A real partnership, with older patients in a central role, is the way forward

Over 100 participants, including high-level policy makers, representatives of health professionals, patients’ organisations, and older patients themselves, gathered at the conference in Warsaw on 12-13 July to explore key challenges and opportunities around ageing and older patients.
At the opening plenary, Andrzej Witold Włodarczyk, the Undersecretary of state for health, Poland, noted that “the topic of the conference fits within the Polish Presidency of the EU, as the ministry of health suggested older age problems as one of the leading subjects”. He presented actions to meet the challenge of ageing population in Poland, including the creation of an Institute of Geriatrics to train specialists, promote a holistic approach and develop solutions for older patients to be implemented in the Polish health system.
Other speakers included Martin Seychell, the Deputy Director-General of DG SANCO, presented the aims and milestones of the European Innovation Partnership for Active and Healthy Ageing, a “vital element to our response to the demographic change” as people in Europe tend to live longer, but with their last years in ill health. Pointing out the need for all actors to work in partnership, he stressed that “patients and older people need to play a very important and central role, and be involved from the onset”. Representing the European Parliament, Antonyia Parvanova, MEP asked whether adding two years of “life without disability” is enough; adding that indicators should be developed to measure not only physical but also mental health, well-being and social inclusion. This echoed a key recommendation from the conference participants: health needs to be addressed in a holistic way.
On the second day, participants had an opportunity to explore in depth specific issues of crucial importance for older patients, in five parallel workshops. Some of the main conclusions brought forward during the lively discussions were:

• Shared decision-making as a key solution to improve the quality and sustainability of healthcare. All patients, including older patients, should be enabled and empowered to become equal partners in their care. Shared decision-making is seen to improve adherence to therapies, self-management, and therefore health outcomes and quality of life. To achieve this, meaningful patient involvement on individual and collective levels is fundamental: many speakers highlighted that existing good practices and guidelines such as the Value+ resources, need to be better applied.
• Patient empowerment through health literacy and quality information. Another message that was echoed throughout the conference was the need for a strategy to improve patient information and (e)-health literacy. More than ever, an ageing Europe will need patients who are aware and informed to be able to self-manage and participate in health-related decision-making.
• Innovative solutions centred on users’ needs. Innovative solutions are an essential component in the future vision of healthcare, but participants felt that it is currently not enough centred on the people who use it. To meet older patients’ needs, they have to be involved in the design, development and implementation. Innovation should be understood as including “low-tech” (e.g. changes in healthcare delivery, structures or systems). In pharmaceutical innovation, a key challenge is to improve the evidence-base for older people’s treatment.
• Integrated care solutions were highlighted as a key wish of patients. Fragmented organization and delivery of care forms a major barrier to good quality care. “Silos” between medical and social care and between different medical specialities have to be broken. An important parameter to improve the organisation of care for older patients is the adequate training and support to healthcare professionals and carers.
• Health inequalities need to be effectively tackled. Many participants raised concerns about the wide health inequalities in Europe, and called for strong responses at national and EU level. In his speech, Philip Chircop, EPF Board member, said: “We cannot stress enough that for patients with chronic diseases, ‘active and healthy ageing’ rests on the cornerstone of equitable access to good quality, patient-centred healthcare.”

In his concluding remarks on the second day, Anders Olauson, EPF President, who chaired the conference said: “EPF has been involved at all level of the [Innovation] Partnership; and we are keen to ensure that the outcome of this conference will contribute meaningfully to the Strategic Implementation Plan”. EPF will also use the outcomes of the conference to prepare a position paper that will feed into the current debates around healthy ageing and older patients, the sustainability of health systems and chronic disease management.

01.08.2011

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