Older people’s health inequalities revealed in anniversary report

Last Updated on September 30, 2025

Age UK’s 10th anniversary State of Health and Care of Older People report has revealed growing inequalities in older people’s health.

The report shows that while the number of older people in the UK continues to rise, healthy life expectancy at age 65 has dropped to 11.2 years for females and 10.1 years for males. However, these declines are not shared equally – the more deprived an area, the shorter the period of life spent in good health, on average. Older people with more advantages often age well, while others face worsening health, limited support and fewer opportunities to live independently.

As the largest group of users of the NHS and social care, older people are bearing the brunt of a struggling health and care system, the report suggests. In the face of a rapidly ageing population, the growth in the number of full-time equivalent GPs has not been keeping pace and there are fewer older people receiving social care support compared to a decade ago. Most services are over-stretched and unpaid carers and staff alike are under intense pressure. Many older people who need help from the NHS or social care cannot access it quickly – and sometimes not at all.

The report shows that the percentage of people aged 65+ with common mental health problems who are receiving no treatment is higher than for every other age group. One in seven (14%) people aged 65-74 have a common mental health condition, including generalised anxiety disorder, depressive episodes and panic disorders. Two-thirds (67%) of people in this age group with clinically significant symptoms did not receive any treatment, with this proportion rising to 78% for the 75+ group.

Some of the most vulnerable older people are unable to access NHS dental treatment, with the ‘oldest old’ (aged 85+) seen least by dental services. In 2025, 16% of respondents to the GP Patient Survey aged 65+ said they had been unable to get a dentist appointment in the last two years.

Satisfaction levels are falling. In 2025, 28% of people aged 65+ felt the length of time they waited for a GP appointment was too long. Respondents to the British Social Attitudes Survey conducted between September and October 2024 felt the most important priority for the NHS should be making it easier to get a GP appointment (51%).

Key findings in the report include:

Growing inequality in access to some NHS services: Those who can afford it are increasingly turning to private healthcare for procedures with long waiting lists such as cataract and knee operations, widening the gap between rich and poor.
Social care under strain and tightly rationed: State-funded support is now largely the preserve of the poorest older people with the most severe social care needs, leaving others to rely on family and friends or struggle without help if they are of modest means.
Lasting pandemic effects: COVID-19 accelerated health decline in older people and worsened NHS waiting times, which remain at record highs.
A legacy of chronic long-term underinvestment: More than a decade of insufficient funding and workforce planning has left the UK short of GPs, hospital beds, and social care professionals, among many others.

Within social care, Age UK has welcomed the establishment of an independent Commission led by Baroness Louise Casey but laments the fact that the Government has set a deadline as late as 2028 for the Commission to report – beyond the current Spending Review period. It has also recently become clear that the Fair Pay Agreement for care professionals will not now crystallise into concrete action until a similar date, after it had originally been implied that this welcome initiative would improve pay for care workers much sooner.

According to Age UK, problems in accessing formal care services are placing greater pressures on unpaid carers:

76% of Directors of Adult Social Services reported an increase in the number of unpaid carers requiring support in 2024/25, according to ADASS.  For the third year in a row, Directors ranked burnout as the number one contributing factor to increases in carer breakdown over the past 12 months.
Around 16% of people aged 65+ in England are unpaid carers, (equivalent to 1.8 million), as are one in five (20%) people aged 50+ (equivalent to 4.3 million).
Age UK research found that 74% of older carers (aged 65+ in the UK) felt under strain; 66% had lost sleep due to worry; and 62% felt unhappy or depressed. More than half (55%) were living with a long-term illness or disability themselves.

The Charity has also welcomed the Government’s 10 Year Health Plan, having contributed to its development. Central to the Plan is the aim of shifting the focus from hospital to community-based care by developing a new Neighbourhood Health Service.

Commenting on the publication of the Charity's 10th anniversary report, Caroline Abrahams, Charity Director at Age UK, said, 'This 10th anniversary report Age UK has produced paints the picture of a health and care system under unprecedented pressure – in some places, at times virtually under siege. We want to recognise the enormous efforts being made by staff from top to bottom to turn this situation around and we thank everyone who is working so hard to that end.

'The uncomfortable truth though is that at present, many older people are not able to get the high-quality healthcare and social care support they need – and they do not have time on their side. Against this context it’s not surprising that satisfaction levels are sharply down and there’s a trend towards more "going private" if they can afford it. Sadly, the result is that inequalities are growing and those who are least advantaged are being left further behind. The starkest evidence of this are gaps in healthy life expectancy the scale of which shame us as a nation.

'If we’re to transform the NHS and make it more effective then older people must be an explicit priority for the new Neighbourhood Health Service, because they are occupying the great majority of hospital beds when in many cases it would be better for them to stay at home with good treatment and support. This must include the right social care as well as health support, so ensuring social care is fully part of Neighbourhood Health is crucial. Local voluntary organisations such as our local Age UKs must be fully brought in too; they are invaluable local assets that do important things the NHS and social care can’t, like help people who are lonely or who have housing issues – problems that when unaddressed accelerate health and care needs.

'The decade that has passed since we first started producing these reports has been largely wasted as regards the need to adapt health and care for a growing older population, even though the trend in population ageing has been so obvious it should have been visible from outer space. With the 10 Year Health Plan we’re now finally trying to do the right things but much later than we should be and at a time when there’s less public money available to invest compared to ten years ago. That’s why we have to go as fast as we possibly can now in achieving transformational change in community-based health and care services, as the NHS will never run optimally until this task is complete. From this point of view we think that the Government needs to accelerate its timetable for social care reform and in our report we call on them to do so.'

To make the health and care system more responsive to the needs of an ageing population, Age UK is calling for the Government to:

Make older people an explicit priority cohort for Neighbourhood Health right from the start and throughout.
Reduce the number of emergency admissions for acute and chronic conditions that could and should be managed in the community to under 100,000 a year.
Guarantee that all older people diagnosed with severe frailty in the community receive a structured medication review and falls risk assessment, as a minimum.
Bring down the numbers of people delayed in hospital when fit for discharge back to pre-pandemic levels (approx. 4,500 on a typical day vs 12,000+ now).
In order to achieve the above, develop and put in place in every area shared community assessments involving NHS and social care services and minimum service requirements for rapid access to care such as physio and occupational therapy, community mental health and other rehabilitation services where needed.
Assess and standardise maximum GP list size, taking into account the size of the older population.
Make funded commitments to grow the community workforce, including District Nurses.
Increase and standardise core skills and capabilities across the workforce relating to older people’s care and frailty.
Request the Casey Commission produces its final report in 2027 at the latest, rather than 2028.
Develop measures to support the care workforce and mitigate the impact of the new Immigration Rules, including bringing the Fair Pay Agreement into force sooner than 2028.
Develop a funded strategy to increase the proportion of unpaid carers who are able to take a break for 24 hours to at least one in four by the end of this Parliament.