Hertfordshire Public Health Service

Workshops for Third Sector Agencies

Older People Health Pack

February 2014

Jim McManusDirector of Public HealthHertfordshire Public Health ServiceHertfordshire County CouncilCounty Hall, Postal Point CH0231Pegs LaneHertford SG13 8DEJim.mcmanus@hertfordshire.gov.uk

Thanks to Jo Mackenzie, Stephany Villanueva, Raj Nagaraj, Mark Jordan and Joel Bonnet for developing these slides

Four workshops to explore the role the voluntary sector can play influencing the development of public health policy and delivering services.

– Wednesday, 26 February, 14:00 – 16:30: Public Health and Younger People

– Thursday, 6 March, 09:30 – 12:00: Public Health and Older People

– Tuesday, 11 March, 14:00 – 16:30: Public Health and Long Term Conditions

– Tuesday, 18 March, 09:30 – 12:00: Public Health and Mental Health

Voluntary groups make an important contribution to improving and protecting the health of the population – from targeted work with vulnerable people to self-management and direct interventions. Public Health skills and capacity, joined with the voluntary sector’s connections and “can do” mindset could produce a major improvement in the health of Hertfordshire and also help integrate care for people across all sectors.

The workshops will be an opportunity for the voluntary sector to contribute to policy development, build relationships, and discuss new commissioning arrangements.

Each workshop will consider four questions:

– What is the scope of public health, and what contribution can the voluntary sector make to service delivery, policy development, campaigning and tackling health inequalities?

– How can the voluntary sector help improve resilience, self-management and secondary prevention, and so help reduce unnecessary hospital admissions?

– How can the voluntary sector be better commissioned to deliver public health interventions? How can relationships between the voluntary sector and commissioners (DH, local public health commissioners, GPs, and others) be improved?

– What scope is there to apply commissioning innovations such as payment by results or a Total Place approach to public health commissioning?

A) Population

0-4

5-9

10-14

15-19

20-24

25-29

30-34

35-39

40-44

45-49

50-54

55-59

60-64

65-69

70-74

75-79

80-84

85-89

90+

10.0 8.0 6.0 4.0 2.0 0.0 2.0 4.0 6.0 8.0 10.0

% of Total Population

Ag

e G

rou

p

2012 Mid Year Estimate by Sex and Age Group- Hertfordshire and England

Females Males England

B) Life Expectancy

Life expectancy in Hertfordshire from 2008-2010 for a man aged 65 was 19 years as compared to a woman also aged 65 at 21 years. For this “ageing well” topic, disability free life expectancy was also examined in Hertfordshire showing that from 2007-2009, the district average was 10.6 years for men and 11.1 years for women which is also similar to the East of England.

17

18

19

20

21

22

2004-06 2005-07 2006-08 2007-09 2008-10

Lif

e ex

pec

tan

cy a

t 65

(ye

ars)

Male and female life expectancy at 65, Hertfordshire and East of England, 2004-06 to 2008-2010

Hertfordshire: Female East of England: Female

Hertfordshire: Male East of England: Male

Source: ONS

C) Population Projections

21% of people are aged 60 and over in Hertfordshire (similar to England at 22%).

There are more women than men aged 60 and over, particularly for the upper ages (80 and over).

Rapid growth of population aged 65 and over is predicted for the next 20 years.

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2010 2015 2020 2025 2030 2035

Hertfordshire: number and % increase in over 65s

Hertfordshire total number of persons 65+

% increase since 2010

East & North Herts CCG:

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70%

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ged

65+

Year

Broxbourne

% increase since 2010

Source: Population Projections Unit, ONS, March 2012

Broxbourne: number and % increase in people aged 65 and over 2010 to 2035

In Broxbourne, there is a 60% increase estimated between 2010 and 2035 (from 15,000 to 24,200) which is lower than for Hertfordshire (70%).

Broxbourne has 6 residential care homes for older people (1 with nursing care) providing 220 bed spaces (22 with nursing care)*. This translates to 14 bed spaces per 1,000 population aged 65+ (which is the lowest in the county). * As at April 2013, Hertfordshire County Council

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65+

Year

East Hertfordshire

% increase since 2010

Source: Population Projections Unit, ONS, March 2012

East Hertfordshire: number and % increase in people aged 65 and over 2010 to 2035

In East Hertfordshire, there is a 90% increase estimated between 2010 and 2035 (from 20,900 to 39,900 people), higher than for Hertfordshire (70%).

East Hertfordshire has 13 residential care homes for older people (7 with nursing care) providing 655 bed spaces (357 with nursing care)*. This translates to 31 bed spaces per 1,00 population aged 65+ (2nd lowest in the district).

In North Hertfordshire there is an estimated 81% increase between 2010 and 2035 (from 21,300 to 38,600) higher than for Hertfordshire (70%).

North Hertfordshire has 22 residential care homes for older people of which 9 provide nursing care. They provide a total of 996 bed spaces of which 444 are with nursing care*. This translates to 46 spaces per 1,000 population aged 65+ (similar to the Hertfordshire average).

In Stevenage there is an estimated 67% increase between 2010 and 2035 (from 11,800 to 19,700 people) similar to Hertfordshire (70%).

Stevenage has 6 residential care homes for older people of which 3 provide nursing care. They provide a total of 458 bed spaces of which 258 are with nursing care*. This translates to 39 spaces per 1,000 population aged 65+ (similar to the Hertfordshire average).

In Welwyn Hatfield there is an estimated 65% increase between 2010 and 2035 (from 17,300 to 28,500 people) lower than Hertfordshire (70%).

Welwyn Hatfield has 15 residential care homes for older people of which 5 provide nursing care. They provide a total of 871 bed spaces of which 464 are with nursing care*. This translates to 51 spaces per 1,000 population aged 65+ (one of the highest in the County).

Herts Valleys CCG:

65% increase estimated between 2010 and 2035 (from 22,700 to 37,500 people) which is lower than Hertfordshire (70%).

Dacorum has 15 residential care homes for older people of which 3 provide nursing are. They provide a total of 812 bed spaces of which 194 are with nursing care*. This translates to 35 spaces per 1,000 population aged 65+ (one of the lowest in the County).

In Hertsmere, there will be an estimated 78% increase between 2010 and 2035 (from 16,000 to 28,500 people) higher than Hertfordshire at (70%).

Hertsmere has 18 residential care homes for older people of which 8 provide nursing care. They provide a total of 997 bed spaces of which 566 are with nursing care*. This translates to 61 spaces per 1,000 population (2nd highest in the country).

In St. Albans there will be an estimated 61% increase between 2010 and 2035 (from 20,500 to 33,000 people) less than Hertfordshire at (70%).

St. Albans district has 20 residential care homes for older people of which 5 provide nursing care. They provide a total of 831 bed spaces of which 237 are with nursing care*. This translates to 38 spaces per 1,000 population aged 65+ (One of the lowest in the County).

In Three Rivers, there will be an estimated 74% increase between 2010 and 2035 (from 14,900 to 25,900 people) similar to Hertfordshire at (70%).

Three Rivers District has 16 residential care homes for older people of which 7 provide nursing care. They provide a total of 740 bed spaces of which 300 are with nursing care*. This translates to 50 spaces per 1,000 population aged 65+ (4th highest in the county).

In Watford, there will be an estimated 65% increase for people aged 65+ between 2010 and 2035 (from 11,000 to 18,200) less than for Hertfordshire (70%).

Watford district has 14 residential care homes for older people of which 4 provide nursing care. They provide a total of 762 bed spaces of which 386 are with nursing care*. This translates to 68 spaces per 1,000 population aged 65+ (highest in the County).

As at April 2013, Hertfordshire County Council

D) Long-term conditions Around 78,000 people aged 65 and over (47%) are limited in daily activities by a health problem or disability- lower than England (52%).

i) Dementia

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18,000

2012 2014 2016 2018 2020

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ple

Year

People aged 65 and over predicted to have dementia, by age, projected to 2020, Hertfordshire

90+

85-89

80-84

75-79

70-74

65-69

Source: www.poppi.org.uk

The number of people estimated to have dementia in Hertfordshire in 2012 was over 13,000. This is expected to rise by a quarter to around 16,500 in 2020. The number of people with dementia generally increases for each 5 year age group because prevalence increases with age.

5,566 people registered with a GP practice in Hertfordshire had a recorded dementia diagnosis in 2011/12. This suggests around 42% of people with dementia have had a diagnosis recorded (similar to 44% for the UK*). *alzheimers.org.uk

ii) Falls • Over 5,000 hospital admissions due to falls in people aged 65 and over

living in Hertfordshire in 2010/11

• Similar rate to East of England

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District

Hospital admissions due to falls, 65 years and over, directly standardised rate per 100,000 population,

Hertfordshire, by district 2010/11

East of England

Hertfordshire

Source: www.injuryprofiles.org.uk

E) Physical Activity

Physical activity decreases with age.

A survey of over 2,000 people aged 55 and over in Hertfordshire revealed only 14% participated in sport and active recreation, at moderate intensity, for 30 minutes on 3 or more days a week. This compares to 26% aged 35-54 and 25% aged 16-34 years.

(source: Active People Survey 2011/12, http://www.sportengland.org/research/active_people_survey.aspx)

* Page 3, activity and weight needs assessment update graph

F) Obesity

36.2% 36.3% 35.5% 32.1% 31.1%

23.6% 24.0% 25.4% 28.4% 28.3%

19.0% 18.5% 17.6% 17.6% 18.4%

12.3% 12.1% 12.0% 12.1% 11.9%

8.9% 9.1% 9.4% 9.9% 10.3%

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20%

30%

40%

50%

60%

70%

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100%

2012 2014 2016 2018 2020

Projection of Older people with a BMI of 30+ [Hertfordshire]

85+

80-84

75-79

70-74

65-69

Source: POPPI, 2012