NHS Chief Medical Officer, Professor Chris Whitty’s annual report calls for improvements in older citizens’ quality of life to be a major aim of policy and medical practice

England’s Chief Medical Officer (CMO), Professor Chris Whitty, has called for greater focus on maximising independence and minimising time spent in ill health among older people.

In his annual report, published on 10 November, he called for quality, enjoyment, and independence to be the principal aims.

His fourth annual report as CMO, he describes how society can maintain older people’s independence via two broad complementary approaches:

• Reduce disease, to prevent, delay, or minimise disability and frailty
• Change the environment so people can maintain their independence for longer

The geography of older age in England is already skewed away from large urban areas towards more rural, coastal, and other peripheral areas, and will become more so, he noted.

And efforts to achieve shorter periods in ill health and an easier environment for those with disabilities should concentrate on areas of the country where the need is going to be greatest.

The report makes the case that older people are currently underserved in healthcare, with less-accessible transport links and insufficient infrastructure designed for older adults, including housing.

Providing services and environments suitable for older adults in these areas is an absolute priority to maximise the period all older citizens have in independence.

The need for research

The report calls for research into multimorbidity, frailty, and social care to be accelerated, and states that the medical profession needs to focus on maintaining generalist skills as doctors specialise.

Medical specialisation, specialised NHS provision, National Institute for Health and Care Excellence (NICE) guidelines, and medical research are all optimised for single diseases, but that is not the lived reality for the great majority of older adults who often transfer very rapidly from having no significant disease states, to several simultaneously.

And the increasing specialisation of the medical profession runs counter to optimising treatment for this group of largely older citizens and patients.

Whitty said: “Maximising the quality of health in older adults should be seen as a major national priority.

“We can make very significant progress with relatively straightforward interventions.

“Older people can, and should, be better served.

“We need to recognise and reflect in policy and medical practice where older people are concentrated geographically, increase clinicians’ generalist skills, improve mental health provision, and make it unacceptable to exclude older adults from research because of older age or common comorbidities.”

Greg Fell, president of the Association of Directors of Public Health, added: “Today’s report from the CMO clearly sets out how important it is that, as a society, we work together to create healthy spaces and places to live and work in.

Thriving communities

“Only by ensuring that people have access to the things that support us to thrive – like good housing, good work, and green spaces – can we ensure that people will continue to enjoy good health and wellbeing as they get older.”

Directors of public health and their teams work in partnership with both local authority colleagues and the voluntary and community sector to help create these spaces, with health and wellbeing at their heart, so that as well as living for longer, people are also living healthier, more-fulfilling lives.

And Professor Dame Linda Partridge, biological secretary and vice president of The Royal Society and Professorial Research Fellow at University College London (UCL), said: “Supporting an ageing population to live well for longer will be a defining challenge of the 21st Century, for the UK and many other economies.

“This timely report from the Chief Medical Officer serves to bring these issues to the forefront of political and public discussion.

“Among the many facets of this challenge, the emerging field of geroscience holds promise for managing and preventing some age-related diseases.

“Capitalising on this promise will require new treatments and an evolution of approaches across the whole life sciences system, from fundamental discovery to trial design.”