Contains: Asthma, Cancer, Chronic Kidney Disease, Chronic Obstructive Pulmonary Disease, Coronary Heart Disease, Diabetes, Epilepsy , Heart Failure,Hypertension, Multiple Sclerosis,Neurological Conditions, Osteoporosis, Palliative Care, Underactive Thyroid (Hypothyroidism)
Related to:Mental Health and Illness, Anxiety and Depression, Carers, NHS Health Checks, Learning Disabilities, Major Causes of Mortality, Physical and Mobility Impairments, Sensory Impairments, Physical and Mobility Impairments, Infectious Diseases and Pandemics, House Conditions, Inequalities, Smoking, Special Educational Needs, NHS Health Checks, Child Health and Wellbeing Survey
- Rates of long term conditions in Bath and North East Somerset are comparatively low, but rising in line with the rest of the country
- Estimates suggest there are approximately 2,469 people aged 18-64 with a serious physical disability in B&NES
- Nearly half of sufferers with long-term conditions surveyed in 2011 felt that they were able to manage their condition
- People with LTCs are more likely to be elderly and live in deprived areas
- People with LTCs are likely to be taking medication, often several medications.
- Many people with LTCs also receive a number of different medications for co-morbidities.
- Emergency bed days for long-term conditions are consistently lower than regional and national levels
Ill health and disability refers mainly to people with long term conditions, which are those that suffer from illnesses which cannot currently be cured but can be controlled with the use of medication and/or other therapies.
Ill-health and disability in Bath and North East Somerset
12,267 residents reported that their day to day activities were limited a lot through a long term illness or disability in the 2011 Census1. This represents 7% of the population as a whole, lower than rates for both the South West and England & Wales.
England & Wales
Day-to-day activities limited a lot
Day-to-day activities limited a little
Day-to-day activities not limited
Table 1 - Census limiting long term illness (2011) Bath and North East Somerset
According to the 2011 Census, 3.68% of households in B&NES with dependent children had at least one person with a long term health problem or disability, this is significantly lower than the South West (4.09%) and England (4.62). 2
2014 synthetic estimates suggest that there are 2,469 people aged 18-64 with a serious physical disability in B&NES. This is expected to increase to 16,408 by 2030, an increase of 2.6% 3
GP Registered Conditions
Chart Guidance - Please use the drop-down selector boxes to view the interactive charts for different health conditions, and hover over the charts to see the values.
There are also separate sections for the following conditions:
- Coronary Heart Disease
- Heart Failure
- Chronic Kidney Disease
- Chronic Obstructive Pulmonary Disease
- Learning Disabilities
- Mental Health Illness
- Palliative Care
- Hypertension - refers to high blood pressure.
- Hypothyroidism - refers to an underactive thyroid which means that your thyroid gland, located in the neck, does not produce enough hormones.
- Atrial Fibrillation - is a heart condition that causes an irregular and often abnormally fast heart rate.
- Stroke or Transient Ischaemic Attack (TIA) - refers to a 'mini-stroke' is caused by a temporary disruption in the blood supply to part of the brain.
- Chronic Obstructive Pulmonary Disease (COPD) - is the name for a collection of lung diseases including chronic bronchitis, emphysema and chronic obstructive airways disease.
Osteoporosis - is a condition that affects the bones, causing them to become weak and fragile and more likely to break (fracture).
Peripheral Arterial Disease (PAD) - is a common condition in which a build-up of fatty deposits in the arteries restricts blood supply to leg muscles. It is also known as peripheral vascular disease (PVD). Although many people with PAD have no symptoms, some people have painful aching in their legs brought on by walking. These aches will usually disappear after a few minutes of resting
- Obesity - is a term used to describe somebody who is very overweight with a BMI (body mass index) over 30.
(All definitions of conditions come from the NHS Choices website - http://www.nhs.uk/Conditions)
In terms of long term conditions, the health of people in Bath and North East Somerset is generally better or in line with the England average (see individual conditions for more details). But the prevalence of the majority of conditions in the registered GP Population of Bath and North East Somerset is rising, just as it is regionally and nationally. 4
- The level of residents with long term conditions who smoke is less than national and regional averages. 5
- Secondary School Survey results showed 9% of pupils had a long standing illness/condition.6
- There is a likely gap in diagnosis of hypertension (big difference between reported and expected counts). Hypertension Reported vs Expected Prevalence " href="#footnote7_qqkjpli">7
- Depression in general and depression in those with Coronary Heart Disease (CHD)/diabetes are significantly higher than national rates, 8 although this may be attributed to increased diagnosis.
- The rate of Diabetes mellitus in 17 years and over in the registered GP population of Bath and North East Somerset has increased slightly from 4% in 2008-2009 to 4.4% in 2010-2012. This rate is significantly lower than the South West and England, which both had prevalence rates of 4.8% and above between 2008-2012. 9
- For Coronary Heart Disease, Chronic Obstructive Pulmonary Disease (COPD), and Stroke, it is suggested that there are good levels of diagnosis. 10
- The rate of obesity in the registered GP Population of Bath and North East Somerset (16+) is lower than the national average (8.1% B&NES, 10.7% nationally. 11 However, the numbers are lower than expected which may suggest under-diagnosis. 12
The Department of Health has highlighted a number of key characteristics and issues associated with people suffering from long term conditions:
- The proportion of people with a limiting long term condition in work is a third lower than those who do not have a long term condition.
- Long term conditions fall more heavily on the poorest in society: people in the lowest social class have 60% higher prevalence of long term conditions and 60% higher severity of conditions than those in the highest social class.
- People with long term conditions are far higher users of health and social care services than average. 13
- People with LTCs are more likely to be elderly and live in deprived areas 14
- People with LTCs are likely to be taking medication, often several medications.
- Many people with LTCs also receive a number of different medications for co-morbidities.
The NHS Health Check is for adults in England between the ages of 40 and 74, who has not already been diagnosed with heart disease, stroke, kidney disease or diabetes, will be invited (once every five years) to have a check to assess their risk of these conditions and will be given support and advice to help them reduce or manage that risk
The data shows that of those offered an appointment, 38% completed a check and of these approximately 6.5% were identified as having a ‘high risk’ of developing cardiovascular disease over the next ten years (206 individuals). The uptake figures are expected to almost double as the checks progress though as it is still early days.
What does the community say?
Voicebox Survey 16
The large scale Voicebox Resident Survey carried out in 2012 asked a number of questions relating to ill health and disability. The survey generated 850 responses representing views from across Bath & North East Somerset:
Day-to-day activities limited because of a health problem or disability
- 7.6% of respondents said that their day-to-day activities were limited a lot and 11.8% stated that their day-to day activities were limited a little.
Types of long term conditions
- 11.7% of respondents said they had a long-term physical condition
- 7.6% of respondents stated that had a long term illness such as HIV, diabetes, chronic heart disease or epilepsy.
- 4.2% of respondents said they had a mental health condition
- 3.5% stated that they suffered from deafness or a severe hearing impairment
- 1.5% said they were blind or partially sighted
- 1% stated that they had a learning disability
Support from local services
When asked to what extent people agreed or disagreed that they have enough support from local services or organisations to help manage their long-term health condition(s):
- 6.2% strongly agreed
- 29.2% tended to agree
- 23.1% neither agreed or disagreed
- 18.2 tended to disagree
Child Health and Wellbeing Survey
For the results of the Child Health and Wellbeing Survey see the Child Health and Wellbeing Survey section.
Long Term Conditions Survey17
In 2011, 65 people in Bath and North East Somerset were asked 6 questions about managing their health and the support that is provided locally. There were only 8 respondents who indicated that they were of an ethnicity other than “white” therefore analysis by ethnicity is not available.
The table below outlines the results of this survey:
Did you discuss what was
most important for you in
managing your own
Were you involved as
much as you wanted to be
in decisions about your
care or treatment?
Not at all
To some extent
More often than not
How would you describe
the amount of information
you received to help you to
manage your health?
I did not
I rarely received
I sometimes received
I always received
the right amount
Have you had enough
support from your health
and social care team to
help you to manage your
I have had no
I have not had
I have sometimes felt
I have always felt
Do you think the support
and care you receive is
joined-up and working for
How confident are you that
you can manage your own
Not at all
Table 3:Overall responses on the support provided to clients with long term conditions
Other than for question 6 the other questions all had a similar level of response.
- Regarding question 6, 52% feel somewhat confident/very confident; 48% not very confident/not at all confident of these; 17% of respondents do not feel at all confident at managing their own health.
- Other than question 6 responses, question 5 on support and care being joined up and working for the client has the lowest percentage of always working (19%) compared with the responses for questions 1-4 being above 25% for always/almost always receiving support. However, question 5 also has the highest percentage of respondents answering “sometimes” and the highest percentage of respondents answering “never” (14%) although this only equates to an extra 2 respondents compared with the other questions.
- In general, with respect to questions 1-5 those that answered well for one question also answered well for the other. If a respondent answered “always” for one question, most of the time the other questions were answered “sometimes” or “always”. This is not the case with question 6 on confidence.
- By age, those under 65 were more likely to respond that they were not get the support that they wanted but were more likely to be more confident at managing their own health. Those respondents aged 75+ were more likely to not feel confident at managing their own health.
- There were 39 women and 22 men who answered the survey. More women than men feel they have not had enough support from their health and social care team to help them to manage their health and a higher percentage of women than men feel that they do not or rarely discuss what is most important for them in managing their own health.
- Those respondents who had one long term condition answered not at all/never fewer times than those with more than one long term condition, however those with 3+ long term conditions also responded more highly that they were almost always supported.
- Looking at responses by condition it should be noted that there may be correlations with other factors such as number of conditions.
- There were a consistent 5 responses (34%) of arthritis sufferers who answered never/rarely/not enough with respect to the first 5 questions, however there were mostly a similar percentage answering almost always/always.
- There were at least 43% of depression sufferers who answered never/rarely/not enough except with respect to the question “How would you describe the amount of information you received to help you to manage your health?” However this only equated to three responses. There was only 1 answer of always/almost always for each question for depression sufferers. This is only the case with depression sufferers.
- Stroke, depression and dementia sufferers were most likely to feel that they were not at all/not very confident at managing their own health (>70% of responses).
Are we meeting the needs? 18
Although the small sample size of 65 for the 2011 Long Term Conditions Survey needs to be taken into account it can be used to get some indication as to whether the needs of those with long term conditions are being met in Bath and North East Somerset.
- The survey shows that there are some long term condition sufferers who do not feel they are getting the care support they need to manage their condition.
- Nearly half (47%) of respondents are not very or not at all confident about managing their condition.
- There were a consistent number of arthritis and depression sufferers who did not feel they were getting the support they needed. Those responses from depression sufferers also indicated the lowest response rate for always/nearly always receiving the support they need.
- There is variation in response by age, those being 75+ being more likely to be less confident but those under 65 feeling less like they were receiving the support they need.
- Those respondents with 3+ conditions were much more polarised in their responses compared with those with fewer conditions.
- Those with 3+ conditions had the highest percentage of respondents who felt supported and also the highest percentage of those who did not feel supported. It is possible that this is due to type of condition, however there is not a large enough sample size to determine this.
- Bath & North East Somerset Council Private Sector Housing Stock Condition Survey 2011 based on a survey of 1000 properties has estimated that 12.5% dwellings are occupied by least one person who considered themselves disabled or who having a long term illness.
- The Survey has estimated that to provide all the adaptations and equipment that this group needs would cost in the region of £15million. Current annual spend by the Council on Disabled Facilities Grants for eligible applicants is in the region of £1 million per year for about 250 grants. In general these grants pay for adapted bathrooms and stair lifts19
- Emergency bed days for long-term conditions are consistently lower than regional and national levels 20 This is likely to represent good management of conditions in the community.
- There is variation at a GP level, with the lowest number of emergency bed days being 498 per 100,000 and the highest 10,252 per 100,000 (B&NES resident population average 6,353 per 100,000). 21
- There does not seem to be any correlation between standardised rates of emergency bed days and deprivation. 22
- 1. Bath and North East Somerset Council (2013) Census Theme Summary: Health and Society http://www.bathnes.gov.uk/services/your-council-and-democracy/local-research-and-statistics/research-library/36268 (Accessed 08/10/13)
- 2. Public Health England (2014) Bath and North East Somerset, Children's and Young People's Mental Health and Wellbeing Profile and data, http://fingertips.phe.org.uk/profile-group/mental-health/profile/cypmh/data#gid/1938132752/pat/6/ati/102/page/9/par/E12000009/are/E06000022
- 3. POPPI/PANSI 2014 estimates of serious physical disability to 2030
- 4. APHO GP Profiles/NHS comparators (2008-2012) QOF Prevalence, http://www.apho.org.uk
- 5. South East Public Health Observatory (2010/11) Cardiovascular disease PCT health profile, Bath and North East Somerset (downloaded 29/03/2012) http://www.sepho.org.uk/NationalCVD/docs/5FL_CVD%20Profile.pdf
- 6. Young People in B&NES Schools (2011) The Health-Related Behaviour Survey 2011, The Schools Health Education Unit
- 7. NHS Comparators (2008-9) Bath and North East Somerset PCT - Hypertension Reported vs Expected Prevalence
- 8. Network of Public Health Observatories (2010/11) APHO GP Profiles, Mental Health|Depression case finding in CHD and/or diabetes patients http://www.apho.org.uk
- 9. Network of Public Health Observatories (2008-2012) APHO GP Profiles , Diabetes Mellitus (Diabetes) QOF Prevalence (ages 17+), http://www.apho.org.uk
- 10. NHS Comparators (2008-09) Bath and North East Somerset PCT – Heart Disease, COPD and Stroke – Reported vs Expected Prevalence figures
- 11. Network of Public Health Observatory (2011-12) APHO GP Profiles, Obesity (ages 16+): QOF prevalence, http://www.apho.org.uk
- 12. NHS Comparators (2008-09) Bath and North East Somerset PCT - Obesity Aged Reported vs Expected Prevalence>=16
- 13. The National Archives/Department of Health (2011) Ten things you need to know about long term conditions (downloaded 29/03/2012) http://webarchive.nationalarchives.gov.uk/+/www.dh.gov.uk/en/Healthcare/Longtermconditions/tenthingsyouneedtoknow/index.htm
- 14. http://www.kingsfund.org.uk/sites/files/kf/field/field_document/managing...
- 15. Bath and North East Somerset PCT (2011) Health Checks Summary Q2 2011/12 (data from GP practices), in-house data
- 16. RMG Clarity (2012) Voicebox 21 Main Results Weighted by Gender, Employment, Tenure and Excluding Non Responses, Bath and North East Somerset Council
- 17. Bath and North East Somerset PCT (2011) Long Term Conditions Survey, Bath and North East Somerset Council in-house analysis
- 18. Bath and North East Somerset PCT (2011) Long Term Conditions Survey, Bath and North East Somerset Council in-house analysis
- 19. Bath & North East Somerset Council (2011) Private Sector Housing Stock Condition Survey, in-house data
- 20. NHS Comparators (2008-2010) Emergency Bed Days for Long Term Conditions per 1000 Population
- 21. SUS data (2010/11) Emergency bed days by GP practice, in-house analysis
- 22. SUS data (2010/11) Emergency bed days by GP practice, in-house analysis