Hot Topic 3 - Ageing Population

How many people in the UK are aged 65+?

1 in 5 - nearly 11 million people

What is an ageing population?

There is an increasing proportion of older people in the population

Why is there an ageing population?

Health improvements - sanitation, nutrition, hygiene and improved control over infectious diseases

Current life expectancy for males in the UK

79.1 years

Current life expectancy for females in the UK

83 years

old-age dependency ratio in 2022

278 pensioners for every 1000 working age people

projected old-age dependency ratio in 2047

302 people of pensionable age for every 1,000 of working age

What is the current greatest challenge in caring for older patients?

There are 4 interlinked problems

1: Multimorbidity

2: Frailty

3: Polypharmacy

4: Dementia

Multimorbidity

more than half of people over 65 live with two or more long-term conditions, so treatment plans must balance competing illnesses and guidelines

Frailty

a syndrome where small insults (an infection, a fall, a new drug) cause a disproportionate decline

Polypharmacy

older patients are often on many medications, raising the risk of interactions, side effects and avoidable hospital admissions, which is why deprescribing has become a priority

Dementia

• Affects roughly 1 million people

• Complicates consent, communication and discharge

Paradox of increased life-expectancy

Despite people living longer, the number of years lived in good health is falling. This gap between life expectancy and healthy life expectancy means more years spent in poor health - puts a strain on the NHS

Statistic about bed days

People aged over 80 years old occupy a quarter of bed days in English hospitals

Problems with discharging old people

Old people have a longer recovery time, therefore when they are still recovering, but well enough to leave the hospital, they are often discharged with a care plan. This involves the integration of social care and healthcare.

Social care in the UK primarily caters to…

Adults with disabilities or chronic illnesses

What does social care include?

• Personal care, such as assistance with bathing, feeding, and dressing

• Domestic help, including housekeeping tasks

• Medication management, ensuring medicines are taken correctly and on time

Challenges Facing Social Care in the NHS and the UK

• An increasing number of individuals require access to social care services

• The reduced spending power over the last 10 years of local governments, the primary funders of public social care

• The introduction of the National Living Wage, which has increased the cost of providing care

Cap on lifetime care costs

• Conservative government had planned an £86,000 cap on what anyone in England would pay for personal care over their lifetime

• Labour government scrapped the cap in July 2024

• There is still no limit on individual care costs, so a small minority face catastrophic bills.

What is the labour government doing to address this funding crisis?

The Labour government launched the independent Casey Commission into adult social care in 2025. Much of the funding announced in recent years has been directed at hospital discharge, because the NHS continues to struggle to move medically fit patients out of hospital and back into the community.

Link between social care and healthcare

There are issues with finding adequate care home spaces for patients which require this. This means that many patients are staying in the hospital longer than they should because there is inadequate social care post-discharge.

What is ‘bed blocking’?

Bed blocking = delayed discharge = patients who are medically fit to leave, but cannot because there is no care package or care home place available

Effects of bed blocking

• Older patients deteriorate in hospital, losing muscle and independence (deconditioning) and risking infections

• It also blocks beds for emergency and elective patients, lengthening A&E waits

• Overcrowded hospitals

• expensive, costing the NHS hundreds of millions of pounds a month.

Solutions

1: Increase investment in social care

2: Encourage Healthy Living

3: Support Family Caregivers

4: Increase access to technology

5: Improve integration of care

Increase investment in social care

Increased funding for home care, respite care and assisted living can help to alleviate the burden on hospitals

Encouraging healthy living

Promoting exercise, healthy eating, and regular health check-ups can help prevent many health problems associated with ageing.

Support family caregivers

Providing support for family caregivers, such as respite care and training, can help reduce the burden on both the caregivers and the healthcare system.

Increased access to technology

• Chronic Disease Management: Devices track blood pressure, blood glucose, and oxygen levels (COPD/asthma) and transmit data directly to GPs or nurses. 

• Early Intervention: Automated alerts warn clinicians of unsafe spikes or drops in health metrics before a crisis requires hospital admission. 

• Virtual Consultations: Video platforms let patients discuss symptoms and receive guidance without traveling to a clinic

• Mattress sensors that can alert a chosen contact if the bed becomes wet.

• A fall detector can automatically sense if you’ve fallen. The alarm alerts someone, usually a member of staff at a response centre, without you needing to push a button.

Autonomy

• Maintaining autonomy is crucial

• However, current problems with care homes/ social care means that patients may not get to choose where they recover from their illness

Justice

Postcode lottery - social care is funded by local governments

What is an ageing population in the UK?

An ageing population means an increasing proportion of people are older. In the UK, nearly one in five people (around 19%) are now aged 65 or over, almost 11 million people, and the over-85s are the fastest-growing group. It is driven by rising life expectancy and falling birth rates, and reflects huge progress in sanitation, nutrition and medicine.

How does the ageing population affect the NHS?

An ageing population increases demand and complexity. Older patients are more likely to be admitted (the average age of acute admission is around 70), to have multimorbidity, frailty, dementia and polypharmacy, and to need longer recovery and post-discharge support. This raises workload, lengthens stays and, when social care is unavailable, causes delayed discharges that block beds across the hospital.

What are the greatest current challenges in elderly medicine in the NHS?

• Multimorbidity

• Frailty

• Polyphramcy

• Dementia

• Under-funded social care system

• Combine factors = increased hospital stay and delayed discharges

• Wider issues of staffing shortages and bed shortages

How is social care different to healthcare?

Social care = assistance with daily living activities for those with disabilities/ chronic illness

Includes help with washing, dressing and eating

Healthcare = delivered by the NHS, it treats and manages disease

Is social care free in the UK?

NO, social care is means-tested, unlike the NHS which is free at the point of use

Local councils fun care for low-income, but many people pay for their own care

Currently no cap on lifetime personal care costs

How many unpaid carers are there in the UK?

There are roughly 5 to 6 million unpaid carers in England, family and friends providing care without pay, who underpin the whole system. Many reduce hours or leave work to care for relatives. Supporting them, through respite, training and fairer recognition, is a recurring recommendation in social care reform