Report by the Audit Commission looks at the challenges and opportunities posed by England's ageing population

Mike Clark 

How can services be targeted and also be preventative? Do current mainstream services need to adapt to meet future needs and expectations?

A recent report by the Audit Commission, Don’t stop me now - preparing for an ageing population, finds that councils in England, particularly those with the fastest ageing populations, are not ready to meet the needs of older people.

The Commission considers that most council services focus on the minority who require social care whilst excluding the invisible majority who may end up isolated and vulnerable if ignored.

The report sets out actions that local authorities can take to support well-being in older life, including:

  • reviewing demographic profiles and reassessing their approach to an ageing population (
  • age-proofing mainstream services and designing targeted services
  • targeting spending to have the most impact and improving evaluation.


Local authorities have an important role in enabling older people to live independently and actively, with a good quality of life, for as long as possible. They have important responsibilities for supporting independent living and addressing social isolation. Older people within the local population are also an important potential resource in commissioning, designing and delivering mainstream and targeted services.

The Commission has found that the best councils innovate to adapt mainstream services for older people, working with public and private sector partners to drive improvements. The report identifies telecare as an example of enabling older people to live independently. A range of telecare services provided by Blackpool Council, where admission into residential care has been delayed, user confidence has increased and help is available when needed, features in case study 22. The report also refers to a pilot scheme for Blackpool residents with heart failure that has led to an 86 per cent reduction in GP visits.

The report considers that well-planned, targeted services support independent later life. Targeted services should be aimed at people who have not yet become dependent, but who have started to develop early signs of isolation or ill health, and should be focused on those older people most at risk.

Early reports from CSCI telecare performance data identify how local authorities and their partners have risen to the challenge of providing innovative, low-cost services using the Department of Health’s Preventative Technology Grant, aiming to provide 160,000 additional older people with telecare over a two year period.

Finally, the Commission provides a simple checklist for targeted services. This can be used by services implementing telecare and telehealth to support independence and reduce hospital and care home admissions:

  • Understand the community and local demographic profile to target services effectively
  • Develop services that match high-risk issues to the area (for example, low life expectancy, high rate of heart disease, isolated BME communities, rural isolation, and so on)
  • Target members of the community most at risk of isolation and ill health
  • Quantify spend on targeted services.


Additional resources
Predictive risk project
The King's Fund has produced ground-breaking models (PARR and the Combined Predictive Model) that help primary care trusts (PCTs) predict the risk of emergency re-admission and first-time admission to hospital by identifying patients who are at risk of, but who have not yet entered, a spiral of emergency admissions.