Summary: This document introduces how the "Live Longer Better" systemic approach is unfolding to transform the challenges of an ageing population into positive outcomes. Its core goals are extending healthspan, reducing social inequalities, and decreasing the need for health and social care support. To achieve this, a network of diverse partners, evidence-based science, and education and engagement programmes are being advanced.

1. An Ageing Population and New Challenges

In 2023, Chief Medical Officer Sir Chris Whitty, in his annual report Health in an Ageing Society, clearly laid out the challenges posed by an ageing population. Many people feel this issue is bearing down on them like an "unstoppable tsunami" — but that is not the case.

On 12 March 2024, NHS Medical Director Sir Steve Powis and Director of Public Health Dr Sarah Price officially launched the "Living Longer Better" system. The message was clear: the NHS alone cannot solve this complex problem, and collaboration across multiple organisations is essential. Then in June, the Health and Social Care Committee launched a formal inquiry into the role of physical activity in improving the health and wellbeing of older people.

"Our mission is to help people live longer and better."

2. Healthspan, Social Inequality, and the Need for a 'Revolution'

Over the next decade, the population aged 70 and over is set to grow significantly, yet under the current approach the outlook for living long and healthily is not bright. This shift will place enormous pressure on health and social care services. But there is no need for despair. The current body of strong scientific evidence shows that we can reduce the risks of falls, dementia, disability, and frailty — and in doing so, substantially reduce the demand for health and welfare services across society.

For example, for every one-year increase in healthspan across one million people, the NHS can save approximately £45 million. Simple service reorganisation or privatisation will not achieve this goal. A genuine revolution is required.

3. The Power of an Integrated System and Network

This revolutionary change is being realised by building one integrated system in which many services and organisations naturally come together. The system applies the concept of Complex Adaptive Systems.

"Non-linear systems are considered complex because their behaviour is heavily determined by local interactions between their parts. When such systems are able to evolve, they are called complex adaptive systems." — Rihani, S (2002)

This integrated system operates locally and is anchored by AgeUK, Active Partnerships, the NHS, local government, faith and voluntary organisations, businesses, and above all, older people themselves. A shared additional goal is combating ageism — the social prejudice directed at older people. Cultural change is being driven to shine a new light on the talents and potential of older people and to reduce the barriers that prevent them from contributing to society.

The system works in a complementary way with NHS England's 'Ageing Well' programme, and emphasises the importance of shifting the health curve for the whole population, not just high-risk groups.

"Shift the Whole Population Curve" — Geoffrey Rose, epidemiologist

The approach also points out that many young people today experience physical decline and psychological difficulties, and so this framework should be applied across the entire life course.

4. The Ultimate Goals and Key Challenges of 'Living Longer Better'

Three core objectives are as follows:

1. Extending healthspan and compressing the period of dependency
2. Reducing social inequalities in healthspan (the rich–poor gap)
3. Decreasing demand for health and social care services

Underpinning these are more specific aims, including:

• Preventing and alleviating isolation
• Improving physical capacity and healthspan
• Correcting negative perceptions of ageing
• Enabling leadership participation from older people of diverse backgrounds
• Creating environments that help people realise their potential
• Strengthening a sense of purpose and supporting carers
• Minimising the effects of poverty
• Preventing and managing dementia and chronic conditions
• Optimising resources
• Including both 'living well (Wellbeing)' and 'dying well' within scope

All knowledge and information relating to this system is freely available to the general public and professionals alike through the website www.howtolivelongerbetter.net.

5. Practical Change: Education and Engagement Programmes

The central strategy of this movement is primarily education (learning) and engagement programmes. The focus is not on technology itself but on encouraging people to think and act in new ways.

1. Learning: Aimed at everyone — older people, families, professionals, volunteers, and policymakers. Practical knowledge is shared through small, interactive online groups.
2. Engagement: Enables individuals, communities, and digital networks to each contribute to improving society.

"We believe that everyone can play a part in making society better."

6. Scientific Evidence and Information Archive

Even if we were to make proper use only of the scientific knowledge and practical experience we already have, most older people could live long and healthy lives. This 'library' focuses on three modifiable factors:

• Loss of fitness
• Disease (especially where it overlaps with reduced physical capacity)
• Social and environmental factors (poverty, discriminatory attitudes, etc.)

The key message is that most serious problems — disability, frailty, dementia, dependency — are not caused by inevitable ageing, but arise because these factors go unmanaged. This archive is accessible to anyone and can be used for prevention and mitigation.

7. Administration and Resources

Learning materials, evidence-based data, practical guides, and resources for this programme are kept up to date and available through: the official website (https://www.howtolivelongerbetter.net) and the science and evidence page (https://www.livelongerbetter.uk/science--evidence.html).

Closing

'Live Longer Better' is not simply about extending lifespan — it is a social transformation in which people of all generations work together to live with meaning and dignity. Learning together, taking action, and staying connected are at the heart of this strategy, all in service of creating an environment where growing older opens up ever more opportunities and possibilities.