NHS must quickly adapt to changing health demands

The Health Profile for England report has stated that the NHS must quickly adapt to the changing health demands facing the nation.

Public Health England’s research has found that there are decreasing rates of people smoking, but rates for diabetes, obesity, dementia and mental health issues are rising. Combined with a growing and ageing population, the health landscape is changing to one that is living for longer but in poorer health.

The Health Profile for England reveals that the average life expectancy has reached 79.6 years for men and 83.2 for women, with predictions that the number of people aged 85 and over in England could exceed two million by 2031. In 2017, there were 1.35 million people aged 85 and over in England.

However, the data used in the research found that, while people may be living for longer, they only usually expect to live about 63 years in good health, meaning men face an average of 16 years of ill health and women 19 years.

With dementia, including Alzheimer's disease, already the leading cause of death in women, Public Health England claim that the death rate for dementia and Alzheimer’s disease may overtake heart disease in men as early as 2020 and is likely to become the leading cause of death in men too. And it is just one of the age-related diseases that have been increasing. For example, the number of people with diabetes is expected to increase by a million – from just under four million people in 2017 to almost five million in 2035.

Professor John Newton, director of health improvement at Public Health England, said: “Now in its 70th year, demands on the NHS have changed significantly. More of us are living longer with painful or disabling conditions, including musculoskeletal problems, skin conditions and sensory loss. While these illnesses often attract less attention than causes of early death such as heart disease and cancer, they have a profound effect on the day to day lives of many people and together they place significant pressure on the NHS. The challenge now is for the NHS to respond to this changing landscape and to focus on preventing as well as treating the conditions which are causing the greatest disease burden across our nation.”

Ian Hudspeth, chairman of the Local Government Association’s Community Wellbeing Board, said: “This increase in the number of people living to a ripe old age can be viewed as a public health success story. However, although populations are living longer, many of these additional years are not spent in good health or free from disability. Over four million of people in the UK over the age of 65 have a limiting long term health condition.

“Early intervention and prevention work by councils is vital to improve the public’s health. Not only does it reduce the risk of people having their lives shortened by conditions such as heart and liver disease, cancer, and Type 2 diabetes, but it also keeps the pressure off the NHS and adult social care. We know that those living in the most deprived communities experience poorer mental health, higher rates of smoking and greater levels of obesity than the more affluent. They spend more years in ill health and they die sooner. Reducing health inequalities is an economic and social challenge as well as a moral one.

“Councils with their public health responsibilities are on the frontline fighting obesity but for this to work effectively they need to be properly resourced. Public health funding has been reduced by £600 million from 2015/16 to 2019/20. We ask the government to reverse reductions to councils’ public health budgets and give local authorities more funding to further this cost-effective work. Any extra funding for the NHS should also include public health funding for councils as the two are so intrinsically linked.”