Health and physical disabilities

Please note: The data in “demographics and trends” has been recently updated in preparation for the population assessment update taking place over the next year. The remainder of this page will be updated when the population assessment is published on 1 April 2022.

Overview and key messages

A significant proportion of the population aged between 18 and 64 who live in West Wales will not be accessing care and support directly to address specific needs. However, they will benefit from general public health information and programmes aimed at encouraging healthy lifestyles and reducing risks to their health brought about by factors such as smoking and obesity. More generally, adults in Wales will also benefit from combined approaches across sectors and within communities to improve the social, economic and cultural well-being of Wales in response to the Well-being of Future Generations (Wales) Act 2015.

Where people within this age range have specific needs because of physical disability or chronic health conditions, proportionate, person-centred and responsive care and support may be required to help them achieve positive personal outcomes and live as independently as possible.

A range of ‘accelerating factors’ within people’s environments might increase the likelihood of them developing an ongoing health condition, or aggravate the effects of existing conditions, and against which mitigating action should be taken. These include unemployment, low wages and poor housing conditions.

Effective promotion of public health, targeted care and support for those with specific needs and more general support for people particularly at risk should combine to optimise the quality of people’s lives and their participation within their communities.

Supporting people to live active and healthy lives will reduce their needs for care and support and lead to improved outcomes at an individual and community level. The contribution of care and support services must be complemented by a range of collaborative approaches to improve people’s social, economic, environmental and cultural well-being.

Public Health has an important role in providing the population with general information and advice on healthy life choices and support in areas such as diet and smoking cessation. This needs to start in the early years but should be sustained where possible across the range of age groups.

Demographics and trends

• There are over 22,000 people who are entitled to Personal Independence Payment (PIP) in the Hywel Dda University Health Board.
• There are over 10,000 people who are entitled to Disability Living Allowance (DLA) in the Hywel Dda University Health Board.
• There are over 13,500 people who are entitled to Attendance Allowance (AA) in the Hywel Dda University Health Board.
• There are currently 217,689 people aged between 18 and 64 in the West Wales region. This equates to around 69% of the adult population across the region, with the proportion being slightly lower in Pembrokeshire at 68%, than that in Carmarthenshire and Ceredigion, at 70% (Office for National Statistics (ONS), 2019).
• 5.5% of people between 16 and 64 in Ceredigion do not have central heating, 3.5% in Pembrokeshire and 2% in Carmarthenshire (StatsWales).
• The National Survey for Wales (NSW) suggested that 36.9%, 27.6% and 25.3% of adults were active for less than 30 minutes a week in Pembrokeshire, Carmarthenshire and Ceredigion, respectively.
• In Pembrokeshire, Carmarthenshire and Ceredigion it was estimated that 25.0%, 21.7% and 23.3% of people had eaten five portions of fruit and veg the day before the survey, respectively.
• 5.8% of adults in Pembrokeshire were e-cigarette users, 6.7% in Carmarthenshire and 4.2% in Ceredigion.

Current care and support provision

There are a range of services and support available to the adult population to help them lead healthy and fulfilled lives; although a significant degree of responsibility for this falls on the individual and responsibility for services and support extends well beyond health and social care.
General services available to promote self-care and well-being include:

• Universal services and amenities within the community
• Prevention and early intervention services including information, advice and assistance
• Third sector provision including a wide range of facilities including transport, social activities, help at home with domestic tasks such as finance management gardening and cleaning and various targeted support groups such as carers’ support; and
• Leisure services, which can where appropriate be accessed via the National Exercise Referral Scheme (NERS) which is in place across the region.

For those with chronic and long term conditions and physical disability, a range of services are provided:

• Chronic conditions management through district and specialist nurses
• Social services support in residential settings and in the community
• Community-based support to reduce risk of deterioration and promote independence
• High level support through the provision of assistive technology, equipment, adaptations, direct payments and home care; and
• Advocacy services to help people make informed decisions about how their needs can be met and to support or improve independence.

Gaps and areas for improvement

Although a drop in the number of people falling within this thematic group is predicted in the medium term, and the current number of people with specific care and support needs is small, it is vital that appropriate provision is in place to promote well-being and independence and prevent escalation of need. The following gaps and areas for improvement have been identified and are set out below against the core principles of the SSWB Act:
 

• Developing appropriate access to a range of information, advice and assistance including Dewis Cymru and Infoengine, and advocacy services relevant to health and social care needs at all key life stages
• Developing consistent, integrated regional services that are accessible and respond to population need
• Improving the early identification, treatment and management of preventable and chronic conditions including diabetes, heart disease and respiratory illness, to improve long term well-being and reduce complications
• Ensuring effective interventions and pathways for prevention, treatment and management of obesity and childhood obesity are routinely available and systematically implemented
• Improving early identification and treatment of risk factors associated with health inequality
• Strengthening transition arrangements between children and young people’s services and adult services
• Developing community-based, user-led, co-produced services that prevent isolation, promote independence and support people to become more resilient and manage their own conditions
• Increasing use of assistive technology, such as telecare to transform domiciliary care and supported living services
• Improving flexibility to deliver step up and down provision to respond to changing needs