Reform is needed to ensure the UK copes with the burgeoning care demands of growing numbers of elderly people, an expert warns.
Elderly patients 'need more support'
By 2025, the number of over-85s will have risen by two thirds - increasing demand on health and social services.
Professor Ian Philp, national director for older people, said systems to spot problems as early as possible were key.
In a report setting out what needs to change, he stressed that prompt action could save many lives.
Professor Philp also wants better management of long-term conditions to reduce the need for hospital or residential care.
KEY ELEMENTS OF OLDER PEOPLE'S CARE
Early intervention and assessment of old age conditions
Long-term conditions management in the community integrated with social care and specialist services
Early supported discharge whenever possible delivering care closer to home
General acute hospital care whenever you need it combined with quick access to new specialist centres
Partnership built around the needs and wishes of older people and their families
There should be a range of community specialist health and care services supporting primary care teams aimed at keeping people out of hospital, he added.
And when a patient does need hospital care specialist services should be available, along with support to ensure discharge is feasible at the earliest possible stage.
Professor Philp is also calling for a closer working relationship between all the relevant agencies.
Drain on resources
The over-65s are the biggest users of the NHS, and account for over 40% of the service's budget.
On any given day 65% of hospital beds are occupied by the over 65s.
Professor Philp said early intervention was vital. For example, if every Strategic Health Authority spent £2m on falls and bone health, they could each save £5m every year by preventing 400 hip fractures.
Nationally, this translates into 800 lives saved and maintaining independence for hundreds of older people.
The old person's "tsar" also said more services need to be offered from local settings and in people's own homes.
He said outcomes were better when stays in acute hospitals were limited and patients were transferred as quickly as possible to community facilities nearer home or back to their own homes.
Professor Philp said progress had already been made, but there was still work to be done.
"In the future, the NHS should design services for older people to ensure that the right care is delivered in the right place by teams with the skills to meet the health and care needs of people with age-related problems."
Health Secretary Patricia Hewitt accepted the need for change.
"Older people have told us loud and clear that they want the NHS to do more to prevent illness and more to keep them living independently in their own homes.
"Professor Philp has made it clear that early intervention and more and better services in the community will give older people what they need and want."
Gordon Lishman, director general of the charity Age Concern, welcomed any move to put the needs and wishes of older people at the centre of their health care.
But he said: "In a climate where NHS trusts are withdrawing community support and tightening budgets, there must be a question mark over whether the health system can deliver?"