Transcript Slide 1

Older People – Local Evidence
Lorraine Yeomans
December 2014
Why are we interested in older people?
• The older population is increasing
• As we age the likelihood that we will need help from the health and
social care sectors increases
• 46% of hospital admissions are for those aged over 65
• 2/3rds of NHS contacts are with those aged over 65
• Limiting longstanding illness affects;
– 36% of people aged 65 – 74
– 47% of people aged over 75
– 69% of over 85s
AgeUK Later Life in the UK November 2014
Let’s not forget patients ‘whole lives’
‘Loneliness can be as harmful to our health as
smoking 15 cigarettes a day’
Social Relationships & Mortality Risk; Holt-Lunstead et al (2010)
• 36% of older people live alone
• 15% of over 65s describe themselves as always or often feeling
lonely
• 17% of older people have less than weekly contact with family, friends
and neighbours
• Over 65s are estimated to spend an average of 80% of their time in
the home – 90% for people over 85
• 45% of older people say TV and pets are their main form of company
How do older people want to be treated?
• AgeUK surveys tell us that:
– 64% of older people think that health and care staff don’t always
treat them with respect for their dignity
– 52% of people think that those who plan services do not pay
enough attention to the needs of older people
– 52% of adults (of all ages) believe that once you reach very old
age people tend to treat you as a child
Diving Deeper!
• Previous session we
sought to provide you with
an overview
• We’re able to drop further
and provide some more
detail around some
themes around Older
People and Islington in
greater detail
• Data sources include ESR,
QOF database and Public
Health England
Where are older people living within Islington?
Islington over 65s
Indices of Multiple Deprivation
Older People & Islington – What do you know?
• A3 printout on each table.
• Select the multiple choice answers for each
column.
Older People & Islington – What do you know?
The answers
Number of
People in
Islington
% of total population
Islington
London
England
Aged 65 and over in 2012
19,000
9%
11%
17%
Aged 85 and over in 2012
2,000
1%
2%
2%
Aged 65 and over in 2037
33,000
12%
16%
24%
Aged 85 and over in 2037
4,000
2%
3%
5%
Projected
Total Number
Total Number
Heart Failure
COPD
Hypertension
Dementia
Coronary Heart Disease
Stroke and Transient
Ischaemic
Attacks
Chronic
Kidney
Disease
Cancer
Depression
1,265
3,385
20,980
890
3,890
2,315
1,795
Islington
Islington
0.6%
1.5%
9.4%
0.4%
1.8%
1.1%
1.6%
3,095
3,365
1.3%
1.5%
Prevalence
Prevalence
London England
London England
0.5%
0.7%
1.1%
1.7%
11.1%
13.6%
0.4%
0.5%
2.2%
3.4%
1.1%
1.7%
2.1%
3.4%
1.3%
1%
1.8%
0.8%
QOF Indicator Summary – GP Practice Level
(2012 data)
QOF Indicator
NHS
Islington
Centile
Percentage of GP
Practices in
Islington over the
75th centile
Mental Health*
100
90%
Depression*
54
19%
Dementia
15
16%
COPD
31
14%
Hypertension
4
5%
Stroke and Transient Ischaemic Attacks
10
0%
Coronary Heart Disease
4
0%
* Mental Health is being discussed in depth at future sessions
Changing Population of Islington
• Islington has a younger population profile than many
other areas of England
• Between 2012 and 2037 ONS modelling suggests:
– 70,000 increase in total population of Islington = 33% growth in
(one of the largest percentage increases in England)
– In absolute terms the population aged between 35 and 64 will
grow the most (additional 34,000 people)
– In percentage terms the population aged between 65 – 79 and
80+ will increase the most with an 80% increase in people in
these age categories (additional 14,000 people). They will
however still make up a small proportion of the overall
population
• Components of population change show:
– +10,000 through net migration (internal and international)
– +60,000 through natural change (births and deaths)
Ageing Population - Islington
40%
35%
30%
25%
2012
2022
20%
2032
2037
15%
10%
5%
0%
Under 20
20 - 34
Source: ONS Sub-National Population Projections
35 - 49
50 - 64
65 - 79
80+
How does that compare? What does it mean?
• Islington has a ‘younger’ overall population than many
parts of England however…
• The total number of people aged over 65, living in
Islington (2012), is greater than or equal to the total
number in;
–
–
–
–
–
–
–
Exeter (19,000)
Reading (18,000)
Mid Devon (17,000)
Oxford (17,000)
Surrey Heath (15,000)
Lincoln (14,000)
West Somerset (11,000)
What else is changing about our population?
• More people than ever are living alone
• More dispersed families
A look to the future….
• Total population in Islington is set to increase by 33% (70,000 people)
between 2012 and 2037 with the proportion of the population aged
over 65 growing the fastest (80% increase from 19,000 to 33,000).
• Some conditions won’t be increasing in prevalence but this increased
population will increase demand.
• Some conditions will increase in prevalence so demand will grow
faster than the population.
•
•
•
•
Dementia
COPD
Obesity
Coronary Heart Disease
Dementia
“Dementia is one of the main causes of
disability in later life, ahead of some cancers,
cardio-vascular disease and stroke”
Age UK
• Applying these rates to the ONS
Population projections for 2012 –
2037 and QOF prevalence data
there could be an almost 50%
increase in the number of people
in Islington with Dementia over the
time period.
• Growth from under 900 to over
1,300
• Based purely on population
growth the numbers could
increase to nearer 1,600
Dementia
•
•
•
•
For people with dementia
40% have felt lonely recently
Only 47% said that their carer(s) received help in caring for them
72% are living with another medical condition or disability as well as
dementia
• Almost 1 in 10 only leave the house once a month
• High levels of loneliness make people twice as likely to develop
Alzheimer’s - Loneliness & Risk of Alzheimer’s, Wilson et al (2007)
COPD
• 3.9% of those aged 25-44
• 7.7% of those aged 45-64
• 9.5% of those aged 64+
• Modelled against Islington’s population profile this suggests there
could be an increase of 47% (1,600) between 2012 and 2037 in the
number of people living with COPD.
• Whole Lives Perspective – less mobile, more isolated, more likely to
be anxious or depressed,
The Organisations
& Workforce in
Health &
Social Care
Organisations
An estimated:
• 43 Establishments delivering Adult Social Care
– 7 Statutory local authority
– 12 Private sector
– 24 Voluntary or third sector
• 3 NHS Trusts within the boundary(including Moorfields Eye Hospital),
some fluidity as the population served by other trusts
• 37 GP practices
• 45 Community Pharmacies
Types of Social Care Organisations
Sources: SfC – NMDS Adult Social Care
Occupational Profile – Health & Adult Social Care
Health
Estimated
Total
Medical and Dental
GPs
Registered Nurses
Therapists/AHPs
Social Workers
HCAs/Care Workers
/Senior Care Workers
Managers
Admin and clerical
Other
Total Workforce
Adult Social Care
Estimated
Total
%
Total
Estimated
Total
%
%
640
10%
640
5%
170
3%
170
1%
1,720
26%
1,820
13%
1,075
16%
1,075
8%
100
1%
200
2%
200
1%
1,740
26%
3,200
45%
4,940
36%
200
3%
200
2%
400
3%
620
9%
620
5%
430
7%
3,400
43%
3,830
28%
6,600
100%
7,000
100%
13,600
100%
Sources: SfC – NMDS Adult Social Care, ESR data, Labour Force Survey 2013
Whittington Health Workforce
120
100
Nurses
190
ST&T
20
15
95
Source: ESR Headcount (all SIP numbers rounded to nearest 5)
Social Care Workforce
Source: SfC NMDS (all staff in post numbers rounded to nearest 5)
The shift in Services and Skills
Industrial Age Medicine needs to transform to Information Age Health Care
Individual
Self Care
Tertiary
Friends & Family
Secondary
Primary
Self Help Networks
Professionals as Facilitators
Professionals as Partners
Professionals as Authorities
Source: Jennings et al – Changing Health Care, Santa Monica: Knowledge Exchange, 1997
Workshop
Hub and Spoke Model
Individual
Self Care
Professionals
as
Authorities
The Patient
or Person
Professionals
as Partners
Self Help
Networks
Professionals
as
Facilitators