Adding years to life and life to years: our plan to increase healthy longevity
The Secretary of State for Health and Social Care addressed the All-Party Parliamentary Group for Longevity at the launch of their longer, healthier lives strategy.
I want to start by congratulating Damian [Green] and the whole APPG on the brilliant work you’ve done to get this issue onto the agenda.
Today is a day for detailed discussion about the proposals in your new Strategy.
But before we get to the policy I want to say a few words about the (small-p) politics.
Among policymakers – especially in government – our ageing society has traditionally been framed as a problem, a liability.
A source of pressure on public services. An unwelcome modern trend, like cybercrime or falling bee numbers.
But this is looking at things through the wrong end of the telescope.
Because of course it’s great news we’re all living longer.
And language matters. The words we use colour perception.
So let’s hear less about our ageing society, and more about healthy longevity.
Less about the burden and the pressure and more about the reward of getting this right.
Because our final years should be an act of enjoyment. Not a task of endurance.
That positive framing is important because too often as a society we sweep these issues under the carpet.
We don’t like to think about getting older. We don’t like to think about our bodies failing. So we don’t give healthy ageing the attention it deserves.
Which brings me to the policy question.
For most of the 70 years the NHS has been in existence we’ve focused on life span.
This has seen extraordinary successes.
Mass-vaccination. The collapse in the adult smoking rate from 45% in the 1970s to 14% today.
But as the NHS enters its eighth decade, it needs to focus more on health span: the number of years a person can expect to live healthily and independently.
In our manifesto we committed to an extra 5 healthy years by 2035. This is the primary long-term clinical goal we’ve set the NHS.
Both parts are important: extra years and healthy years. Adding years to life, and life to years.
The next question is how do we get there?
Today I want to touch on 3 things.
People and place
The first is place and its relationship to people.
Because however you choose to measure the evidence is clear: your chance of a healthy old age is closely tied to where you live.
A man born in Blackpool can expect only 53 years of healthy life, while a man born in Buckingham gets 68.
That’s wrong.
Tackling this postcode inequality matters to this government. It’s what we mean when we talk about ‘levelling up’.
The underlying factors are a complex interaction between demography and economy.
But because healthcare inequalities are geographically concentrated, it means we can take a targeted approach.
This starts with improving access to healthcare.
50 million more GP appointments. 50,000 more nurses. 40 new hospitals. It’s what those flagship commitments are all about.
And we can boost access even further: by using more of our brilliant community pharmacists as a first port of call for people seeking primary care, by using technology to reduce the burden on clinicians, by having everyone in every part of the NHS operating right at the top of their licence.
But having the right NHS services is just one part of building healthier places.
It’s about warm, properly insulated homes, low-crime neighbourhoods, and action on the environment like our cross-government work on air quality.
It’s the kind of urban design that supports healthy living, more opportunities for walking and cycling – bearing down on the 40% of car journeys that are less than 2 miles.
This is something that the Prime Minister is strongly personally committed to, and our announcement yesterday of 250 miles of new cycling routes is another milestone on that journey.
One of the biggest health impacts a place can have is whether it supports good local jobs.
By good jobs I mean jobs that are purposeful and rewarding, not just well paid. Where employers invest in things like mental health or muscular-skeletal support as part and parcel of being a good employer.
And this absolutely includes jobs in the NHS.
As one of the country’s biggest employers, the NHS can have an outsized impact on the opportunities available to local communities.
For example, I’m proud of the work we’re doing with the Prince’s Trust to get 10,000 school leavers job-ready for roles in the NHS and social care.
It’s not just the NHS
The second part of this agenda – and closely linked to place – is a recognition that healthy longevity is not just the NHS.
Only around a quarter of what leads to longer, healthier lives is the result of what goes on in hospitals.
The rest is down to genetics, the environment, and the lifestyle choices we make.
Yes, we can and we should use the infrastructure of the NHS to help support healthier choices. Measures like dedicated alcohol care teams in hospitals, or targeted anti-smoking interventions aimed at CVD patients.
But increasingly we understand that there are effective, non-clinical approaches to healthier living and ageing.
Look at the use of homeshares to tackle loneliness. Bringing together people with spare rooms and people who are happy to chat and lend a hand around the house in return for affordable accommodation.
Or take the social prescribing revolution.
A growing body of evidence suggests that activities like joining a book group or singing in a choir or learning to play an instrument can have huge health and wellbeing benefits.
Benefits that include everything from sleep quality to reduced anxiety to improved memory.
Over the next few years we want to bring these kinds of treatments to almost a million people.
We’ve set up a National Academy for Social Prescribing to aimed at making the NHS a world-leader in this field.
Technology
Third, and this won’t be a surprise coming from me, is better technology.
More proactive, preventative healthcare depends on a strong data infrastructure. On being able to link disparate datasets from different parts of the system to create a complete narrative about a person’s care.
Let’s take an example.
We know that atrial fibrillation – irregular heartbeat – is a common cause of stroke, but the risk varies from person to person.
By analysing lots of different data points for atrial fibrillation patients – age, frailty, previous bleeding and so on – you can create an individualised risk score.
In turn, this allows GPs to take pre-emptive action, for example prescribing anticoagulants.
In the past assembling all the information needed to produce that score was so time-consuming as to be impractical. It was held on different databases in different formats, often as free text rather than machine-readable code.
But now we can do it with AI.
In fact, a team right here at King’s – Dr Dan Bean and Dr Paul Scott – have built an AI tool that’s able to replicate the analysis of human experts in a fraction of the time.
Adult social care is increasingly a site of healthtech innovation.
Internet-linked devices can help people live at home for longer and stay connected to family and friends.
They can also help providers deliver smarter, more responsive care.
For example, there’s a provider up in Warwickshire – WCS Care – doing great things with acoustic monitoring.
The tech lets the staff hear crying or breathing problems, sending an alert to a monitoring station staffed by a night manager.
It means that staff aren’t knocking on residents’ doors every hour and disturbing people.
Everyone sleeps better, and staff estimate that night-time falls have reduced by 34%.
Interestingly, when they analysed the data they found that lots of people were staying awake late into the night.
This led the care home to set up a ‘wide awake club’ to support night owls and get them back into a healthier rhythm.
I want to spread this kind of innovation far and wide, and I’ve set up a dedicated adult social care unit in NHSX.
This will focus on setting technical standards, improving data sharing, enhancing skills and fixing the digital infrastructure.
Like longevity itself, better tech is an opportunity we wholeheartedly embrace.
Conclusion
I’ll end where I began, and this is the message I want to leave you with.
Longer life is not a problem to be tackled but a goal to be pursued.
And not just for government, or even the NHS, but for each and every one of us.
There’s a huge prize ahead if we get this right: 5 more years of healthy life. More enjoyment out of life. More time for the things that matter most in life.
I’m looking forward to working with you all to make it happen.