Solving the elderly care crisis

  • To circumvent budget cuts and the increased strain of an ageing population on the NHS, innovation is needed to continue to provide adequate social care to the elderly
  • By 2030, one in five of England’s population will be over 65, and those over 80 are the fastest growing demographic
  • Strategic risk management capabilities of local authorities, primary care trusts, charities and voluntary organisations will need to be enhanced to cope with the twin problems of funding and an ageing population

The NHS may well be a national icon – celebrated by Danny Boyle’s NHS buoyant dance routine at the Opening Ceremony of the 2012 London Olympics – but an ageing population that brings with it increased demands for social care, allied to straitened public finances, is creating a growing funding crisis in providing care to the elderly.

It is a complex issue, and one for which all the main political parties are still searching for a panacea. But as the NHS itself edges past its 65th birthday, the venerable institution now has to deal with people living longer, and with more disabilities and frailties.

When the NHS was founded in 1948, 48% of the population died before they reached 65; but that figure has now fallen to around 14%. Modern medicine may be transforming lives, but has increased the demand on the services provided by the NHS.

People aged over 65 now account for more than 50% of gross local authority spending on adult social care – with that figure set to rise in the coming years. By 2030, one in five of England’s population will be over 65, and those over 80 are the fastest growing demographic.

Prevention and innovation

Tackling these twin problems of funding and demographics is critical, not just for local authorities and primary care trusts, but also for charities and voluntary organisations operating in the realm.

A focus on prevention and innovation in service design is beginning to help – with a fundamental shift taking place to provide services outside of hospitals, such as rehabilitation in the local community following acute injuries and illnesses; good discharge planning and post-discharge support; and rapid support close to home in times of crisis.

Of course, good hospital care is still provided when needed, but moving social care out into the community is one way of providing better value for taxpayers’ money.

Risk management

Of course, innovation brings with it risk. Any changes carry the threat of failure, and could see needy people stripped of their services – but service providers must adapt to remain effective.

Even if it seems aspirational or unattainable in the current climate, innovation aimed at improving patient care is happening. The East of England Ambulance Service in Cambridgeshire, in collaboration with Cambridge Community Services, for instance, has been delivering rapid response intervention services to deal with the issues of older people at home, avoiding inappropriate hospital admissions.

Meanwhile, the Aneurin Bevan University Health Board, has up-skilled its nursing home sector workforce, so it can improve and extend end-of-life care in its local nursing homes.

Many other hospitals and primary and community care providers are coming up with new ideas, along with voluntary and community organisations and the private sector.

But successful innovation requires proper funding, as well as a willingness to take risks while keeping the focus on the vulnerable people being served.

There is also an increase in market competition to consider, which is also placing more focus on the risks associated with competition, such as product and service quality, and the patient experience. Reliance on third parties and risks associated with these new supply chains are just some of the strategic risks now relevant and can carry huge costs of failure.

But these are the challenges faced by everyone attached with providing social care to the elderly today and it is clear that strategic risk management capabilities will need to be enhanced to deal with an ageing population.