Clackmannanshire and Stirling Strategic Plan Strategic Needs Assessment 2016 - 2019 Health and Social Care Partnership Table of Contents Executive Summary.......................................................................................................................................5 1 Introduction ...............................................................................................................................................7 1.1 Background ...................................................................................................................................7 1.2 What is a Strategic Needs Assessment ....................................................................................... 10 1.3 Identified Gaps............................................................................................................................11 2 Population................................................................................................................................................11 2.1 Current Population......................................................................................................................11 2.1.1 Ethnic Origin................................................................................................................................16 2.1.2 Religion........................................................................................................................................16 2.1.3 Sexual Orientation ......................................................................................................................17 2.2 Projections of future population................................................................................................. 17 2.3 Dependency Ratio....................................................................................................................... 19 2.4 Population Considerations/Implications..................................................................................... 21 3 Life Circumstances ...................................................................................................................................21 3.1 Scottish Index of Multiple Deprivation ....................................................................................... 21 3.2 Housing .......................................................................................................................................24 3.3 Fuel Poverty ................................................................................................................................26 3.4 Employment, Benefits and Financial Issues................................................................................ 27 3.5 Life Circumstance Considerations/Implications.......................................................................... 31 4 Risk Factors ..............................................................................................................................................32 4.1 Smoking.......................................................................................................................................32 4.2 Alcohol ........................................................................................................................................35 4.3 Drugs ...........................................................................................................................................37 4.4 Diet and Obesity..........................................................................................................................38 4.5 Risk Factors Considerations/Implications................................................................................... 40 5. Population Health ...................................................................................................................................41 5.1 General Health ............................................................................................................................41 5.2 Life Expectancy and Healthy Life Expectancy ............................................................................. 41 2 | Page Approved by Clackmannanshire & Stirling Integration Joint Board 24 February 2016 5.3 Long Term Health Conditions ..................................................................................................... 43 5.3.1 Dementia.....................................................................................................................................45 5.3.2 Cancer .........................................................................................................................................47 5.4 Projected Long Term Health Conditions..................................................................................... 48 5.5 Multi‐Morbidity...........................................................................................................................50 5.6 High Resource Individuals........................................................................................................... 54 5.7 Disability......................................................................................................................................55 5.7.1 Learning Disability.......................................................................................................................55 5.7.2 Physical Disability........................................................................................................................58 5.8 Mental Health and Wellbeing..................................................................................................... 60 5.9 Premature Mortality ................................................................................................................... 65 5.10 Cause of Death............................................................................................................................67 5.11 Population Health Considerations/Implications......................................................................... 68 6 Current Provision of Health and Social Care Services.............................................................................. 69 6.1 Workforce ...................................................................................................................................69 6.2 General Practice Services............................................................................................................ 70 6.3 Unscheduled Care ....................................................................................................................... 72 6.3.1 Accident &Emergency Attendances............................................................................................ 72 6.3.2 Emergency Admission to Hospital .............................................................................................. 74 6.4 Delayed Discharges from Hospital .............................................................................................. 81 6.5 Community Care Assessments.................................................................................................... 84 6.6 Care at Home ..............................................................................................................................85 6.7 Self‐Directed Support.................................................................................................................. 90 6.8 Day Care......................................................................................................................................91 6.9 Telecare.......................................................................................................................................93 6.10 Care Homes.................................................................................................................................93 6.11 Equipment...................................................................................................................................96 6.12 Specialist Accommodation.......................................................................................................... 96 6.13 Experience of Care Recipients..................................................................................................... 97 6.14 End of Life Care ........................................................................................................................... 98 6.15 Respite Care ..............................................................................................................................100 3 | Page Approved by Clackmannanshire & Stirling Integration Joint Board 24 February 2016 6.16 Substance Misuse Support Services.......................................................................................... 102 6.17 Provision of Health & Social Care Services Considerations/Implications .................................103 7. Carers ....................................................................................................................................................103 7. 1 Characteristics of Unpaid Carers............................................................................................... 103 7.2 Experience of Carers ................................................................................................................. 106 7.3 Carers Considerations/Implications.........................................................................................