Reimagining social care for an ageing population

With more than one million people aged 85+ in the UK, and a predicted 2.7 million by 2039, the country finds itself deep into a health and social care crisis. But while it’s undoubtedly true that the system is already over stretched, we believe that by working together we can rethink and redefine care for society’s most vulnerable.

We’ve provided £20m of funding to create a new Advanced Care Research Centre (ACRC) at the University of Edinburgh, which will bring together experts from many disciplines across the University to tackle the need for better care for our ageing population. With expertise in fields ranging from social care to technology and landscape architecture they will bring new perspective to the problem.

One of the key challenges the academics at the ACRC will tackle is how our care system, which traditionally supported people with a single medical condition, can support the increasing number who have multiple issues. Lead academic Professor Bruce Guthrie says it is time to stop thinking solely about how we extend life with often arduous treatments and to think harder about how we improve the quality of the life we already have.

Among the academics who will be providing new insights is Professor Catharine Ward Thompson, Professor of Landscape Architecture, who advises on the impact of the outside built environment on health and wellbeing. Another is Professor Ian Underwood, Professor of Electronic Displays, who leads the uniquely interdisciplinary ACRC leadership training programme. 

Professor Guthrie explains: “The ACRC will work with people in later life and their families and with health and social care services to really understand how we might have a different care system. We really need that because the numbers of the oldest old is rapidly increasing. The current system is barely coping with providing barely adequate care to the existing population. If you jump forward 20 or 30 years, even that isn’t sustainable without an enormous increase in budget, so we need to get both better and more efficient.”

Key areas of research

The ACRC is underpinned by three cross-cutting areas of activity – stakeholder engagement, data infrastructure and the Academy for Leadership Training in Advanced Care.

The academics will explore public views of ageing, later life and care, but not everyone affected finds these concepts easy to articulate, particularly those for whom English is not their first language. That’s why one of the early projects is to ask the public to upload photos that represent what care in later life means to them to an online gallery. As well as being used in a travelling exhibition, the images will be a powerful visual tool to engage with policy makers.

In future there will be greater use of data to support our understanding of later life, which is why the ACRC seeks to transform the data infrastructure of health and social care. “In healthcare, what’s typically stored is the presence of a particular condition, but much of what you need to know in later-life care is only ever recorded in free text notes – things like whether the person lives alone or if they’ve had a fall,” explains Professor Guthrie.

The ACRC will turn this free-text information into data that can be analysed and used to develop more effective and efficient care. The next generation of leaders in the field will also be developed, at the Academy for Leadership Training in Advanced Care, which offers a four-year, interdisciplinary PhD. Professor Guthrie explains: “We only expect a minority of Academy graduates to become academics. Others will move to jobs in health and social care delivery or policy, some to set up their own companies, some to move into the voluntary sector or to work in the private sector. Wherever they work though, we expect them to become the future leaders in later life care.”

A brighter tomorrow

All of this will be underpinned by four complementary areas of research and development: data-driven insight that will help to predict frailty trajectories and allow more targeted care; deep understanding of the experience of later life, and the choices people make in the context of their social and financial circumstances; a ‘community collaboratory’ that uses new technologies and artificial intelligence to support better living and better care; and the development of flexible care models that use technology to tailor care to individual circumstances and preferences.

Professor Guthrie says: “The common rhetoric is that the ageing population is an utter disaster that’s going to destroy society. But living longer is actually a good thing. If I think back to my childhood people didn’t usually live to be older than 80. That was quite unusual and now it’s completely normal and we are expecting many of the children born today to live into their 90s and many of them will see their 100th birthdays. We want to make sure that more years are spent with good quality of meaningful life.”