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Programme Observatory Venice Summer School 2011

Preliminary Programme Outline
The Ageing Crisis: A Health Systems Response

Summer School 2011 will focus on the implications of population ageing for health policy and the ways health systems can provide solutions to the challenges of an ageing society. The course will present a multi-faceted picture of the ageing effect on health systems and policies, looking at the evolving life expectancy and morbidity ratios; changing needs, the implications for financing, and the interface between different types of care, taking into account variations across Europe and inequalities between and within countries. A particular focus will also be the potential of health promotion and prevention to maintain people’s health and self-reliance as well as the use of technology and innovative models of integrated care to better assist  older people living with chronic conditions.

The Summer School will address the topic of ageing from a policy makers’ perspective, outlining models for developing an integrated policy that can meet all these challenges, providing practical examples and tools but also taking into account the constraints and pressures that policy makers have to face. Crucially, the course will draw on the participants’ experience and sharing of knowledge and insights, and will build contacts and networks and to provide resources for future work. An important contribution to the Summer School will also be the approach taken on this issue at European and international level, including by the World Health Organisation and the European Union.

MODULE 1: The challenges of ageing
The first module will set out the overall challenges that demographic ageing will bring; the projected ageing trends and what they are likely to mean; the overall challenges for society and economy that this represents; and the context within which health systems will have to respond.

Projections: This section will set out the projected challenges of ageing, and the reference scenarios such as the Ageing Reports of the European Commission for numbers of older people, ratios between retired people and those still working, how much of older life is likely to be in good health, what this may mean for costs, and how these scenarios are different between European countries. The session will also look at the sources of data, assumptions underpinning ageing projections, how different scenarios might vary, and how far they could still be changed by active interventions now.

Consequent wider policy challenges: This section will build on the scenarios above to look at the policy challenges for society and the economy that demographic ageing will bring.  This will cover issues such as sustaining overall public finances, with a reducing proportion of working-age people relative to retired people, and the long-term consequences of financial crisis.  The session will also look at maintaining growth and overall prosperity, and changes in the current boundaries between employment and retirement.  Governance issues will be taken into account, with review of different levels of responsibility for responding to these challenges, at regional, national or European level.

Context of health system challenges: This session will turn from the wider context to the specific set of issues facing health systems.  Health systems need increasingly  to deal with ageing but also with changing population health needs (for example with the increasing weight of chronic diseases), with constant innovations in medical technologies and techniques, rising public expectations, and increasing pressure on budgets.  Moreover, as the population ages and workforces shrink, health systems will face particular difficulties in recruiting and retaining skilled staff and making it all the more important that they work effectively with other sectors, in particular on social and long-term care. 

Policy-maker round table: In order to explore these overall policy challenges, the School will include a round-table session with high level politicians, policy makers and officials from regional, national and European  and international level.  This will give the opportunity to hear and debate their insights and to understand different perspectives on ways forward as a basis for the next two modules.

MODULE 2: Promoting healthy ageing
A great deal can be done to help people stay healthy as they get older. This module will set out how to do this, looking at overall principles, key areas on which to focus, practical examples and resources.

Key targets for promoting healthy ageing and minimising illness: This session will draw on current evidence to identify the key causes of mortality and morbidity in later life where interventions can make the greatest difference.  These include interventions to tackle obesity and hypertension, heart disease and stroke, dementia, falls, immunisations, medication errors, and to maintain integration in society.  The session will also look at evidence on how this can best be achieved, in particular by taking a holistic approach appropriate to the target population.

Best practice in health promotion for older people: Many different projects have been undertaken to help promote healthy ageing.  This session will look at evidence about what works best, drawing on material from different projects and countries across Europe, in order to provide concrete examples and to distil some general principles for good practice in health promotion for older people. There is also a growing body of evidence about how we really process information and what is most effective in changing behaviour, from areas such as cognitive psychology, as well as from fields which are often seen as being quite separate, such as marketing and retailing.  This session will look at the scope for learning lessons from these areas and applying them to health promotion.

Working in partnership: Bringing together different actors and sectors into effective partnerships will be essential, and this session will look at how to do this successfully.  This session will look at how health systems can best work  together with older people and the organisations representing and supporting them, including getting the specific perspective of older people and learning from them.  It will also tackle how health systems can best  work in partnership across different sectors and with those responsible for areas such as long-term and social care, in dealing with co-morbidity.

Maintaining economic and social integration: One key objective for an integrated approach is helping people remain in their jobs and in their own homes as they get older.  This session will build on the partnerships discussion to explore the scope for a more integrated approach with employment, education, training and social services to help maximise labour force participation and independent living as people age, such as through flexible work arrangements, lifelong learning, supporting healthy living and help with any medical conditions, and maintaining integration with the local community.

MODULE 3: Adapting health systems to ageing
Health systems will have to change in order to respond to population ageing.  This module will address some of the key issues, as well as identifying potential solutions and resources.

Ensuring integrated care: A key challenge facing health systems will be ensuring integrated care.  This means combining different elements of care (primary care, hospital care, rehabilitation) for a single condition; integrating care when a patient has several different conditions to ensure a coherent overall package of care; and bringing together care from health systems with care from other services, in particular social care and long-term care.  The session will look at how to achieve this drawing on models of care for complex chronic conditions, the use of care coordinators and of information technology, the active involvement of patients and their families, and lessons from concrete examples.

New technologies for supporting healthy ageing: New technologies are being developed that can make a substantial difference in the quality of care and its efficiency and overall cost.  This session will look at some of the technologies available or on the horizon and how they can support objectives such as healthy living (through supporting physical activity programmes or healthy eating), maintaining independent living ( through assisted living and remote monitoring), and ensuring  integrated care (by enabling integrated medical records and sharing of information).  This session will also look at how best to work with technology partners, such as major provider companies, as well as research and policy initiatives related to new technologies, such as the European Innovation Partnership for active and healthy ageing proposed by the European Commission. 

Ethical issues: This session will explore ethical issues around care for older people.  This can include end-of-life issues such as euthanasia, the role of palliative care, and how far people wish to end their lives at home rather than in hospital or other institutions.   The session will also explore how to ensure involvement of older people in making decisions that affect them, even in difficult situations such as progressive lack of capacity due to dementia, and balancing the rights of patients with their own health and capacity for decision-making (e.g: remote monitoring, restricting movement).

PROGRAMME 2011