What is our Vision for Health and Care Services?
Frequently Asked Questions:
- Why do we need a Better Care Plan?
- What challenges do we face within the health and care system?
- What do we aim to achieve?
Why do we need a Better Care Plan?
Our Joint Strategic Needs Assessment provides us with the detailed information we need to inform our vision. Overall health and life expectancy in Wiltshire are well above the national average.
People over 65 make up 20% of the county’s population and will make up 22.5% of the county’s population within the next seven years and the number of older people is rising much faster than the overall population of the county. Older people are more likely to need health and care services and we know that nearly half of Wiltshire’s NHS resources (47.4%) are consumed by people aged over 65. Much of this resource is needed for frail and vulnerable older people.
Dementia in particular can affect people of any age, but is most common in older people. One in 14 people over 65 has a form of dementia and one in six people over 80 has a form of dementia. The prevalence of dementia in Wiltshire is predicted to rise because of this ageing population. Oxford Brookes University and the Institute of Public Care (2013) estimate that there are approximately 6,538 people with dementia. It is predicted that this number will increase by 27.8% by 2020 – equating to an additional 1,800 people with dementia and will nearly double by 2030 to 11,878 people. It is also estimated that there will be an increase in those people with severe dementia from approximately 800 in 2012 to 1,600 in 2030.
Whilst increased life expectancy is a cause for celebration, the high rate in growth in the number of elderly people and people with dementia in Wiltshire is placing a burden on care budgets, creating financial pressures and capacity issues for health and social care.
For NHS services, we have estimated that without transformational change, we would need an additional £60.1m by 2021 – of that 97.85% (£58.8m) would be required for people aged 65 and over.
What challenges do we face within the health and care system?
- Care and support is fragmented, so people experience gaps in care and patients are treated as a series of problems rather than as a person. Care and support plans do not link together, which is inefficient and frustrating for people on the receiving end of our services. People have to repeat their stories to different agencies and are not always kept informed.
- The health and care system gives a higher priority to treatment and repair, rather than prevention or early intervention. Often, people are not eligible to receive services until they reach a point of crisis, when a little support earlier may have avoided the crisis from developing.
- Acute hospitals, specialist hospitals, including mental health hospitals, and emergency departments are under pressure, with unacceptably high levels of delayed transfers of care and extended lengths of stay in hospital.
- Too many people make a decision about their long-term care and support whilst they are in hospital, and this may result in frail elderly people being rushed into decisions and possibly an unnecessary admission to a residential or nursing home.
What do we aim to achieve?
Our focus for the Better Care Fund must therefore be upon frail older people. We know that if we do not, the impact will be felt by people of all ages.
Our vision for better care is based upon the four priority outcomes which are set out in our Joint Health and Wellbeing Strategy