Abstract

By 2050 one in four people will be over 65, at which age both men and women can expect to spend around half of their remaining life expectancy in good health. However, the likelihood of losing functional ability and living with complex health conditions increases as we age. As life expectancy increases, so too does the amount of time many spend in poor health. In addition, there is significant geographical variation in how people age, driven by wider determinants such as deprivation, worklessness and poor quality housing, leading to considerable health inequality across the country.

Importantly there are substantial economic and organisational impacts on the health and social care system in supporting people whose ageing is problematic. These can be expected to continue to increase in the absence of a sustainable approach to prevention.

For these reasons supporting people to age well are now key priorities for the NHS . Getting this right means ensuring health and social care policies pay particular attention to the needs of disadvantaged and marginalised populations. The NHS Long Term Plan published in early 2019 has now begun to do this in England by deploying frailty as a useful paradigm of problematic ageing which can help in population health management to identify and target those individuals who may be at greatest risk of death, urgent care or permanent care home utilisation.