1. Population ageing and urgent activity. “Admission prevention” as one part of a bigger story Prof David Oliver Royal Berkshire NHS Foundation Trust

2. 51% more over 65, 101% more over 85

3. Ageing, health and care Key facts and figures Not all doom and gloom Shift to prevention, wellbeing, inequalities Implications for population health Implications for services Including urgent and emergency care Older people as “core business” Spend, efficiency, variation Quality and care gaps Integration, disintegration, care co-ordination Integrate around the person before worrying about structures/organisations etc

5. From Kings Fund report 2012 on Emergency Bed use in Older People

7. What could have happened differently to support Mrs Andrews and her husband ? Pre-crisis Around 999/out of hours At ED In AMU On ward(s) In discharge planning In capacity and responsiveness outside hospital In seven weeks post discharge Around care home respite admission

8. 6 March (wide official endorsement) free at www.kingsfund.org.uk Solutions set out here and in key references Conferences with all slides available on 22 October 2013 and 18 June 2014

9. 10 components of care Recognise multiple interdependencies and transitions. End silo-thinking. Focus on the “what” less than the “where and by whom”

10. For each component Goals Current situation What we know can work –In conducive local environment Key references and guidelines Practical recent examples from UK services

11. 10 components of care Recognise multiple interdependencies and transitions. End silo-thinking. Focus on the “what” less than the “where and by whom”

12. Thank you D.Oliver@kingsfund.org.uk David.Oliver@royalberkshire.nhs.uk

13. Prof David Oliver david.oliver@royalberkshire.nhs.uk