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Joint Strategic Needs Assessment Profile 2009

INTRODUCTION

This is the Joint Strategic Needs Assessment for the Newton Abbot area, encompassing , , and .

The aim of the Joint Strategic Needs Assessment is to collaboratively identify current and future health and well being needs and inform future service planning and delivery. The purpose of this town profile is to provide a detailed assessment of current need and service activity at a local level. This profile looks at the health and social care needs of the town and its rural surroundings and other smaller surrounding settlements.

Data for this report was gathered and collated by the NHS Devon information teams, and the Adult and Community Service and Children and Young Peoples Service and Strategic Intelligence teams.

A glossary is available providing detailed definitions and background information for the measures in this report: http://www.infopoint.devonpct.nhs.uk/Library/Public_Health_Commissioning/JSNA_2009_Glossary_Devon.pdf

FEEDBACK

Any feedback or questions concerning the information in this report would be gratefully received. We would be keen to receive feedback on whether you recognise the community as described in the profile, is any key information is missing or any local priorities or issues you wish to identify. Please contact [email protected] with any comments or questions.

EXECUTIVE SUMMARY

 Deprivation is greatest in urban parts of Newton Abbot, whilst the surrounding rural areas and smaller towns such as Kingskerswell and Bovey Tracey are less deprived  The population of Newton Abbot is predicted to increase by 9,059 people between 2006 and 2021 – a rise of 13.3%. The largest change is predicted to be in the 70 to 74 age group with an increase of 49.7%  Birth rates in the area are above the Devon average, with particularly high rates in Bovey Tracey  Life expectancy is just above average, with longer life expectancy seen in rural areas and small towns  Much lower than average number of children and young people from black and ethnic minority groups  Slightly lower than average GCSE performance  Slightly higher than average youth crime rate  The rate of referrals for older people aged 65+ into Adult and Community Services in Newton Abbot is the 4 th highest referral rate for this age group across Devon (out of 29 Devon towns)  The rates of older people aged 65+ in Newton Abbot receiving assessments and reviews through Adult and Community Services are both in line with the Devon average  The rate of Safeguarding alerts for vulnerable adults in is in line with the Devon average  Outpatient and A&E attendances are above average, whilst elective and non-elective admissions to hospital are below average  Alcohol related admissions are average, although rates are higher in Newton Abbot urban area  Teen conception rates are higher in Newton Abbot urban area and Kingskerswell DEPRIVATION

The main source of information on deprivation is the 2007 Indices of Deprivation, which combine data on different social issues to produce an overall deprivation score for local areas, known as the Index of Multiple Deprivation. In the Newton Abbot town area the most deprived areas are in parts of the town of Newton Abbot. The least deprived areas are the villages to the South and West of Newton Abbot.

A breakdown of the individual domains from the Indices of Deprivation 2007, reveal particular issues around education, crime and income deprivation affecting the elderly. A separate Child Wellbeing Index was released in 2009, which reveals that whilst Newton Abbot is near the Devon average, there are issues in relation to the health, education and crime domains affecting children.

Devon Town Indices of Deprivation 2007 Devon Town Child Well-Being Index 2009 Newton Abbot - Devon Rank Newton Abbot - Devon Rank

IMD 17 CWI 13 Income 13 Income 14 Employment 13 Health 9 Health 15 7 Education 9 Education Barriers 17 Crime 8 Crime 8 Housing 13 Living Env. 20 Environment 17 Income (0-15) 14 13 Income (60+) 8 Children in Need 1 3 5 7 9 11131517192123252729 1 3 5 7 9 11 131517 19212325 2729 Most Deprived Least Deprived Most Deprived Least Deprived

For full description of domains please view the glossary

DEPRIVATION IN URBAN AND RURAL AREAS

The following chart compares index of multiple Urban and Rural IMD Scores 2007 deprivation scores for the urban area of Newton Newton Abbot Kingskerswell Kingsteignton Bovey Tracey Abbot with the surrounding rural hinterland, along Chudleigh/Rural Devon with average urban and rural Index of Multiple 25.00 Deprivation scores for Devon and England as a whole. 20.00

This reveals that in general the urban centres in 15.00 this area are generally much more deprived than the surrounding rural areas. Newton Abbot itself is the most deprived urban area, with 10.00 Kingskerswell and Bovey Tracey the least deprived. Rural areas around Newton Abbot are 5.00 much less deprived than the Devon and England rural averages. 0.00 21.22 13.34 14.79 14.11 17.92 17.87 22.49 11.95 16.39 12.93 Urban Rural POPULATION

The population of Newton Abbot is predicted to increase by 9,059 people Projected population breakdown by quinary age bands for 2021, between 2006 and 2021 – a rise of based on 2006 population estimates 13.3%. The total number in the 85+ younger age groups (from 0 to 19) is 80-84 predicted to decrease by 140 to 75-79 70-74 16,131 – a fall of 0.9%. The 20 to 44 65-69 year age band is predicted to see an 60-64 55-59 increase of 1,152 to 20,747 or 5.9%. 50-54 The 45 to 64 age group should also 45-49 Males 2006 40-44 see an increase, in this case of 2,996 35-39 people (15.9%) to 21,819. The older 30-34 Females 2006 25-29 age groups (65 years and older) are 20-24 Males 2021 due to see an increase in number of 15-19 Projection 10-14 Females 2021 5,051. This equates to a 37.7% 5-9 Projection increase over the 15 years that these 0-4 projections cover and will take the 3,500 3,000 2,500 2,000 1,500 1,000 500 0 500 1,000 1,500 2,000 2,500 3,000 3,500 population in this group up to 18,432. The largest change is predicted to be in the 70 to 74 age group with an increase of 49.7%.

The proportion of Newton Abbot’s population from BME communities based on the 2001 census is 1%. This is comparable to the overall Devon BME of 1.1%.

BIRTHS

The birth rate in the Newton Abbot area is marginally above the Devon average, with over 650 births per year. Particularly high birth rates were seen in the Bovey Tracey area.

Area Average Birth Birth Rate per 1,000 women aged 15-44 by Devon Town, 2003-7 births Rate

Rate Devon Rate per year Newton Abbot 254 52.73 70.00 Bovey Tracey 76 64.35 Chudleigh 44 50.76 60.00 Kingskerswell 37 45.31 50.00 Kingsteignton 113 52.38 Newton Abbot 40.00 Hinterland 137 49.44 Newton Abbot 30.00 Town Area 661 52.42

20.00 Teignbridge District 1,139 51.89 10.00 Southern Locality 2,272 50.52 0.00 Devon 6,721 50.02

Moret Devon Urban 4,797 50.35 Ottery GTorr Seaton Tiverton N Abbot N Dartmouth Devon Rural 1,925 49.24 Ash /Buck Ash

Teignmouth Lynt / Lynm / Lynt Molton South /Northam

LIFE EXPECTANCY

Life expectancy in the Newton Abbot area is slightly above the average for Devon. Life expectancy in the rural hinterland was generally longer than in the towns, although Kingskerswell did have the longest life expectancy

Area Female Male Total Life Expectancy at Birth by Devon Town, 2003-7 Newton

Life Expectancy Devon Abbot 81.0 78.2 79.7 Bovey Tracey 84.1 79.7 82.0 84 Chudleigh 85.6 78.6 82.1

83 Kingskerswell 83.8 84.2 83.9 Kingsteignton 83.1 80.3 81.7 82 Newton Abbot 81 Hinterland 84.3 80.9 82.6 80 Newton Abbot Town 79 Area 82.9 79.6 81.4

78 Teignbridge District 83.0 79.6 81.4 77 Southern Locality 83.2 79.3 81.4 Moret

Ottery G G Torr Exeter Totnes Seaton Honiton Tiverton N N Abbot Dawlish Crediton Exmouth Sidmouth Braunton Ivybridge Tavistock Devon 83.0 78.9 81.0 Dartmouth Axminster Ilfracombe Cullompton Barnstaple Ash / Buck / Ash

Teignmouth Holsworthy Lynm Lynt/ Kingsbridge Okehampton Molton Urban 82.5 78.4 80.5 Bideford/Northam Devon Rural 84.0 80.0 82.0

CHILDREN AND YOUNG PEOPLE

Newton Abbot Town Area has average numbers of those with Special Educational Needs; slightly lower than average GCSE performance; a slightly higher than average youth crime rate; and, perhaps surprisingly, a much lower than average number of children and young people from black and ethnic minority groups.

SPECIAL EDUCATIONAL NEEDS (2007/08)

This graph represents the percentage of young people with SEN attending a DCC school in 07/08 by their town of residence. The national average for the proportion of pupils identified with SEN (i.e. Statemented, School Action Plus and School Action combined) is approximately 20%. We want children and young people to access services and provision within their Local Learning Communities wherever possible. Some children with complex needs will require access to specialist support in additionally resourced provision or special schools. Where there are significant variations it reflects the level of support needed within the community. Data Source: DCSF School Census (Oct 07, Jan 08 and May 08)

YOUTH OFFENDING (2008) Devon's First Time Entrants (FTEs) figure has been below the regional and national average since 2004/5, and continues to fall - current projections for the financial year 2009/10 are that the FTE rate will drop by over a third, compared to the baseline year of 2007/8. Within Devon, such small numbers of FTEs can cause significant statistical variations from one year to the next, particularly in the smaller towns and communities. In general, around two thirds of FTEs do not re-offend, but the pattern of those who re-offend more persistently (Persistent Youth Offenders - PYOs) is even more liable to fluctuation outside of the four largest communities (Barnstaple, Exeter, Exmouth and Newton Abbot). Preventative work by the Youth Offending Service and Children's Trust is increasingly focused, therefore, on the towns where there is a longer term pattern of FTEs and PYOs above the Devon average. Data Source: Devon Youth Offending Team 2009 GCSE PERFORMANCE (2008) The graph illustrates GCSE performance in 2008 for pupils in Devon Maintained Schools by Town of residence.

Devon pupils’ achievement at GCSE level is slightly above the National average (49.5%) but there still too many pupils not gaining 5 or more GCSEs including Maths and English.

The Local Authority has established a ‘Narrowing the Gap’ Programme to improve the attainment of the lowest 20% of achievers, and a ‘Raising the Bar’ programme to stretch the most able.

Data Source: Devon Learning and Development Partnership

ETHNICITY AND FIRST LANGUAGE (2007/08)

This graph represents the percentage of young people with a first language other than English who were attending a DCC school in 07/08 by their town of residence. In this time period there were 4,440 pupils from a minority ethnic background in Devon schools (4.65% of the total school population) and of these 1,731 have English as an additional language.

There are over 60 different languages spoken by children and young people in Devon schools the largest minority language groups being Polish (252) and German (88).

There are few schools without minority ethnic pupils and an increase in those schools with over 6% Black Minority and Ethnic pupils on roll. Currently, the largest ethnic group are Polish families located across the county. Data Source: DCSF School Census (Oct 07, Jan 08 and May 08) ADULT AND COMMUNITY SERVICES

Older People 65+ The table illustrates that service activity for older people Adult & Community Services Activity (during 2008/09) aged 65+ in Newton Abbot is in line with the overall Older People 65+ Rate per 1000/65+ Population Devon average for the proportion of people based in Care Homes and the proportion receiving Community 100 Based Care and Housing Related Support. Newton 80 Abbot The rate of referrals for older people aged 65+ into Adult and Community Services in Newton Abbot is 178.1 (per 60 Teignbridge 1000 65+ population). This is the 4 th highest referral rate 40 for this age group across Devon (out of 29 Devon 20 Devon towns). The proportion of referrals for older people aged Rate per 1000 pop 1000 per Rate 0 65+ in Newton Abbot dealt with at point of contact and Care Home Community Housing those sent on for further assessment is in line with the Based Care Related overall Devon average of 14% and 86% respectively. Support There is an over representation in the number of referrals from Local Authority Housing Departments for clients aged 65+ in Newton Abbot. The rate of older people aged 65+ in Newton Abbot receiving assessments is 71.1 (per 1000 65+ population) and 92.5 for reviews, these rates are both comparable to the Devon average. 7% of adult clients in Teignbridge who were assessed on Falls risk groups based on new enquiries received for the Home Improvement Agency were identified as in the High risk group, compared to 15% for the Devon average.

Mental Health and Learning Disabilities

Applying the nationally accepted prevalence rates for Dementia to the population in Newton Abbot shows that there are an estimated 1028 people in the area with Dementia. This gives an overall prevalence rate in the 65 and over population of 7.48%.

The table below presents people in Teignbridge aged 18-64 predicted to have a mental health problem, projected to 2025 Data Source: PANSI

% 2008 2025 Change Depression 1,898 2,049 8% Neurotic disorder 12,267 13,224 8% Personality disorder 3,254 3,528 8% Psychotic disorder 408 441 8% Adult & Community Services Activity (during 2008/09) Learning Disabilities 18-64 Rate per 1000/18-64 In Teignbridge the proportion of people with learning Population disabilities aged 18-64 receiving Community Based 3 Care is comparable to the overall Devon average (although in the table appears to be considerably 2.5 Teignbridge below due to the scale used). The proportion placed 2 in Care Homes is over represented when compared to 1.5 Southern the overall Devon average. 1 Devon

pop 1000 per Rate 0.5 0 Community Based Care Home Care

Physical Disabilities 18-64 This table demonstrates that Newton Abbot is in line with Adult & Community Services Activity (during 2008/09) the overall Devon average for the number of people with Physical Disabilities 18-64 Rate per 1000/18-64 physical disabilities aged 18-64 receiving Community Population Based Care and the number based in a Care Home. The rate of referrals for people aged 18-64 into Adult 6 and Community Services in Newton Abbot is 10.2 (per 5 Newton Abbot 1000 18-64 population). This is the 3rd highest referral 4 rate for this age group across Devon. Teignbridge 3 The rate of people with physical disabilities aged 18-64 2 Devon in Newton Abbot receiving assessments is 3.5 (per 1000 1 18-64 population) and 2.9 for reviews, these rates are Rate per 1000 pop 1000 per Rate 0 both comparable to the Devon average. Community Based Care Home The rate of Safeguarding alerts in Teignbridge is 1.9 (per Care 1000 18+ population) which is in line with the Devon average of 1.6. Carers

The rate of carers receiving information and advice provided by Carers Link services The rate of Carers assessments and reviews in 16 Newton Abbot is in line with the Devon average of 14 Devon Tow n Rate Devon Rate 8.2 (per 1000 18+ population). 12 The table opposite illustrates that the rate of carers 10 receiving Information and advice provided by Carers 8 Link services in Newton Abbot is in line with the 6 Devon average at 8.3 (per 1000 18+ population). A 4 large proportion of this is carers of people with 2 physical disabilities and mental health problems. 0

Moret Ottery Exeter G Torr

Totnes Seaton Honiton Tiverton N Abbot Dawlish Crediton Exmouth Sidmouth Ivybridge Braunton Tavistock Dartmouth Axminster Ilfracombe Barnstaple Cullompton Ash / Buck / Ash Teignmouth Lynt / Lynm Lynt/ Holsworthy Kingsbridge Okehampton South Bideford / Northam / Bideford User Experience / Feedback

2009 ACS Home Care and Direct Payments User Surveys Overall, satisfied w ith help received in ow n home

Feel safe in ow n home Have as much contact w ith other

Home Care Home people as w ant

Feel in control of daily life

Overall, satisfied w ith services purchased using direct payments

Feel safe in ow n home Have as much contact w ith other people as w ant DirectPayments Feel in control of daily life

Teignbridge Devon 50% 60% 70% 80% 90% 100%

Results of the 2008 Place Survey reveal that 38.9% of Newton Abbot residents who responded to the survey felt that older people are able to get the support needed to continue to live at home compared to the Devon average of 36%. The 2009 ACS User Survey results for Direct Payments recipients indicate that respondents in Teignbridge feel less safe than in Devon overall. However, low response rates in some districts can skew survey results.

HOSPITAL ACTIVITY

The rate of outpatient attendances in the Newton Abbot town area is the highest in Devon, although the rate of elective admissions to hospital is below the Devon average. The rate of Accident and Emergency attendances is also marginally above the Devon average, although non-elective admissions to hospital, which cover emergencies, maternities and transfers, are below the Devon average. Within the area the highest rates of admission and attendance are generally seen in the urban area of Newton Abbot, although highest rates of hospital admissions were also seen in Chudleigh and Kingsteignton.

Outpatient Attendances by Devon Town, Direct Age Elective Admission to Hospital by Devon Town, Direct Age Standardised Rate per 1,000 population, 2008/9 Standardised Rate per 1,000 population, 2008/9 1200.00 160.00 DASR Devon Rate DASR Devon Rate 140.00 1000.00 120.00 800.00 100.00

600.00 80.00

60.00 400.00 40.00 200.00 20.00

0.00 0.00 Ottery Ottery Exeter GTorr Exeter GTorr Totnes Totnes Seaton Seaton Honiton Honiton Tiverton Dawlish Moreton N Abbot N Dawlish N Abbot N Tiverton Moreton Crediton Crediton Exmouth Exmouth Ivybridge Sidmouth Braunton Braunton Sidmouth Ivybridge Tavistock Tavistock Dartmouth Dartmouth Axminster Axminster Ilfracombe Ilfracombe Barnstaple Barnstaple Cullompton Cullompton Ash / Buck / Ash Ash / Buck Ash/ Teignmouth Teignmouth Holsworthy LyntLynm / LyntLynm / Holsworthy Kingsbridge Kingsbridge Okehampton Okehampton South Molton South South Molton South Bideford/Northam Bideford/Northam

A&E Attendances by Devon Town, Direct Age Standardised Non-Elective Admission to Hospital by Devon Town, Direct Age Rate per 1,000 population, 2008/9 Standardised Rate per 1,000 population, 2008/9 600.00 140.00 DASR Devon Rate DASR Devon Rate 120.00 500.00

100.00 400.00

80.00 300.00 60.00

200.00 40.00

100.00 20.00

0.00 0.00 Ottery Ottery GTorr Exeter GTorr Exeter Totnes Totnes Seaton Seaton Honiton Honiton Moreton Tiverton Dawlish N Abbot N Dawlish Abbot N Tiverton Moreton Crediton Crediton Exmouth Exmouth Ivybridge Braunton Sidmouth Ivybridge Sidmouth Braunton Tavistock Tavistock Dartmouth Dartmouth Axminster Axminster Ilfracombe Ilfracombe Cullompton Barnstaple Cullompton Barnstaple Ash / Buck / Ash Ash / Buck / Ash Teignmouth Teignmouth Holsworthy LyntLynm / Holsworthy LyntLynm / Kingsbridge Kingsbridge Okehampton Okehampton South Molton South South Molton South Bideford/Northam Bideford/Northam

Hospital Activity, Direct Age Standardised Rates by Activity Type, 2008/9

Area A&E Attends Outpatient Attends Elective Admissions Non-Elective Admissions Newton Abbot 378.1 1145.4 125.4 102.6 Bovey Tracey 322.2 1086.8 121.2 92.4 Chudleigh 294.5 1090.9 129.5 102.1 Kingskerswell 264.1 1043.6 101.7 82.9 Kingsteignton 335.9 1102.0 129.8 102.8 Newton Abbot Hinterland 285.2 1030.0 108.5 91.6 N Abbot Town Area 329.6 1091.6 120.2 97.1 Teignbridge District 335.3 1054.8 123.8 96.0 Southern Locality 261.3 975.2 110.1 93.3 Devon 300.3 951.4 126.9 104.8 PUBLIC HEALTH – ALCOHOL-RELATED ADMISSIONS

Alcohol-Related admissions include those where acute, chronic and mental conditions are known to relate either fully or partially to alcohol use. Further details on how these figures are derived can be found in the glossary. The Newton Abbot area has a similar rate of alcohol-related admissions to Devon as a whole. The highest rate of admissions is seen in the town of Newton Abbot itself, which accounts for over 250 admissions per year.

Area Admissions DASR* Alcohol-Related Admissions by Devon Town, Direct per year per Age Standardised Rate, 2006-8 100k Newton DASR Devon Abbot 447 1375.6 Bovey Tracey 122 1076.9 2000 Chudleigh 65 1236.2 1800 Kingskerswell 93 1239.5 1600 Kingsteignton 155 1050.2 1400 Newton 1200 Abbot 1000 Hinterland 253 1082.5 800 Newton 600 400 Abbot Town 200 Area 1,135 1192.7 0 Teignbridge District 2,242 1232.5 Ottery

GTorr Exeter Southern Totnes Seaton Honiton Dawlish NAbbot Tiverton Moreton Crediton S Molton S Exmouth Braunton Ivybridge Sidmouth Tavistock Dartmouth Axminster Locality 4,348 1133.8 Ilfracombe Barnstaple Cullompton Ash / Buck Ash/ Teignmouth Holsworthy Lynt / Lynm Lynt Bideford/No Kingsbridge Okehampton Devon 12,742 1215.3 Devon Urban 8,877 1319.4 Devon Rural 3,863 1012.1 * Direct age standardised rate, see glossary PUBLIC HEALTH PUBLIC HEALTH TEEN CONCEPTIONS DEATH RATES 2003-7 Levels of conceptions amongst females aged below The table below presents mortality or death rates for the 18 were above average in parts of Newton Abbot Newton Abbot town area compared with Devon. This and Kingsteignton. The rates in surrounding rural highlights that death rates are consistent with the Devon wards and areas such as Bovey Tracey and average, with no significant differences present. Chudleigh were below average.

Average DASR Devon Relation- deaths DASR ship to Measure per year Average All Causes 718 526.8 533.3 N.S. All Causes, Female 384 457.5 448.3 N.S. All Causes, Male 335 620.1 640.6 N.S. All Causes, under 75 204 245.6 254.4 N.S. Cancer 198 167.5 163.9 N.S. Cancer, under 75 93 111.6 105.5 N.S. Circulatory 268 179.7 183.8 N.S. Circulatory, under 75 54 62.3 65.8 N.S. N.S. = Not statistically significant. For more information on definitions and measures, see glossary