Austerity cuts to the NHS, public health and social care in England have been linked with a sharp increase in frailty, in the first study of its kind.
The coalition government’s austerity programme in the early 2010s is associated with steeper increases in frailty with age compared with the pre-austerity years between 2002 and 2010, the study led by the University of Edinburgh shows. The findings were published in the journal Plos One.
More people living with frailty means that relatively minor health problems, such as urinary tract infections, are likely to have a greater effect on the population’s long-term health and wellbeing. Frailty is generally characterised by issues such as reduced muscle strength and fatigue.
Previous research had found 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 through which drastic cuts were associated with decreased life expectancy had been unclear until now.
In the new study, researchers analysed data on the frailty index, which captures age-related declines in functional ability and physical and mental health. The analysis included more than 16,000 people enrolled in the English Longitudinal Study of Ageing 2002-2018, with an average age of 67.
Researchers found that frailty index scores increased more rapidly with age after the implementation of austerity policies. This was the case for all population groups, across genders and socioeconomic groups, but was particularly so for the oldest people in England.
“Compared to the 2000s, we found that older people in England were becoming more frail, more quickly during the 2010s, and that frailty was particularly common in the poorest in society,” the researchers wrote. “Our work is another warning about the possible impacts of austerity on the health of an ageing nation.”
Prof Adam Gordon, the president of the British Geriatrics Society, said the findings showed how the number of people living with frailty had increased sharply since austerity began.
“As frontline healthcare professionals, we see every day how social isolation, the inability to get out, to exercise and to eat well, impact upon health and wellbeing 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, those over the age of 80 have seen their average wait times double, more than for any other age group.”
People living with frailty also face the longest waiting lists for elective surgery, and for care in the community, Gordon said. “Besides the suffering experienced by those involved, this is an example of how austerity can end up costing 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 embarrassment. In this election year, it’s essential that all major political parties have clear strategies for investment care and support services, not just for older people who already live with frailty, but for those at risk of developing it in the near future.”
Caroline Abrahams, Age UK’s charity director, said frailty was often the all too visible yet frequently neglected feature of older people’s health.
“Characterised by vulnerability to sudden changes and deterioration in health, frailty is often in the background of pressures across the NHS as older people are made to reach crisis point before getting any help,” she said. “This includes needing emergency care, and avoidable stays in hospital for want of a decent package of social care or proactive support in the community.
“It is not surprising that when fewer services are available to the public, more older people experience frailty that could have been managed or even avoided. We’ve seen this again with the impact of the pandemic and cost of living crisis that have left older people without the services and support to stay well.”
Abrahams said frailty was avoidable and with the right support the condition could be improved or at the very least remain stable. “Responding to that reality is critical for the future success of both NHS and social care and for the wellbeing of our older and ageing population,” she said.
Wes Streeting, the shadow health secretary, said: “Fourteen years of the Conservatives hollowing out our public services has left our country weaker and less healthy. People’s lives have been cut short and what should be their golden years are increasingly spent in pain and discomfort.”
The government said it was providing the NHS and social care with £14.1bn this year and next to improve care for patients across the country.
“We are committed to improving healthy life expectancy by five years by 2035 and reducing regional disparities by 2030 to help people live longer, healthier lives,” a spokesperson added.
