Changing is not easy We all deny, delay, discount How can we be helped to change? Do we need a big social movement to get these messages across? And to understand that to some extent we can make our own future. The new settlement must maximise individual and collective action for better later lives.

11. Three Policy Risks for Better Later Lives 1. Our voluntary pension’s savings system High housing costs, downwards pressure on wages and denial mean many will not save enough. 2. NHS demand, funding and re-modelling We have a National Illness System, hospital centric, it fails to join up; and demand is rising fast. The current system will fail older people. 3. Social care - a crisis now, where will be in 5 years? These significant risks need to be addressed

12. Care for Ageing Social care needs have increased, yet public funding has reduced The social care market is shrinking; serious concerns about care quality, workforce skills and supply Confusion about who pay for what and no insurance market developed. Many more people will be frail or have long term conditions: People aged 85+ In England: - 17% more by 2020 - and 40% more by 2025 The current system is in crisis and need is growing

13. We need commitment to transform social care: To build the workforce numbers and skills To produce more domiciliary care and care homes To help those who cannot pay for themselves To support carers and families better To build community responses to support informal care This requires a ten year programme to re-structure health and social care services and stimulate a quality market of services and homes. If not done, many will have a poorer later life

14. Health for Ageing The NHS Five Year Forward View defined three key changes: More prevention; Service re-configuration and innovation; funding to support the changes Are they happening? Prevention matters greatly: What we do to ourselves determines our health more than the NHS Yet prevention is seen as secondary

15. Wanless Report 2002 and Prevention Wanless: vital to engage people in living healthier lives for a sustainable NHS. Vital too for better later lives Thirteen years after Wanless little has been done to address this! We need a national campaign and persistent programme to reduce obesity, low physical exercise, poor nutrition, smoking and alcohol. People deny or do not know the risks and consequences. Nothing like enough being done to change this. We have to make this happen over the next decade or many in deprived communities and social groups, will have poor later lives

16. Funding for NHS and Social Care Preventing illness and expanding community action to provide support for others are both essential. But these will take time and NHS and social care will demand more funding in the meantime. New funding ought to go into service re-configuration and prevention, not to prop up the old system. A ten year programme of change, with strong leadership and a national campaign is needed to help many more people live healthier lives.

17. An Agenda for Ageing Better How can our society ensure many more enjoy a good later life? This requires action by all of us, individuals, communities, private and voluntary sectors, academia and government And Ageing Better aims to contribute Realising the benefits of longer lives should be our collective goal

18. Individuals We all have to act to improve our well-being in later life: We need information and advice of what works We need help to make changes in our attitudes and behaviours We must prepare and plan for a later life We need older people themselves to have a stronger voice We must be much better at listening to them

19. Communities Better later lives cannot be achieved just by the state We need to stimulate and support community action to help older people have a better later life, particularly the frail and ill. We must stimulate more volunteering by many willing older people; a benefit to them and to others We need to find what works to do so and make it happen

20. Private sector An innovative private sector must support ageing with better products and services, especially harnessing technology and realise the growth opportunities from the “silver society” Voluntary sector The many good charities can help more by working together more and also considering future older people as well as todays. Academia We need more research that is likely to be useful. And innovations that generate useful evidence Funders, academics, older people, policymakers and practitioners need jointly to discuss where evidence and research is needed.

21. Government Leadership is crucial to: affirm the benefits of longer lives give leadership to the agenda for change transform health and care systems for an ageing society address housing supply failures for old and young maximise the benefits of an ageing society, the silver economy, longer working, GDP growth. We await an announcement to address this

22. The new settlement Each of us must own our better ageing But we need some help to realise it from our families, communities and public policy and services. All the key parties, people, charities, business, government jointly need to commit to work for improved well-being in later lives now and later. We should commit to make significant improvements by 2025.

23. Annex Centre for Ageing Better A What Works Centre, promoted by Government, endowed by BIG, independent of both, funded for ten years. We start with the person; driven by evidence; focused on change, independent, open andcollaborative We will use evidence and our voice and to help make change, working with older people and organisations to improve later life. Next week we will publish our review of who has well-being and who doesn’t, of what makes for a better later life and our programmes. We look forward to exploring how we may work together to help people enjoy their longer lives. Geoffrey Filkin November 2015.