The challenge of population ageing was clearly analysed and presented by the Chief Medical Officer Sir Chris Whitty in his 2023 Annual Report Health in an Ageing Society  The NHS is already providing a number of services to help people reduce the risk of disease, notably immunisation, screening, health checks and the Ageing Well programme. It has also produced a major policy paper on the benefits of physical activity. However the NHS is only one of the agencies which needs to adapt to the challenge of population ageing so to complement and supplement these preventive services the Public Health team in NHS England developed a system for Living Longer Better with the aims of 

  • Increasing healthy life expectancy
  • Closing the gap between the most and the least deprived and
  • Reducing the need for health and social care

The purpose of Live Longer Better is to bring together all the programmes and initiatives into a single system, a system being a set of interconnected activities with a common set of objectives. The set of objectives which have been developed in the Live Longer Better work launched with the support of Sport England in 2020 are set out below: they are to
  • prevent and mitigate isolation
  • increase physical ability and resilience and increase healthspan
  • promote knowledge and understanding about living longer better among older people and the wider population to counteract the detrimental effects of ageism
  • involve older people from all ethnic and cultural groups in the leadership and management of transformation
  • create an environment in which people can fulfil their potential
  • enable strengthening of purpose
  • support carers better
  • minimise and mitigate the effects of deprivation
  • reduce the risk of and delay or prevent dementia
  • prevent and minimise the effects of disease and multimorbidity
  • optimise the use of resources
  • enable both living well and dying well
Based on the military principle the strategic objectives should be agreed once and then local networks based on a defined population need to develop a network to achieve the strategic objectives taking into account local history, geography and politics. The strategy sets out WHAT is to be achieved, the local networks decide HOW it will be achieved. The development of Integrated Neighbourhood Teams has led to the identification of the neighbourhood as the key population

The system specification can be seen here.
THE NHS CONTRIBUTION 
The system development project will also ensure that the three strategic objectives set out in the Darzi review and now in the Neighbourhood Health Service model are met, namely:
  • Shifting from hospital to community care
  • Changing from analogue to digital
  • Moving from treating sickness to preventing it
 The Medical Director of the NHS Sir Stephen Powis convened the first Living Longer Better Colloquium on the 12th of March at which it was agreed that  this system was the most appropriate method for meeting the challenge of population ageing and that links should be established to all the other key Departments and organisations because the NHS by itself cannot meet the challenge. The report can be seen here 

KEY NATIONAL PARTNERS 
Obviously the NHS is only one of the agencies which can contribute to meeting the objectives .other key agencies are
  • Sport England, which has published its very useful Active Lives Survey and the Active Partnerships. It has also played a key role in developing We Are Undefeatable, with the major disease specific charities and the Faculty of Sport and Exercise Medicine 
  • AgeUK which launched its excellent Act Now, Age Better campaign on the 29th of April
  • Local Authorities
  • the National Academy of Social Prescribing which is promoting and facilitating non-drug therapy, as is the College of Medicine 
  • ukactive and fitness and gym network
  • The Clinical Professions;  and the RCGP Active Practices initiative   is having a big impact 
  • Housing and social care providers
These are important national agencies but change takes place locally and the development of a community of practice of local initiatives is of high importance
​COMMUNITY ACTION
Please contact us if you are running a project designed to help people live longer better. We are learning from work being done by health services and local authorities serving defined populations but also from what is probably the key population - the neighbourhood. This is a term which has come back into use in the NHS, for example in INTs Integrated Neighbourhood Teams. The term Community is used in other developments and the Centre for Ageing Better is leading work on Age Friendly Communities , for example learning from the work in Greater Manchester. The work of the Agile Ageing Alliance is of particular relevance and importance.

​Please also draw our attention to any projects which you know about


Muir Gray and Sarah Price
​[email protected] 
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