GovWire

The focus of this report by Chief Medical Officer (CMO) Professor Chris Whitty 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. It is aimed at policymakers (government and professional bodies), healthcare professionals, medical scientists and the general public.

People are living longer; this is a triumph of medicine and public health. It is something to celebrate, but alongside this we have a responsibility in medicine, government and wider society to plan to ensure that older age is as healthy, independent and enjoyable as possible into the future.

We can maintain peoples independence via 2 broad approaches, which are complementary. The first is to reduce disease, including degenerative disease, to prevent, delay or minimise disability and frailty. The second is to change the environment so that, for a given level of disability, people can maintain their independence longer. We must do both.

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. 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. Expansion of medical and NHS services need to be in these areas.

Many people in older age live with multiple conditions (multimorbidity). Medical training, NHS services and research need to respond to this reality.

This is an optimistic report; there are many things we can do to improve health and independence of older citizens if we are systematic about it. This will however require active decisions and actions by individuals, government and health professionals.

Report chapters:

• Chapter 1: introduction
• Chapter 2: understanding health in an ageing society
• Chapter 3:local authority context
• Chapter 4: enabling older adults to live free from disease for longer
• Chapter 5: supporting older adults to live well with disease
• Chapter 6: physical environments that enable independence
• Chapter 7: research to improve health in an ageing society