Cuts to the NHS, public health and social care in England have been linked to a sharp increase in vulnerability, the first study of its kind has found.
The coalition government’s austerity program in the early 2010s is associated with a greater increase in vulnerability with age, compared with the pre-austerity years between 2002 and 2010, the study led by the University of Edinburgh found. The findings were published in the magazine Plos One.
More people who are vulnerable means that relatively minor health problems, such as urinary tract infections, are likely to have a greater impact on the long-term health and wellbeing of the population. Frailty is generally characterized by issues such as reduced muscle strength and fatigue.
Previous research has shown that a slowdown in improvements in life expectancy coincided with the government’s sharp cuts to health and social care funding after David Cameron came to power more than a decade ago. However, the mechanism by which drastic cuts were associated with reduced life expectancy was until now unclear.
In the new study, researchers analyzed data on the frailty index, which records age-related declines in functional skills and physical and mental health. The analysis involved more than 16,000 people who took part in the English Longitudinal Study of Aging 2002-2018, with an average age of 67 years.
Researchers found that frailty index scores rose faster with age after the implementation of austerity policies. This was the case for all population groups, regardless of gender and socio-economic groups, but especially for the oldest people in England.
“Compared to the 2000s, we found that older people in England became increasingly frail at an accelerated rate in the 2010s, and that frailty was particularly common among the poorest in society,” the researchers wrote. “Our work is yet another warning about the potential impact of austerity on the health of an aging nation.”
Professor Adam Gordon, chairman of the British Geriatrics Society, said the findings showed that the number of people living with frailty has increased sharply since the start of austerity.
“As primary care professionals, we see every day how social isolation, the inability to get outside, exercise and eat well, impacts the health and well-being of older people,” he said. “Older people with frailty are more likely to need the help of health and social care services. In emergency departments, people over the age of 80 have seen their average wait times double, more than any other age group.”
People who are vulnerable also face the longest wait lists for elective surgery and for care in the community, Gordon said. “In addition to the suffering experienced by those involved, this is an example of how cuts could cost the nation more in the longer term.”
He added: “We are desperately failing our parents and grandparents and this should be a source of national shame. In this election year, it is essential that all major political parties have clear strategies for investment care and support services, not only for older people who are already vulnerable, but also for those at risk of developing this in the near future.”
Caroline Abrahams, charity director of Age UK, said frailty is often the all-too-visible but often neglected feature of older people’s health.
“Characterized by vulnerability to sudden changes and deterioration in health, frailty often takes a back seat to pressures within the NHS, as older people are pushed to reach a crisis point before receiving any help,” she said. “This includes needing emergency care and avoidable hospital stays in the absence of a decent social care package or proactive support in the community.
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“It is not surprising that when there are fewer services available to the public, more older people experience frailty that could have been managed or even avoided. We have seen this again with the impact of the pandemic and the cost of living crisis, which has left older people without the services and support to stay healthy.”
Abrahams said frailty was avoidable and that with the right support the condition could be improved or at least kept stable. “Responding to that reality is vital for the future success of both the NHS and social care and for the wellbeing of our older and aging population,” she said.
Wes Streeting, the shadow health secretary, said: “Fourteen years of the Conservatives gutting our public services has left our country weaker and less healthy. People’s lives have been shortened and what should be their golden years are increasingly spent in pain and discomfort. Not only has this taken its toll on people’s lives, an unhealthy society also means greater pressure and costs on the NHS.
“Labor will deliver the investment and reforms needed to get the NHS back on its feet. It will be the mission of the next Labor government to prevent ill health, with tough action on junk food advertising, so people live well for longer.”
The government has been approached for comment.