The challenge of population ageing was clearly analysed and presentedby the Chief Medical Officer Sir Chris Whitty in hs 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 but 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 system development 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 used in the Living Longer Better work launched with the support of Sport England in 2020 are set out below:

• To prevent and mitigate isolation
• To increase physical ability, resilience and healthspan and prevent frailty and falls
• To reduce the risk of, and delay or prevent dementia
• To prevent and minimise the effects of disease and multimorbidity
• To promote knowledge and understanding about living longer better among older people and the wider population to counteract the detrimental effects of ageism
• To create an environment in which people can fulfil their potential
• To enable strengthening of purpose
• To support carers better
• To minimise and mitigate the effects of deprivation
• To enable dying well as well as living well

Based on the military principle the strategic objectives should be agreed once and then local populations 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 system specification can be seen here.

The initiatives involved in 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 
Please contact us if you are running a project designed to help people live longer better. Please also draw our attention to any projects which you know about

Muir Gray and Sarah Price [email protected]