Health and physical disabilities

Most people in the West Wales region between the age 18 to 64 will not access care and support for a specific need or protected characteristic. Instead, they are served by public health information and national and local programmes designed to encourage healthy lifestyles and practices. These programmes are aimed at reducing specific health risk factors such as cardiovascular disease, often achieved by strategies to reduce obesity and smoking and improve diets.

There are a proportion of people who have a range of specific needs because of physical disability or chronic health conditions that may require extra support to enable them to live as independently as possible.

• 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.

Although a drop in the number of people is predicted within this group 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.

People with health conditions and/or physical disabilities will have a range of care and support needs depending on their personal circumstances. Broadly speaking, this range will encompass:

• Universal needs - for example, information and advice, low level support, preventative services, such as dietetic support and advice

• Multiple and complex needs requiring coordinated multi-agency support to address and manage specific issues.

The Welsh Government’s Framework for Action on Independent Living, published in 2013, set out actions to promote an inclusive and enabling society, to ensure people of all ages and from all communities can maintain independent living, enjoy well-being and access appropriate support when and how they need it. Wherever possible we will seek to “co-produce” services in West Wales. That is, we will work with stakeholders including disabled people to design, deliver and evaluate new initiatives.

Listed below are some of the recurring themes and issues identified:

• Improving infrastructure and information, to ensure people with a disability or limiting condition and can access premises providing the care and support services they are entitled to

• Recognising the changing requirements of people with a disability or limiting condition. Many buildings were compliant with the 1995 disability legislation to be wheelchair accessible however, almost all people with disabilities now use scooters

• Increasing availability and choice of appropriate and accessible accommodation

• Involving people with different disabilities at the planning and design stage of new and refurbished premises, recognising their views and experience can ensure that any new development is easy to use and accessible

• Reducing restrictions around home improvements and modifications to help people manage in their own homes for as long as possible

• Identifying alternative solutions for people living in rural areas where public transport is not adequate

• Improving assessments and person-centred planning to ensure they reflect what really matters for individuals and can flex up and down in response to changing needs.

The pandemic has led to increased isolation and a disruption of normal life, having a dramatic impact on access to services generally and particularly for people with a disability or limiting condition, many of whom were shielding during the pandemic. With access to primary care and out-patient services severely curtailed or becoming virtual, many people have been unable or too vulnerable to access their regular support.