1. 2nd October 2017 Age UK London - Working for You
Health &Social Care 2017
Summary
2nd October 2017

2. Long Term conditions (LTCs)
England 15 million+ people have an LTC
LTC = “a health problem that can’t be cured but can be controlled by medication/other therapies - includes high blood pressure, depression, dementia and arthritis”
In our 80’s – only 1 /7 will not have any LTCs
Aged 85, 80% of us will have at least 2 LTCs
Similar pattern care needs – in our late 80’s, over 1 in 3 of will have difficulties undertaking five or more tasks of daily living unaided

3. Long Term conditions (LTCs)
Increasing, particularly those with 3+ LTCs
Affects many parts of life, ability to work and have relationships, housing, education opportunities.
Care of people with LTCs accounts for 70% of money spent on health/social care in England.
We need right health/care to live as well as we can!

4. Government Policy LTCs May 2015
Most people have more than one LTC , and spend most of their time not in contact with health or social care services
Recurring concern about benefit contact with health service brings for people with LTCs.
“We want to think differently about living well – rather than ‘managing’ long term conditions – in a way that is meaningful to people and their families and the lives they want to lead”.

5. Context Social Care
£160 million cut total spending real terms on older people’s social care in 2010 to 2015
Nearly 1.2 million people 65+ don’t receive help they need with essential daily living. A 17.9% increase last year and a 48%increase since 2010
Nearly 1 in 8 older people live with some unmet need
Age UK analysis - local government spending on social care will fall 8.3 % real terms between 2015/16 – 19/20
% of older population receiving social care support fell 15.3% in 2005/06 to 9.2% in 2013/14

6. Carers & Care Market
2011 = 8.2 million carers - by = 9m+, helping loved ones with increasingly complex needs
2m+ carers aged 65+, 417,000 of whom are 80 plus
37%+ of carers 80+ providing 20 hours or more of care a week
34% providing 35 hours or more.
Nearly two thirds of older carers have a health condition or disability
72% report feeling pain or discomfort, rising to 76%for those providing 20+ hours of care a week

7. Carers & Care Market
Despite numbers carers rising, no substantial increase in proportion of population providing care
Alongside:
Rapidly rising levels of unmet need
Impact of changing family structures
Greater geographic dispersal
Rising State Pension age
… suggests provision of informal care has not been able to fill gap left by declining care services
2015/ local authorities reported at least one home care provider ceased trading in their area

8. State of Healthcare
NHS funding increased 2015/16, primarily due to £2 billion pledged 2014 Autumn Statement, but insufficient to plug NHS’s growing deficit
End 2013/14 deficit NHS hospitals = £109m - has accelerated rapidly to £2.5 billion end of 2015/16
Despite funding increases, money coming into hospitals not keeping pace costs of services. Due to:
Treatments they deliver over recent year
Hospitals’ need to achieve ‘safer staffing levels’ in wake of the Mid-Staffordshire Inquiry
Many hospitals seeking to address shortfalls through increased recruitment and costly agency fees

9. Doctors
Doctors - fastest growing group health care professional recent years
Whilst numbers of hospital and community health service doctors increased from 97,130 in 2010 to 104,498 in 2015, - numbers of GPs fell by 3.4 per cent from 35,243 to 34,055
Demand in general practice growing steadily 20 yrs.
, longitudinal study concluded consultations had grown by 38.3% from 217 million consultations pa to 300 million pa

10. GPs
2010/11 and 2014/15 Analysis by Kings Fund found that:
Number of GP contacts with patients increased by 15.4 per cent between
Proportion of contacts with those aged 85+ increased by 16 per cent over the period, compared to just four per cent amongst those aged 18 to 64.

11. Impact on Older People
No. older people reporting a good experience of getting a GP appointment in decline
Numbers older people attending A&E departments increased significantly last 5 years
Overall, number of hospital inpatient episodes has risen significantly in recent years
Older people account for 65% of these admissions and generally stay longer in hospital

12. Outpatient Services
2010/ /15 number of outpatient appointments people aged 60+ increased by a third from 28.1 million a year to 36.1 million
Increase far exceeds increase in the overall numbers of people in this age group
Effective use of outpatient services essential in managing many long-term conditions and avoiding multiple and repeat visits across different specialties

13. Delays
Delayed discharges – increased because of waits for home care
Waits for residential care - increased 40%
Since beginning 2014/15
Number of days delayed waiting for a care package in your own home has more than doubled
Total number of people waiting has risen at a much slower rate (28.8 per cent), suggesting waiting times for each individual are getting longer rather than a rapid rise in the number of individuals waiting

14. But…….it’s complex….
Prevalence all major chronic and long-term conditions increase significantly with age
Older population is extremely diverse - ‘65+ generation’ as two generations
Increasingly common people in their 60s & even 70s to have living parents/older relatives
Huge diversity within those generations particularly in the likelihood of living with poor health and disability as we age.

15. On aggregate growing older population is driving greater demand for health/care services
Too simplistic an equation to say more older people inevitably equals a greater burden of disability and disease
It is a calculation that misses:
Possibility of improving health in later life
Fails to account for changing nature and complexity of some of our health needs as we age
But…….it’s complex….

16. Good News!
Acquiring a health condition does not necessarily mean high levels dependency on health/care services
Most people 75+ have one or more health conditions, but almost 50 per cent of them do not consider themselves to be living with a ‘life limiting’ long-term condition, meaning that even if they have one or more health conditions this is not perceived to have a significant impact on their lives
Good newsthe onset of age-related conditions and disability can be prevented or delayed!