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Creating a Sustainable 21st Century Healthcare System

There is now widespread agreement that all societies are facing the twin challenge of limited resources and an ageing population. It will happen at different times in different countries but this is arguably the biggest health and social care policy issue facing governments across the globe. This leaves the question of what needs to be done in response. This report Creating a Sustainable 21st Century Healthcare System by the International Longevity Centre - UK and supported by EY seeks to bring forward some potential answers to that question.

Challenges to meet, opportunities to embrace
We have identified 12 global health trends which are set to influence the present and future climate for healthcare, and which will affect the development of existing and new innovations. Non-communicable diseases, such as cancer and diabetes, are now the leading causes of disease globally and account for 63% of all deaths worldwide1. This rise, in part due to medical developments, ageing populations and more sedentary lifestyles, has also resulted in greater numbers of people suffering from comorbidity – the presence of 2 or more chronic health conditions simultaneously.

The increased pressure on health services brought about by these rises is being exacerbated by a global shortage of healthcare workers. In 2013, there was a deficit of 7.2 million workers, a figure which is set to almost double in the next 20 years2, with regional differences being made worse by internal and international migration. With the future need for long-term care services also set to grow as the number of older people increases, countries are likely to see greater pressures on family members to provide care.

The cumulative effect of these pressures is that global spending on health is predicted to rise by an annual average of 5.3% until 20173, as governments spend more in order to maintain the current level of quality and provision. While a preventative approach to healthcare has the potential to reduce costs, there has been little investment in this area. In Europe, only 3% of healthcare expenditure is allocated to prevention and public health programmes, with some countries allocating as little as 1%4.

However, although there are certainly challenges ahead, the overall picture is far from bleak, with a number of global trends offering opportunities to make health systems more sustainable in the face of ageing populations. Advances in health technology have the potential to significantly influence patient’s access to health care and the way that health care is delivered; for example through the convergence of medical devices and information technology. Simultaneously, humanity’s increased ability to generate data, combined with the digitalisation of heathcare systems, has created an opportunity to revolutionise healthcare through the use of ‘big data’.

These technological advances are helping to facilitate positive global trends in how people look after their own health and interact with health services. Increased access to health information through new communication technologies is raising people’s health literacy, and contributing towards a shift to
personal responsibility for health. Countries are beginning to embed support for selfmanagement in their health care services, and recognising that these services are more effectively integrated around the individual. Governments are also investigating how to integrate their health and social care services to create a more seamless care experience for the user, with opportunities being created for financial savings through improved efficiency and productivity.