3 mitchell new mm ifa 2012 v3 120529
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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