More ageing people with complex mix of health and social care needs

Rising numbers of older people with elevated rates of health and social care needs in the community may necessitate a large increase in the nursing workforce.

The Office for National Statistics (ONS) projects the population will rise to 73.2 million people in 2035, as opposed to 62.3 million in 2010, a rise of 17.5 per cent over 25 years, or an average of 0.7 per cent per annum. The population aged over 65 is expected to increase from 10.3 million to 16.9 million, an increase of 64.4 per cent, or 2.58 per cent per annum.

Currently, about half of patients admitted to hospital are over 65, and about 10 per cent are over 80; longer lengths of stay for older people also mean nurses provide care on a daily basis for an even higher percentage of older patients (NHS Information Centre, 2011). With the population, in particular the population aged over 65, set to increase, demand (and therefore supply) will need to increase sharply in response.

However, ageing will also reduce the available supply of nurses relative to the total size of the population. Buchan & Seccombe (2011) note about one in three currently employed nurses are 50 or older. The implication is that over the next 20 years retirement rates could exceed the combined rate of new entrants to training, plus migrant entrants and re-entrants, leading to a supply shortage.

About 30 per cent of people over 65 have mental health ideas (for example dementia or depression). Many have disabling chronic conditions such as heart problems and diabetes. There will be greater numbers of older people with complex health and social care needs in the community, often without family or other support networks, and they may not speak English as a first language. This has been termed the 'silver tsunami' (Jeste, 2011) and the 'carequake' (Department of Health, 2010). It has the potential to further increase the number of nurses needed in the workforce.

Sources or references

• Suggested by number of stakeholders in workshops during CfWI research on nursing.
• From unpublished CfWI report (report available on request).
• NHS Future Forum, 2011, Integration: A report from the NHS Future Forum.
• Office for National Statistics, UK population projections.
• Jeste, D. V. (2011). Promoting successful ageing through integrated care. BMJ 343: d6808.
• NHS Information Centre, 2011. Hospital Episode Statistics: Headline figures, 2010-11. Leeds: NHS Information Centre.
• Department of Health, 2010. Front line care: An overview of Front Line Care the report by the Prime Minister’s Commission on the Future of Nursing and Midwifery in England. London: Department of Health.
• Buchan, J. and I. Seccombe (2011). A decisive decade: The 2011 UK nursing labour market review, RCN.

Some of the information in this section is provided by stakeholders and expert groups, and does not necessarily represent the views of the CfWI.