- going out of doors and walking down the road
- getting up and down stairs
- getting around the house on the level
- getting to the toilet
- getting in and out of bed
The overall prevalence of all causes of visual impairment** in those aged 65-74+ with visual acuity (VA) of less than 6/18 (moderate or severe) is 6.5%, and 12.4% for those aged over 75. VA of less than 6/18 is largely used as the point which approximates to the statutory threshold for qualifying as registered severely sight impaired (blind) or registered sight impaired (partially sighted)
Of those aged over 75, approximately half have cataracts or refractive error (i.e. correctable sight loss) and if these are excluded, the prevalence estimate of those with registerable eye conditions is 6.4% in this age group. A small proportion have both cataracts and some other registerable cause of vision impairment and these are included within this figure
Age related macular degeneration is the most common cause of registerable sight loss in older people
In future years with the predicted increase in diabetes, visual impairment due to diabetic retinopathy may have further impact on the number of people with registerable eye conditions
The prevalence rates for both visual and mobility problems have been applied to ONS population projections for the 65 and over population to give estimated numbers of people (graphs below) predicted to have visual or physical impairment projected to 2030.
In Merton the numbers are projected to rise by 36% for physical disability and by about 35% for visual disabilities by 2030, suggesting that around an additional 2,500 people will have either a physical or visual disability if no action is taken to try to prevent avoidable impairment.
In Sutton, reflecting the older population, the numbers are projected to rise by 48% for physical disability and by about 44% for visual disabilities by 2030, suggesting that around an additional 4,000 people will have either a physical or visual disability if no action is taken to try to prevent avoidable impairment.
Population projections for people with physical disabilities
Key Commissioning Implications for People with Physical Disabilities
The projected increases in cases of poor mobility or visual impairment have particular implications for social care. Some of these conditions are preventable, therefore social and health service commissioners need to focus on supporting preventative services (primary and secondary) now to reduce potential increases.
Consideration also needs to be given to the type of support services that will be required to enable people to remain independent for as long as possible.
Commissioning of community and voluntary services for people with physical disabilities up to 2013 should take into account that over the next 5-10 years it is expected that the number of people with a physical disability will increase by approximately 5%. The greatest increase in absolute numbers of people affected by a physical disability and personal care disability are estimated for those aged 45 – 54 years.
Consideration also needs to be given on how better to ascertain health status and health outcomes of people with physical disabilities and more broadly people with disabilities.
Key Facts for People with a Long Term Illness
Data from the 2001 Census recorded whether people were reporting as suffering from a limiting long term illness (long term illness, health problem or disability which limits daily activities or work) which gives an indication of levels of ill-health in a community.
The higher levels of reporting are more closely linked to wards where there are higher levels of deprivation and where the population is older. There is also variation in long term illness in age and gender and by ethnic group
In Merton, the proportion of the population stating good health in Merton was 72.7% compared to 70.8% in London and 68.8% in England.
In terms of self reported disability; 13.8% of people in Merton reported having a limiting long term illness. This was lower than average for London (15.5%) and England (17.9%).
Within the wards of Merton the figure ranged from 10.5% in Dundonald to 18.7% in St Helier.
Population projections suggest that by 2015 there will be nearly 11,500 people in Merton over 65 years with a limiting long term illness.
In Sutton, the proportion of the population stating good health was 71.5% compared to 70.8% in London and 68.8% in England.
In terms of self reported disability; 14.8% of people reported having a limiting long term illness. This was lower than average for London (15.5%) and England (17.9%).
Within the wards of Sutton the proportion ranged from 12.5% in Stonecot to 18.3% in Sutton South
Population projections suggest that by 2015 there will be nearly 12,500 people in Sutton over 65 years with a limiting long term illness
However, given all of this data is based on the 2001 census it therefore does not necessarily reflect the situation in 2011. The Census data from 2011 is expected to be reported in 2012/13 which will help revise these estimates.
People with Limiting Long term Illness
People with Limiting Long term Illness by age and ethnicity
People with Limiting Long term Illness by ward
Key Commissioning Implications for People with a Long Term Illness
Increasingly people are living longer and are therefore more likely to develop long term conditions. As medical and assistive technologies improve people will continue to live longer with more complex conditions
As these conditions become increasing complex with time and with increasing numbers of older people, more preventative services (primary and secondary) are need to be in place to support these people to stay independent and able to live in their own home
With increasingly limited resources support needs to be targeted in areas of deprivation where there is likely to be greater need
Key Facts for Children with Disabilities
An estimated 7% of children in the UK are disabled. Under the Children Act (1989), local authorities are required to keep a register of all children with disabilities. Registration is voluntary and is not a prerequisite for receiving services. Referrals to the register may be from statutory and voluntary agencies or by self-referral from the young person, their parent or carer. The completeness of registration for milder disabilities is difficult to estimate as registration depends on parental response and consistency between professionals in the application of registration criteria.
In recent years there has been a rise in children and young people registered with autism spectrum disorder (ASD) but also a decrease in children diagnosed as having communication problems which suggests that some of the increase in ASD is the result of a change in diagnostic practice. Recent studies have consistently suggested that about 60 children out of 10,000 will have some form of ASD which means that there would be around 1,900 children and young people under the age of 19 in South West London with ASD.
Profound multiple disabilities includes children with complex health needs. Over the last decade the prevalence of severe disability and complex needs has risen due to factors including the increased survival of pre-term babies and the greater likelihood that children will survive following severe trauma or illness and increased survival in life limiting conditions. Changes in models of care have also resulted in fewer children in this group being in residential education and care and an increase in the numbers being cared for in the community and accessing local schools and services.
The first table shows information taken from the Children's disability registers in Sutton and Merton which record data for children and young people living in Boroughs. This detailed Information on children with disabilities is held in slightly different categories between Sutton and Merton but does provide useful insight into the current picture of children with disabilities.
In Merton there was a total of 597 children on the register in July 2011. Nearly two thirds of the children registered are boys, reflecting the fact that boys are far more likely to be diagnosed as being on the autistic spectrum (ASD) than girls. In the table looking at type of disability recorded the figures are greater than the total number of children on the register. This is because many children are registered in more than one category.
In Sutton there was a total of 862 children and young people on register in July 2011. Nearly three quarters of the children registered in Sutton are boys, reflecting the fact that boys are far more likely to be diagnosed as being on the autistic spectrum (ASD) than girls. In the table looking at type of disability recorded the figures are greater than the total number of children on the register. This is because many children are registered in more than one category.
Tables of information on Children with Disabilities
Key Commissioning Implications for Children with DisabilitiesOne of the major causes of disabilities in children is low and very low birth weight.
If nothing changes and the proportion of low and very low birth weight babies stays the same (approximately 3% of all births), there will be an absolute increase in numbers of these children; by 2012/13 it would be expected there will be 104 children with future special needs born in Merton and 84 in Sutton per annum (based on ONS live annual births figures for 2009)
This will have implications for
paediatric and neonatal services,
social care services
specialist education (SEN)
increased pressure on continuing care/short breaks budget
Further recommendations on People with Learning Disabilities were published in the Director of Public Health Annual Report 2008. If the trend of increasing demand in continuing care and palliative care continues community services for children with disabilities and complex health needs will need to be strengthened and increased
*The data is taken from Bridgwood, A. (1998) People Aged 65 and Over: Results of an Independent Study Carried Out on Behalf of the Department of Health as Part of the 1998 General Household Survey, page 43.
**Figures are taken from 'The number of people in the UK with a visual impairment: the use of research evidence and official statistics to estimate and describe the size of the visually impaired population', Nigel Charles, RNIB, July 2006.