Older people let down by crisis in NHS and social care, says Age UK

The crisis in the NHS is largely a crisis in older people’s preventive care, and we need to act now to fix it, says a new report from the charity Age UK.

A new in-depth report from the Charity Age UK, ‘Fixing the Foundations’, reveals how the NHS and social care system is struggling and sometimes failing to cope with the needs of older people. 

Longstanding problems, predating the pandemic but exacerbated by it too, are piling pressure on families and carers and leaving the NHS in constant crisis mode, the report says. This is contributing to ambulances being stacked up outside hospital emergency departments at the moment, and long waits for people of all ages to access urgent care.

NHS figures show half (49 per cent) of all people arriving in A&E by ambulance are over 65 and a third (35 per cent) over 75. The proportion of older people feeling supported to manage their health condition has fallen by almost 20 per cent since 2016/17, while one in five over 80s have some unmet need for social care, according to Age UK.

‘Fixing the Foundations’ provides a first-hand account of older people’s difficulties in getting the good, joined up health and social care they need to manage at home, leaving them at risk of crisis which often results in being admitted to hospital. 

It also shows how living with multiple long term health conditions, as a significant proportion of older people do, including more than two thirds of those aged over 85, makes it especially hard to navigate health services which are still usually organised around individual illnesses and diseases. Meanwhile social care was often inadequate or absent in these older people’s lives, according to the report. 

Age UK estimates that over 1.6 million older people have some level of fundamental care and support needs, such as help to get dressed, washed or getting out of bed, that is not being fully addressed. For those older people who do receive care and support it is often coming from unpaid family carers, who provide a far greater volume of care in our country than formal services. 

However, figures from 2019 estimate that 3.3 million older people now live alone and 1.5 million older people are ageing without children in our society and their numbers are expected to rise significantly in the coming years as our population ages. There are now 2.6 million people over 50 who have unmet social care needs, increasing to 15 per cent of people in their 70s and 21 per cent of people in their 80s. 

Between 2016/17 and 2021/22 the proportion of older people receiving long term support from their local authority went down by 13.5 per cent. In 2022, there were 165,000 vacant posts in social care- an increase of 50% and the highest rate on record. 

A call for change

On the back of the report the charity is calling for a number of changes in the health and social care system, including widespread social care reform, multidisciplinary working and the introduction of Integrated Care Systems (ICS) to develop comprehensive strategies for meeting the health and social care needs of older people at home, and in care homes, living in their areas. 

Alongside a better-paid health and social workforce, the charity also wants to see a step change in the recognition of and financial and practical support on offer to unpaid carers.

Caroline Abrahams, Age UK Charity Director, said: “As our new report shows, we need to turbocharge our efforts to recruit, retain and support all the brilliant professionals that older people depend on to help them stay well at home, especially if they are struggling to manage several serious health conditions, like heart disease and diabetes, as many are. We need lots more social care staff, and hugely important community health professionals like District Nurses and Occupational Therapists, as well as GPs. Then we need to get them working effectively together – not only at the point when an older person is at immediate risk of needing a hospital bed, as with urgent response teams and virtual wards, but well before they reach that point too.

“Although this winter is not yet over it won’t be long before next winter is upon us, and it’s imperative we start work now to make sure it’s a much better one for the NHS and social care, and for older people too. At Age UK we are committed to doing everything we can to support a major national effort to this end – the voluntary sector, including our wonderful local Age UK [branches], has a big potential role to play. As we have learned this year, and as our new report shows, if we can get it right for older people in the NHS and social care then we’ll go a long way towards making the whole health and care system work more smoothly for people of all ages.

Five years ago Age UK published a report called The Failing Safety Net, which looked at many of the same issues covered in this new report and made many similar recommendations.

Ms Abrahams added: “It would be terrible if Age UK had to publish another report in five years’ time that once again found these same problems were still to be addressed. The fact is we know what has to happen to unblock our jammed-up hospitals and give older people the dignified health and social care support they need and deserve, and it’s down to the Government above all, to provide the leadership and resources to make it happen.”