Muscle Health Public Involvement in Research Group – Written evidence (INQ0071)

Submission by; Muscle Health Public Involvement in Research Group, which is affiliated to NIHR Birmingham Biomedical Research Centre (University Hospitals Trust Birmingham NHS Foundation Trust and University of Birmingham)

Summary

1.              Promotion of healthy living will ultimately be beneficial to the economy and quality of life for the nation. However like many quality initiatives, investment is required to start with.

2.              Investment is required in;

3.              i)              Health promotion/education (to whole population about benefits of healthy eating and exercising, as well as empowering people to become actively involved in caring for their own health).

ii)              Consistently offering access to evidence-based, high quality healthcare throughout the country. Large centres of excellence to deliver acute/secondary care do not necessarily match geographical demand of ageing population causing difficulties accessing them at an early enough point to make a significant difference to the health outcome and quality of life. Need more physiotherapy, joint replacements and community support locally to ensure accessibility.

iii)              Education about community living and caring for all ages.

4.              Plan ways to use technologies and evidence from other countries to model healthier ways of living to increase quality of life of individuals but also wealth of the nation.

1.0              Introduction

1.1              The Muscle Health Public Involvement in Research group, which is affiliated to NIHR Birmingham Biomedical Research Centre (University Hospitals Trust Birmingham NHS Foundation Trust and University of Birmingham) supports academic and clinical researchers deliver the best research possible by working with them from early stages of thinking about and designing a study. We offer a lay and patient perspective to aid clinicians and scientists. We are particularly focussed on muscle health and hence mobility.

1.2              As lay people, we do not feel qualified to respond in full to all of the questions asked, particularly the scientific and technological ones. However we are aware of many research projects, our own health/experiences and that of our friends and families.

2.0               How firm is the scientific basis for public health advice about healthy lifestyles as a way to increase health span, including physical health and mental health?

2.1.               What are the practical impediments for this advice being acted on?

i) Inconsistency with how advice is provided and monitored. It seems very dependent on your postcode and individual’s family circumstances, their attitude, relationship with clinicians and support network.

ii) Economic situation of country and individuals. For example, pension and available spend seem to dramatically affect longevity and health outcomes, which in turn is affected by access to education and academic achievement.

2.2.               Are there examples of good practice in the UK/devolved nations, or elsewhere?

i) Canada offer annual health check. Netherlands encourage exercise and particularly support cycling via cycle lanes and general infrastructure,

USA’s work on care homes and nursery children has shown that outcomes for both age groups improves with spending time with each other. ‘Care Home for 4 year olds’, Channel 4 programme with Dr Zoe Wyrko (Consultant Geriatrician) showed compelling evidence about community, social interaction, exercise/mobility and reciprocal benefits.

ii) Retirement villages such as those provided by ExtraCare in Birmingham (there are 5) seem good at catering for general interests and promoting needs of residents but concern that elderly people mixing with elderly people will result in element of isolation for all age groups.

3.0              How complete is the understanding of behavioural determinants and social determinants of health in old age, and of demographic differences?

3.1              Very aware of the researchers finding that access to company improves nutrition and exercise, yet poverty and loneliness are so prevalent, particularly for those with lower incomes who are often struggling with multi-morbidities, and attitude that there is little that can be done to help themselves (by the individual). More affluent and those with more academic education are more engaged and motivated regarding caring for themselves.

4.0               What would be the implications of a paradigm shift to people leading healthier lives for longer and spending less time suffering ill health?

4.1              Implications of a paradigm shift to people leading healthier lives for longer and spending less time suffering ill health;

• Increase in numbers of volunteers.
• Increase in numbers wanting to access leisure facilities (swimming pools, gyms, exercise classes and leisure pursuits including adult education classes).
• Reduction in available spend by pensioners on necessities and other items from their ‘disposable income’.
• Demand for more community based treatment centres.
• Increase in usage of public transport and road/rail networks. Rural areas particularly affected by this as aware of disproportionate balance between older adults residing in more rural areas.
• Fewer residential care homes may lead to further pressure on housing stock, as more people able to continue to live at home, independently.

4.2              In particular hip and joint replacements are now commonplace and must be prioritised. The present arrangement whereby Clinical Commissioning Groups CCGs) authorise such treatment on an elective basis results in prospective patients having extended painful waiting times before an operation is sanctioned.

4.3              We suggest that the NHS set a mandatory National Standard both for the treatment and timing. Thus taking it out of the hands of the CCGs, who presently do not prioritise them highly enough. Quicker treatment will result in shorter hospital stays, less periods of extended pain for patients and subsequent reduced opioid use, all potential savings to NHS costs.

4.4              Improving the mobility of the elderly by promptly attending to their failing joints will enable them to look after themselves independently which is one of the targets of this project. Therefore active life for patients is an efficient way to achieve the government’s target of five more years of health and independence.

4.5              For those elderly people who have to be cared for in a home we have become aware of various schemes in Holland and America where students are housed free of charge in an elderly persons care home in exchange for helping provide a living environment for the residents.

The students are free to live the life they want to live. In exchange they make sure that they spend 30 hours each month on being a “good neighbour” to the residents. For example the students host the evening meal in the Home’s restaurant every day of the week, but this is just an example of the great things they do for the residents. Their vibrant lives really colour the daily living of the elderly. Apart from neighbours, the students and residents become very good friends, with a deep and meaningful relationship that gives both sides a great deal of positivity and support.

20 September 2019