Helen Cameron Presentation - Positive Ageing in London

A Call to Action
Positive Ageing in London Forum
Helen Cameron
NHS England London Region
9 December 2013
Every day the NHS saves lives and helps people stay well, but it
was created 65 years ago when many people faced choosing
between poverty if they fell seriously ill or forgoing care altogether.
In 1948:
• Population was 47 million
• Food rationing was still in place
• A quarter of homes had no electricity
• Life expectancy for men was 66 years
The NHS today
• Population in England today is estimated as over 57 million
• The NHS treats 1,000,000 people every 36 hours.
• We are living longer than ever before.
• Between 1990 and 2010, life expectancy in England increased by 5.2
years For example: Londoners are living longer than ever before. Figures
from the Office for National Statistics show men and women have a life
expectancy of 79.3 years and 83.6 years respectively, which is higher than
the national average.
However, the above masks significant variation not just in life expectancy
but in the length of time people can expect to live healthy lives, free from
serious illness. In Tower Hamlets, women have a healthy life expectancy of
54.1 years, compared to 72.1 years for women in Richmond-uponThames: a gap of nearly 18 years.
• 88% of patients in the UK described the quality of care they received
as excellent or very good.
The challenges are significant
• Rising demand for services as the population ages
• An increasing number of people with long-term conditions and
multiple healthcare needs
• Huge variations in quality and healthcare outcomes
• A period of financial constraints
The national ‘Call to Action’
Tackling the challenges
A national ‘Call to Action’ was launched by NHS
England on 11 July inviting the public, NHS staff
and politicians to help NHS meet future demand
and tackle funding gaps through ‘honest and
realistic’ debate.
London’s Call to Action
• London – A Call to Action launched on 14 October
• London’s Call to Action is engagement that will allow everyone to
debate about the future of health and care provision in London
• Gather views, data and information that Clinical Commissioning
Groups (CCGs) and NHS England can use to develop their
commissioning plans
London’s Call to Action
Engagement will be patient and public-centred through local
and regional events as well as through on-line and digital
• CCGs are leading on public engagement in their areas
from October – December
• NHS England (London Region) is leading on engagement
with London healthcare stakeholders from now until
December and will hold pan-London events in the New
London’s unique challenges
• Wide variations between and within boroughs in health, life expectancy and
the quality of health care
• Inner London has higher levels of adults who smoke and binge drink, while
obesity is a bigger problem in outer London. (London is the childhood
obesity capital of Europe)
• 42% of people in London are from a minority ethnic group, with 100+
• A transient population in some communities makes continuity of care
• Greater pockets of deprivation and more people not registered with a GP
• Over reliance on big hospitals (350,000 patients per catchment area
compared to 500,000 in rest of England, therefore it’s financially
More challenges
• London spends 46% per person above the England average on
older people’s social care and 20% per person above the England
average on younger adults’ social care
• 90% of patients’ interactions with the NHS are in the primary care
sector, e.g. with GPs, yet focus of attention historically has been
on hospitals and acute care
• The quality of care that patients receive is variable – both in a
primary care setting, for example with their GPs, and also in
• Patient expectations have changed, e.g. Patients want to see their
GP more quickly – before and after work and at the weekend. And
many patients with long term conditions want to see their GP more
An opportunity for improvements
• Build a health service, not just an illness service – we must get
better at preventing disease
• Give patients greater control over their own health
Develop effective preventative approaches
Use technology to enable new and improved ways for patients to
get better information and help from healthcare professionals
Exploit the full potential of transparent data
Moving away from a ‘one-size fits all’ model of care
• Transform the way care is delivered through general practice by
helping people to manage their long term conditions better
Doing nothing is not an option
Preserving the values that underpin a universal health service, free at
the point of use, will mean fundamental changes to how we deliver
and use health care services.
Call to Action is NOT about:
• Privatising the NHS
• Charging for services
• Restricting access
For more information
• The London Call to Action is on the London pages of the
NHS England website
• Information also available on the myhealthlondon.co.uk
• The dialogue will be on-going through December and we
will be engaging on the London wide themes in the New
Financial Challenges – the context
• Within the NHS £1,000 buys you one of the following:
Between 3
and 14 trips
to A&E
1.3 weeks of
continuing care for
an older adult
10 hours in a
Neonatal Intensive
Care Bed
31 GP
s with a GP
3.5 first
appointment diabetes
3 days in an
acute mental
health inpatient
50 ambulatory
blood pressure
One fifth of a hip
1 cataract
A Call to Action: over to you
Time to tell us what you think
Discussion - thinking to the future
• What are the key characteristics of the NHS that we must retain
for future generations?
• What future opportunities should we be looking to seize?
• What three things would make the biggest difference in improving
patient experience for older people and their carers?
• Please complete a questionnaire online at
• Get involved in the debate online at,

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