Later Life in the United Kingdom

With an estimated 4 million older people in the UK who have a limiting longstanding illness or disability (increasing to 6.25 million by 2030)₁, it is evident more needs to be done to meet the challenge of an aging population. Some of the commonly experienced illnesses and disabilities in later life include: frailty, malnourishment, falls, hip fractures, sensory loss, incontinence, heart disease and strokes, arthritis, common mental health problems such as depression and anxiety, loneliness and isolation, and dementia, to name just a few.

The impact of an aging population on hospital care is of great concern:

• Of the 18.7 million adult admissions to hospital last year, around 7.6 million (41%) were aged 65+₂
• People aged 65+ make up 42% of elective admissions and 43% of emergency admissions to hospital₃
• People aged 65+ make up 23% of all A&E attendances and 47% of admissions to hospital from A&E.87₄
• Average length of stay for emergency admissions increases with age, from an average of 5.2 days for all admissions to 6.5 days for those aged 65-74, 8.3 days for those aged 75-84, to 10.1 days for those aged 85+₅

‘Q’ to help improve later life for people in one of the UK’s most deprived regions

Age UK Thanet’s day centre, Randolph House, opened in 2004 and is located in the Cliftonville West ward, of the once thriving seaside town of Margate, ranks 4th out of 32,844 Lower Super Output Areas (LSOA) in England – which makes it within the most deprived 1% in the country₆. Of the Thanet population, 23.1% are aged 65 & over, in the south east it is 18.9% and England 17.9%. And more than half of this age group in Thanet (55%) have at least one long-term limiting health problem, in the south east this reduces to 46% and England 51.5%₇.

Age UK Thanet provides a range of services to help the people of Thanet have healthier and happier later lives. Current services include: independent living support, helping with hospital discharge and settling at home, drop-in sessions to support those suffering with dementia, foot-care, outreach at home and care homes, intergenerational activities, meal services, hairdressing, transport and general information and advice, to name just a few.

Applying Behavioural Insights To Love Later Life

To build capability of Q Members, in March 2018 Q member Eric Barratt worked with Dan Berry, a Behavioural Insights Strategist at Hill + Knowlton Strategies developed a scalable training programme ‘Applying Behavioural Insights to Improve Healthcare’ and tools to enable learners to generate low cost interventions to improve health and care and a blog was recently published on the Q website giving details about the programme₈.

The feedback received from the 42 Q members that attended the training sessions was overwhelmingly positive, with the pick of these being a tweet saying:

“Today was a real game changer; I came away with loads of ideas. Behavioural science should prob be embedded in #QI methodology IMHO #QCommunity”

We plan to build on the successes of this training programme to develop a workshop that is suitable for a target audiences of varying abilities with a focus on involving services users in the co-design and the implementation of innovative solutions. We intend to rollout the adapted training programme and the innovative solutions through the UK’s health and social care system.

For this project we propose:

1. Reconfiguring the existing workshop programme and tools alongside a small working group of Age UK staff and service users to ensure the content is suitable for their clients, staff and volunteers
2. Develop a toolkit to enable the reproduction of the workshop programme
3. Hold train the trainer sessions with Age UK staff to upskill them to deliver the training session and support subsequent improvement projects
4. Use Liberating Structures tools to select the best ideas and support implementation of ideas
5. Help design, refine and test the subsequent solutions
6. Develop tools and resources to enable the spread and adoption of the designed solutions across the rest of the country

We have a fantastic team of Q Members who are passionate and committed to this project to help the people of Thanet and beyond love later life!

References:

₁ Age UK estimate based on General Lifestyle Survey 2011, ONS 2013 and mid-2014 based population     projections, ONS 2015

₂ Hospital Episode Statistics, Admitted Patient Care, England – 2014-15, published Nov 2015

₃ Older People’s Care in Acute Settings: Benchmarking Report, NHS Benchmarking Network, March 2016

₄ Older People’s Care in Acute Settings: Benchmarking Report, NHS Benchmarking Network, March 2016

₅ Older People’s Care in Acute Settings: Benchmarking Report, NHS Benchmarking Network, March 2016

₆ https://www.kentlive.news/news/kent-news/21-most-deprived-areas-kent-497851

₇ Age UK Local Statistics Tool: Areal Profile – Population and Loneliness

₈ https://q.health.org.uk/news-story/behavioural-insights-nudging-for-improvement/