An Overview of Disease and Health Research Vol. 4

The world population aged 65+ will triple from 6.9% to 20% by 2050. The fact that people are living longer is a positive reflection on improvements in health and long-term care services; at the same time, falling birth rates are leading to a decrease in the working age populations available to provide care. This chapter considers the health and social care challenges that many countries are increasingly facing with an aging population and a reduced workforce. Providing long-term care services to meet the needs of older people is complex. As people age, they will require both health and social care services to maintain their functioning and retain a good quality of life. Integration of these, previously separate services will need to be achieved in order to provide cost-effective long-term care. The World Health Organisation recommended in 2020 that all countries should have integrated long-term care strategies to better support their older populations. Exploration of the rhetoric and reality of policies of integration of neighbourhood services for older people is now needed. Such an analysis can provide evidence on the strengths and weaknesses of different strategies, but it may also highlight the need to temper rhetoric with reality, as well as identify challenges for the future.  Countries are at various points in the journey to address the challenge of integration. Some, like Japan, which has the most rapidly ageing society in the world, started to address this challenge systematically in the 1990s. By 2017, it had introduced a national policy for integrated long-term health and social care services for older people at a local geographical level (neighbourhood). Other countries, such as England, have only recently embarked on a plan for integration of health services for older people. It has also chosen to develop services at a neighbourhood level. We describe the evolution of the neighbourhood approach to care for older people in both countries. We also consider historical and cultural factors, and the future role of technology. Through international comparisons, the reader can identify critical lessons that could inform the strategy development in their own country. In conclusion, this chapter provides an overview comparing the development of neighbourhood care models in two countries with different historical, cultural and health and social care backgrounds.