Chief Medical Officer's annual report warns of ageing population

Chief Medical Officer, Chris Whitty has published his annual report, in which he recommends actions to improve quality of life for older adults and prioritise areas with the fastest growth in older people.

The focus of the report is on how to maximise the independence, and minimise the time in ill health, between people in England reaching older age and the end of their life.

The report is aimed at policymakers (government and professional bodies), healthcare professionals, medical scientists and the general public.

Professor Whitty says there are two ways to maintain people's independence. The first is to reduce disease, including degenerative disease, to prevent, delay or minimise disability and frailty and the second is to change the environment so that, for a given level of disability, people can maintain their independence longer.

He also points out that the geography of older age in England is already highly skewed away from large urban areas towards more rural, coastal and other peripheral areas, and will become more so and therefore the efforts to achieve shorter periods in ill health and an easier environment for those with disabilities, should concentrate on areas of the country where the need is going to be greatest. This means that the expansion of medical and NHS services needs to be in these areas.

Whitty said: "In general, helping people maintain health is the role of public health and medicine. Improving the environment for older adults includes issues around urban planning, building design, social care and aids to independent living. There is of course a lot of overlap; for example, an urban environment which allows older adults to use active transport, especially walking, safely will both improve their current independence and their future health."

He continued: "For policymakers, the biggest concern I have is that government and professional bodies have not recognised the degree to which the population living in older age is concentrating geographically in the United Kingdom in general, and England specifically. The great majority of people move out of cities and large towns before older age, concentrating geographically in coastal, semi-rural or peripheral areas, often with relatively sparse services and transport links. Manchester, Birmingham and London will age very slowly but areas such as Scarborough, North Norfolk or the south coast are going to age rapidly and predictably. Providing services and environments suitable for older adults in these areas is an absolute priority if we wish to maximise the period all older citizens have in independence. The provision of health and social care also needs to be concentrated in these areas.

"For the medical profession, wider healthcare professionals and medical scientists I would like to highlight the importance of multiple long-term conditions in older age, often called multimorbidity. This is increasing and will continue to increase in the future. Medical specialisation, specialised NHS provision, National Institute for Health and Care Excellence (NICE) guidelines and medical research are all optimised for single diseases but that is not the lived reality for the great majority of older adults who often transfer very rapidly from having no significant disease states to several simultaneously. The increasing specialisation of the medical profession runs counter to optimising treatment for older citizens and patients. We must address this seriously as a profession."