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Northamptonshire Analysis
The authority on Northamptonshire statistics

Adults with Disabilities JSNA

Executive Summary

Northamptonshire is home to around 560,400 adults and PANSI and POPPI estimate that in 2015, almost 116,000 of them have some form of disability, some 20.68% of the population, lower than most of our geographical authorities and below the regional and national averages (22% and 21.1% respectively).

The proportion of adults with a physical disability in Northamptonshire is below the national and regional averages at 18.35%.

The proportion of adults with learning disabilities in Northamptonshire is similar to the regional and national averages at 2.33% of the adult population. 

The ONS Disability Prevalence Estimates estimate that females make up 54% of the disabled adult population of England. Applying these proportions to Northamptonshire’s population, it would suggest that around 62,600 of the 116,000 disabled adults in Northamptonshire are female.

There were around 22,200 eligible Disability Living Allowance (DLA)/Personal Independence Payment (PIP) claimants in the county in May 2016. The peak age for numbers of DLA claimants is 70-74 years.  15% of the total number of claimants in the county are in this age band.

The majority of Attendance Allowance claimants are aged 80 and over.

There is predicted to be a total increase of around 23,000 adults with a physical disability between 2015 and 2025, with a further increase of approximately 11,800 in the subsequent 5 years to 2030.  The majority of these increases are in the over 65 population of the county, whose numbers are anticipated to grow by almost a third in the next 10 years (from around 58,400 to 78,300) and to increase by a further 11,800 or so in the following 5 years to 2030. 

Numbers of adults with a learning disability in Northamptonshire are predicted to increase from 13,076 in 2015 to 14,106 10 years later.  In the subsequent 5 years to 2030, numbers are expected to rise by another 500 or so to 14,689. Younger adults aged 18-64 make up the majority of adults with a learning disability in Northamptonshire, but the figure shows that the older age group, 65 and over, is the one that will grow by the most over the next 10 and 15 years.

The number of younger people with a moderate or severe learning disability is expected to increase by around 100, the number of older people by around 150 by 2030.

Within 10 years, estimates suggest there will be around 450 more adults with an autistic spectrum disorder by 2025 than there were in 2015, around 350 of these will be aged 65 and over.  The following five years to 2030 will see that number increase by another 250 or so, the majority again being older people.

Compared to the Northamptonshire average, there are higher proportions of physically disabled people in the boroughs of Wellingborough, South Northamptonshire, East Northamptonshire, Daventry and Kettering (in order, starting with the district with highest proportions). Northampton Borough has the lowest proportion of physically disabled residents but, being the largest populated borough, has the highest absolute numbers. The proportion of adults with a learning disability is similar across all the boroughs/districts.

Approximate number of adults with a disability in each borough/district; 

  • Corby     10,350
  • Daventry    13,500
  • East Northamptonshire    14,950 
  • Kettering     16,000 
  • Northampton     33,000
  • South Northamptonshire    14,800 
  • Wellingborough     13,250


89% of the above are those with physical disabilities, the remaining 11% have learning disabilities, with the exceptions of Northampton (88% PD) and Wellingborough (90% PD).

From April 2016 up until January 14th 2017, Northamptonshire’s Adult Social Care team received 8,123 new requests.

When viewed as a rate per 1,000 of the adult population (aged 16 and over) of boroughs, it is Kettering that has the highest rate of new requests for support with 21.44 per 1,000 adult residents.  Kettering’s rate is almost 3 people per 1,000 higher than the second highest rate of 18.66 in Wellingborough.  The five other localities were below the county average of 18.64 per 1,000 adult residents with South Northamptonshire being the lowest at 14.1.

In September 2016, there were 7,086 people receiving long term support from Northamptonshire County Council’s Adult Social Care Services.  Of these, 2,764 were aged between 18 and 64, the remaining 4,322 were aged 65 and over.  This represents 1.26% of the total adult population of the county, 0.64% of the 18 to 64 population and 3.45% of the population aged 65 and over.

88.4% of adults aged 18-64 receiving support from Northamptonshire’s Adult Social Care Services have their ethnicity recorded as ‘White British’. This is slightly lower than the 91.5% of the general population of the county recorded as ‘White British’ according to the 2011 census.

The Younger Adults teams, where the majority of clients are under 65 years of age, see an almost 50/50 gender split, however the other teams where the average age is higher have a higher proportion of female clients.  This will be, at least in part, due to the longer life expectancy for females in Northamptonshire. 

In 2015/16, Northamptonshire spent almost £84m between health and NCC per annum split 80% NCC & 20% Health.

Northamptonshire is spending 83% more on average per adult with LD than the English national average.

Total spending is forecast to grow from combined health & NCC £83.6m today to £97.4m in 2020 if the model of care is unchanged. £3.2m year on year increase in cost achieving lesser outcomes.

People with LD receiving care within Northamptonshire have poorer outcomes in employment.

Please see the ‘Children with Disabilities’ chapter for an indication of future needs

Key Issues & Gaps

The PANSI and POPPI tools use a different definition of physical disability for the 18-64 age bands and the over 65 group. Whereas the projections are for ‘physical disabilities’ for 18-64 year olds, the predictions for older people are for ‘people whose day to day activities are limited’ by a long term illness.

The projection tools don’t determine particular conditions, the only differentiation is between ‘physical disability’ and ‘learning disability’.

The reduction in numbers of individuals claiming Disability Living Allowance has reduced in the most recent years, though this reduction may be due to the replacement of DLA with Personal Independence Payments. Similar data for the new PIP benefit is not available at the time of writing.

The employment status of disabled adults known to Adult Social Care is more likely to be skewed towards unemployed individuals due to only the more serious conditions receiving support.

Social Care data often has many unrecorded fields, for example ethnicity where 2% of the 7,000+ records have no recorded ethnicity, over 2,700 clients have no primary health condition recorded.

The numbers of people with physical disabilities in East Northamptonshire aged 55 and over is anticipated to increase dramatically. In common with other areas, it’s the 75 to 84 year age group that is likely to see the most significant increases, around 45% between 2015 and 2025.

Gaps due to lack of recording are:

  • People with LD and autism
  • People with dementia and LD
  • People with profound and multiple learning disabilities
  • People with LD and challenging Behaviour
  • People with LD and mental illness
  • Key national target diseases

 

Summary of Recommendations

Improve data entry requirements across statutory services to address the gaps in knowledge in relation to learning disabilities and co-morbid conditions such as mental health, autism and dementia

Record where peoples behaviour are a significant challenge to services to enable contribution to the county’s dynamic risk register

Recording of ethnicity to increase ability to provide culturally sensitive care

Prevention programmes to avoid development of physical disabilities in older age

Develop a programme to increase levels of paid employment in Adult Social Care clients with disabilities and collect data regarding outcomes for those obtaining paid employment

Work with CCG’s and other commissioning partners to identify reasons for higher or avoidable hospital admission rates in people with learning disabilities

Develop a targeted self-care/empowerment programme to increase independence in Adult Social Care clients

Develop support to facilitate more people who receive Adult Social Care services, and those in contact with Mental Health services to live independently, including reducing the numbers of people in these categories in ‘unstable’ accommodation

Further analysis of cost of care

Further analysis of length of interventions

Are voluntary organisations positioned according to need or are inequalities being created due to spatial location of services?

Scope

This chapter defines an adult as anyone over the age of 18. In most cases, the adult population is split into two groups, ‘Younger Adults’ aged 18 to 64 years of age and ‘Older People’ aged 65 and over.

There is some crossover with the Children with Disabilities section as that part of the JSNA covers children from birth to the age of 25 (where possible). For indications of future needs, please see the ‘Children with Disabilities’ chapter.

A disability, for the purpose of this chapter, is a physical or mental impairment that limits an individual’s ability to complete day to day tasks. The disabilities covered in this chapter include long term health conditions, whether they be from birth, progressive or acquired, physical disabilities, mental disabilities, learning disabilities (distinct from learning difficulties), and autism.  Whilst cancer, HIV and MS are considered disabilities under the Act, they are not included in this particular section of the JSNA.

Overview

 A 2010 study by the Improving Health and Lives Learning (IHaL) Disabilities Observatory[1] found five key determinates of health inequality.  These are;

  • Greater risk of exposure to social determinants of poorer health such as poverty, poor housing, unemployment and social disconnectedness.
  • Increased risk of health problems associated with specific genetic and biological causes of learning disabilities.
  • Communication difficulties and reduced health literacy.
  • Personal health risks and behaviours such as poor diet and lack of exercise.
  • Deficiencies relating to access to healthcare provision.

 

The study noted that people with learning disabilities have poorer health than their non-disabled peers, differences in health status that are, to an extent, avoidable. It also noted that health inequalities faced by people with a learning disability began in childhood and that they were often caused as a result of lack of access to timely, appropriate and effective healthcare.

The outcomes for adults with disabilities compared to the wider population are poorer in almost every manner. People with learning disabilities have a shorter life expectancy and increased risk of early death when compared to the general population[2].  The 2011 IHaL study summarises the available UK research literature concerning the health status and needs of children and adults with learning disabilities, including mortality causes, determinants of health inequalities, genetic and biological factors, health literacy, personal health risks and behaviours and access to quality healthcare.

The Northamptonshire Transforming Care Partnership was set up in response to the serious case review of Winterbourne View Hospital in 2012 and is made up of Health and Social Care Commissioners for adults and children/young people, Learning Disability Partnership Board, Housing, Education, Programme Manager, Regional lead for TCP, Adults and Children’s Safeguarding representation, Police, Local Educational Training Boards, Direct Professional Representation, carers, people with lived experience, 3rd Sector representation, and a range of Provider representatives. The aim of the partnership is to keep people with learning disabilities out of hospital and focus on the following.

  • Prevention - better train professionals involved in the care of people with learning disabilities and to give families more information about how to stay well.
  • Early Intervention – A good choice of well-trained providers, personal budgets to help people have more control over choosing how to meet their needs and help to enable people to get the most from healthcare and support.
  • Keeping Well – helping people to stay well in their community, easier access to mainstream health and care services, special training and support for people with complex needs, buying different services to meet people’s needs and working with GP’s and general hospitals to ensure people get good care.
  • Avoiding a Crisis – a range of options to prevent people being admitted to hospital if they become unwell such as emergency respite care and specialist community services to provide 24 hour, 7 day help to keep people out of hospital.
  • Crisis Support – specialist community services working differently to help stop people going into hospital, spending money on community help rather than hospital beds and should someone be admitted to hospital working hard to help them return home as quickly as possible.

 

Fig 1

The plan involves health and social care working closely together through a Transforming Care Board and various work groups looking at effective ways to spend money. Asking people and their families what they think is part of the plan, as is asking for expertise and help from the voluntary sector. Care Treatment reviews will track the effectiveness of this new approach. More details can be found at the Northamptonshire Transforming Care Partnership website - http://www.neneccg.nhs.uk/learning-disability-commissioning-building-together/.

 As a result of the Transforming Care Plan, care and support will become:

  • Closer to home
  • In line with best models of care
  • Co-ordinated and person centred
  • Personalised and responsive to needs over time
  • Based on the individual’s and their family’s wishes
  • Value for money

 

[1] http://www.improvinghealthandlives.org.uk/uploads/doc/vid_7479_IHaL2010-3HealthInequality2010.pdf

[2] https://www.improvinghealthandlives.org.uk/publications/978/Health_Inequalities_&_People_with_Learning_Disabilities_in_the_UK:_2011

Definitions

The Equality Act 2010 defines a disability as a physical or mental impairment that has a ‘substantial’ and ‘long-term’ negative effect on your ability to do normal daily activities[1]. 

  • ‘substantial’ is more than minor or trivial, e.g. it takes much longer than it usually would to complete a daily task like getting dressed
  • ‘long-term’ means 12 months or more, e.g. a breathing condition that develops as a result of a lung infection

 

The Equality Act 2010 also makes provisions for progressive illnesses,

  • A progressive condition is one that gets worse over time. People with progressive conditions can be classed as disabled.
  • However, you automatically meet the disability definition under the Equality Act 2010 from the day you’re diagnosed with HIV infection, cancer or multiple sclerosis.

 

A disability can arise from a wide range of impairments which can be:

  •  sensory impairments, such as those affecting sight or hearing;
  • impairments with fluctuating or recurring effects such as rheumatoid arthritis, myalgic encephalomyelitis (ME), chronic fatigue syndrome (CFS), fibromyalgia, depression and epilepsy;
  • progressive, such as motor neurone disease, muscular dystrophy, and forms of dementia;
  • auto-immune conditions such as systemic lupus erythematosis (SLE);
  • organ specific, including respiratory conditions, such as asthma, and cardiovascular diseases, including thrombosis, stroke and heart disease;
  • developmental, such as autistic spectrum disorders (ASD), dyslexia and dyspraxia;
  • learning disabilities;
  • mental health conditions with symptoms such as anxiety, low mood, panic attacks, phobias, or unshared perceptions; eating disorders; bipolar affective disorders; obsessive compulsive disorders; personality disorders; post-traumatic stress disorder, and some self-harming behaviour;
  • mental illnesses, such as depression and schizophrenia;
  • produced by injury to the body, including to the brain.

 

The above list is not exhaustive, anyone with an impairment not covered by the list above could still have a disability covered under the Act if it meets the requirements of the initial definition.

The Act further states that a person who has cancer, HIV infection or multiple sclerosis (MS) is a disabled person. This means that the person is protected by the Act from the point of diagnosis.

The Equality Act 2010 also contains guidance to conditions that are not covered under its description of a disability[2], citing as an example an addiction to non-prescribed drugs, alcohol dependency, hay fever, a tendency to set fires, to steal or to abuse. However, symptoms arising as a result of an excluded condition would still be covered under the definition, such as liver disease as a result of alcohol dependency, although the alcohol dependency would not be covered under the definition.

Learning Disability vs Learning Difficulty

A learning difficulty is distinct from a learning disability in that a learning difficulty means an individual may have difficulty processing certain forms of information, but there is no impact on general intelligence.  A learning difficulty could include a physical definition, have ‘a significantly greater difficulty in learning than the majority of people of that age, or have a disability which prevents the use of facilities generally provided by post ̶16 education and training’.[3]

A learning disability is linked to an overall cognitive impairment.  A learning disability is not the same as a learning difficulty or mental illness.

A learning disability can be mild, moderate or severe. Some people with a mild learning disability can talk easily and look after themselves, but take a bit longer than usual to learn new skills. Others may not be able to communicate at all and have more than one disability, described as Profound or Multiple Learning Disability.  A diagnosis of a profound and multiple learning disability (PMLD) is used when a child has more than one disability, with the most significant being a learning disability.[4]

People with a moderate learning disability or profound and multiple learning disabilities (PMLD), will need more care and support with areas such as mobility, personal care and communication.[5]

Agreed Definitions in Northamptonshire

NHS Northamptonshire and all the county’s NHS Trusts (NHFT, Northampton General Hospital and Kettering General Hospital), Nene Commissioning, East Midlands Ambulance Service, Northamptonshire County Council, the Housing Authorities at the seven Borough and District Councils, Northamptonshire Police, Northamptonshire Probation Trust, Northamptonshire Local Involvement Network (LINK), Connexions, Northamptonshire Centre for Independent Living, Northamptonshire Dyslexia Association and a variety of other local agencies have agreed on a definition of learning disability, learning difficulty and developmental delay to be used across organisations in Northamptonshire and jointly produced a pamphlet to establish a shared understanding of the terms.

A copy of this pamphlet can be found here.

[1] https://www.gov.uk/definition-of-disability-under-equality-act-2010

[2] https://www.gov.uk/government/publications/equality-act-guidance

[3] https://www.gov.uk/definition-of-disability-under-equality-act-2010

[4] http://www.nhs.uk/Livewell/Childrenwithalearningdisability/Pages/Whatislearningdisability.aspx

[5] https://www.mencap.org.uk/learning-disability-explained/what-learning-disability

 

Prevalence of Disability in the Adult Population of Northamptonshire 

 

It was estimated in 2011/12 (latest ONS figures available), around 10.8 million adults in Great Britain have a disability[1].  This is around 17.5% of the adult population in the country at the time[2].  Around 5.7 million of these were people aged between 18 and 64, the remaining 5.1 million aged 65 and above.

 

[1] https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/321594/disability-prevalence.pdf

[2] https://www.ons.gov.uk/peoplepopulationandcommunity/populationandmigration/populationestimates/datasets/populationestimatesforukenglandandwalesscotlandandnorthernireland

 

PANSI and POPPI Forecasting

Using the PANSI[1] and POPPI[2] systems, tools designed to explore the possible impact of demography and particular conditions on populations, it is estimated that there were around 9.1 million disabled adults in England alone by 2015. Northamptonshire is home to around 560,400 adults[3] and PANSI and POPPI estimate that almost 116,000 of them would have some form of disability in 2015.  This equates to nearly 21% of the population

The figure below shows the percentage of adult population with a disability for Northamptonshire and neighbours in the East Midlands and compares them to the East Midlands and England average.

 Fig02

Northamptonshire’s proportion of 20.68% is lower than most of our neighbours and below the regional and national averages.  The next figure shows the proportion of disabled residents in Northamptonshire by borough and district using the same data sources.

Fig03

The proportion of adults with learning disabilities in Northamptonshire is similar to the regional and national averages at 2.33% of the adult population. The proportion of adults with a physical disability in Northamptonshire is below the national and regional averages at 18.35%

The following figure shows the proportion of adults with learning and physical disabilities in Northamptonshire’s boroughs and districts, compared to the county average.

Fig04

The ONS Disability Prevalence Estimates, 2011/12 suggest the gender split is not equal for adults with disabilities in Great Britain, with females making up 54% of the disabled adult population[1]. Applying that to Northamptonshire’s population, it would suggest that around 62,600 of the 116,000 disabled adults in Northamptonshire are female.

Disability Benefits Claimants

The following figure shows the number of eligible Disability Living Allowance or Personal Independence Plan Claimants in Northamptonshire by borough and district. There were around 22,200 eligible DLA/PIP claimants in the county in May 2016.  The figure also shows the changes in numbers from May 2012 and May 2014. The Disability Living Allowance became Personal Independence Payments in 2013; claimants aged 65 and over in April 2013 will remain in receipt of DLA, whereas other existing DLA claimants and new claimants were required to submit a new claim for a PIP.

fig05

The following figure shows the DLA claimants in each borough/district by 5 year age band. Whilst the numbers of claimants are higher in Northampton than the rest of the county, as expected, the pattern is quite similar across the whole county.  The number of claimants begins to rise at 40 years of age and all over the county the peak age for numbers of DLA claimants is 70-74 years. 15% of the total number of claimants in the county are aged between 70 and 75.

fig06fig07

The next figure shows the numbers of claimants of Attendance Allowance by borough/district by five year age band. Attendance Allowance is payable only to those aged 65 and over who have a disability that requires some assistance or supervision to safely complete daily tasks. The majority of Attendance Allowance claimants were aged 80 and over. In three of the more rural areas of Northamptonshire, the number of claimants peaks in the age 90 and over category. In Corby, the peak age group was 80-84 years old. This may be indicative of inequalities in life expectancy for this cohort between boroughs/districts.

 fig08

 

[1] https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/321594/disability-prevalence.pdf

[1] http://www.pansi.org.uk/

[2] http://www.poppi.org.uk/

[3] https://www.ons.gov.uk/peoplepopulationandcommunity/populationandmigration/populationestimates/datasets/populationestimatesforukenglandandwalesscotlandandnorthernireland

Projections

The PANSI and POPPI prediction tools have different descriptions of physical disability between the two age groups, for more information please visit www.pansi.org.uk and www.poppi.org.uk (registration is required, but is free).  As a result, the data has not been combined in the figures in this section and are presented as adults aged 18-64 and adults aged 65 and over. The younger group is defined in PANSI as having a moderate or serious physical disability, the older cohort are defined in POPPI as having a condition that affects the ability to complete day to day tasks, either a little or a lot.

PANSI and POPPI project the future numbers of adults with disabilities to 2030.  The following figures show the anticipated growth in numbers of adults with a disability in Northamptonshire using the 2014 figure as a starting point.

fig09

 

fig10Physical Disability

fig11fig12

We can see a steady rise in numbers of 18-64 year olds and a much more significant increase in over 65’s with a physical disability. This prediction tool expects a total increase between 2015 and 2025 of around 23,000 adults with a physical disability with a further increase of approximately 11,800 on top of that in the subsequent 5 years to 2030. The figure clearly shows the majority of these increases are in the over 65 population of the county, whose numbers are anticipated to grow by almost a third in the next 10 years (from around 58,400 to 78,300) and to increase by a further 11,800 or so in the following 5 years to 2030.  By this time, POPPI anticipates there being over 90,000 residents of Northamptonshire with a physical disability.

fig13

The figure above displays the percentage changes in the numbers of adults with a physical disability from 2015 to 2025 and 2030. This clearly shows the higher percentages of increase in numbers of older people with a physical disability, particularly those with an impairment that affects their condition ‘a lot’.

Learning Disability

The PANSI and POPPI prediction tools have a uniform description for learning disabilities for all adults, so the two age groups can be shown on one figure, the figure below shows the baseline estimates.

 fig14

 

Numbers of adults with a learning disability in Northamptonshire are predicted to increase by around 1,000 from 13,076 in 2015 to 14,106 10 years later.  In the subsequent 5 years to 2030, numbers are expected to rise by another 500 or so to 14,689

Younger adults aged 18-64 make up the majority of adults with a learning disability in Northamptonshire, but the figure shows that the older age group, 65 and over, is the one that will grow by the most over the next 10 and 15 years.

The following figure shows the numbers of adults with a learning disability whose condition is deemed to be either moderate or severe. Again the age groups are 18 to 64 and 65 and over.

fig15

This figure shows the prediction that the number of younger people with a moderate or severe learning disability is expected to increase by around 100, the number of older people by around 150 by 2030.

The following figure shows the estimated projection of adults with autistic spectrum disorders in Northamptonshire. Whilst the number of younger adults grows steadily across the time period covered by the projection, the older age group numbers rise much more sharply. This is due to increased life expectancy and an increased awareness of autistic symptoms leading to later diagnosis.

fig16

Within 10 years, this tool estimates there will be around 450 more adults with an autistic spectrum disorder by 2025 than there were in 2015, around 350 of these will be aged 65 and over.  The following five years to 2030 will see that number increase by another 250 or so, the majority again being older people.

The figure below shows the anticipated percentage changes in the numbers of people in Northamptonshire with a learning disability between 2015 and 2025, 2015 and 2030 and the change between 2025 and 2030. This shows the large increases in older people with a learning disability much more clearly.

fig17Learning Disabilities & Other Conditions

There is little to no data recorded relating to people with multiple conditions, for example those with a learning disability and also autism, or a learning disability and dementia for example. Using the estimated population of Northamptonshire with a learning disability in 2015, 13,076 individuals, it’s possible to estimate numbers by applying national prevalence percentages to this cohort.

Learning Disability and Dementia – The Alzheimer’s Society estimate the prevalence of dementia in over 65’s to be 7.1%[1].  Applied to the 2,601 over 65’s with a learning disability, this gives an estimate of 185 Northamptonshire residents aged 65 and over with both a learning disability and dementia.

Learning Disability and Autism – The National Autistic Society estimates the prevalence of autism in the general population to be 1.1%[2]. Applying this to the population of Northamptonshire with a learning disability suggests around 144 people in the county could have both conditions.

Learning Disability and Challenging Behaviour – The National Institute for Health and Clinical Excellence estimate that between 5 and 15% of people with a learning disability develop behaviour that challenges. They note it’s more likely in those with more severe learning disabilities.  Applying both lower and upper estimates to Northamptonshire’s population with a learning disability gives estimated numbers of people with a learning disability who may display challenging behaviour between 654 and 1,961.

Mental Health – The Mental Health Foundation acknowledges that it’s very difficult to estimate the prevalence of mental illness in the population of the UK, due to varying methods of diagnosis, funding issues and not least the hidden nature of mental illness. They quote the Adult Psychiatric Morbidity Survey (APMS) as being amongst the most reliable source of prevalence data.  The APMS found that in 2016, around 17% of people aged 16 and over had experienced a common mental health issue in the last week, noting the increase from 16.2% in 2007. Applying this estimate to the population of the county with a Learning Disability, the number is 2,223.

Public Health England’s Learning Disabilities Observatory identified the main causes of mortality in adults with learning disabilities[3].  The three most common causes of death for people with LD are circulatory diseases (22.9% of deaths), respiratory diseases (17.1%) and cancer (13.1%).  Applying these percentages to the population of Northamptonshire results in the following numbers of people likely to die from these conditions.

  • Circulatory Diseases – 2,995
  • Respiratory Diseases – 2,236
  • Neoplasms (Cancers) – 1.713

 

The most detailed review to date of the circumstances of deaths of people with learning disabilities in England is the Confidential Inquiry into the premature deaths of people with learning disabilities (CIPOLD). A premature death is defined as when ‘without a specific event that formed part of the ‘pathway’ that led to death, it was probable that the person would have continued to live for at least one more year’.

The CIPOLD enquiry studied the deaths of 249 people with LD and 58 comparators and the overview panel was able to reach agreement about the question of prematurely of 96% of the LD cohort. The median age of death was 65 for men and 63 for women, 13 and 20 years less than the general population. 

42% of the deaths in the CIPOLD study were found to be premature and 49% were what the Office of National Statistics classify as potentially avoidable. Applied to the number of Northamptonshire residents with LD with just the top 3 causes of death, it equates to around 2,900 premature deaths and around 3,400 potentially avoidable deaths.

[1]https://www.alzheimers.org.uk/info/20025/policy_and_influencing/251/dementia_uk

[2] http://www.autism.org.uk/about/what-is/myths-facts-stats.aspx

[3]https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/613182/PWLDIE_2015_main_report_NB090517.pdf

Local Representation

  • The Northamptonshire average percentage of the population with a physical disability is 18.35%, this is below the national and regional averages.
  • The Northamptonshire average percentage with a learning disability is 2.33%, which is similar to the regional and national averages.
  • Compared to the Northamptonshire average, there are higher proportions of physically disabled people in the boroughs of Wellingborough, South Northamptonshire, East Northamptonshire, Daventry and Kettering.
  • Northampton Borough has the lowest proportion of physically disabled residents but, being the largest populated borough, has the highest absolute numbers.
  • The proportion of adults with a learning disability is similar across all the boroughs/districts.

 

The annex looks more closely at the predicted numbers of residents in each of Northamptonshire’s seven boroughs and districts.

 

Access to Services

 Education, Training & Employment

Numbers of claimants of Disability Living Allowance (DLA) and Employment and Support Allowance (ESA) have been declining in Northamptonshire since 2014, when a peak of over 51,000 adults aged 18 and above claimed these two benefits. By 2016, this number had reduced to below 39,000.  It should be noted that this reduction is potentially due to the ending of DLA and its replacement with Personal Independence Plans (data for which was not available from NOMS).

fig19

The chart below shows the decline in the number of DLA claimants and the increases in the number of ESA claimants. The majority of DLA claimants are older, aged 60 and above.  This may also be partly due to the phasing out of DLA, as new assessments and re-assessments are transferred to a PIP. ESA payments are obviously more common among working age people, with the peak demand appearing between 35 and 44 years of age.

fig20

The majority of Adult Social Care clients don’t work due to their age, health conditions or disability; this is likely to be because the adults with disabilities who access social care have the most need. The figure below shows the proportions of males and females of working age who are not in paid employment.  The employment status of 10% of the cohort is not known, however it would be reasonable to assume that most of these clients with unknown employment status are not working, so the percentage of 86.8% is likely to be a conservative estimate.

fig21

The Adult Social Care Outcomes Framework 2015/16[1], Measure 1E, the proportion of adults with a learning disability in paid employment, shows Northamptonshire’s percentage of working age (18-64) people with a learning disability known to social services to be 3%, lower than the national average of 5.8%.  The East Midlands regional average for this measure was more comparable 3.3%.  3.2% of male service users were employed, according to this source, slightly higher than the 2.8% of female service users.

ASCOF Measure 1F, the proportion of working age adults (18-69) who are receiving secondary mental health services and who are on the Care Programme Approach at the end of the month who are recorded as being employed, shows the percentage in Northamptonshire as 0.8%, well below both regional (4.7%) and national (6.7%) averages. There was no difference in this figure according to gender.

Primary Acute Care

Four Strategic Health Facilitators who support GP practices and primary care pathways and the two acute hospitals. There are several success stories where people who pose a significant challenge have been supported to access mainstream healthcare facilities.

The CCGs also have a list of contracted community providers and residential services through which they commission support packages for adults with Continuing Health Care needs. A list and description of services offered to residents of Northamptonshire with a learning disability can be found here, http://www.nhft.nhs.uk/main.cfm?type=3.

The table below shows Recorded Disease Prevalence of learning disabilities, 2015-16, at CCG level.  There has been a slight decrease from 2014/15 to 2015/16 in both CCGs.

A report by the Learning Disabilities Observatory entitled ‘Hospital Admissions That Should Not Happen’[1] found that around 8 out of every 100 hospital admissions of people with a learning disability could be considered avoidable had adequate community nurse or family doctor care been available.  This compares to a figure of 5 out of every 100 admissions for adults without a learning disability. In the general population these admissions are mainly in the elderly, however for adults with a learning disability they are likely to be from across the age spectrumThe most common reason for a hospital admission for people with a learning disability is convulsions and epilepsy; other common conditions include diabetes, constipation and influenza/pneumonia.

The report suggested that those providing health services should watch to see how often these unnecessary admissions of patients with learning disabilities occur, report on how often they go into hospital and inform community nurses and family doctors when they leave hospital, in addition to thinking of how these admissions could be prevented.

The NHS Digital Learning Disability Monthly Statistics, December 2016 estimates low numbers (between 0 and 5) of patients with a learning disability whose provider is Northamptonshire Healthcare Foundation Trust (NHFT).[2]

The figure below shows the proportion of patients on CCG GP Practice lists with a learning disability.  The numbers for Nene CCG are predictably higher than the smaller Corby CCG; Nene CCG has 3,175 patients recorded as having an LD across 69 practices compared to the 312 across 5 practices in Corby.[3]

The government is committed to reducing the incidence of co-morbidities and premature deaths for people with learning disabilities (LD) and supports the recommendations from the Confidential Inquiry into premature deaths for people with learning disabilities (CIPOLD). The learning disability annual health check extended service is designed to encourage practices to identify all patients aged 14 and over with learning disabilities, to maintain a learning disabilities 'health check' register and offer them an annual health check, which will include producing a health action plan. From the numbers currently on practice registers, it is estimated that approximately 240,000 patients fall into this category across the country. There is thought to be a total of 1.2 million people with learning disabilities currently living in England.

In Northampton, 61% of learning disability (LD) annual health checks (AHC) were completed for year 2016-2017, in Nene CCG and Corby CCG.

This translates into 1940 AHCs of 3193 people with LD age 14+ on the GP LD register.  This is broken down into:

  • Nene CCG data, 1806 LD AHCs of 2933 people eligible, 62%.
  • Corby CCG data, 134 LD AHCs of 260 people eligible, 52%.
  • An action plan for 2017-18 has been created to reach 70%.

 

[1] https://www.ndti.org.uk/uploads/files/IHAL-2013-02_Hospital_admissions_that_should_not_happen_ii.pdf

[2] http://www.content.digital.nhs.uk/catalogue/PUB23230

[3] http://content.digital.nhs.uk/qof

Social Care

Social Care services in Northamptonshire for people with a learning disability are made up of:

  • Residential and supported living packages of care 
  • Day centres and opportunities that support adults whose behaviour challenges
  • Adult respite and emergency beds for people who display a lower level of challenge 
  • The Council are leading and working with partners to deliver a Transitions programme, which is already showing success for individuals during transition 
  • The Council Transitions service has designated workers in local specialist schools, further education colleges and a SENSE college and this is already improving communication and connections between services.

 

The Council has a children’s Autism Team and is also piloting two autism outreach workers to support young people from the age of 18 onwards. This has improved outcomes for number of young people during and after transition. The local Healthcare Trust has a specialist autism team as well as professionals in the community teams who assist with diagnosis and advice.

The above services take into account the adult social care plan “Our Future”, which sets out the strategic priorities for adult social care, including: 

  • Improving short term support, and maximising reablement  
  • Further personalising long term support, increasing choice and control  
  • Improving reviews to identify what is working, what outcomes are being achieved, and what happens next 
  • Placing wellbeing at the heart of the approach to integrating health, care and other services Empowering and support people in maintaining and increasing their independence 
  • Making the best use of the resources across organisations with a clearer focus


In September 2016, there were 7,086 people receiving long term support from Northamptonshire County Council’s Adult Social Care Services.  Of these, 2,764 were aged between 18 and 64, the remaining 4,322 were aged 65 and over.  This represents 1.26% of the adult population of the county, 0.64% of adults aged 18 to 64 and 3.45% of adults aged 65 and over.

fig24

The average age for a Younger Adult (aged 18-64) with a physical disability receiving services is 50, Younger Adults requesting support with a PD have an average age of 54, suggesting that PD clients may receive services now at an earlier age than previous YA clients requesting services.

The average age for a Younger Adult with a learning disability receiving services is 38, Younger Adults requesting support with a LD have an average age of 31. The average age for a client with a LD to finish services is 43, suggesting that LD clients may receive services for around 12 years from start to finish.

Amongst the younger age group, the most common primary need is Learning Disability, but for the older cohort the most common categories are Personal Care & Support and Support with Memory and Cognition. Learning Disability support is the third most common category in over 65s.  Personal Care & Support is the second most common category for 18-64 year olds

There are some primary impairment listings with clear differences in age groups. Those needing personal care support and support with memory and cognition are usually older, over 65 years of age, while those with learning disabilities that require support are more often younger adults.

88.4% of adults aged 18-64 receiving support from Northamptonshire’s Adult Social Care Services have their ethnicity recorded as ‘White British’. This is slightly low compared to the 91.5% in the general population of the county according to the 2011 census[5]. However there are 2.2% of clients in this age group who have no ethnicity recorded in their documentation. If we assume that the same proportion of that 2.2% is also White British and add it to the recorded percentage, this brings the total up to 90.3%, much closer to the county’s census result.

The proportion of White British clients is 88.4% for both of the age groups we have been looking at, 18-64 and 65 and over. In fact, the ethnicity proportions for all ethnicities across the two age groups is very similar.

In the case of older people, 2.5% of the cohort had no ethnicity recorded. Making the same assumption as above about 88.4% of these non-recorded clients being White British and add it to the recorded population, we get a figure of 90.6% to compare to the census figure of 91.5%.

The Younger Adults teams, where the majority of clients are under 65 years of age, see an almost 50/50 gender split, however for the other teams where the average age is higher, as shown in the figure above, there’s a higher proportion of female clients. This will be, at least in part, due to the longer life expectancy for females in Northamptonshire[6]

When viewed as a rate per 1,000 of the adult population (aged 16 and over) of the borough, it is Kettering that has the highest rate of new requests for support with 21.44 per 1,000 adult residents.  Kettering’s rate is almost 3 people per 1,000 higher than the second highest rate of 18.66 in Wellingborough.  The five other localities were below the county average of 18.64 per 1,000 adult residents with South Northamptonshire being the lowest at 14.1.

From April 2016 up until January 14th 2017, Northamptonshire’s Adult Social Care team received 8,123 new requests.

The table below shows the geographical source of referrals by borough and district, and compares it to the proportions in 2015/16.  There has been a reduction in the proportion of cases that were marked ‘other’ or not recorded.  For comparison purposes, the percentage of the adult population of each borough has been included. 

The following two figures show the number of clients receiving long term services from Adult Social Care by borough/district and social care team, along with the proportion of clients by team in each borough or district.

The following chart shows the primary health conditions of Northamptonshire’s Adult Social Care clients, data extracted in September 2016.  The different colours represent the client’s settings.  The largest cohort in this measure are those that have not had the health condition recorded on the care management (39%). For simplification of this chart, these unrecorded clients have been omitted, they number 2,713 at the time of data extraction.

Of the 61% who have a condition recorded, those with a long term physical condition make up the largest group, 22.5% of the total.  Dementia is the next largest recorded condition (17.5% of total clients), followed by Learning Disability, affecting 10.5% of the cohort.

The table following the figure shows the actual numbers of social care clients by primary need and support setting.

Mental Health Services

Northamptonshire Healthcare Foundation Trust (NHFT) provide a range of community, hospital and outpatient mental health services. A list and description can be found at http://www.nht.nhs.uk/main.cfm?type=CONTENT6

Services more likely to be accessed by people with  with learning disabilities are:

  • Children and young people are also supported by the local Child and Adolescent Mental Health Service (CAMHS)
  • An Autism and Asperger’s services team that provides diagnosis and short term assessment and intervention
  • Acute inpatient wards

 

Northamptonshire’s range of health services for people with learning disabilities are;

  • There are two multi-disciplinary specialist Community Teams for People with Learning Disabilities (CTPLDs), located at opposing sides of the county. These teams are further divided into teams that support children and young people and adults whose behaviour challenges respectively. The teams work together to provide an effective transition from childhood to adulthood. The adult community team also provides case management for people with continuing healthcare needs.
  • There is a specialist Intensive Support Team who provide intensive support and crisis response 8am-8pm seven days a week. The team works in partnership with the Community Teams supporting adults to remain in their local community . Both services work together to avoid admissions, and support each individual through a focussed pathway to discharge should they be admitted to inpatient services. There are advanced, skilled professionals within these services who offer behaviour therapy, psychology and psychiatry as required
  • A respite service for adults with complex health needs
  • A jointly funded respite service for children and young people with complex needs
  • Two case managers who support a small number of people with highly complex needs to step down from specialist placement and hospital provision; working closely with local commissioners

 

 

Drug & Alcohol Misuse

In common with their non-disabled peers, people with disabilities often ‘self-medicate’ with drugs and/or alcohol. The effects of alcohol often exacerbate the negative feelings and experiences leading people to self-medicate in the first place, isolation, unhappiness, bereavement, abuse, in addition to the well documented health issues associated with drug and alcohol abuse.[7]

A 2010 study titled The Impact of Drugs on Different Minority Groups – Disabled People[8] used data from the British Crime Survey 2008/09 to conclude that people without a long standing illness or disability (LSID) were more likely to use Class A drugs, stimulant drugs and other drugs than those with a LSID, however the report recognises that these results aren’t statistically significant. The chart below shows the national estimated percentage of adults with a LSID who use illicit drugs in 2014/15.[9]  

fig25

Housing

The first figure in this section shows the numbers of Northamptonshire residents with a long term health problem or disability by age and tenure, based on data from the 2011 census. This shows that older people with a health problem or disability are most likely to either own or share ownership of their homes. Younger people are more evenly split between owning their home and renting.

fig26

ASCOF[10] Measure 1G shows that in 2015/16, 66% of working age (18-64) Adult Social Care service users who received long-term support during the year with a primary support reason of learning disability support were living on their own or with their families. The national average for ASCOF 1G in the same year was 75.4% and the East Midlands average was 76.3%. In Northamptonshire, the proportion of females was slightly higher at 67.5% than males (64.9%).

The proportion of adults in contact with secondary mental health services living independently, with or without support (ASCOF Measure 1H) in Northamptonshire 2015/16 is 11.4% compared to 58.6% nationally and 48.1% regionally. In this instance, the percentage of male service users was higher at 12% than for females at 10.6%

Figure 23 shows the accommodation status of the clients of working age. The National Indicator 146 definitions define 5 of the 6 categories in the figure as being stable, the exception being ‘Registered care/ nursing home’ which, amongst other categories not recorded by Adult Social Care, is classified as ‘unstable’.  By this definition, 20% of adults aged 18-64 known to Adult Social Services in Northamptonshire are in ‘unstable’ accommodation, around 550 people.

fig27Voluntary / Charity Sector

There are 46 voluntary organisations aimed at people with mental health issues in Northamptonshire and a further 5 national organisations offering support to residents of Northamptonshire. A full list can be found on the Voluntary Impact Northamptonshire website, http://www.voluntaryimpact.org.uk/, and below is a map showing the locations of these voluntary services.

fig28

There are 26 voluntary organisations offering support to people with learning difficulties based in Northamptonshire. A further 3 organisations are based elsewhere but offer services to Northamptonshire residents.  A list can be found at the same location as above, the map below shows their locations.

The third map shows the locations of voluntary organisations offering support for those with a physical disability.  There are 75 organisations in this field based within the county and a further 11 based outside of Northamptonshire, but offering services to residents of the county.

fig29

The third map shows the locations of voluntary organisations offering support for those with a physical disability.  There are 75 organisations in this field based within the county and a further 11 based outside of Northamptonshire, but offering services to residents of the county.

fig30

The national charity Scope has a list of national charities working with people with disabilities. The list can be found here - https://www.scope.org.uk/support/families/diagnosis/links

National charities carry out large amounts of studies and research, often they have case studies related to the particular disability they work to support.

 Profile of Adults Entering and Leaving Services

From April 2016 up until January 14th 2017, Northamptonshire’s Adult Social Care team received 8,123 new requests. The table below shows the geographical source of referrals by borough and district, and compares it to the proportions in 2015/16.  There has been a reduction in the proportion of cases that were marked ‘other’ or not recorded.  For comparison purposes, the percentage of the adult population of each borough has been included. 

fig31fig32

 

The following tables show the number of new Adult Social Care clients by primary reason. A new client is defined as ‘Clients not in receipt of long term support at the time the request for support was made. A person who previously received long term support which had ceased before the new request was made must be included as a new client.’

fig33

The next table shows the numbers of clients already accessing short term support, an 'existing client', by primary support reason. 

 

fig34

The following table shows the numbers of existing clients accessing long term support by primary reason.awd35

 The final table shows the numbers of people accessing long term support who have been accessing that support for over 12 months.

 

fig36

 fig37fig38

 fig39

fig40

.

 Armed Forces Personnel

There are approximately 4,000 people in Northamptonshire claiming an armed forces pension, widows pension or have been awarded compensation by the Ministry of Defence. It’s not possible to give an accurate figure from MoD data as some individuals may be in receipt of two or more types of remuneration.  Of this number, using simple addition for convenience, 3,757 are veterans[11].

The Ministry of Defence’s Armed Forces Mental Health Annual Statistics estimate that 3.2% of UK Armed Forces personnel were assessed with a mental disorder in 2016/17[12].  Applied to the estimated Ex-Forces population of Northamptonshire this would equate to around 120 people.

The MoD Armed Forces Mental Health Annual Statistics further estimate the prevalence of particular conditions within this population, the table below shows the MoD estimates of proportion and the number of Northamptonshire residents when this proportion estimate applied to this population of c120 people. Please note that totals may not match due to rounding.

fig41

 

[5] http://content.digital.nhs.uk/qof

[6] http://www.content.digital.nhs.uk/catalogue/PUB21900

[7] https://www.ncbi.nlm.nih.gov/pubmed/17578397

[8] http://www.ukdpc.org.uk/wp-content/uploads/Evidence%20review%20-%20The%20impact%20of%20drugs%20on%20different%20minority%20groups_%20disabled%20people.pdf

[9] https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/462885/drug-misuse-1415.pdf

[10] http://www.content.digital.nhs.uk/catalogue/PUB21900

[11] https://www.gov.uk/government/statistics/location-of-armed-forces-pension-and-compensation-recipients-2016

[12] https://www.gov.uk/government/statistics/uk-armed-forces-mental-health-annual-statistics-financial-year-201617

Financial

fig42Nene and Corby CCGs spent £9M in 2015/16 on providing in-patient and specialist healthcare services for people with a learning disability and/or autism whether they are in Northamptonshire or placed out of area. £6,032,908 of this money is spent by the CCGs and £2,992,270 by Specialised Commissioning. This figure does not include spend on NHS Continuing Healthcare or Section 117 Mental Health Act aftercare which is shown separately and totals £13,471,000 and £117,215 respectively. Northamptonshire County Council is expecting to spend approximately £60m on social care for those with a learning disability.

  • Total spending is forecast to grow from combined health & NCC £83.6m today to £97.4m in 2020 if the model of care is unchanged. £3.2m year on year increase in cost achieving lesser outcomes
  • Outcomes are poorer - People with LD receiving care within Northamptonshire have poorer outcomes in employment
  • Assessment & Systems - the face RAS assessment was considered unsuitable for LD, leading to workarounds in care placement that have escalated care costs by 10-20% (according to high-needs team estimations)
  • We are out of line with the county’s peers - Northamptonshire is spending 83% more on average per adult with LD than the English national average.
  • People’s care needs are changing -  The council is not responding quickly enough and the assessment backlog is 600+ out of 2800
  • Market dynamics - the market is currently distorted in the favour of providers and dictating price. 
  • We jointly spend £11m per annum with the same 15 providers and get very different prices
  • Workforce - the distribution of staff is aligned with 2010 cost and volume pressures rather than current pressures (e.g. MH staff-to-user ratio 3:1 vs Learning Disabilities 84:1)
  • Market Management - the rising spend is attributable to growing care costs rather a growth in the number of service users. This could be attributed to issues with market management and commissioning capability.
  • Right care at the right time - people’s outcomes are escalating through a lack of proper assessment and care setting placement is worsening outcomes
  • Transition - the transition services need bolstering and the divide with CYPF needs closing immediately.
  • The progression has not yet been adopted – the provision of care is not being stepped down in line with reducing need where the opportunity arises because of other demands and pressure

 

fig43

A report by PA Consulting found the following reasons were big contributors to Northamptonshire’s comparatively high spend on Learning Disabilities;

  • Growing care costs, lack of market management
  • Escalating the cost of outcomes through a lack of an effective assessment tool
  • Lack of provider management due to inexperience of care managers
  • Missing opportunities to reduce the amount of care when the level of need decreases
  • Lack of the ‘right care at the right time’

 

Issues & Gaps

  • The PANSI and POPPI tools use a different definition of physical disability for the 18-64 age bands and the over 65 group.  Whereas the projections are for ‘physical disabilities’ for 18-64 year olds, the predictions for older people are for ‘people whose day to day activities are limited’ by a long term illness. 
  • The projection tools don’t determine particular conditions, the only differentiation is between ‘physical disability’ and ‘learning disability’.
  • The reduction in numbers of individuals claiming Disability Living Allowance has reduced in the most recent years, though this reduction may be due to the replacement of DLA with Personal Independence Payments.  Similar data for the new PIP benefit is not available at the time of writing. 
  • The employment status of disabled adults known to Adult Social Care is more likely to be skewed towards unemployed individuals due to only the more serious conditions receiving support.
  • Social Care data often has many unrecorded fields, for example ethnicity where 2% of the 7,000+ records have no recorded ethnicity, over 2,700 clients have no primary health condition recorded. 
  • We have no data from Mental Health Services
  • It is not possible to specify ethnicity in the disabled population data
  • There needs to be much more known in relation to people with Profound and Multiple Learning Disabilities (PMLD)

Recommendations

  • Improve data entry requirements across statutory services to address the gaps in knowledge in relation to learning disabilities and co-morbid conditions such as mental health, autism and dementia.
  • Record where peoples behaviour are a significant challenge to services to enable contribution to the counties dynamic risk register
  • Recording of ethnicity to increase ability to provide culturally sensitive care
  • Prevention programmes to avoid development of physical disabilities in older age
  • Develop a programme to increase levels of paid employment in Adult Social Care clients with disabilities
  • Work with CCG’s and other commissioning partners to identify reasons for higher or avoidable hospital admission rates in people with learning disabilities
  • Develop a targeted self-care/empowerment programme to increase independence in Adult Social Care clients
  • Develop support to facilitate more people who receive Adult Social Care services, and those in contact with Mental Health services to live independently, including reducing the numbers of people in these categories in ‘unstable’ accommodation
  • Further analysis of cost of care
  • Further analysis of length of interventions
  • Are voluntary organisations positioned according to need or are inequalities being created due to spatial location of services?

 

Annexe - Locality Profiles

Corby

  • Approximately 10,350 people in Corby have a disability of some description. That is a rate of 203.6 per 1000 residents aged over 18
  • 89% of them have a physical disability
  • 11% have a learning disability
  • A little over half of the people with a disability in Corby are aged 65 and over

 

fig44

 

fig45

 

fig46

  • Numbers of Corby residents with a physical disability are expected to increase by almost 25% in the 10 years from 2015 to 2025.  The increase is most pronounced in those aged 65 to 85
  • The number of people in these age groups with a physical disability is anticipated to increase again sharply between 2025 and 2030
  • The numbers of Corby citizens with a learning disability is expected to rise by 12%, with the age bands seeing the highest increases being 35-44 and the three age bands between 55 and 84.

 

Daventry

  • Approximately 13,500 people in Daventry have a disability of some description. That is a rate of 212.2 per 1000 residents aged over 18
  • Around 89% of them have a physical disability
  • 11% have a learning disability
  • About 53% of the people with a disability in Daventry are aged 65 and over

 

fig47

 

fig48

fig49

  • Predicted increase of 24% in the numbers of people with physical disabilities in Daventry
  • The numbers of younger people with a physical disability is predicted to fall over the next 10-15 years, but the increase in numbers of older people with a physical disability is expected to be much higher than any decreases in younger cohorts
  • The number of adults with a learning disability is predicted to grow by almost 6% in the ten years between 2015 and 2025. The older cohorts will see the biggest increases, with the 75-84 age group anticipated to grow by over 70%.

 

East Northamptonshire

  • Approximately 14,950 people in East Northamptonshire have a disability. That is a rate of 212.6 per 1000 residents aged over 18
  • 89% of them have a physical disability
  • 11% have a learning disability
  • 54% of the people with a disability in East Northamptonshire are aged 65 and over

 

fig50

fig51

fig52

  • The numbers of East Northamptonshire residents with physical disabilities aged 18 to 54 will gradually decrease over the upcoming 10 to 15 years
  • The numbers of people with physical disabilities aged 55 and over is anticipated to increase dramatically.  In common with other areas, it’s the 75 to 84 year age group that is likely to see the most significant increases, around 45% between 2015 and 2025
  • The numbers of East Northamptonshire residents with a learning disability is expected to fall for those aged 18 to 54
  • The numbers of East Northamptonshire residents with a learning disability aged 55 and over is expected to increase at a greater rate than the decrease in younger adults. Particularly sharp increases are expected in those aged 75 and over.

 

Kettering

  • Almost 16,000 people in Kettering have a disability of some description. That is a rate of 210.1 per 1000 residents aged over 18
  • 89% of them have a physical disability
  • 11% have a learning disability
  • 54% of the people with a disability in Kettering are aged 65 and over

 

fig53

fig54

fig55

  • The numbers of Kettering residents with physical disabilities aged 75 and above will gradually increase over the upcoming 10 to 15 years. This is in line with other areas of the county
  • The numbers of residents with physical disabilities aged 18-54 has been forecast to remain similar across the upcoming 10 to 15 years
  • The numbers of Kettering residents with a learning disability aged 55 and over is expected to increase over the next 10 to 15 years
  • Particularly sharp increases are expected in those aged 75 and over
  • The predicted increase in the number of older people with learning disabilities is than for physical disabilities

 

Northampton

  • Approximately 33,000 people in Northampton have a disability of some description. That is a rate of 192.8 per 1000 residents aged over 18, the lowest rate in the county
  • 88% of them have a physical disability 
  • 12% have a learning disability
  • Half of all the people with a disability in Northampton are aged 65 and over. This is the lowest proportion of any area in the county

 

fig56

fig57

fig58

  • As the area of the county with the highest population, the increases in numbers of people, particularly older people, with disabilities is the largest of the seven boroughs and districts
  • The numbers of Northampton residents with disabilities aged 55 and above will gradually increase over the upcoming 10 to 15 years. This is in line with other areas of the county. A particularly sharp increases is expected in those aged 75 and over
  • The numbers of Northampton residents with physical disabilities aged 18-54 has been forecast to remain similar across the upcoming 10 to 15 years
  • In Northampton, younger people are more likely to have learning disabilities and older people to have physical disabilities

 

South Northamptonshire

  • Approximately 14,800 people in South Northamptonshire have a disability of some description. That is a rate of 212.1 per 1000 residents aged over 18. 
  • Of these 89% of them have a physical disability and 11% have a learning disability
  • 53% of the people with a disability in South Northamptonshire are aged 65 and over. 

 

fig59

fig60

 

 

  The numbers of South Northamptonshire residents aged 18-54 with disabilities is anticipated to fall during the upcoming 10 to 15 years.
 
  The numbers of older South Northamptonshire residents with either a physical or learning disability is anticipated to increase considerably over the next 10 to 15 years.  The numbers of South Northamptonshire residents aged 18-54 with disabilities is anticipated to fall during the upcoming 10 to 15 years.
 
  The numbers of older South Northamptonshire residents with either a physical or learning disability is anticipated to increase considerably over the next 10 to 15 years.

  The numbers of South Northamptonshire residents aged 18-54 with disabilities is anticipated to fall during the upcoming 10 to 15 years.
 
  The numbers of older South Northamptonshire residents with either a physical or learning disability is anticipated to increase considerably over the next 10 to 15 years.fig61

  • The numbers of South Northamptonshire residents aged 18-54 with disabilities is anticipated to fall during the upcoming 10 to 15 years
  • The numbers of older South Northamptonshire residents with either a physical or learning disability is anticipated to increase considerably over the next 10 to 15 years.

 

Wellingborough

  • Approximately 13,250 people in Wellingborough have a disability of some description. That is a rate of 222.5 per 1000 residents aged over 18, which is the highest rate in the county
  • 89.6% of them have a physical disability 
  • 10.4% have a learning disability
  • 56% of the people with a disability in Wellingborough are aged 65 and over. This area has the highest proportion of older people with disabilities in the county.  

 

fig62

fig63

 

fig64

  • Wellingborough residents with a disability follow a similar pattern to the other districts and boroughs of Northamptonshire
  • The numbers of Wellingborough residents aged 18-54 with disabilities has been forecast to fall slightly across the upcoming 10 to 15 years
  • The numbers of Wellingborough residents with physical disabilities aged 55 and above will increase over the upcoming 10 to 15 years. This increase will account for more than the fall in the younger population, resulting in an overall increase
  • Particularly sharp increases are expected in those aged 75 and over with both kinds of disabilities.

 

Full Adults with Disabilities Chapter

The full JSNA chapter on breastfeeding can be accessed by clicking on the link below;

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