Read: The huge rise in people with major illness will have a significant impact, inside and outside the NHS
The scale and impact of the growth in the number of people living with major illness as the population ages has been laid bare in ground-breaking new analysis. It makes for shocking reading, with over nine million people projected to be living with major illness by 2040, an increase of 2.5 million since 2019.
The project, led by the Health Foundation, focused on the levels of ill health in the population in England up to 2040. The number living with serious diseases will rise from almost one in six of the adult population in 2019, to nearly one in five by 2040, with huge implications for the NHS, social care and public finances. Eighty per cent of the projected increase will affect people aged 70 and over, as baby boomers reach old age and life expectancy increases.
Cases of dementia are expected to rise 45% by 2040, heart failure by 92%, cancer by 31%, diabetes by 49%, chronic pain by 32% and anxiety or depression by 16%. The research indicates that by the age of 70, people will have an average of three long-term conditions, rising to more than five by the age of 85. Only one of the 20 conditions listed – coronary heart disease – is expected to drop as a result of declining smoking rates and the use of medications such as statins.
The research makes for sobering reading on a number of levels, and reaches far beyond the obvious implications for the NHS. Many more individuals will be living their lives in poor health which will have a knock-on effect on their families, as well as a wider societal impact. There will also be economic repercussions for other public services, the labour market and public finances.
Health experts agree that much of the projected ill health - caused by smoking, poor housing, unemployment, poor food and air quality, and obesity – could be avoided. There have been improvements in the number of people smoking and lower cholesterol rates in recent years but these will be offset by the impact of obesity levels – which have broadly doubled in the last 30 years - as those who have been obese earlier in their lives reach old age. There is also concern about obesity rates for children which will also have a significant impact on the NHS.
The Health Foundation has called for a long-term programme of reform to modernise and invest in the NHS, alongside a bold new strategy to address the health and wellbeing of the nation. Many experts - and those working in the NHS - want to see one that focuses more on preventative healthcare, especially in relation to obesity which has such a detrimental effect on people’s physical and mental wellbeing outcomes.
The Purpose Coalition’s work has highlighted that many companies already recognise the value of initiatives which support the health and wellbeing of their workforce. Discounts on gym or Weight Watchers membership, exercise and yoga classes or cycle to work schemes all feature in health and well-being strategies. The best employers embed a supportive approach into their business culture and recognise that a wellbeing strategy can also extend to social connection and financial health. Virgin Money, for example, encourages an ethos of be well, keep well and get well amongst staff to help them to reflect on their health and wellbeing throughout the year and have support in place when things go wrong. It has also introduced a holistic health and wellbeing app – Virgin Pulse - to help them manage their wellbeing proactively.
NHS Trusts are in a strong position to connect with their local communities and focus on addressing their particular health needs. Purpose Health & Social Care Coalition member, the South Warwickshire University NHS Foundation Trust, runs a stop smoking in pregnancy service to improve the health and wellbeing of mothers and babies while its ‘Be Active, Be Healthy’ service offers exercise sessions for children, families and adults in pre and postnatal periods. The independent care sector can also be part of the solution. Ramsay Health Care UK, one of the largest independent healthcare providers in the country, has invested over £28m in 2020/21 in diagnostic services to increase capacity in response to a growing demand, especially in relation to cancer services. Its local partnerships demonstrate how an integrated approach between the public and private sector can bring real benefits to local communities.
This report was the first in a programme of research which aims to support policymakers by looking at patterns of illness over the next two decades. A second report in the autumn will focus on the implications for health inequalities and will undoubtedly show how they significantly impact the level of major illnesses in our most disadvantaged communities.
