On 24 January 2023, the Secretary of State for Health and Social Care, Steve Barclay MP, announced a Major Conditions Strategy which will focus on cancers, cardiovascular diseases, including stroke and diabetes, chronic respiratory diseases, dementia, mental ill health and musculoskeletal disorders.
Responding, BGS President, Professor Adam Gordon, said:
The UK’s ageing population is a triumph, reflecting healthier lives and advances in medical practice across the life course. However, the ageing population also brings challenges as more of us are living longer with multiple long-term conditions, requiring ever more complex care in later life. BGS welcomes acknowledgement of this from the Secretary of State in his announcement of a strategic focus on major conditions, most of which will primarily affect older people. We are particularly pleased to see dementia included within the group of conditions as dementia is one of the major causes of disability in later life.
We are however concerned that this is an outdated approach to planning NHS services. When the NHS was established, it was set up on the basis of single conditions and diseases. However, in recent years, there has been an acknowledgement that many people have multiple conditions and that planning of care needs to take a more holistic, person-centred approach. We worry that this focus on major conditions represents a backwards step that will not meet the needs of older people, the NHS’s largest patient group. A proactive approach towards older people’s healthcare is needed to ensure that older people at risk of becoming unwell are identified early and action taken.
This focus on specific conditions also, perhaps unintentionally, creates a hierarchy of disease with a risk that other conditions excluded from the list are felt not to be serious or important. This is concerning, especially considering that this list fails to include frailty, which affects around 47% of hospital inpatients aged over 65 at any given time. Frailty affects a quarter to a half of those aged over 85 and costs the UK healthcare systems £5.8 billion per year. Any cross-cutting health strategy must have a significant focus on frailty and we are surprised to see its absence from this statement.
The BGS has over 4,600 members who are healthcare professionals working with older people in acute, primary and community care across the UK. We urge the Government to call on our expertise in the healthcare of older people as it develops this Strategy, to ensure it is fit for purpose, supported by the right workforce and relevant for the needs of the population."
