Sir Muir Gray - The Oxford Elixir Of Life Is Knowledge

    11:09AM Aug 8, 2024

    Speakers:

    Dr. Paul Ch’en

    Keywords:

    people

    nhs

    aging

    fitness

    years

    local primary school

    networks

    tells

    life

    called

    prescription

    disease

    developing

    system

    introduce

    live

    rewiring

    oxford

    dementia

    group

    Come so so is a legend in the world of public health, the NHS in medicine as a whole. I've asked him in advance. I've asked

    him in advance on how he wanted me to introduce him as his list of accomplishments and academics are just too long to list up of note, he is an international renowned authority on healthcare systems and has advised governments of several countries outside the UK, including Australia, New Zealand, Italy, Spain and Germany. He's also a visiting professor in the north department of surgical Sciences at the University of Oxford. Received and most what he told me and the modest gentleman that he is, he asked me to introduce him as just the very experienced public health professional, where he's currently leading a program called Live Long better, designed to increase health span and reduce the gap between the most and the least deprived. He's also leading the Oxford value and stewardship program. His mission is to reduce waste in the NHS, for example, polypharmacy, to shift the resources to an invention such as activity. His talk titled bees, birds and the bees 2.0 is a somewhat unusual title, but I'm sure he will in line with us with his true intentions of his title, over to you today.

    Because I'm a very experienced public health professional, remembering the Oscar Wilde says, experience the name we give you a mistake. And what I'm going to do is start off by getting speech. I want you to imagine that your parents or grandparents or people that bridge from or a boss or a bulls copper, but I get the same talk the job coach, or I need to get the same talk to fellow the wrong society, because everyone is confused at what's happening. Okay, so I'm now going to speak to imaginary you're picky, three in a block of fax up after a terrible facts of life, no birds and the bees, where the bees come from, the birds and the bees, 2.0 what's happening to us as We live longer? Can we get the microphone working? Please? Let me just see the technology works here.

    There's the energy so

    technology,

    using the button I

    So ladies and gentlemen, aging the normal biological process of aging, is not a cause of major problems until the late 90s. And of course, the wonderful example we had was Her Majesty. What a way to go. We get rid of Boris Johnson and then pop off two days later, serving people to the end. But it does affect two things. First is your ability, maximum level ability, maximum heart rate, for example. And the second is resilience, your ability to respond to a change in temperature or stumble or inactivity, so you have to take It seriously.

    What the hell am I doing wrong? I

    There are only two phases in life, a phase of growth and development, a turning point, and then it's downhill all the way. But Ed, don't worry about that, because aging is only one of four processes taking place, and the first of these is loss of fitness. And Daniel Lieberman, who's a very clever professor at Harvard, said that this is not a lifestyle issue, it's an environmental issue. The genes that you have inherited from hundreds of generations. Favor being able to run about all the time, and if any calories are about, you put on fat as quickly as possible. We now live in a world in which inactivity is required of us. And I never use the word lifestyle. I mean, if you're commuting from Vauxhall to barking and sitting eight hours in front of a computer screen. You don't have a lot of lifestyle time to change things, but I am working with it with organizations. The computer should switch off every five every hour for five minutes, and they shouldn't go on again until you can show you done five minutes press walking. That's a pretty simple technology thing to solve, but it's a cultural change. So a fitness gap opens up the longer we live. The good news is that at any age you can close the fitness gap. Now, what do I mean by fitness? Well, it's a loss of maximum level of ability and a loss of resilience, just the same as aging, which is why everyone, including the medical profession has confused these two things until very recently. Now, fitness is sometimes helpful to think of five assets of fitness, strength, stamina, suppleness and skill. And what's the fifth? S, psychological pathetic aid, then you have disease. And most diseases are environmental in our origin. You need a bit of luck to avoid Alzheimer's, which is only 60 or 65% of dementia and Parkinson's, but diseases are environmental type two diabetes, high blood pressure, heart disease. These are mismatched diseases between our genome and the environment in which we live. Now what we see you after disease starts is that the fitness gap gets wider faster, and you may drop below what I call the line, the line, and that's the point at which you can't get the toilet in time. And that's it. Game over social care. Why does the fitness gap get wider faster? It's not because, well, there is a disease. I had a myocardial infarction 11 years ago. So that's a chunk of heart muscle, but the fitness gap gets wider faster because of attitudes of other people. The sun comes to see you from Middlesbrough and you say, Well, I'm fine. A bit difficult get the shops in summertime. So what does the sun do? Oh, Caddo. Oh, don't do that, Mum, we'll do it for you. We'll take we'll do things for you, well intentioned ageist approach, and that is, we need to look at this, because at any age, no matter how many conditions you've got, you can close the fitness gap. So the third factor is social factors. Far too many people are affected by deprivation, and all of us are affected by ageism, by negative thinking, well. And ageism is not all bad, is it? Well? I think it is. And hottest day of the year, and I'm counting the days till I get my next winter fuel pain. The government's going to give me 250 pounds because of my age, and I was not imprisoned for the whole of the week 18 to 24 September. Don't ask me. Don't ask me. But I'd like to ask all of you who are born before 25th then 1957 let's campaign against the winter fuel grant for everyone, I reckon it's a quarter of a billion pounds a year. There's a million people get this winter fuel allowance. That's a billion pounds over the next, the next four years, and the NHS asking for 30 billion pounds coming on the other half of my life is called the value in stewardship program, and 50% of all the money in the NHS is wasted. That's no good. That equals about 34 billion pounds. Supposing we gave a billion pounds to primary schools, children could have a decent meal liberty. And actually, I think you as older people, why don't you support your local primary school? I'll come back to that. So ladies and gentlemen, here are the facts of life. There are four things affecting us as we live longer, and we can influence all of them, understand aging, regain fitness, prevent attacks and take social action. Okay? Well, that's that's the talk, ladies and gentlemen, to the the club. Just checking my time here, this is one of the most useful things. Actually, is it they've been this, in my view, this will change medicine more than the genome, but that's that's a personal point of view. So let's just think what we're trying to achieve, and it's about living longer, better, compression of morbidity at the end of life. That's the key issue tied into that is the difference between the most and the least deprived sections of society, and it's large and growing, V North 0x two and Oxford o x4 for example. So these are the policy issues. How are we going to do this? We have to do this because this will save the NHS. You see the top diagram is what happens to many people at the moment, with multiple admissions in the last few years of life. But if you are able to increase, in care, your fitness, physical, cognitive and emotional, and reduce your risk of long term conditions. And have a bit of luck, you be admitted to hospital less often. And being admitted to hospital is a high risk issue for people in their 70s, 80s and 90s. It's called the de conditioning syndrome. About 10% of the muscle mass is lost in a week, very significant changes taking place. So how are we going to do this? Well, this is the century of the system in the network. And I have lived through 20 reorganizations of the NHS, most of which have made no difference at all. But here's the system that we've been developing. And I hope you're going to, I think you'd find this. I put this in the handout that I've given. These are the key thing is, is to have strategic objectives. That's what I've learned for the military. You need strategic objectives, and then you let local operational commanders take into account local history, geography and politics. So we don't tell people how to run the health service locally. We set the objectives. So just have a look at these. These are the objectives that we've developed in discussion with older people to reduce the risk of dementia, to enabling strengthening of purpose. And then that brought the foot of the list there to enable dying well, as well as living well. Every bridge club, every Bulls Club, every mosque, should be talking about dying well once a year, let's talk about it. It's not just a legal matter. It's something we need to talk about. And that is now starting to emerge and surround doing a great job with that. So these this is the system. Now, systems are delivered by networks. This is the sense of the system and the network. And a network, obviously consists of the local organizations, but we're also developing digital networks, which were great to get round glass involved in starting to bring together issues. Now, people immediately say rightly that not all older people are yet online, and I accept that, but I was told 50 years ago, when I started working on Aging, that old people will never use the telephone. You're wasting your time. You are trying to arrange this weekend telephone club for all the people, because all people won't use the telephone. Where's the same this thing called the internet. Remember Tim Berners Lee, when asked his ambition in 2000 said that no one would use the word the internet in 10 years time. I mean digital. We don't see an electric health service. We'll come to our electric health service, digital just part of it, part of it all. So it's just not going to happen. So developing networks now, just to show the sort of thing we're doing, this is the information I've had from the NHS in the last year about the drugs that I take for my heart disease and various other problems. And the next slide is going to show you how the information I've had about diet, exercise, depression in the last 11 years is my myocardial infarction.

    Not one word. So what we're introducing is a very clever little bit of technology called Wish. And a wish was developed by Alan Naismith, and it means that when they supposing you were diagnosed with with type two diabetes, by the time the GP is typed M ETF, the wish system looks at your record, sees your postcode, and writes an activity prescription,

    writes an activity prescription that will be said. To you and to the pharmacy. And I would expect to read this, but this is because this is what I wrote for myself. And it tells me there are walks available in Summertown, Jericho health walks. There's the British Heart Foundation website. And it also tells me that, because I live O, x2, A, j, q, and I've got, I've got a type of lung disease called C L a b, and if you heard of C L a b, my G, P, hadn't either. It's called, it's called coughing like a bastard. Everyone in Glasgow who grew up before the Kenny Riot has got CREP, I can tell you, but the prescription tells me, well, why don't you join the Summertown covid society? I mean, they probably turned me down for my singing voice, but that's as a revised singing is very good for you. And the GP record was my diagnosis, my treatments and my post load. This is a very simple thing to do, and we are. We're going to launch it in Hertfordshire and later this year, and then take over the NHS, so activity, prescriptions, and these are the sort of resources we've got. X is for exercise, Lin, Roger, better educational program. And I've sued some of our objectives in the handout I've given you, and goals are is very keen for goals that to meet round glass, because it's aiming at 30% of the population who are is called least activated. They've got too many, too many barriers to overcome, to respond to a letter from the GP or whatever. But we're going to use the principles of what's called social pedagogy that everyone's got a contribution to make. So when we start reaching these troops, and we'll be doing it with football clubs, for example, local communities, we'll be saying, Yeah, I know you've got lots of problems, but actually, you know you worked as a gardener for 40 years, and I know four people around here who can't manage their garden. They're getting depressed about it, so I think you could help them. So everyone make a contribution. Is what we're going to be doing in groups and a particular intergenerational adopt your local primary school. But this requires a cultural revolution, systems, networks and culture, a cultural revolution. So what we're doing is developing a new language, let's use words like purpose and enabling. I don't really like the word care means doing things for people. And we have a training program online, which I think my aim is to offer to everyone, probably starting at 55 when they start getting your pension. Discussions, you need to understand the facts of life, because people are very confused, including, as I said, the medical profession. So new language purpose ikigai, the Japanese call it. Let's start introducing this. And we have to train the way professionals think. And if you're a group of professionals, as many of you are I'd show you this and say that when I look at you, this is what I see, and what I'm going to do is rewire your brain. We have to change the brains of professionals and volunteers rewiring. It's not education. It's rewiring new circuits. And here are some of the things that I've been doing. So our book on variability and dementia, our book sold 70. It started when I was 60. Someone said, third time. Someone said, How do you feel to be 60? I said, Oh, fuck 60. Just got to get a fucking grip. And I started a group called fuck 60, but right out of time. But when I was 70, I did it. And I took fuck 60 the publishers, oh, we don't like the title, I said, Oh, big. Big was published. Oh, we don't buy the F word, but we are English graduates. We prefer alliteration. So became so at 7080, and 90, I and then Dr Green's walking cure. I'm going to get walking as a prescription. Link to every drug, prescription, particularly walking in a green environment. So this will be, this is going to be my obsession for the next couple of years, and then finally, this is the education revolution. We knowledge is the elixir of life, and it needs to be consumed, not a robot, but by learning. And it's what called the fourth education revolution that. People learn more from other learners than they do from the teacher. So this is all done in groups online. So just to finish, I think we got two minutes just turn to your neighbor and speak for two minutes about what I've been saying, and one message you'll take away. And then there may be time for question, if not is performance related, coffee. Okay, turn to your neighbor, introduce yourself and spend two minutes.