version 1.0 health intelligence unit, nhs dumfries …...version 1.0 published february 2016 health...

Version 1.0

Published February 2016

Health Intelligence Unit, NHS Dumfries & Galloway

For more information please visit www.dg-change.org.uk

http://www.dg-change.org.uk

Executive Summary

The Strategic Needs Assessment for Adult Health and Social Care Integration is a collection

of evidence from a wide range of sources which has been pulled together to help inform the

Dumfries & Galloway Partnership Strategic Plan. The evidence includes both numbers and

statistics, and also explanations and quotes from people who have been consulted about

aspects of health and social care.

This needs assessment reflects the context in which the integration of health and social care

needs to operate. It includes information about different groups of people, some of the chal-

lenges and information around some of the services currently being provided. It is intended

that people working towards integration will be able to use this evidence as a reference

when it comes setting the scene for making decisions. The needs assessment answers

questions like ‘How many people would that affect?’ and ‘Is that becoming more or less of

an issue?’ as well as ‘Do we know enough about this topic?’. The needs assessment does

not offer suggestions or ‘fixes’ for the issues, nor does it discuss organisational and financial

arrangements and how these might be affected by integration.

The health and social care system is immensely complex and it is very difficult to cover

every aspect of every service; instead we have brought together a broad but shallow skim

across a wide range of topics. The evidence was pulled together over the spring and sum-

mer of 2015 and is a snapshot in time which mostly references information published in

2014. Many regular reports continue to be published by the government and other public

bodies over the time of producing the needs assessment and it is anticipated that updates

and amendments will be needed in the future.

This needs assessment has been produced as part of a suite of annexes that support the

Strategic Plan, and therefore does not cover information that might be reasonably expected

to be covered by another annexe, e.g. finance or performance management. There is also

a wider family of documents that have recently been produce to inform planning, such as

the Local Area Profiles (see www.crichtonobservatory.org.uk/) and the Poverty Strategy

(see http://www.dumgal.gov.uk/CHttpHandler.ashx?id=16608&p=0)

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http://www.crichtonobservatory.org.uk/

http://www.dumgal.gov.uk/CHttpHandler.ashx?id=16608&p=0

The needs assessment covers evidence around the following areas:

When drawing all the data together, certain themes began to emerge that many topics had

in common. We have brought these themes together to provide the context within which

services are being planned for the future. In the following sections the themes are de-

scribed and a small selection from the evidence has been provided from the joint strategic

needs assessment:

Figure 1: Emerging Themes from the Dumfries & Galloway Health and Social Care

Joint Strategic Needs Assessment, August 2015

Geography and population ‘At risk’ populations

The influence of rurality Primary (community) health care

How the population changes Secondary (hospital) health care

Inequalities Social work services

Housing Physical & sensory disability

Unpaid Carers Mental health & wellbeing

Long-term conditions & multi-ple complex needs

Health behaviours

4

Isolation

The geography of Dumfries & Galloway can be physically isolating for people living in more

rural areas, particularly when driving becomes a problem and public transport is poor. It

also means that planners have to be creative to be able to deliver services evenly across

the region.

Just as important is the idea of social isolation. When people don’t have a strong support

network of friends and family, or find their community unsupportive or even just find that

they don’t have enough time to themselves, like many unpaid Carers, then their health and

wellbeing can suffer. Small communities can be very supportive but are not always equally

welcoming to everyone.

Here are a couple of examples that illustrate why isolation was chosen as theme:

The number of older adults (aged 75 or older)

living alone are likely to nearly double (from

6,400 to 11,700) by 2037

NRS Households projections, 2012 based

According to the Census 2011 there

were nearly 15,000 unpaid Carers in

our region, and 29% (4,300) of these

were providing more than 50 hours

of care per week

Census 2011, table LC3301SC

“Most of the things [for people with dementia] are in

Dumfries. We could get the taxi into the village and there

is a stagecoach every three hours; the Glasgow bus. There

are three steps and you have to go backwards. The local

buses you can walk on but there is no local bus, and here

you have a bus that is free and you have these three steps.

There is no bus service round here; our nearest bus stop is

about three miles away. I've always got to get a taxi. When

my husband was in the hospital it cost me £10 every day

just to get to the hospital bus.”

(PYF Case Study, Over 65,

Annandale & Eskdale, 29 August 2013)

“Since losing my husband

after 40 years of marriage, I

feel isolated, confused and

worthless. GP's have lost

their connection with the fam-

ily. I was disgusted with the

service provided by my late

husband's GP both while he

was unwell and also towards

me on the day he died.”

Community Survey 2011, F, 51

-60, Wigtownshire

Nearly every new resident that now arrives in my care

home suffers from some degree of social isolation.

The rise of dementia sufferers combined with the fact

that people are staying at home longer means that

having 1 or 2 short visits each day from care at home

is not sufficient to alleviate loneliness in many cases.”

Care Home Manager, 2014

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Increasing Complexity

People are living longer on average than in the past. This is good news that people are now

surviving much longer with illnesses or conditions that were fatal in the past. But this does

mean that there are rising numbers of people who are living with multiple illnesses, on lots

of different drugs and with more complicated needs.

Society has also become more complex. Many people now live further away from their

families, and there are lots of different combinations of what we understand by the word

‘family’. The region is becoming more diverse which means that supporting people in the

right way for them is becoming more complicated.

There are also increasing numbers of different options for supporting people, shared be-

tween friends and family, public sector, charities, community volunteers, private businesses

and others. This is great news for people having lots of options but it does make under-

standing where to get what you need much harder.

Here are a couple of examples of what we mean:

There are around 12,500 people who are

living with 2 or more chronic illnesses, and

there are around 300 more people every

year.

Scottish Patients at Risk of Re-admission SPARRA

database, April 2015

The Scottish Public Health

Observatory estimates that for

Scotland in 2013 the difference

between life expectancy and healthy

life expectancy (in other words the

period of time in relative ill-health

before death) for women was

estimated to be 19.3 years of ill-

health, and for men to be 16.3 years

of ill-health.

ScotPHO Healthy Life Expectancy 2013

“I am at my wits’ end struggling to get the

support that [I] need and deserve. It was

difficult to find out where and who to go to.

Everything that was needed was in all

different departments. Support should be

[accessible] in one place instead of going

from pillar to post.”

Nithsdale Community Consultation on Health and

Social Care

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Resilient People

It is important for everyone to be healthy and living life on their own terms for as long as

possible. That is why two of the national health and wellbeing outcomes are:

People are able to look after and improve their own health and live in good health

for longer; and

Health and social care services are centred on helping to maintain or improve the

quality of life of services users.

In practice, this means focussing on things like: anticipatory care and prevention, tackling

health behaviours like smoking, poor diet and lack of exercise, re-ablement after events to

support people to return to previous independence, housing/adaptations that support

staying in your own home, making it attractive to volunteer and strengthening communities.

There is work focussing on all these areas and more, across the organisations supporting

the integration of health and social care.

Here is one example of an intervention that aims to improve people’s health by improving

their resilience (amongst other things):

The Keep Well project is an inequalities targeted intervention centred around the primary

prevention of cardiovascular disease; the team deliver health checks that take a whole

lifestyle approach lasting around an hour and follow-up one-to-one health coaching support

to people from deprived circumstances and specific vulnerable populations (such as the

“First I was diagnosed with dilated cardiomyopathy [heart failure] and then COPD, and

then I had diabetes. I’ve had osteoarthritis for years. The medications for heart failure

meant and I kept taking chest infections and every month I was at the hospital with

another chest infection. I’ve been on steroids for the past 8 years continually; its 15

mgs every day and then if doesn’t take effect it’s got to go up to 45 or 50. It’s very

difficult to lose weight on steroids, but I try. Then my knee cracked so now I need a

new knee. I don’t have any soft tissue in my knee, its bone rubbing against bone. I use

two sticks, I can’t walk outside I have to go on the scooter; I couldn’t even walk into a

wee shop. I am on a nebuliser five to six times a day plus I take medication and

inhalers, so that doesn’t help my breathing, my heart failure doesn’t help my breathing,

I am on high doses of morphine which doesn’t help my breathing plus I have problems

with knees and feet and now my legs play up. I get terrible, terrible pain not just in the

joints but in the muscles so they are trying to work out. It may well just be the steroids.

I’ve lost the muscle tone since being on steroids. So it’s not just the illness it’s the side

effects”.

PYF Case Study, Dumfries, interview, 8 September 2014

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homeless and unpaid Carers amongst others). The figure below illustrates the before and

after wellbeing levels of a group of people who had health coaching support; showing a

statistically significant improvement using 4 different measures.

Having established good wellbeing, these people are more likely to go on to make healthier

lifestyle choices to improve their health and cope better in the face of adverse

circumstances. Here are other examples where getting the right support can make a huge

difference to how people cope with challenges:

Figure 2: Proportion of clients who indicate poor mental health & wellbeing at

baseline and at follow up (95% confidence intervals)

Source: Keep Well Database, NHS D&G

“I lost 2 stone and got the

confidence to get a new job.”

Keep Well Health

Coaching Client

“I am hopeful because I am now volunteering at

AD action and I can share my experiences with

others. I am also hopeful for a brighter future,

that I will not still need help when I am older. For

once in my life I feel I am getting things sorted

and I can see an end in sight. Before I felt

anxious, vulnerable, powerless and stupid but

now I have got all these feelings under control. I

have used other services before and spoken to a

lot of people but the OT service has been the

best so far as I felt supported and listened to.”

Occupational Therapy patient, March 2013,

NHS Dumfries & Galloway

I was living a totally isolated existence

until I joined the Time Bank and shared

my skills in IT. The quality of my life has

improved tremendously and I feel I have

purpose again. If I can help others

achieve the same, then I believe I am

doing a good job.”

Volunteer, Stewartry, Third Sector First Dumfries

& Galloway,

Stakeholder Report January 2015

8

Resilient Organisations

The perfect model of health and social care integration is to provide safe, high quality

support to people within the limits of the funds and people available to provide that support.

However, there are strong pressures that have been highlighted in the needs assessment

that are felt by all the organisations supporting health and social care.

The workforce is getting older, and there are more people than ever looking for support.

There are difficulties attracting the right people into jobs, and short term fixes are extremely

expensive. Many people in the health and social care workforce are retiring soon and there

are a lot of pressures on existing staff who need to be fit and healthy to do their jobs.

Here are just a few examples:

Reporting from the Dumfries &

Galloway NHS Board Report on

Revenue and Capital Financial

Performance: 3 Months to 30 June

2015 indicated that one of the key

financial risks identified was the

continued high costs associated

with medical locums and cover of

medical staffing rotas (£2.9m year to

date).

Available from www.nhsdg.scot.nhs.uk/

About us/Boards & Committees

NHS Vacancies at Sept 2014: 20 consultant

doctor posts (8.2% of workforce), 66.5 nursing

and midwifery posts (3.9%) and 11.7 allied

health profession posts (4.5%)

Scottish Workforce Information Standard System

(SWISS)

Only 61% of NHS and Council staff are meeting

basic physical activity guidelines

Physical Activity and Wellbeing Staff Survey 2014, DG

Health & Wellbeing

On the challenge of recruiting support workers:

“What about when the country is back up and running and shops can pay

£7.50 hourly rate of pay. Do you work 9-5, go home, put your feet up? Or do

you want to work for less money and you might get a phone call saying “can

you quickly nip to the pharmacy, this person’s meds need changed. Someone

is not well can you stay there until the GP comes?”

Interview with Private Care Company, 18 September 2013

9

http://www.nhsdg.scot.nhs.uk/

The Right Support, in the Right Place, at the Right Time

Going hand in hand with services becoming more complex, there is evidence to show that it

is a big challenge to get the balance right across the various services, or in other words to

ensure that people have the right support, in the right place, at the right time.

The balance across services might refer to what happens in acute hospital against what

happens in a community hospital or GP clinic, the balance of how support is shared across

all the partners involved in integration or even the balance between short term emergency

fixes against longer term preventative planning for people.

There are some markers that the ambition of right support, right place, right time are not

being fully met, one of which is the number of emergency hospital admissions, which are

less desirable than planned admissions and another is the number of delayed discharges.

This is the situation now in Dumfries & Galloway:

Emergency admissions have gone up

18% over the last four years for

residents aged 85 or older, from 1,600

in 2009/10 to 1,900 in 2013/14

Source: SMR01, ISD Scotland

The number of bed days lost due to

delayed discharges across all our

hospitals have increased from 3,000 in

2011-12 to 12,800 in 2014-15

Local delayed discharge data, NHS Dumfries &

Galloway

“Sometimes I need to see the GP but can’t get an

appointment; they say I should phone at 8am, but I

need someone to help me phone, and my support

workers are not here at that time in the morning.”

Nithsdale Community Consultation on Health and Social

Care

“The Community Hospital at Stranraer is virtually closed down at the weekend, most

patients are sent to Dumfries which I would say is ridiculous, the staff and nurses and

consultants in the actual hospital are very good. Outpatient department are a joke, you

can go up there and sit there for as long and at times there are a group of doctors and

sometimes nurses all sitting and drinking tea. As for NHS 24 they are an absolute joke!

Before my late wife died I was on the phone for a good two hours just trying to get a

doctor, my wife was in a lot of pain due to cancer, the doctor had to come from near

Glasgow, a damn disgrace, you can’t beat the local service and doctors.”

PYF Public Survey, Over 65, Wigtownshire, July 2014

10

1 “What do we know now that we didn’t know a year ago?” © National End of Life Care Intelligence Network 2012 available from: www.endoflifecare-intelligence.org.uk/view.aspx?rid=464

Person centred

The White Paper, Equity and Excellence: Liberating the NHS (England, 2010) coined the

phrase “no decision about me, without me”. The organisations that support health and

social care integration are much wider than the NHS, but the idea that all services should be

person-centred is a shared core value across them all.

People tell us that one of the most important things to support people is to really listen to

them. Having choices over how their support is delivered is really valued by people.

“It doesn’t matter to me if the counsellor was a man or a woman. What’s

important is that I could make a proper connection with them, and that we

could relate to each other. But it is important that they are non-judgmental.”

ADS counsellor feedback (Male client)

Here is another example: It is thought that most people approaching the end of their life

would prefer to die at home or in a hospice setting. Dying in hospital is the least desirable

option, according to the National End of Life Care Intelligence Network in England1; and this

might be similar to what people in Dumfries & Galloway might also feel:

“Dumfries & Galloway has an ageing population which will include older LGBT

people. Many older LGBT people however are not out and are scared to be ‘found

out’ due to their history of living under legislative and societal homophobia. They are

often isolated from family, or haven’t had children, so unless they have a surviving

partner, they are likely to be ageing alone. Our respondents felt that LGBT services

were often more focussed on the needs of younger people, and that care homes and

older people’s services are often not even aware of the existence of LGBT older

adults, far less their needs, and as such they are completely invisible and their needs

are overlooked. They also described a fear of prejudice or harassment at the hands

of staff or other residents / service users within older people’s services.”

‘The Needs of People Affected by LGBT Issues in Dumfries & Galloway’, 2014

11

The preferred place of death of people with Electronic Palliative Care Coordination System (EPaCCS) record: (2011)

Where Dumfries & Galloway residents actually died 2010-2012 (NRS deaths registrations and Carlisle records):

Home 47% Hospice 33% Home 25% Hospice setting 9% (DGRI Alex Unit)

Care home 29% Hospital 1% Care home 17% Hospital 49% (DGRI 28%) (Other 21%)

Inequalities

The term inequalities is used to refer to both the personal characters protected by law, such

as age and ethnicity, as well as other aspects that make people more vulnerable to ill

health, such as poverty or the demands of being an unpaid Carer.

There are many cases where it can be seen that social inequalities are linked to health

inequalities or worse outcomes for people. In the most general terms, people at the bottom

have worse outcomes across most things that are measured. For instance, those living in

the most deprived 20% of neighbourhoods are more than twice as likely to be admitted as

an emergency compared to those living in the least deprived areas. For admissions in

2011/12 to 2013/14 the admission rate in SIMD12 quintile 1 was 16,063 per 100,000

population and 6,948 per 100,000 population in SIMD12 quintile 5.

Another example is the large differences in life expectancy at birth across the region at

intermediate geography zone (2009-13), with 10.7 years between the best life expectancy

for men in Annan South (80.4 years) and the worst life expectancy for men in Stranraer

Central (69.7). Female life expectancy has an even greater range of 12.1 years between

best life expectancy in Georgetown (89.8) and worst life expectancy in Dumfries West

(77.7).

People also tell us that when your face doesn’t fit, for whatever reason, small communities

can be very isolating.

“Scared to come out as LGBT in case there's homophobic people

out there living close by, and its small town.”

Community Survey 2014, Male, LGBT, Wigtownshire

To give an idea of the scale of inequalities across the region:

There were 13,000 benefits

claimants across the

region in May 2014

DWP

6,200 young women 16-34

have low level or no

qualifications

Census 2011, table KS613SC 1,500 residents speak

English not well/not at all

Census 2011, table QS213SC

12

If Dumfries & Galloway is comparable to the national research done by the British Legion,

an estimated 2,300 veterans out of an estimated 11,300 in our region may be suffering with

psychological health problems.

The needs assessment does not have information about absolutely everything, and a range

of gaps in local knowledge have been identified over the course of putting it together. Some

of the areas where not enough information was available at the time of production include:

the challenges faced by the third sector work force, housing needs for vulnerable people,

needs of gypsy traveller and black & minority ethnic communities, physical health of mental

health patients, social capital and community resilience, the impact of obesity and several

others. There is work planned or in progress for many of these areas, but that may not be

available to support planning at this time.

The following pages contain a population profile for each locality with some of most useful

statistics gathered together. For further explanation and analysis of these stats, please see

the main body of the Strategic Needs Assessment.

“'It’s big. Our research tells us that up to 20 per cent of veterans suffer from

psychological health problems. That’s over half a million people from an

estimated three million veterans according to the British Legion. A worryingly

large number, given that service personnel start out as fit, healthy and selected

through rigorous training. Veterans are also strongly represented in the

criminal justice system and in the homeless population”.

Interview featured in The Psychologist vol 28, no.5, with incoming Society President of the

British Psychological Society, Military and Veteran Specialist, May 2015

13

Health & Social Care Locality Profile

Annandale & Eskdale Nithsdale Stewartry Wigtownshire Dumfries & Galloway Scotland

# (%) # (%) # (%) # (%) # (%) # (%)

All 38,305 59,217 23,973 28,775 150,270 5,327,700

0-14 5,670 (14.8%) 9,182 (15.5%) 3,336 (13.9%) 4,282 (14.9%) 24,470 (15.0%) 852,005 (16.0%)

15-64 23,508 (61.4%) 37,703 (63.7%) 14,195 (59.2%) 17,364 (60.3%) 92,770 (61.7%) 3,528,833 (66.2%)

65-84 8,109 (21.2%) 10,906 (18.4%) 5,616 (23.4%) 6,395 (22.2%) 31,026 (20.6%) 836,135 (15.7%)

85 & over 1,018 (2.7%) 1,426 (2.4%) 826 (3.4%) 734 (2.6%) 4,004 (2.7%) 110,727 (2.1%)

Average Age at Census 2011 43.8 years 42.2 years 46.2 years 44.1 years 43.6 years 40.3 years

Males 18,748 (48.9%) 28,671 (48.4%) 11,561 (48.2%) 13,994 (48.6%) 72,974 (48.6%) 2,586,532 (48.5%)

Females 19,557 (51.1%) 30,546 (51.6%) 12,412 (51.8%) 14,781 (51.4%) 77,296 (51.4%) 2,741,168 (51.5%)

Age Group 15-64 65+ 15-64 65+ 15-64 65+

15-64 65+ 15-64 65+

D&G %age Change

15-64 65+

Census Actual: 2001 23,563 7,064 36,794 10,104 14,610 5,423 18,476 5,740 93,443 28,331

Census Actual: 2011 24,047 8,522 38,410 11,642 14,455 6148 18,054 6,738 94,966 33,050

NRS Projection 2012: 2017 e22,950 e9,400 e36,650 e12,800 e13,800 e6,750 e17,200 e7,400 89,282 37,826 -4.6% 10.2%

2022 e21,950 e10,100 e35,050 e13,800 e13,200 e7,350 e16,500 e7,950 85,446 40,717 -8.7% 18.6%

2027 e20,800 e10,900 e33,250 e14,900 e12,500 e7,950 e15,650 e8,550 81,017 43,878 -13.4% 27.8%

2032 e19,500 e11,700 e31,150 e15,950 e11,700 e8,550 e14,650 e9,200 75,895 47,065 -18.9% 37.1%

2037 e18,650 e11,950 e29,800 e16,350 e11,200 e8,750 e14,000 e9,400 72,606 48,216 -22.4% 40.4%

Age Group <75 75+ <75 75+ <75 75+

<75 75+ <75 75+

D&G %age Change

<75 75+

Census Actual: 2011 3,525 1,475 6,475 2,475 2,425 1,200 3,275 1,250 15,705 6,419

NRS Projection 2012: 2017 e3,675 e1,650 e6,750 e2,775 e2,500 e1,325 e3,425 e1,400 16,606 7,522 4.0% 11.3%

2022 e3,675 e1,900 e6,775 e3,200 e2,525 e1,550 e3,425 e1,625 16,673 8,683 4.4% 28.5%

2027 e3,625 e2,150 e6,675 e3,625 e2,500 e1,750 e3,400 e1,825 16,475 9,857 3.2% 45.9%

2032 e3,575 e2,375 e6,575 e3,975 e2,450 e1,925 e3,325 e2,000 16,218 10,817 1.6% 60.1%

2037 e3,500 e2,575 e6,450 e4,300 e2,400 e2,075 e3,275 e2,175 15,891 11,714 -0.5% 73.4%

Years IZ Years IZ Years IZ Years IZ Years IZ D&G Average

Please Note: Gretna and Canonbie are omitted due to errors caused by

deaths registered in England not being included.

Males, Highest IZ, 80.4 Annan South 80.2 George-town 78.9 Castle

Douglas 78.3

Machars South

80.4 Annan South Males 77.5

Males, Lowest IZ, (diff) in years

75.7 Annan North 73 Lincluden &

Lochside 77.5 Dalbeattie 69.7

Stranraer Central

69.7 Stranraer

Central

Males, Difference (years) 4.7 7.2 1.4 8.6 10.7

Females, Highest IZ 84.1 Lochmaben &

Parkgate 89.8 George-town 86.4

Crocketford & Carsphairn

82.5 Stranraer

West 89.8 George-town Females 81.9

Females, Lowest IZ, (diff) in years

80.8 Lockerbie & Annandale

77.7 Dumfries

West 81.7 Fleet 78.5

Stranraer Central

77.7 Dumfries

West

Females, Differnce (years) 3.3 12.1 4.7 4 12.1

Age Group All Ages Age 75+ All Ages Age 75+ All Ages Age 75+ All Ages Age 75+ All Ages Age 75+ All Ages Age 75+

Urban areas 0 0 32,841 2,904 0 0 10,593 1,020 43,434 3,924 1,861,851 139,991

Small towns 16,394 1,747 6,031 544 11,753 1,537 4,092 457 38,270 4,285 675,274 57,822

Accessible rural 16,466 1,224 13,233 1,585 3,161 264 6,960 615 39,820 3,688 615,313 45,678

Remote rural 5,831 557 7,290 630 8,995 1,161 7,684 808 29,800 3,156 319,776 29,854

Provide 50+ hours care; 1+

Limiting long term illness 50+ Hrs 1+ LLTI 50+ Hrs 1+ LLTI 50+ Hrs 1+ LLTI 50+ Hrs 1+ LLTI 50+ Hrs 1+ LLTI 50+ Hrs 1+ LLTI

Urban areas 0 0 850 10,112 0 0 368 3,505 1,218 13,617 50,074 569,197

Small towns 457 5,308 166 1,719 317 4,004 123 1,411 1,063 12,442 16,810 206,295

Accessible rural 474 5,012 371 4,135 83 935 218 2,380 1,146 12,462 14,292 177,911

Remote rural 169 1,803 241 2,463 241 3,014 258 2,743 909 10,023 7,881 98,452

Annual

Average

Rate per 1,000

women

aged 16-44

Annual

Average

Rate per 1,000

women

aged 16-44

Annual

Average

Rate per 1,000

women

aged 16-44

Annual

Average

Rate per 1,000

women

aged 16-44

Annual

Average

Rate per 1,000

women

aged 16-44

Annual

Average

Rate per 1,000

women aged 16-45

Annual Average (2010-2012) 338 56.1 596 57.7 186 54.7 291 64.1 1,410 58.1 58,469 56.8

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# (%) # (%) # (%) # (%) # (%) # (%)

All 38,305 59,217 23,973 28,775 150,270 5,327,700

0-14 5,670 (14.8%) 9,182 (15.5%) 3,336 (13.9%) 4,282 (14.9%) 24,470 (15.0%) 852,005 (16.0%)

15-64 23,508 (61.4%) 37,703 (63.7%) 14,195 (59.2%) 17,364 (60.3%) 92,770 (61.7%) 3,528,833 (66.2%)

65-84 8,109 (21.2%) 10,906 (18.4%) 5,616 (23.4%) 6,395 (22.2%) 31,026 (20.6%) 836,135 (15.7%)

85 & over 1,018 (2.7%) 1,426 (2.4%) 826 (3.4%) 734 (2.6%) 4,004 (2.7%) 110,727 (2.1%)

Average Age at Census 2011 43.8 years 42.2 years 46.2 years 44.1 years 43.6 years 40.3 years

Males 18,748 (48.9%) 28,671 (48.4%) 11,561 (48.2%) 13,994 (48.6%) 72,974 (48.6%) 2,586,532 (48.5%)

Females 19,557 (51.1%) 30,546 (51.6%) 12,412 (51.8%) 14,781 (51.4%) 77,296 (51.4%) 2,741,168 (51.5%)

Age Group 15-64 65+ 15-64 65+ 15-64 65+

15-64 65+ 15-64 65+

D&G %age Change

15-64 65+

Census Actual: 2001 23,563 7,064 36,794 10,104 14,610 5,423 18,476 5,740 93,443 28,331

Census Actual: 2011 24,047 8,522 38,410 11,642 14,455 6148 18,054 6,738 94,966 33,050

NRS Projection 2012: 2017 e22,950 e9,400 e36,650 e12,800 e13,800 e6,750 e17,200 e7,400 89,282 37,826 -4.6% 10.2%

2022 e21,950 e10,100 e35,050 e13,800 e13,200 e7,350 e16,500 e7,950 85,446 40,717 -8.7% 18.6%

2027 e20,800 e10,900 e33,250 e14,900 e12,500 e7,950 e15,650 e8,550 81,017 43,878 -13.4% 27.8%

2032 e19,500 e11,700 e31,150 e15,950 e11,700 e8,550 e14,650 e9,200 75,895 47,065 -18.9% 37.1%

2037 e18,650 e11,950 e29,800 e16,350 e11,200 e8,750 e14,000 e9,400 72,606 48,216 -22.4% 40.4%

Age Group <75 75+ <75 75+ <75 75+

<75 75+ <75 75+

D&G %age Change

<75 75+

Census Actual: 2011 3,525 1,475 6,475 2,475 2,425 1,200 3,275 1,250 15,705 6,419

NRS Projection 2012: 2017 e3,675 e1,650 e6,750 e2,775 e2,500 e1,325 e3,425 e1,400 16,606 7,522 4.0% 11.3%

2022 e3,675 e1,900 e6,775 e3,200 e2,525 e1,550 e3,425 e1,625 16,673 8,683 4.4% 28.5%

2027 e3,625 e2,150 e6,675 e3,625 e2,500 e1,750 e3,400 e1,825 16,475 9,857 3.2% 45.9%

2032 e3,575 e2,375 e6,575 e3,975 e2,450 e1,925 e3,325 e2,000 16,218 10,817 1.6% 60.1%

2037 e3,500 e2,575 e6,450 e4,300 e2,400 e2,075 e3,275 e2,175 15,891 11,714 -0.5% 73.4%

Years IZ Years IZ Years IZ Years IZ Years IZ D&G Average

Please Note: Gretna and Canonbie are omitted due to errors caused by

deaths registered in England not being included.

Males, Highest IZ, 80.4 Annan South 80.2 George-town 78.9 Castle

Douglas 78.3

Machars South

80.4 Annan South Males 77.5

Males, Lowest IZ, (diff) in years

75.7 Annan North 73 Lincluden &

Lochside 77.5 Dalbeattie 69.7

Stranraer Central

69.7 Stranraer

Central

Males, Difference (years) 4.7 7.2 1.4 8.6 10.7

Females, Highest IZ 84.1 Lochmaben &

Parkgate 89.8 George-town 86.4

Crocketford & Carsphairn

82.5 Stranraer

West 89.8 George-town Females 81.9

Females, Lowest IZ, (diff) in years

80.8 Lockerbie & Annandale

77.7 Dumfries

West 81.7 Fleet 78.5

Stranraer Central

77.7 Dumfries

West

Females, Differnce (years) 3.3 12.1 4.7 4 12.1

Age Group All Ages Age 75+ All Ages Age 75+ All Ages Age 75+ All Ages Age 75+ All Ages Age 75+ All Ages Age 75+

Urban areas 0 0 32,841 2,904 0 0 10,593 1,020 43,434 3,924 1,861,851 139,991

Small towns 16,394 1,747 6,031 544 11,753 1,537 4,092 457 38,270 4,285 675,274 57,822

Accessible rural 16,466 1,224 13,233 1,585 3,161 264 6,960 615 39,820 3,688 615,313 45,678

Remote rural 5,831 557 7,290 630 8,995 1,161 7,684 808 29,800 3,156 319,776 29,854

Provide 50+ hours care; 1+

Limiting long term illness 50+ Hrs 1+ LLTI 50+ Hrs 1+ LLTI 50+ Hrs 1+ LLTI 50+ Hrs 1+ LLTI 50+ Hrs 1+ LLTI 50+ Hrs 1+ LLTI

Urban areas 0 0 850 10,112 0 0 368 3,505 1,218 13,617 50,074 569,197

Small towns 457 5,308 166 1,719 317 4,004 123 1,411 1,063 12,442 16,810 206,295

Accessible rural 474 5,012 371 4,135 83 935 218 2,380 1,146 12,462 14,292 177,911

Remote rural 169 1,803 241 2,463 241 3,014 258 2,743 909 10,023 7,881 98,452

Annual

Average

Rate per 1,000

women

aged 16-44

Annual

Average

Rate per 1,000

women

aged 16-44

Annual

Average

Rate per 1,000

women

aged 16-44

Annual

Average

Rate per 1,000

women

aged 16-44

Annual

Average

Rate per 1,000

women

aged 16-44

Annual

Average

Rate per 1,000

women aged 16-45

Annual Average (2010-2012) 338 56.1 596 57.7 186 54.7 291 64.1 1,410 58.1 58,469 56.8

15

Health & Social Care Locality Profile Continued


Annual

Average (%)

Annual

Average (%)

Annual

Average (%)

Annual

Average (%)

Annual

Average (%)

Annual

Average (%)

All Causes 440 662 324 394 1,820 54,188

Cancer 139 (32%) 194 (29%) 100 (31%) 104 (26%) 538 (30%) 15,548 (29%)

Ischaemic Heart Disease 52 (12%) 91 (14%) 44 (14%) 62 (16%) 248 (14%) 7,772 (14%)

Respiratory Disease 57 (13%) 79 (12%) 38 (12%) 50 (13%) 225 (12%) 6,952 (13%)

Stroke 42 (10%) 63 (10%) 32 (10%) 37 (9%) 173 (10%) 4,611 (9%)

Senility & Dementia (only available locally)

30 (7%) 56 (8%) 27 (8%) 24 (6%) 137 (8%) n/a n/a

External Causes 21 (5%) 28 (4%) 10 (3%) 15 (4%) 75 (4%) 2,487 (5%)

Other Diseases 98 (22%) 151 (23%) 73 (22%) 102 (26%) 424 (23%) 16,529 (31%)

Annual

Average (%)

Annual

Average (%)

Annual

Average (%)

Annual

Average (%)

Annual

Average (%)

DGRI Acute 122 (28%) 239 (36%) 253 (26%) 181 (15%) 505 (28%)

DGRI Palliative Care Ward 34 (8%) 95 (14%) 91 (9%) 25 (2%) 168 (9%)

Galloway Community Hospital

0 (0%) 0 (0%) 0 (0%) 327 (28%) 109 (6%)

Cottage Hospitals 75 (17%) 46 (7%) 152 (16%) 113 (10%) 210 (12%)

Other Hospitals 24 (6%) 17 (3%) 21 (2%) 40 (3%) 61 (3%)

Residential Care 79 (18%) 112 (17%) 220 (23%) 160 (14%) 318 (17%)

Domiciliary 105 (24%) 154 (23%) 235 (24%) 337 (28%) 449 (25%)

Migration

# # # # #

Net migration: Inter-Census estimate; 10 yr avg

581 -45 151 96 783

All People SIMD Local

Quintile 1 All People

SIMD Local


SIMD Local


SIMD Local


SIMD Local


SIMD Local

Quintile 1

All People 38,305 5,844 (15%) 59,217 17,688 (30%) 23,973 636 (3%) 28,775 6185 (21%) 150,270 30,353 (20%) 5,327,700 1,024,841 (19%)

Income deprived 4,210 1,145 (27%) 7,270 4,035 (56%) 2,535 135 (5%) 4,500 1525 (34%) 18,515 6,840 (37%) 700,475 290,740 (42%)

Employment deprived 2,290 610 (27%) 4,185 2,195 (52%) 1,275 70 (5%) 2,230 795 (36%) 9,980 3,670 (37%) 423,245 171,255 (40%)

# (% h'holds) # (% h'holds) # (% h'holds) # (% h'holds) # (% h'holds) # (% h'holds)

All Households (Census 2011)

15,800 27,721 10,995 13,469 67,980 4,745,554

People aged 65+, alone 2,458 (16%) 4,091 (15%) 1,898 (17%) 2.252 (17%) 10,699 (16%) 623,734 (13%)

No central heating 304 (2%) 547 (2%) 297 (3%) 337 (3%) 1,485 (2%) 109,930 (2%)

No cars or vans 3,331 (21%) 6,517 (24%) 1,871 (17%) 3,170 (24%) 14,890 (22%) 1,448,288 (31%)

Lone parent with dependent children

867 (5%) 1,660 (6%) 528 (5%) 803 (6%) 3,858 (6%) 169,707 (4%)

Occupancy: 1 or more rooms fewer than basic standard

736 (5%) 1,551 (6%) 421 (4%) 715 (5%) 3,423 (5%) 214,345 (5%)

# (%) # (%) # (%) # (%) # (%) # (%)

Women aged 16-34 3,250 6,544 1,947 2,717 14,458 654,325

Women aged 16-34; No or Level 1 qualifications

1,505 (46%) 2,692 (41%) 704 (36%) 1,315 (48%) 6,216 (43%) 225,355 (34%)

Men aged 16-34 3,284 6,331 1,958 2,672 14,245 645,490

Men aged 16-34; No or Level 1 qualifications

1,814 (55%) 3,273 (52%) 973 (50%) 1,578 (59%) 7,638 (54%) 259,606 (40%)

Women aged 16-64 10,998 20,035 7,262 9,009 47,304 1,748,204

Men aged 16-64 10,559 19,000 6,828 8,635 45,022 1,680,857

Males in lowest Socio-economic class (DE) 16-64

3,055 (29%) 5,650 (30%) 1,778 (26%) 2,741 (32%) 13,225 (29%) 422,649 (25%)

DWP May 2014: Adults 16-64

22,950 37,068 13,898 17,062 90,978

All benefit claimants 2,895 (13%) 5,445 (15%) 1,710 (12%) 3,010 (18%) 13,060 (14%)

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16


Annual

Average (%)

Annual

Average (%)

Annual

Average (%)

Annual

Average (%)

Annual

Average (%)

Annual

Average (%)

All Causes 440 662 324 394 1,820 54,188

Cancer 139 (32%) 194 (29%) 100 (31%) 104 (26%) 538 (30%) 15,548 (29%)

Ischaemic Heart Disease 52 (12%) 91 (14%) 44 (14%) 62 (16%) 248 (14%) 7,772 (14%)

Respiratory Disease 57 (13%) 79 (12%) 38 (12%) 50 (13%) 225 (12%) 6,952 (13%)

Stroke 42 (10%) 63 (10%) 32 (10%) 37 (9%) 173 (10%) 4,611 (9%)

Senility & Dementia (only available locally)

30 (7%) 56 (8%) 27 (8%) 24 (6%) 137 (8%) n/a n/a

External Causes 21 (5%) 28 (4%) 10 (3%) 15 (4%) 75 (4%) 2,487 (5%)

Other Diseases 98 (22%) 151 (23%) 73 (22%) 102 (26%) 424 (23%) 16,529 (31%)

Annual

Average (%)

Annual

Average (%)

Annual

Average (%)

Annual

Average (%)

Annual

Average (%)

DGRI Acute 122 (28%) 239 (36%) 253 (26%) 181 (15%) 505 (28%)

DGRI Palliative Care Ward 34 (8%) 95 (14%) 91 (9%) 25 (2%) 168 (9%)

Galloway Community Hospital

0 (0%) 0 (0%) 0 (0%) 327 (28%) 109 (6%)

Cottage Hospitals 75 (17%) 46 (7%) 152 (16%) 113 (10%) 210 (12%)

Other Hospitals 24 (6%) 17 (3%) 21 (2%) 40 (3%) 61 (3%)

Residential Care 79 (18%) 112 (17%) 220 (23%) 160 (14%) 318 (17%)

Domiciliary 105 (24%) 154 (23%) 235 (24%) 337 (28%) 449 (25%)

Migration

# # # # #

Net migration: Inter-Census estimate; 10 yr avg

581 -45 151 96 783

All People SIMD Local


SIMD Local


SIMD Local


SIMD Local


SIMD Local


SIMD Local

Quintile 1

All People 38,305 5,844 (15%) 59,217 17,688 (30%) 23,973 636 (3%) 28,775 6185 (21%) 150,270 30,353 (20%) 5,327,700 1,024,841 (19%)

Income deprived 4,210 1,145 (27%) 7,270 4,035 (56%) 2,535 135 (5%) 4,500 1525 (34%) 18,515 6,840 (37%) 700,475 290,740 (42%)

Employment deprived 2,290 610 (27%) 4,185 2,195 (52%) 1,275 70 (5%) 2,230 795 (36%) 9,980 3,670 (37%) 423,245 171,255 (40%)

# (% h'holds) # (% h'holds) # (% h'holds) # (% h'holds) # (% h'holds) # (% h'holds)

All Households (Census 2011)

15,800 27,721 10,995 13,469 67,980 4,745,554

People aged 65+, alone 2,458 (16%) 4,091 (15%) 1,898 (17%) 2.252 (17%) 10,699 (16%) 623,734 (13%)

No central heating 304 (2%) 547 (2%) 297 (3%) 337 (3%) 1,485 (2%) 109,930 (2%)

No cars or vans 3,331 (21%) 6,517 (24%) 1,871 (17%) 3,170 (24%) 14,890 (22%) 1,448,288 (31%)

Lone parent with dependent children

867 (5%) 1,660 (6%) 528 (5%) 803 (6%) 3,858 (6%) 169,707 (4%)

Occupancy: 1 or more rooms fewer than basic standard

736 (5%) 1,551 (6%) 421 (4%) 715 (5%) 3,423 (5%) 214,345 (5%)

# (%) # (%) # (%) # (%) # (%) # (%)

Women aged 16-34 3,250 6,544 1,947 2,717 14,458 654,325

Women aged 16-34; No or Level 1 qualifications

1,505 (46%) 2,692 (41%) 704 (36%) 1,315 (48%) 6,216 (43%) 225,355 (34%)

Men aged 16-34 3,284 6,331 1,958 2,672 14,245 645,490

Men aged 16-34; No or Level 1 qualifications

1,814 (55%) 3,273 (52%) 973 (50%) 1,578 (59%) 7,638 (54%) 259,606 (40%)

Women aged 16-64 10,998 20,035 7,262 9,009 47,304 1,748,204

Men aged 16-64 10,559 19,000 6,828 8,635 45,022 1,680,857

Males in lowest Socio-economic class (DE) 16-64

3,055 (29%) 5,650 (30%) 1,778 (26%) 2,741 (32%) 13,225 (29%) 422,649 (25%)

DWP May 2014: Adults 16-64

22,950 37,068 13,898 17,062 90,978

All benefit claimants 2,895 (13%) 5,445 (15%) 1,710 (12%) 3,010 (18%) 13,060 (14%)

17



Clients in Residential

Care

Clients with

Home Care


Care

Clients with

Home Care


Care

Clients with

Home Care


Care

Clients with

Home Care


Care

Clients with

Home Care

Adults Older People 306 368 321 640 264 255 165 336 1,056 1,599

Adults Learning Disabilities ≤10 89 ≤10 153 18 63 ≤10 60 34 365

Adults Physical and Sensory Disability

≤10 44 ≤10 133 ≤10 45 ≤10 47 15 269

Adults Mental Health ≤10 18 ≤10 57 ≤10 ≤10 ≤10 ≤10 ≤10 89

# (%) # (%) # (%) # (%) # (%)

No. Referrals 189 253 72 195 709

No. Adults Referred 158 231 69 171 629

16-25 years 31 (16%) 30 (12%) 13 (18%) 25 (13%) 99 (14%)

26-64 years 100 (53%) 120 (47%) 36 (50%) 75 (38%) 331 (47%)

65+ years 58 (31%) 103 (41%) 23 (32%) 95 (49%) 279 (39%)

# (%) # (%) # (%) # (%) # (%) # (%)

All people, all ages 38,691 59,282 24,022 29,329 151,324 5,295,403

White: Scottish 29,506 (76.3%) 50,435 (85.1%) 17,998 (74.9%) 23,624 (80.5%) 121,563 (80.3%) 4,445,678 (84.0%)

White: Other British 7,969 (20.6%) 6,475 (10.9%) 5,259 (21.9%) 4,759 (16.2%) 24,462 (16.2%) 417,109 (7.9%)

White: Irish 198 (0.5%) 370 (0.6%) 189 (0.8%) 306 (1.0%) 1,063 (0.7%) 54,090 (1.0%)

White: Gypsy/Traveler 37 (0.1%) 33 (0.1%) 19 (0.1%) 13 (0.0%) 102 (0.1%) 4,212 (0.1%)

White: Polish 343 (0.9%) 315 (0.5%) 143 (0.6%) 182 (0.6%) 983 (0.6%) 61,201 (1.2%)

White: Other White 301 (0.8%) 609 (1.0%) 238 (1.0%) 232 (0.8%) 1,380 (0.9%) 102,117 (1.9%)

Mixed or multiple ethnic groups

83 (0.2%) 231 (0.4%) 58 (0.2%) 41 (0.1%) 413 (0.3%) 19,815 (0.4%)

Pakistani 41 (0.1%) 113 (0.2%) 8 (0.0%) 5 (0.0%) 167 (0.1%) 49,381 (0.9%)

Indian 54 (0.1%) 219 (0.4%) 12 (0.0%) 16 (0.1%) 301 (0.2%) 32,706 (0.6%)

Bangladeshi 12 (0.0%) 35 (0.1%) 7 (0.0%) 1 (0.0%) 55 (0.0%) 3,788 (0.1%)

Chinese 48 (0.1%) 160 (0.3%) 27 (0.1%) 44 (0.2%) 279 (0.2%) 33,706 (0.6%)

Other Asian 45 (0.1%) 122 (0.2%) 20 (0.1%) 43 (0.1%) 230 (0.2%) 21,097 (0.4%)

African 20 (0.1%) 72 (0.1%) 13 (0.1%) 22 (0.1%) 127 (0.1%) 29,638 (0.6%)

Caribbean or Black 16 (0.0%) 25 (0.0%) 7 (0.0%) 24 (0.1%) 72 (0.0%) 6,540 (0.1%)

Arab 7 (0.0%) 30 (0.1%) 14 (0.1%) 8 (0.0%) 59 (0.0%) 9,366 (0.2%)

Other ethnic group 11 (0.0%) 38 (0.1%) 10 (0.0%) 9 (0.0%) 68 (0.0%) 4,959 (0.1%)

All Black & Minority Ethnic Groups (incl. Gypsy/Traveller)

374 (1.0%) 1,078 (1.8%) 195 (0.8%) 226 (0.8%) 1,873 (1.2%) 215,208 (4.1%)

Proficiency in Spoken English (Census 2011)

# % people

aged 3+ #

% people

aged 3+ #

% people

aged 3+ #

% people

aged 3+ #

% people

aged 3+ # % people aged 3+

Not well/Not at all (People aged 3+)

336 1.00% 627 1.00% 209 0.90% 357 1.20% 1,529 1.00% 73,540 1.40%

# (%) # (%) # (%) # (%) # (%) # (%)

All People 38,742 60,582 24,022 29,329 151,324 5,295,403

All Carers 3,786 (10%) 5,770 (10%) 2,494 (10%) 3,058 (10%) 14,955 (10%) 492,231 (9%)

<25 years 224 (2%) 383 (2%) 143 (3%) 208 (3%) 948 (2%) 37,393 (2%)

25 to 64 years 2,652 (13%) 4,114 (13%) 1,629 (13%) 2,089 (14%) 10,369 (13%) 359,860 (13%)

65+ years 910 (11%) 1,273 (11%) 722 (12%) 761 (11%) 3,638 (11%) 94,978 (11%)

Provide 0 hours unpaid care per week

34,956 (90%) 54,812 (90%) 21,528 (90%) 26,271 (90%) 136,369 (90%) 4,803,172 (91%)

Provide 1 to 19 hours unpaid care per week

2,007 (5%) 3,095 (5%) 1,433 (6%) 1,494 (5%) 7,936 (5%) 273,333 (5%)


387 (1%) 532 (1%) 217 (1%) 325 (1%) 1,448 (1%) 46,315 (1%)


290 (1%) 487 (1%) 199 (1%) 272 (1%) 1,235 (1%) 40,501 (1%)

Provide 50 or more hours unpaid care per week

1,102 (3%) 1,656 (3%) 645 (3%) 967 (3%) 4,336 (3%) 132,082 (2%)

So

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(20

14

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Pro

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18



Care

Clients with

Home Care


Care

Clients with

Home Care


Care

Clients with

Home Care


Care

Clients with

Home Care


Care

Clients with

Home Care

Adults Older People 306 368 321 640 264 255 165 336 1,056 1,599

Adults Learning Disabilities ≤10 89 ≤10 153 18 63 ≤10 60 34 365

Adults Physical and Sensory Disability

≤10 44 ≤10 133 ≤10 45 ≤10 47 15 269

Adults Mental Health ≤10 18 ≤10 57 ≤10 ≤10 ≤10 ≤10 ≤10 89

# (%) # (%) # (%) # (%) # (%)

No. Referrals 189 253 72 195 709

No. Adults Referred 158 231 69 171 629

16-25 years 31 (16%) 30 (12%) 13 (18%) 25 (13%) 99 (14%)

26-64 years 100 (53%) 120 (47%) 36 (50%) 75 (38%) 331 (47%)

65+ years 58 (31%) 103 (41%) 23 (32%) 95 (49%) 279 (39%)

# (%) # (%) # (%) # (%) # (%) # (%)

All people, all ages 38,691 59,282 24,022 29,329 151,324 5,295,403

White: Scottish 29,506 (76.3%) 50,435 (85.1%) 17,998 (74.9%) 23,624 (80.5%) 121,563 (80.3%) 4,445,678 (84.0%)

White: Other British 7,969 (20.6%) 6,475 (10.9%) 5,259 (21.9%) 4,759 (16.2%) 24,462 (16.2%) 417,109 (7.9%)

White: Irish 198 (0.5%) 370 (0.6%) 189 (0.8%) 306 (1.0%) 1,063 (0.7%) 54,090 (1.0%)

White: Gypsy/Traveler 37 (0.1%) 33 (0.1%) 19 (0.1%) 13 (0.0%) 102 (0.1%) 4,212 (0.1%)

White: Polish 343 (0.9%) 315 (0.5%) 143 (0.6%) 182 (0.6%) 983 (0.6%) 61,201 (1.2%)

White: Other White 301 (0.8%) 609 (1.0%) 238 (1.0%) 232 (0.8%) 1,380 (0.9%) 102,117 (1.9%)

Mixed or multiple ethnic groups

83 (0.2%) 231 (0.4%) 58 (0.2%) 41 (0.1%) 413 (0.3%) 19,815 (0.4%)

Pakistani 41 (0.1%) 113 (0.2%) 8 (0.0%) 5 (0.0%) 167 (0.1%) 49,381 (0.9%)

Indian 54 (0.1%) 219 (0.4%) 12 (0.0%) 16 (0.1%) 301 (0.2%) 32,706 (0.6%)

Bangladeshi 12 (0.0%) 35 (0.1%) 7 (0.0%) 1 (0.0%) 55 (0.0%) 3,788 (0.1%)

Chinese 48 (0.1%) 160 (0.3%) 27 (0.1%) 44 (0.2%) 279 (0.2%) 33,706 (0.6%)

Other Asian 45 (0.1%) 122 (0.2%) 20 (0.1%) 43 (0.1%) 230 (0.2%) 21,097 (0.4%)

African 20 (0.1%) 72 (0.1%) 13 (0.1%) 22 (0.1%) 127 (0.1%) 29,638 (0.6%)

Caribbean or Black 16 (0.0%) 25 (0.0%) 7 (0.0%) 24 (0.1%) 72 (0.0%) 6,540 (0.1%)

Arab 7 (0.0%) 30 (0.1%) 14 (0.1%) 8 (0.0%) 59 (0.0%) 9,366 (0.2%)

Other ethnic group 11 (0.0%) 38 (0.1%) 10 (0.0%) 9 (0.0%) 68 (0.0%) 4,959 (0.1%)

All Black & Minority Ethnic Groups (incl. Gypsy/Traveller)

374 (1.0%) 1,078 (1.8%) 195 (0.8%) 226 (0.8%) 1,873 (1.2%) 215,208 (4.1%)

Proficiency in Spoken English (Census 2011)

# % people

aged 3+ #

% people

aged 3+ #

% people

aged 3+ #

% people

aged 3+ #

% people

aged 3+ # % people aged 3+

Not well/Not at all (People aged 3+)

336 1.00% 627 1.00% 209 0.90% 357 1.20% 1,529 1.00% 73,540 1.40%

# (%) # (%) # (%) # (%) # (%) # (%)

All People 38,742 60,582 24,022 29,329 151,324 5,295,403

All Carers 3,786 (10%) 5,770 (10%) 2,494 (10%) 3,058 (10%) 14,955 (10%) 492,231 (9%)

<25 years 224 (2%) 383 (2%) 143 (3%) 208 (3%) 948 (2%) 37,393 (2%)

25 to 64 years 2,652 (13%) 4,114 (13%) 1,629 (13%) 2,089 (14%) 10,369 (13%) 359,860 (13%)

65+ years 910 (11%) 1,273 (11%) 722 (12%) 761 (11%) 3,638 (11%) 94,978 (11%)

Provide 0 hours unpaid care per week

34,956 (90%) 54,812 (90%) 21,528 (90%) 26,271 (90%) 136,369 (90%) 4,803,172 (91%)


2,007 (5%) 3,095 (5%) 1,433 (6%) 1,494 (5%) 7,936 (5%) 273,333 (5%)


387 (1%) 532 (1%) 217 (1%) 325 (1%) 1,448 (1%) 46,315 (1%)


290 (1%) 487 (1%) 199 (1%) 272 (1%) 1,235 (1%) 40,501 (1%)

Provide 50 or more hours unpaid care per week

1,102 (3%) 1,656 (3%) 645 (3%) 967 (3%) 4,336 (3%) 132,082 (2%)

19



No.

Diagnosed

(% of list

size)

No.

Diagnosed

(% of list

size)

No.

Diagnosed

(% of list

size)

No.

Diagnosed

(% of list

size)

No.

Diagnosed

(% of list

size)

No.

Diagnosed (% of list size)

Please Note: People can have more than one

diagnosis and be counted more than once. These

figures cannot be summed to give the total people with

chronic illness.

Asthma 2,611 (6.2%) 3,747 (6.3%) 1,570 (6.7%) 1,969 (6.7%) 9,897 (6.4%) 331,129 (6.1%) Diabetes 2,382 (5.7%) 3,072 (5.2%) 1,248 (5.3%) 1,894 (6.5%) 8,596 (5.6%) 259,986 (4.8%) Coronary Heart Disease 2,232 (5.3%) 2,976 (5.0%) 1,264 (5.4%) 1,678 (5.7%) 8,150 (5.3%) 231,442 (4.3%) Hypothyroidism 1,658 (4.0%) 2,154 (3.6%) 1,005 (4.3%) 1,356 (4.6%) 6,173 (4.0%) 206,104 (3.8%) Chronic Kidney Disease 1,393 (3.3%) 1,817 (3.1%) 427 (1.8%) 1,304 (4.4%) 4,941 (3.2%) 231,442 (4.3%) Chronic Obstructive Pulmonary Disease 1,137 (2.7%) 1,726 (2.9%) 541 (2.3%) 882 (3.0%) 4,286 (2.8%) 175,185 (3.2%) Stroke & Transient Ischaemic Attack 1,077 (2.6%) 1,349 (2.3%) 577 (2.5%) 819 (2.8%) 3,822 (2.5%) 117,457 (2.2%) Atrial Fibrillation 846 (2.0%) 1,125 (1.9%) 543 (2.3%) 637 (2.2%) 3,151 (2.0%) 88,058 (1.6%) Dementia 359 (0.9%) 595 (1.0%) 274 (1.2%) 306 (1.0%) 1,534 (1.0%) 42,841 (0.8%) Mental Health 325 (0.8%) 580 (1.0%) 203 (0.9%) 213 (0.7%) 1,321 (0.9%) 47,757 (0.9%) Epilepsy 302 (0.7%) 437 (0.7%) 181 (0.8%) 234 (0.8%) 1,154 (0.7%) 40,887 (0.8%) Rheumatoid Arthritis 303 (0.7%) 360 (0.6%) 175 (0.7%) 188 (0.6%) 1,026 (0.7%) 31,782 (0.6%)

# (%) # (%) # (%) # (%) # (%)

Adults w. 2+ long term conditions 3,099 4,820 2,002 2,575 12,496

Aged 16 to 59 430 (14%) 816 (17%) 242 (12%) 389 (15%) 1,877 (15%)

Aged 60 to 64 227 (7%) 427 (9%) 144 (7%) 215 (8%) 1,013 (8%)

Aged 65 to 69 400 (13%) 574 (12%) 262 (13%) 367 (14%) 1,603 (13%)

Aged 70 to 74 467 (15%) 638 (13%) 275 (14%) 404 (16%) 1,784 (14%)

Aged 75 to 79 547 (18%) 820 (17%) 352 (18%) 481 (19%) 2,200 (18%)

Aged 80 to 84 523 (17%) 793 (16%) 356 (18%) 360 (14%) 2,032 (16%)

Aged 85 to 89 316 (10%) 482 (10%) 240 (12%) 240 (9%) 1,278 (10%)

Aged 90 to 94 150 (5%) 221 (5%) 112 (6%) 95 (4%) 578 (5%)

Aged 95+ 39 (1%) 49 (1%) 19 (1%) 24 (1%) 131 (1%)

# # # # #

Items dispensed: No of items 895,068 1,173,746 501,184 744,506 3,314,504

Items dispensed: Cost of items ('000s)

£7,533k £10,658k £4,241k £6,056k £28,488k

All people: Total number of people

41,999 59,406 23,506 29,379 154,290

All people: Average number of items

21 20 21 25 21

All people: Average Cost per annum

£179 £179 £180 £206 £185

People receiving medication: Total number of people

33,061 46,799 16,508 23,207 119,575

People receiving medication: Average number of items

27 25 30 32 28

People receiving medication: Average Cost per annum

£228 £228 £257 £261 £238

# (%) # (%) # (%) # (%) # (%) # (%)

All people 38,691 59,282 24,022 29,329 151,324 5,295,403

One or more condition/ disability (as below)

12,123 (31%) 18,394 (31%) 7,988 (33%) 10,039 (34%) 48,544 (32%) 1,584,727 (30%)

Deafness or partial hearing loss

3,176 (8%) 4,447 (8%) 2,110 (9%) 2,402 (8%) 12,135 (8%) 350,954 (7%)

Blindness or partial sight loss 1,002 (3%) 1,587 (3%) 717 (3%) 867 (3%) 4,173 (3%) 125,660 (2%)

Learning disability 143 (0%) 327 (1%) 108 (0%) 140 (0%) 718 (0%) 26,349 (0%)

Learning difficulty 560 (1%) 947 (2%) 398 (2%) 502 (2%) 2,407 (2%) 106,154 (2%)

Developmental disorder 230 (1%) 399 (1%) 151 (1%) 173 (1%) 953 (1%) 31,712 (1%)

Physical disability 2,879 (7%) 4,497 (8%) 1,859 (8%) 2,689 (9%) 11,924 (8%) 355,182 (7%)

Mental health condition 1,262 (3%) 2,250 (4%) 897 (4%) 1,209 (4%) 5,618 (4%) 232,943 (4%)

Other condition 7,539 (19%) 11,501 (19%) 4,891 (20%) 6,309 (22%) 30,240 (20%) 988,430 (19%)

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20


No.

Diagnosed

(% of list

size)

No.

Diagnosed

(% of list

size)

No.

Diagnosed

(% of list

size)

No.

Diagnosed

(% of list

size)

No.

Diagnosed

(% of list

size)

No.

Diagnosed (% of list size)

Please Note: People can have more than one

diagnosis and be counted more than once. These

figures cannot be summed to give the total people with

chronic illness.

Asthma 2,611 (6.2%) 3,747 (6.3%) 1,570 (6.7%) 1,969 (6.7%) 9,897 (6.4%) 331,129 (6.1%) Diabetes 2,382 (5.7%) 3,072 (5.2%) 1,248 (5.3%) 1,894 (6.5%) 8,596 (5.6%) 259,986 (4.8%) Coronary Heart Disease 2,232 (5.3%) 2,976 (5.0%) 1,264 (5.4%) 1,678 (5.7%) 8,150 (5.3%) 231,442 (4.3%) Hypothyroidism 1,658 (4.0%) 2,154 (3.6%) 1,005 (4.3%) 1,356 (4.6%) 6,173 (4.0%) 206,104 (3.8%) Chronic Kidney Disease 1,393 (3.3%) 1,817 (3.1%) 427 (1.8%) 1,304 (4.4%) 4,941 (3.2%) 231,442 (4.3%) Chronic Obstructive Pulmonary Disease 1,137 (2.7%) 1,726 (2.9%) 541 (2.3%) 882 (3.0%) 4,286 (2.8%) 175,185 (3.2%) Stroke & Transient Ischaemic Attack 1,077 (2.6%) 1,349 (2.3%) 577 (2.5%) 819 (2.8%) 3,822 (2.5%) 117,457 (2.2%) Atrial Fibrillation 846 (2.0%) 1,125 (1.9%) 543 (2.3%) 637 (2.2%) 3,151 (2.0%) 88,058 (1.6%) Dementia 359 (0.9%) 595 (1.0%) 274 (1.2%) 306 (1.0%) 1,534 (1.0%) 42,841 (0.8%) Mental Health 325 (0.8%) 580 (1.0%) 203 (0.9%) 213 (0.7%) 1,321 (0.9%) 47,757 (0.9%) Epilepsy 302 (0.7%) 437 (0.7%) 181 (0.8%) 234 (0.8%) 1,154 (0.7%) 40,887 (0.8%) Rheumatoid Arthritis 303 (0.7%) 360 (0.6%) 175 (0.7%) 188 (0.6%) 1,026 (0.7%) 31,782 (0.6%)

# (%) # (%) # (%) # (%) # (%)

Adults w. 2+ long term conditions 3,099 4,820 2,002 2,575 12,496

Aged 16 to 59 430 (14%) 816 (17%) 242 (12%) 389 (15%) 1,877 (15%)

Aged 60 to 64 227 (7%) 427 (9%) 144 (7%) 215 (8%) 1,013 (8%)

Aged 65 to 69 400 (13%) 574 (12%) 262 (13%) 367 (14%) 1,603 (13%)

Aged 70 to 74 467 (15%) 638 (13%) 275 (14%) 404 (16%) 1,784 (14%)

Aged 75 to 79 547 (18%) 820 (17%) 352 (18%) 481 (19%) 2,200 (18%)

Aged 80 to 84 523 (17%) 793 (16%) 356 (18%) 360 (14%) 2,032 (16%)

Aged 85 to 89 316 (10%) 482 (10%) 240 (12%) 240 (9%) 1,278 (10%)

Aged 90 to 94 150 (5%) 221 (5%) 112 (6%) 95 (4%) 578 (5%)

Aged 95+ 39 (1%) 49 (1%) 19 (1%) 24 (1%) 131 (1%)

# # # # #

Items dispensed: No of items 895,068 1,173,746 501,184 744,506 3,314,504

Items dispensed: Cost of items ('000s)

£7,533k £10,658k £4,241k £6,056k £28,488k

All people: Total number of people

41,999 59,406 23,506 29,379 154,290

All people: Average number of items

21 20 21 25 21

All people: Average Cost per annum

£179 £179 £180 £206 £185

People receiving medication: Total number of people

33,061 46,799 16,508 23,207 119,575

People receiving medication: Average number of items

27 25 30 32 28

People receiving medication: Average Cost per annum

£228 £228 £257 £261 £238

# (%) # (%) # (%) # (%) # (%) # (%)

All people 38,691 59,282 24,022 29,329 151,324 5,295,403

One or more condition/ disability (as below)

12,123 (31%) 18,394 (31%) 7,988 (33%) 10,039 (34%) 48,544 (32%) 1,584,727 (30%)

Deafness or partial hearing loss

3,176 (8%) 4,447 (8%) 2,110 (9%) 2,402 (8%) 12,135 (8%) 350,954 (7%)

Blindness or partial sight loss 1,002 (3%) 1,587 (3%) 717 (3%) 867 (3%) 4,173 (3%) 125,660 (2%)

Learning disability 143 (0%) 327 (1%) 108 (0%) 140 (0%) 718 (0%) 26,349 (0%)

Learning difficulty 560 (1%) 947 (2%) 398 (2%) 502 (2%) 2,407 (2%) 106,154 (2%)

Developmental disorder 230 (1%) 399 (1%) 151 (1%) 173 (1%) 953 (1%) 31,712 (1%)

Physical disability 2,879 (7%) 4,497 (8%) 1,859 (8%) 2,689 (9%) 11,924 (8%) 355,182 (7%)

Mental health condition 1,262 (3%) 2,250 (4%) 897 (4%) 1,209 (4%) 5,618 (4%) 232,943 (4%)

Other condition 7,539 (19%) 11,501 (19%) 4,891 (20%) 6,309 (22%) 30,240 (20%) 988,430 (19%)

21



# # # # #

Emergency dept attendances (DGRI & Galloway CH)

7,621 18,159 4,448 11,894 46,181

Outpatient attendances: New Returns New Returns New Returns New Returns New Returns

DGRI & Galloway Community Hospital 11,104 27,321 21,415 57,114 6,932 17,077 10,231 23,757 50,208 126,609

Cottage hospital and other community settings 3,590 20,026 2,893 21,761 2,143 12,133 2,219 10,556 11,015 65,379

Acute hospital admissions

(DGRI & Galloway CH): # # # # #

Elective inpatient 1,450 2,406 867 1,625 6,400

Emergency inpatient; 3,272 6,336 1,937 2,717 14,835

Acute day case 3,150 5,222 2,057 2,744 13,224

Cottage hospital admissions 473 268 336 261 1,342

New Returns New Returns New Returns New Returns New Returns

Outwith D&G Outpatient attendances 546 1,170 1,042 1,998 395 968 595 1,498 2,578 5,636

Outwith D&G Hospital admissions: Inpatient 541 1,038 408 586 2,573

Outwith D&G Hospital admissions: Day Case 220 377 140 209 946

C Hosp DGRI C Hosp C Hosp GCH & C

Hosp Midpark Total

2011/12 350 138 250 414 1,094 796 3,042

2012/13 996 921 433 38 645 1,008 4,041

2013/14 1,688 2,641 1,812 237 877 1,482 8,737

2014/15 2,822 3,177 3,334 347 1,306 1,849 12,835

#

Rate per 1,000

emergency

admissions #

Rate per 1,000

emergency

admissions #

Rate per 1,000

emergency

admissions #

Rate per 1,000

emergency

admissions #

Rate per 1,000

emergency

admissions

Falls related emergency admissions (2014/15) 158 4.4 328 5.3 168 6.4 149 5.1 803 5.2

Glossary (Abbreviations): # - Number / Count % - Percentage DGRI - Dumfries & Galloway Royal Infirmary FY - Financial Year running April - March CH - Community Hospital Incl. - Including IZ - Intermediate Zone LLTI - Limiting Long-Term Illness QOF - Quality & Outcomes Framework SIMD - Scottish Index of Multiple Deprivation (2012 issues used throughout this profile) SPARRA - Scottish Patients At Risk of Re- Admission

Glossary (Organisations): DWP: Department of Work & Pensions https://www.gov.uk/government/organisations/department-for-work-pensions/about/statistics ISD: Information Services Division (part of Na-tional Services Scotland) http://www.isdscotland.org/ NRS: National Records of Scotland http://www.nrscotland.gov.uk/statistics-and-data/statistics/statistics-by-theme SCOTPHO: Scottish Public Health Observatory http://www.scotpho.org.uk Admission

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# # # # #

Emergency dept attendances (DGRI & Galloway CH)

7,621 18,159 4,448 11,894 46,181

Outpatient attendances: New Returns New Returns New Returns New Returns New Returns

DGRI & Galloway Community Hospital 11,104 27,321 21,415 57,114 6,932 17,077 10,231 23,757 50,208 126,609

Cottage hospital and other community settings 3,590 20,026 2,893 21,761 2,143 12,133 2,219 10,556 11,015 65,379

Acute hospital admissions

(DGRI & Galloway CH): # # # # #

Elective inpatient 1,450 2,406 867 1,625 6,400

Emergency inpatient; 3,272 6,336 1,937 2,717 14,835

Acute day case 3,150 5,222 2,057 2,744 13,224

Cottage hospital admissions 473 268 336 261 1,342

New Returns New Returns New Returns New Returns New Returns

Outwith D&G Outpatient attendances 546 1,170 1,042 1,998 395 968 595 1,498 2,578 5,636

Outwith D&G Hospital admissions: Inpatient 541 1,038 408 586 2,573

Outwith D&G Hospital admissions: Day Case 220 377 140 209 946

C Hosp DGRI C Hosp C Hosp GCH & C

Hosp Midpark Total

2011/12 350 138 250 414 1,094 796 3,042

2012/13 996 921 433 38 645 1,008 4,041

2013/14 1,688 2,641 1,812 237 877 1,482 8,737

2014/15 2,822 3,177 3,334 347 1,306 1,849 12,835

#

Rate per 1,000

emergency

admissions #

Rate per 1,000

emergency

admissions #

Rate per 1,000

emergency

admissions #

Rate per 1,000

emergency

admissions #

Rate per 1,000

emergency

admissions

Falls related emergency admissions (2014/15) 158 4.4 328 5.3 168 6.4 149 5.1 803 5.2

For further information on the sources and commentary for the data see the full Strategic Needs Assess-

ment for Adult Health and Social Care Services. Electronic versions of the

full needs assessment and the execu-tive summary are available on the

‘Dumfries & Galloway Change’ web-site under ‘Health & Social Care Inte-

gration’.

www.dg-change.org.uk/

23

version 1.0 health intelligence unit, nhs dumfries …...version 1.0 published february 2016 health...

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