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Joint Strategic Needs Assessment Older People in Birmingham – Key findings from the JSNA Iris Fermin, Head of Information and Intelligence Jim McManus, Joint Director of Public Health

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Page 1: Joint Strategic Needs Assessment Older People in Birmingham – Key findings from the JSNA Iris Fermin, Head of Information and Intelligence Jim McManus,

Joint Strategic Needs Assessment

Older People in Birmingham – Key findings from the JSNA

Iris Fermin, Head of Information and Intelligence

Jim McManus, Joint Director of Public Health

Page 2: Joint Strategic Needs Assessment Older People in Birmingham – Key findings from the JSNA Iris Fermin, Head of Information and Intelligence Jim McManus,

www.bhwp.nhs.uk

The JSNA for Older People

• The Joint Strategic Need Assessment (JSNA) for Older People is a compilation of work that has been executed aiming to highlight and understand the complexity of the needs and issues around health and social care of this age group.

• The objective of the JSNA is to enable Public Health and Commissioners to provide the best care through appropriate commissioning strategies, identifying groups that are more at risk, and changes in the population health patterns

• Figures in this presentation are taken from the JSNA report

Page 3: Joint Strategic Needs Assessment Older People in Birmingham – Key findings from the JSNA Iris Fermin, Head of Information and Intelligence Jim McManus,

www.bhwp.nhs.uk

Birmingham’s Age Structure 2007

Page 4: Joint Strategic Needs Assessment Older People in Birmingham – Key findings from the JSNA Iris Fermin, Head of Information and Intelligence Jim McManus,

www.bhwp.nhs.uk

Project Age Structure 2020

Page 5: Joint Strategic Needs Assessment Older People in Birmingham – Key findings from the JSNA Iris Fermin, Head of Information and Intelligence Jim McManus,

www.bhwp.nhs.uk

Demographic Trends

49-74%

50+26%

Birmingham 2007 male popula-tion by age group

44-68%

45+32%

Birmingham 2007 male popula-tion by age group

49-71%

50+29%

Birmingham 2007 female popula-tion by age group

44-65%

45+35%

Birmingham 2007 female popu-lation by age group

Rate of increase of 23% from 45+ to 50+

Rate of increase of 21% from 45+ to 50+

Page 6: Joint Strategic Needs Assessment Older People in Birmingham – Key findings from the JSNA Iris Fermin, Head of Information and Intelligence Jim McManus,

www.bhwp.nhs.uk

Key Points

• The age structure of Birmingham is youthful, • People are living longer despite our life expectancy being lower than

England and the age group 45 and over makes up 33.7% of the population.

• Older people are a complex population segment that requires lots of services. – It is most characterised by long term conditions and the 75 and over age

range is the critical group. Two of the most important issues in terms of health are physical mobility and mental health.

• Physical mobility for older people is put at risk due to falls.• Falls have a social cost for the population and an economical cost

for the authorities. In the last year there have been increases in falls and its resulting consequences in Birmingham.

Page 7: Joint Strategic Needs Assessment Older People in Birmingham – Key findings from the JSNA Iris Fermin, Head of Information and Intelligence Jim McManus,

www.bhwp.nhs.uk

Key Points 2

• Mental health admissions were 16,956 for 2007/08, with drugs related mental health disorder being the highest reason followed by dementia. – Females are most affected except, however, in drugs related mental

disorders. – Longer life expectancy of the female population is a contributory factor

for the high dementia prevalence. – Age-specific rates for mental health show that at 70 and over mental

health problems are acute.• There are several social determinants that have an impact on older

people’s health and their experience in later life: transport, housing, participating in physical activity, eating patterns, alcohol and drugs; among others.

Page 8: Joint Strategic Needs Assessment Older People in Birmingham – Key findings from the JSNA Iris Fermin, Head of Information and Intelligence Jim McManus,

www.bhwp.nhs.uk

Health determinants

45s

Fem

aleM

ale

Time50s

Male

Fem

ale

hypertension

CH

D

CO

PD

Cance

r

85+

Page 9: Joint Strategic Needs Assessment Older People in Birmingham – Key findings from the JSNA Iris Fermin, Head of Information and Intelligence Jim McManus,

www.bhwp.nhs.uk

Social determinants

Drugs & Alcohol &

SmokingHousing

Transport &

Isolation

Healthy life expectancy

Be active

Nutrition

Page 10: Joint Strategic Needs Assessment Older People in Birmingham – Key findings from the JSNA Iris Fermin, Head of Information and Intelligence Jim McManus,

www.bhwp.nhs.uk

Falls

Findings Recommendations

Osteoporosis as secondary diagnosis

Revision of the mechanism for detection

Increase in arthritis and rheumatoid arthritis

Study interventions for improvement risk factors management

Increase in joint replacement

Introduce mechanism to facilitate awareness about fall and its consequences

75+ most vulnerable Prediction modelling and more focus study

Mortality and secondary cost

More than age

Page 11: Joint Strategic Needs Assessment Older People in Birmingham – Key findings from the JSNA Iris Fermin, Head of Information and Intelligence Jim McManus,

www.bhwp.nhs.uk

Mental Health

Findings Recommendations

Increase in dementia, depression and stress

Revision of the mechanism for early detection

Drugs related mental health affect more male and dementia, depression affect more female

Study interventions for improvement drug-mental health related illness

More people living along is admitted due to mental health

Investigate isolation issues: housing, transport, ill-health

Accommodation is one of the most used resource

Prediction modelling and more focus study

Page 12: Joint Strategic Needs Assessment Older People in Birmingham – Key findings from the JSNA Iris Fermin, Head of Information and Intelligence Jim McManus,

www.bhwp.nhs.uk

Personalisation & Social CareFindings Recommendation

Improvement in delay of transfer is needed

Study into causes and decompose of the data for better understanding and alignment of the strategy

Close the gap between services and demand for End of life and palliative care

Define an effective strategy to increase satisfaction and LTCs register

Gap in services such as Transport, Housing and people awareness

Promote living independently

Mismatch of type of specialist housing provision

Revision of demand and supply for housing

Page 13: Joint Strategic Needs Assessment Older People in Birmingham – Key findings from the JSNA Iris Fermin, Head of Information and Intelligence Jim McManus,

www.bhwp.nhs.uk

Females/Males – where’s the gap?

• There is a common view that• There is a gap between males and females on health –

men are actually getting illnesses earlier– Drugs related mental health affects men more. – For those males with mental health problems, from the age of 45

and over there is unmet need and lack of provision. Males over 45 don’t seem to be going into services.

• LTCs more aggressive for male

Page 14: Joint Strategic Needs Assessment Older People in Birmingham – Key findings from the JSNA Iris Fermin, Head of Information and Intelligence Jim McManus,

www.bhwp.nhs.uk

The Gap….

Page 15: Joint Strategic Needs Assessment Older People in Birmingham – Key findings from the JSNA Iris Fermin, Head of Information and Intelligence Jim McManus,

www.bhwp.nhs.uk

Key Priorities for Commissioners• Intervening from the age of 50 onwards as envisaged in Ageing with

Opportunity to prevent and minimise decline in health

• Mental Health – Depression and dementia

• Falls – preventing and intervening earlier

• Personalisation – individual budgets, impact of isolation of independent living, holistic palliative care

• Early Intervention and prevention agendas to prevent worsening of situation and worsening of care need

• Housing and Transport

• Cancers and Long Term Conditions

Page 16: Joint Strategic Needs Assessment Older People in Birmingham – Key findings from the JSNA Iris Fermin, Head of Information and Intelligence Jim McManus,

www.bhwp.nhs.uk

Information and Analysis

• The data need to reflect age-specific issues• Social and health determinants data relation is needed• Data from interventions and services should be made

available • Recording of low level spatial data is needed• Sharing and availability of data should be encouraged