Ageing Well: Understanding the health and

wellbeing needs of the population aged 65 and over in Shropshire

A Strategic needs assessment

Rachel Robinson

Director of Public Health, Shropshire

Overview

• Why are we all here?

• Why and what is a needs assessment?

• Why are you here?

• Strategic Needs Assessment

Today people in Nuneaton and Bedworth are living longer, but not necessarily healthier lives…Shropshire's

Why we are here?

4

• RTAs

• Estimated Diabetes

• Overweight or Obese

• Suicide and Mental

Health

• Excess winter deaths

• Alcohol admissions

5

We will do everything in our power to enable people across

Shropshire to pursue happy, healthy lives and put people and

communities at the heart of everything we do.

We will share responsibility to transform our services

We will use data/information/insights and understanding to

inform what we do - (Joint Strategic Needs Assessment - JSNA)

What is a needs

assessment?

“The JSNA should be the source of evidence from which everything flows”

Joint across organisations and communities

Joint Strategic Needs Assessment

• The purpose of this needs assessment is to:

– Identify the health and wellbeing needs of the population

of the over 65s population in Shropshire;

– Map the services/assets in the area;

– Make recommendations for how services can be

improved / redesigned to make sure they are being

delivered to the people who need them most.

– Theme based needs assessment support priorities for

which a demonstrable and imminent commissioning decision needed to be made.

– Moving to Place Based needs assessments from April

Joint Strategic Needs Assessment (JSNA)

Ageing Well: Understanding the health and wellbeing

needs of the population aged 65 and over in Shropshire

Shropshire Key

Facts

Sources: 2018 Mid-Year Population Estimates, 2016 Based Sub-National Household Projections, 2011 Census, Office for National Statistics (ONS).

Table CTSOP3.0: Number of properties by Council Tax band, (snapshot 31st March 2018), Valuation Office Agency (VOA) published 29th November 2018.

Total Population Mid-2018: 320,300

Total Households Mid-2018: 137,600

Number of Dwellings 2018: 142,180

Area: 319,730 hectares

Population Density: 1 person per hectare

Average: Mean Age: 44 years, Median Age: 47 years

© Crown copyright 2019 OS 100049049Codepoint UK, Ordnance Survey

Each Postcode Unit contains an average of 15 adjoining addresses.Scale: 1:308,289

Shropshire Residential Postcode Units

© Crown copyright 2019 OS 100049049Codepoint UK, Ordnance Survey

Each Postcode Unit contains an average of 15 adjoining addresses.

Northumberland Residential Postcode Units

Scale: 1:308,289

Area and Population• 2017 Population 317,000+, 24% of which aged 65+ 1.2% aged 90+, which

is higher than England’s 18% and 0.9% respectively

• Shropshire’s 65+ population increased by 48% taking it to a third of

population by 2037.

• Meanwhile the 85+ population will increase by 135%, taking it from 3% of

population now to 7% in 2037.

• While Shropshire ranks as the 115th most deprived area out of 152

authorities, there are pockets of deprivation and inequalities

• The Treasury estimated that 6% of the population is lesbian or gay, - applied

to the estimated 76,030 people aged over 65 in Shropshire = 4,561 people.

6% of estimated 5,135 nursing and residential beds in Shropshire and T&W

= 308 beds

Shropshire People 2017

Population Change by

Broad Age group

The shift in age structure in Shropshire with projected decline in the age groups below 65 years of age and growth in the older age groups above 65 years. Of particular concern for service providers is the more than doubling of the elderly population, as this age group places the greatest demand upon services.

Shropshire People Projections

Period Shropshire: population aged 65+

Shropshire: % of population aged 65+

West Midlands: % of population aged 65+

England: % of population aged 65+

2010 62,149 20.4% 16.8% 16.3%

2011 63,929 20.8% 17.0% 16.4%

2012 66,485 21.6% 17.4% 16.9%

2013 68,683 22.2% 17.7% 17.3%

2014 70,902 22.8% 18.0% 17.6%

2015 72,720 23.3% 18.2% 17.7%

2016 74,302 23.6% 18.3% 17.9%

2017 76,030 23.9% 18.4% 18.0%

Trends in Percentage of Shropshire’s

People Aged 65 and Over

Internal Net Migration

Shropshire % of Place Plan Population

Aged 65 +

Health in Shropshire2016-18 Males Females

Life Expectancy 80.5 83.5

Healthy Life Expectancy 64.0 64.6

Life expectancy at 65 19.3 21.3

Pneumococcal vaccination 71.3%

Flu vaccination 72.6%

Shingles vaccination 49.9%

Healthcheck coverage 44.3%

QOF Recorded Dementia in 65+ 1.2%

QOF Recorded Hypertension 16.5%

QOF Recorded Depression 11.8%

QOF Recorded Obesity 11.5%

Health in ShropshireRate of Deaths from disease among

people aged 65 years and over from

Shropshire rate per

100,000

Comparison with

England

Cardiovascular Disease 1,032.3 Better

Cancer 1,050.6 Similar

Respiratory Disease 559.7 Better

Dementia 941 Similar

Cardiovascular Disease 1,032.3 Better

Deaths in Person’s Usual Place of

Residence

Shropshire

Percentage

Comparison with

England

% deaths all ages 51.7% Higher

% deaths 85+ 60.6% Higher

% deaths 75-84 47.7% Higher

% deaths 65-74 42.6% Similar

% deaths <65 39.6% Similar

% of dementia 65+ 75.9% Higher

Health in ShropshireEmergency Hospital Admissions

for Falls and Hip Fractures

Shropshire rate

per 100,000

Comparison

with England

Emergency hospital admissions due to falls

in people aged 65 and over 1,733 Better

Emergency hospital admissions due to falls

in people aged 65 – 79 774 Better

Emergency hospital admissions due to falls

in people aged 80 and over4,515 Better

Hip fractures in people aged 65 and over 589 Similar

Hip fractures in people aged 65 – 79 216 Similar

Hip fractures in people aged 80 and over 1,668 Worse

Vision Related Indicator Shropshire

rate per

100,000

Comparison

with

England

Preventable sight loss related to Age Related Macular

Degeneration aged 65+106.5 Similar

People registered blind or partially sighted aged 65-74 365 Lower

People registered blind or partially sighted people aged 75+ 2,691 Lower

Loneliness in older people

Wem

Shrewsbury

Bishop's Castle

Bridgnorth

Oswestry

Ludlow

Craven Arms

Market Drayton

Ellesmere

Church Stretton

Cleobury Mortimer

Whitchurch

Shifnal

Much Wenlock

Albrighton

Broseley

Highley

Pontesbury and Minsterley

-4.9 - -4.4

-4.3 - -4.2

-4.1 - -3.8

-3.7 - -3.4

-3.3 - -2.7

Place Plan Boundaries

2011 Census Table CT0467 Log odds of loneliness for those aged 65 and over

Loneliness in 65+ Population

Value Closer to 0 = greater level of loneliness

© Crown copyright and database rights 2019 OS 100049049

Projecting Older People Population Information System

Predictions of disease prevalence 2019 2020 2025 2030 2035

People aged 65+ with a limiting long term illness whose day-to-day activities

are limited a little19,676 20,087 22,593 25,305 27,561

People aged 65+ with a limiting long term illness whose day-to-day activities

are limited a lot16,502 16,875 19,329 21,955 24,482

People aged 65+ with depression 6,783 6,919 7,641 8,564 9,349

People aged 65+ with severe depression 2,141 2,186 2,491 2,805 3,077

People aged 65+ with dementia 5,543 5,680 6,611 7,737 8,910

People aged 65+ with a longstanding health condition caused by a heart attack 3,871 3,954 4,412 4,956 5,431

People aged 65+ with a longstanding health condition caused by a stroke 1,843 1,883 2,123 2,384 2,617

People aged 65+ with a longstanding health condition caused by bronchitis

and emphysema1,337 1,364 1,513 1,701 1,864

People aged 65+ with a fall 21,000 21,442 23,995 27,348 30,362

People aged 65+ predicted numbers of hospital admissions due to falls 2,505 2,571 3,022 3,569 3,943

People aged 65+ with a bladder problem less than once a week 2,542 2,598 2,913 3,315 3,667

People aged 65+ with a bladder problem at least once a week 12,932 13,207 14,827 16,736 18,524

People aged 65+ with a moderate or severe visual impairment 6,926 7,106 8,152 9,161 10,023

People aged 75 and over with registrable eye conditions 2,355 2,445 2,982 3,341 3,667

People aged 65+ with some hearing loss 48,019 49,268 55,611 63,552 70,328

People aged 65+ with severe hearing loss 6,208 6,397 7,541 9,187 10,297

People aged 65+ unable to manage at least one activity on their own 14,434 14,765 16,803 19,335 21,877

People aged 65+ with a BMI of 30 or more 20,489 20,879 22,689 25,210 27,314

People aged 65+ with diabetes 9,849 10,043 11,063 12,423 13,603

People aged 65+ with a learning disability 1,652 1,682 1,854 2,085 2,292

People aged 65+ with a moderate or severe learning disability 222 225 242 272 296

People aged 65+ with autistic spectrum disorders 744 758 844 952 1,044

A&E attendance 65+ April 13 to March 18

• There were 93,437 attendances for those 65 and over – made up

of 44,544 unique patients

A&E attendance 65+ April 13 to March 18

– Discharge Destination

Inpatient Admissions 65+ April 14 to March 18

• There were 133,463 inpatient spells for those 65 and over –

made up of 47,542 unique patients

Inpatient Treatment Specialty

Inpatient Length of Stay

Outpatient Attendances 65+ April 14 to March 18

• There were 617,431 outpatient appointments for those 65 and

over – made up of 64,959 unique patients

Treatment Specialty of Outpatient Appointments

Global Burden of Disease – Top 15 Causes of

Death in 2017 in 70+ Age Group in Shropshire

Global Burden of Disease – Top 15 Diseases as

% of Total DALYS in 2017 in 70+ Age Group in

Shropshire

Single Person Households

All single person

householdsOlder single person

households

Wem

Shrewsbury

Bishop's Castle

Bridgnorth

Oswestry

Ludlow

Craven Arms

Market Drayton

Ellesmere

Church Stretton

Cleobury Mortimer

Whitchurch

Shifnal

Much Wenlock

Albrighton

Broseley

Highley

Pontesbury and Minsterley

Place Plan Boundaries

4% - 8%

9% - 12%

13% - 17%

18% - 24%

25% - 40%

Department for Business, Energy & Industrial Strategy, Sub-Regional Data 2015

Proportion of Households Fuel Poor

Fuel Poverty

• Shropshire has a significantly worse age

standardised rate than England for

admission episodes for alcohol-related

conditions

– for persons aged 65+ male and female

Why are you here?

• The evidence

• You - the key stakeholders

– people with an interest in the area

– Know what's happening in Shropshire

– Developing recommendations and next steps

• Additions – are there gaps?

• Identify key themes

• Shape recommendations as stakeholder group.

How do the gaps feed into recommendations?

• Targeted work arising from Needs Assessment

• Starting Point