Today, Age UK launches ‘The health and care of older people in England 2015’ report, that analyses the degree to which the needs of older people are being met by health and care services. Jill Mortimer, Policy Adviser at Age UK , looks at the findings of the report.
What’s really happening in health and social care services? Over the years, in our Care in Crisis series we documented the devastating budget cuts that meant fewer and fewer people were getting public support for help with their day to day activities.
Trends in the NHS
But what about the NHS? Hasn’t it been protected through the last five years of cuts in public services? If so, what lay behind last year’s winter crisis? And why is Monitor, the health services financial regulator, now talking about the ‘worst financial crisis in a generation’?
These are the kinds of questions people are now asking and in our new report we try to answer them. We have updated our usual annual analysis of trends in social care and added analysis of trends in the NHS. We present the most authoritative and up to date facts and figures to understand older people’s health and care needs and the extent to which these are being met by our health and care systems.
Taken as a whole, the results are very worrying.
Although the NHS budget has been protected it has only increased by 0.8 per cent a year over the last five years when most experts believe it needs to increase by 3 to 4 per cent to keep up with new technologies and treatments and increases in the numbers of older people with multiple health conditions and other factors that increase demand.
Cuts to social care funding
Spending on social care has continued to fall and as a result even fewer people now receive publicly funded support. The rate has dropped from 15 per cent of people aged 65 and over in 2005/06 to 9 per cent in 2013/14 – this at a time when the numbers of older people in our population are growing.
It is the primary and community based services where supply is most obviously failing to meet rising demand. Unfortunately, these are the services on which many older people depend in order to sustain their independence.
So for example, demands on GP practices have increased steadily whilst the budget has remained static. It’s not surprising therefore that in a BMA survey in 2015, 74 per cent of GPs agreed that their workload was unmanageable and unsustainable compared to 67 per cent in 2014.
In another 2013 survey, 20 per cent of district nurses said they provided only a poor or fair service linked to increases in the number of people they saw each day: dispiriting for them and not in the best interests of older people.
Public funding for care services in the home decreased by 20 per cent since 2010/11. Fewer people, with higher needs received them. More than one million older people with difficulties with everyday tasks of daily living – like washing, getting to the toilet, getting out of bed, eating – didn’t get any help of any kind at all – not from neighbours, family or friends or that they have paid for themselves.
Increased pressure on hospitals
The result of all this is much more intense pressure on hospitals.
The number of A&E attendances by people aged 60 and over increased by two thirds between 2007/8 and 2013/14.
There has also been an increase of 48 per cent between 2001 and 2013 in hospital admissions of people aged 75 years and over for conditions such as pneumonia and urinary tract infections, many of which could have been avoidable if there had been earlier access to good primary and community health and care services.
In addition, loss of hospital capacity because patients are waiting for a suitable place to go to before they can be discharged is increasing alarmingly. The number of bed days lost has rocketed by 40 per cent between 2011/12 and 2014/15.
Changing the funding of health and social care
Most older people are appropriately concerned about their health and the role that the NHS and social care play in helping to be resilient as they age matters a lot to them. There are also some positive developments going on in many local areas as professionals try to join up health and care services around the needs of individual older people,. But we fear they will not be enough. Unless there is significant change to the funding our health and care services in the Spending Review in November we look to the future with considerable foreboding.
Age UK is calling on the Government to invest in care for older people. Sign our Don’t Cut Care petition