Health and Social Care: Module 2 Information handout

Provision of services in the local area

There are two main factors that influence service provision and planning within different areas. These are:

  • Demographic characteristics
  • National standards, targets and priorities.

What is demography?

Demography includes studies of populations based on factors such as age, race, sex, economic status (income level and employment), level of education, birth rates, death rates, marriages, divorces and life expectancy, among others. Demographics are used by governments and non-government organisations to learn more about a population's characteristics for many purposes, including policy development and economic market research.

Why is demography important in Health and Social Care?

The information is used for planning services, such as health and welfare services, education and housing. For example, the number of people aged 10–20 fell during the 1980s and in the first half of the 1990s. This led to many school closures, a shrinkage in the potential market for teenage clothes, and a fall in the number of young people available for recruitment into jobs by employers. At the same time, the forecast rise in the number of people aged 75+ over the next 20 years will lead to a greater demand for accommodation for older individuals.

Services provided around the country aim to meet the patterns of varying needs of individuals in different areas. There are a number of demographic characteristics that are considered when planning and providing health, social care and early years services. These statistics give rise to regional variations in service provision, in other words the reason why the same services are not available in every area.

The main demographic characteristics are:

Health needs

Ill health data which deals with illnesses and deaths is routinely collected by health organisations and interpreted by a range of organisations such as the Office for National Statistics. These show the focus of need for particular health service provision in different areas. (Health Maps Wales)

The health needs of an area may be affected by other demographic factors such as the type of industry in an area. Health needs may arise from pollution caused by factories, nuclear power stations,or geographical location. People in warmer climates may suffer less with colds and flu; people living in rural areas may suffer less with bronchial disorders or stress than those living in industrial areas. For example, the prevalence of chronic conditions varies across the local authorities in Wales. Rhondda Cynon Taff had the highest number of people with self-reported limitinglong-term illness (over 63,000 people), followed by Cardiff (over 57,000 people).The local authority with the lowest number of people reporting a limiting long-term illness was the Isle of Anglesey (15,000 people). It must be remembered however, that due to the different population sizes, the picture is slightly different when examining the level of effect on populations. Although Merthyr Tydfil had the fourth lowest number reporting limiting long-term illness, it was the local authority with the highest rate. The average percentage of self-reported limiting long-term illness in all personsin Wales was 23.3%, but this varied from 18.8% in Cardiff to 30% in Merthyr Tydfil. The most obvious differences occur for Cardiff and Conwy, which have slightly younger and older populationsrespectively. (WAG: A profile of long-term and chronic conditions in Wales)

Age profile of the population

This means statistics which show the ages of all the people within the different areas. This affects the provision of health, social care and early years services within different areas e.g. if there is a high proportion of elderly people in an area there would be more day care centres or residential homes there than an area where there is a high proportion of young children. In this area there would be more childcare facilities such as crèches and nurseries.

Number of single parents

If there is a high proportion of single parents in an area there may be a need for more social housing and more childcare facilities.

Level of unemployment

This is important as the number of people unemployed may have an effect on the type of services required, so more job centres. Theremay be possibly more deprivation, leading to lack of healthy diet and less exercise

Level of disability

The number of people registered as disabled within an area would need the requirement of more disability service provision, for example, day centres, occupational therapy, meals on wheels, physiotherapy and specialist hospitals.

Level of deprivation

Material deprivation has also been shown to be associated with limiting long-term illness. The average rate of limiting long-term illness is 40% higher in the 20% ofelectoral divisions in Wales which are the most deprived, than in the 20% most affluentelectoral divisions (WAG: A profile of long-term and chronic conditions in Wales)

Useful online links:

A picture of health in Merthyr Tydfil

Key statistics for Merthyr Tydfil

Chief Medical Officer’s report (Wales) – Page 65 comparison of lifestyle profiles in Wales

Chief Medical Officer’s report (England)

National standards, targets and priorities:

These are set to raise standards in the provision of care and to improve the health of the population. They are set by the Welsh Assembly Government and Public Health Wales for almost every type of condition and service provider, for example, targets are set:

  • to increase the uptake of immunisation programmes for young children
  • to improve the number of women attending breast screening programmes
  • to reduce the waiting time for appointments following referral from primary to secondary care
  • to reduce the incidence of teenage pregnancy and STIs.

The standards, targets and priorities are published by the Welsh Assembly Government and Public Health Wales as policies and initiatives. Look at the links below for some examples.

WAG Health and Social Care topics

Designed for Life

Public Health Wales was established as an NHS Trust on 1 October 2009 and has four statutory functions:

  • To provide and manage a range of public health, health protection, healthcare improvement, health advisory, child protection and microbiological laboratory services and services relating to the surveillance, prevention and control of communicable diseases.
  • To develop and maintain arrangements for making information about matters related to the protection and improvement of health in Wales available to the public; to undertake and commission research into such matters and to contribute to the provision and development of training in such matters.
  • To undertake the systematic collection, analysis and dissemination of information about the health of the people of Wales in particular including cancer incidence, mortality and survival; and prevalence of congenital anomalies.
  • To provide, manage, monitor, evaluate and conduct research into screening of health conditions and screening of health related matters.

Public Health Wales

Designed for Life

This is the Welsh Government’s 10-year vision for creating world-class health and social care in Wales in the 21st century. Launched in May 2005, it describes the kind of health and social care services the people of Wales can expect by 2015 and how these can be developed. Its primary focus is on health services and health improvement.

The first 3-year plan: Redesigning Care: 2005-2008:

  • A continued drive to strengthen prevention: more action to reduce smoking and help smokers to quit, and more health promotion in schools and the workplace.
  • Action to improve access: including action to reduce treatment waiting time so that by December 2009 there will be a total wait of no more than 26 weeks from GP or dental referral to treatment.
  • Demonstrable improvements in frontline services, especially in relation to cancer, coronary heart disease, chronic disease and long-term illness, mental ill health and services for children and young people and for older people.

The next period 2008-2011 will focus on Higher Standards:

  • Achieving more clinically focused targets
  • Tackling wellbeing and health inequalities
  • Workforce development.

The third framework Ensuring Full Engagement: 2011-2014 aims to take the strategy forward, so thatWales will have services designed for a healthier, longer living population, who are treated quickly and effectively.

Our Healthy Future (OHF)

This isWales’s first strategic framework for public health and sets the foundation for the Government’s ambitions for public health. It is structured in six themes and includes ten priorities that will guide the Assembly Government, the health service and Local Government up to the year 2020. The development of OHF was informed by both the National Advisory Board and the Bevan Commission.

Our Healthy Future summary:

There are six action areas:

  • Health and well-being throughout life
  • Healthy sustainable communities
  • Reduced inequities in health
  • Prevention and early intervention
  • Health as a shared goal
  • Strengthening evidence and monitoring progress

These areas are a way to structure thinking and planning. They help government and its partners to deliver the ten priority outcomes:

  • Reducing inequities in health
  • Reducing the level of smoking
  • Increasing physical activity
  • Reducing unhealthy eating
  • Stopping the growing harm from alcohol and drugs
  • Reducing the number of teenage pregnancies
  • Improving health in the workplace
  • Increasing immunisation rates
  • Improving people’s mental well-being
  • Reducing the number of accidents and injuries

National plans

Some outcomes are supported by national plans:

  • Fairer Health Outcomes for All: reduce inequities in health.
  • Tobacco Control Strategy for Wales: reduce the level of smoking
  • Sexual Health and Wellbeing Action Plan: reduce the number of teenage pregnancies

Local plans

Locally, the priority outcomes are being incorporated by Local Authorities and Health Boards in their planning. For example:

Merthyr Tydfil Health Social Care and Well-being Strategy 2011-14

NHS Wales Annual Operating Framework

Efficiency and productivity measures have been issued as part of this framework. The aim of the framework is to drive organisations to deliver more efficient and effective services where waste is eliminated, cost is reduced, productivity is maximised and the desired outcome is delivered.The 17 Efficiency measures for 2009/2010 are set out below:

  • Measure 1: Average Length of Stay – Elective Care
  • Measure 2: Average Length of Stay – Emergency Care
  • Measure 3: Same Day Surgery ‘Basket’ Procedures
  • Measure 4: Elective Cases Treated as a Day Case
  • Measure 5: Elective Operations Carried out on Day of Admission
  • Measure 6: Elective Admissions with No Procedure
  • Measure 7: Long Stay Bed Day Reduction
  • Measure 8: Outpatient Follow up Rates
  • Measure 9: Outpatient Did Not Attend (DNA) Rates
  • Measure 10: Outpatient Clinic Cancellation Rates
  • Measure 11: Outpatients: GP Referral Management
  • Measure 12: Theatres: Operations Cancelled at Short Notice
  • Measure 13: Theatre Utilisation: Late Starts/Early Finishes
  • Measure 14: Accident & Emergency Follow Up Rates
  • Measure 15: Workforce: Sickness & Absence Rates
  • Measure 16: Workforce: Agency/Locum Expenditure
  • Measure 17: Prescribing: National Indicators

The Operating Framework for the NHS in England 2012/13

Useful websites:

Welsh Local Government association:

Localhealth boards in Wales

Statistical outputs which are used to monitor the incidence and prevalence of conditions and diseases. It also covers the prevention and treatment of these disorders by the NHS.

Statistics relating to information gathered on public health, health services provided by the National Health Service (NHS), social care, and health and safety at work.

Population statistics which describe the demographic characteristics of the UK population.

These include statistics on the size and geographic distribution of the population, on the factors driving population change (births, deaths and migration) and on topics such as families and older people.

Health Maps Wales is an interactive tool that can be used to explore a variety of health indicators grouped under broad categories, such as cancer, common procedures and causes of injury. The maps allow the user to explore data at their geographic area of choice (where available), to look at trends in data over time and to compare areas against local or national figures.

Health Trends in Wales

Profile of chronic conditions in Wales

Data on resident population, births, maternities, deaths, mortality and migration for local administrative areas and health areas throughout the UK, together with explanatory material and illustrative maps.

Disclaimer:

All the web links used here were current and live at the point these resources were created. We do not hold responsibility for any of the links cited becoming broken or no longer in existence.

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