NHS GRAMPIAN
The Health of the Grampian Population:
A review of current and future health challenges
Aim
Board members are asked to consider the information presented on the burden of disease in our local population and the changes to the make-up of the population which will impact on the design and delivery of health and care services for our population.
Strategic Context
NHS Grampian Board considers information on the health needs of the population to inform improvement in people’s wellbeing and services. The two papers attached ‘The Health of the Grampian Population: A Review of current and future health challenges’ and summary briefing paper have been produced to inform service planning including the production of the Health and Care Framework.
Discussion
The information provided was reviewed and the following issues were highlighted to the Health and Care Framework (H&CF) Steering Group as areas that required particular focus in the initial stages of the H&CF development. These include:
· An ageing population means that the prevalence of long term conditions including dementia and certain cancers will increase thus putting greater demand on health services in the future. End of life care will also become increasingly important. Service planners need to take this into consideration.
· The strong link between poverty, deprivation and many key measures of health in children means that improving the health of children in Grampian is very much linked to reducing health inequalities and should be a priority.
· A relatively higher morbidity from diseases of the digestive system, injury and poisoning, diseases of the circulatory, musculoskeletal and connective tissue and respiratory systems in all age population groups highlights the need to prioritise these areas.
· A relatively higher mortality from cancer, coronary heart disease (CHD) and injury in working age population group highlights the need to tackle this area.
· There is a clear correlation between Higher levels of deprivation (as measured by the Scottish Index of Multiple Deprivation (SIMD) scores,) and premature mortality (under 75) for cancer and ischaemic heart disease (IHD). This should be tackled.
· As a priority, smoking and obesity should be tackled since rising levels of both lifestyle risk factors will reduce quality of life and life expectancy whilst placing significant increased pressures on health services due to associated increases in conditions such as diabetes, heart disease, arthritis, mental health problems and cancers.
· It is projected that there would be substantial increases in colorectal, breast and lung cancers in the next 10 years relative to actual cases seen between 2001 and 2005. Regular bowel and breast cancer screening has been shown to reduce the risk of dying from these cancers. Explicit plans to improve uptake of bowel cancer screening particularly among men and breast cancer for women should be a priority.
· Improving mental health, especially tackling the inequality of suicide in men and young people from deprived areas, should be a priority.
· Small pockets of vulnerable individuals that are hard to reach may not be accessing services e.g. immunisation, screening, that they need to stay healthy and it is important that NHS Grampian identifies ways to make these services more accessible to the ‘hard to reach groups’.
· Infectious diseases, particularly outbreaks and environmental hazards, continue to pose a clear and present danger to the people of Grampian. This requires significant amount of resources. The need for emergency plans and effective business continuity plans cannot be overemphasised. This should be a priority.
· The significantly high proportion of emergency admission in elderly requires a review of emergency care utilisation to assess whether or not their care could have been provided outside the hospital if different types of support were available.
· Improving access to dental care remains a priority.
Key Risks
Strategic Risk 607: Alignment of strategy with intelligence, learning and resource: The report brings together a range of information regarding the health status of the population and identifies variation across Grampian in terms of health outcomes and uptake of services. In light of the report, the Health and Care Framework is focusing on the ten areas prioritised for action in the initial stages of development.
Conclusion
The paper sets out information about the burden of disease in our local population. It shows how our population profile is expected to change in the next 5 to 10 years. Understanding the make-up of the population is important if we are to design health services that will provide the best possible care for people. Using the demographic information and what we know about the prevalence of disease we can build a profile of how we need to further develop our services to ensure they are responsive to need. Emphasis is placed on where things need to change if we are to continue to improve the health of the Grampian population and reduce health inequalities.
Recommendations
NHS Grampian Board is asked to:
1. Note the health needs of the population
2. Ensure findings are used to inform future plans presented to the Board for approval.
Executive Lead
Dr Lesley Wilkie, Director of Public Health & Planning
Name of person submitting paper
Dr Emmanuel Okpo
Consultant in Public Health Medicine
November 2010
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