EXTRA investment of £9 million – over and above the millions already spent on four key health services in Gwent – may be required in the near future to tackle demand caused by an ageing population.

A significant increase in the proportion of over-50s attending A&E, and the linked increase in the number of complex cases this produces, will have a “major impact” on orthopaedics, emergency medicine, care of the elderly, and rehabilitation services provided by Aneurin Bevan Health Board, according to its annual plan.

And this will mean these and other services having to change the way they deal with patients, with a focus on earlier intervention to try to prevent or minimise some of the multiple health problems that can come with ageing.

Around one-in-six Gwent residents are over 65 years old, and this figure is likely to rise to one-in-four by 2030, according to the Public Health Wales Observatory.

While there has been a rise in over-50s attending A&E, it is particularly steep among over- 75s, with an 18 per cent increase in the last five years in Gwent.

Many of these older patients also have more complex needs than younger attenders, over- 85s for example having an average of six diseases.

They are also more likely to have a to wait for longer due to the complexity of their health needs, and are more likely to arrive by ambulance.

An ageing population also places more demand on orthopaedics in terms of increasing the need for hip and knee replacements and other joint repair.

Care of the elderly services will have to be expanded to cope with extra numbers, and the Gwent Frailty Programme’s work in providing enhanced care and treatment in people’s homes to try to avoid hospital admissions, is an example of this.

Similarly, rehabilitation services have a key role to play in helping increasing numbers of people stay mobile after illness or surgery.