Understanding the population who might require social care services

Section 4 sets out in detail the prevalence levels relating to vulnerable groups who are most likely to receive social care services. An overview of Barnet identifies that the general population are healthier and living longer, it is expected this trend is will be reflected in the disabled population, as a result. Prevalence modeling using the Projecting Adult Needs and Service Information System (PANSI) for Barnet estimates a 11% increase in prevalence for learning disability and mental health client groups and an increase of 17% of people with a moderate of physical disability.

2008 2010 2015 2020 2025 % increase

Total population aged 18-64 predicted to have a learning disability

5,180 5,265 5,434 5,589 5,742 11%

Total population aged 18-64 predicted to have a moderate or serious physical disability

20,032 20,459 21,298 22,440 23,384 17%

People aged 18-64 predicted to have depression

5,416 5,516 5,690 5,852 6,007 11%

People aged 18-64 predicted to have a neurotic disorder

34,992 35,636 36,761 37,824 38,818 11%

People aged 18-64 predicted to have a personality disorder

9,288 9,459 9,756 10,024 10,295 11%

People aged 18-64 predicted to have a psychotic disorder

1,164 1,185 1,223 1,257 1,291 11%

The learning disability modelling in the PANSI model is based on the work on understanding demand by Emerson and Hatton. This work furthers goes on to subdivide the population predicted to have a learning disability to identify those known to specialist health and social care learning disability services as set out in the table below.

  2001 2011 2021

 People known to services (estimate)

Projected % increased based on Emerson and Hatton model

Projected actual increase from 2001

Projected % increased based on Emerson and Hatton model

Projected actual increase from 2001

20-59 718 7% 50 8% 5760-79 154 36% 56 59% 9180+ 7 58% 4 98% 7Total 879 12% 105 16% 141. Whilst prevalence levels are increasing, the predicted numbers of people known to health and social care services is predicted to rise at a greater rate due to an increase in the number of young disabled individuals with complex health needs who are being identified through the children’s service and transition as a result of people with complex disabilities surviving childhood and as a consequence of population growth and people with a learning disability living longer with increased physical healthcare needs. In addition, prevalence rates of learning disability are higher amongst the south east asian community which is set to increase within Barnet. In Learning Disability Services this will mean identifying service users at a young age; assessing need and preferences; maintaining input at a level that supports independence and responds to choice and providing services that are responsive and flexible; to a growing population of people who are presenting with higher need; from a wider and divers community base and are increasingly aware of their rights.

Adults with a physical disability

Effective management of long term conditions relating to a physical disability will require a joined up approach across health and social care to ensure that people are supported to live as independently as possible. Levels of need are predicted to increase significantly as a result of the projected population increase in the number of people aged between 30 and 64 and increasing numbers of people living with long term neurological conditions.

As the need for services increases with age and there will be an increase of 25% in the number of people aged 50-64, who tend to have higher needs than those aged 20-50, we can expect increase demand for health and social care services.

The time course of conditions also varies widely. The average time between diagnosis and death for someone with motor neurone disease is 14 months, while someone with multiple sclerosis may live with the condition for decades. Even within specific conditions, the needs of individuals, for example for social care support, vary widely. The diagnosis or onset of a long term neurological condition generally marks the beginning of profound changes in the life of the person and the lives of their carer, family and friends. It may affect relationships, career prospects, income and expectations for the future.

Neurological conditions nationally account for 20% of acute hospital admissions and are the third most common reason for seeing a GP. Furthermore based on national prevalence data, we can expect within Barnet at this time for there to be 1890 people with a neurological condition requiring help with daily living and for there to be 4590 carers of people with a neurological condition. The predicted increases in demand will mean it is essential that health and social care organisations work within a Long Term Conditions management model to provide effective whole systems support to enable people to live as independently as possible in their own homes. Services will need to meet the needs of more diverse groups of people and to accommodate services users accessing services through direct payments and individualised budgets.

Adults with mental health problems

Barnet has average levels of mental illness in comparison to the English average. However the number of people between the ages of 18 and 25 with mental health problems in Barnet is predicted to rise steadily from 50,860 to 56,411 between 2008 and 2025 (source PANSI and section 2)

Adults with mental health problems are the most disadvantaged and socially excluded group in society. Addressing barriers to social inclusion forms the wider agenda for mental health services (mental health and social exclusion report 2004). The Layard report 2005 (PM Policy Unit) identified ‘mental health is the biggest social problem of our country as it affects people with mild and moderate mental health problems’. The mental health agenda requires a broad whole system focus which moves away from a focus on mental health specific policy targeted at specialist mental health services. Although in development higher quality support is still needed at home and this is reflected as a specific target within the Barnet LAA to take account of the fact that Barnet has lower numbers of acute beds than neighbouring boroughs however higher numbers of people are living in registered care.

The predicted demographic growth in people of 65 years and above within the Borough over the next ten years is below the national average rate for older people. However the post war generation (referred to as the baby boomer generation), will by the end of the period, begin to feed into the 75+ age group resulting in a 25% growth in older people. This age group is where there is known to be increased demand on health and social care services. Therefore improvements in developing a more preventative approach over the next ten years will lay a good foundation for managing a significant predicted growth in older people in the latter period of this strategy and beyond.

Older people

Currently Barnet has the second largest population over 65 and over 85 in greater London. Older people are more likely to suffer from chronic and long term conditions and are also more likely to suffer from falls / factures which bring them into contact with health services. Older people represent the largest proportion of users of NHS services, however can and do get better after a period of rehabilitation and convalescence. It is vital that these episodes of acute/ medical treatment are used as opportunities for people to optimise their functioning and return home safely.

It should be noted that it is possible that the projections in the table below overestimate the percentage rate of increase in the Barnet population in view of the large scale residential developments that will be providing new accommodation over the next ten to fifteen years and which may be acquired more readily by younger age groups. Percentage changes from

2007ONS sub-national population

projections 20042008 2009 2014 2019 2024 2029

England 65+ 1.46% 3.20% 16.21% 26.12% 36.75% 50.64%England 75+ 0.94% 1.87% 10.54% 22.39% 45.49% 59.97%

Barnet 65+ 0.89% 1.78% 10.69% 18.49% 28.95% 43.43%Barnet 75+ 0.00% 0.00% 3.88% 9.48% 25.86% 37.93%

London 65+ 0.13% 0.39% 6.50% 11.70% 19.92% 33.17%London 75+ -0.09% -0.26% 2.86% 6.88% 19.84% 28.83%

However the continued rise in the numbers of people living longer is likely to have an impact on demand for social care services and in particular for positive interventions for people with dementia as prevalence increases with age. The significant bulge predicted in the number of people over 85 from 2017 onwards in Barnet, in common with the national picture, will greatly increase the chances of demand on social care services. The older population will become more ethnically and socially diverse, more consumer aware and this will have an increasing impact on the demand for types of services. In addition there will be more single older person households. In 2008 there were an estimated 3,549 persons with dementia in Barnet. By 2025 this number is expected to increase 10% and by 2015, 36%.