Population ageing remains a continuous challenge for health care providers due to the escalating number of patients with chronic conditions. This represents a considerable economic burden for health systems across the globe. Ever since its debut in the 80’s, prevention, early diagnosis, and treatment of human immunodeficiency virus (HIV) infection has captured the attention of the scientific community. Highly active antiretroviral therapy (HAART) radically modified the paradigm of living with HIV by prolonging survival and improving the prognosis of a previously terminal disease. Today, thanks to HAART, HIV is a chronic condition with a life expectancy similar to that of the general population and a significantly improved quality of life. However, the changes in survival for HIV infected individuals have unearthed the appearance at an earlier age of health problems that used to be observed exclusively in older adults. Continue reading →
David Oliver (BGS President Elect and Consultant Geriatrician) and David Buck (King’s FundSenior Fellow, Public Health and Inequalities) discuss the National Institute for Health and Care Excellence (NICE)’s new guidelines on preventing disability, frailty and dementia in later life. The article can be read in full on The King’s Fund Blog:
Life-expectancy is now 79 for men and 83 for women, and when we reach the age of 65 we can expect to live another two decades on average.
Living longer lives is a cause for celebration but there are still major inequalities in life expectancy and healthy life expectancy at birth, in rates of premature deaths, and in life expectancy at 65 between different socioeconomic groups. We also face a rising prevalence of long-term conditions, dementia, disability and frailty related to rapid population ageing, which has big implications both for individuals and for health and social care systems.
‘So what?’ you cry, yet another bunch of stuff to wade through. But this time it’s different – what is so interesting about these guidelines is not so much the detail but the principles and linking themes behind them, and the fact that, instead of just advising clinicians, the guidelines include direct advice to the government on health and wider social policy.
So what’s in it? For starters, NICE calls for government interventions to make smoking and drinking less affordable and accessible; and to make the maintenance of healthy weight and regular exercise more affordable and accessible. Hardwiring these recommendations on affordability into local and national public health strategies is a challenge to those, of any party, who do not see price as a policy lever on behaviours other than tobacco use. Given that Public Health England also supports minimum unit pricing of alcohol, two important government health bodies have now put their cards on the table….[continues]
Prof David Oliver is BGS President-Elect, is a Consultant Geriatrician at the Royal Berkshire Hospital, Visiting Professor of Medicine for Older People at City University London and a Kings Fund Visiting Fellow. He recently stood down from his role as National Clinical Director for Older People at the Department of Health.
This is my first blog since becoming President-Elect of the British Geriatrics Society. Alongside my day job as a busy coalface geriatrician, I have spent the best part of four years seconded to the Department of Health as a senior government advisor in the Civil Service. I resigned at the end of 2012 because I couldn’t reconcile my new role as a BGS officer with the role as National Clinical Director or (as the press would have it) “tsar”.
No longer bound by the Civil Service Code, I am free again to speak my mind. A particular issue I want to discuss here is the thorny subject of “admission prevention”, “admission avoidance”, “care closer to home”, “care outside hospital” – take your pick.