The Profile of People who have a Disability in Sutton and Merton
 
 
 
Contents
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Where do People who have a Disability Live
The Index of Multiple Deprivation is a composite of a range of different indices that look at a number of measures of deprivation. One of the Indices (or domains) looks specifically at measures of Health and Disability and ranks them according to small geographical areas. The map identifies areas with relatively high rates of people who die prematurely or whose quality of life is impaired by poor health and/or disability.

 

Reflecting the overall good health there are only 3 areas within this domain that are in the 20% most deprived across England in terms of health and disability; Belmont (Shanklin area), Sutton Central and Beddington South (Roundshaw area) 

 
MapWhere people with a disability live
 
 
Key Facts on People with Learning Disabilities
Our local prevalence information on people with learning disabilities suggests that they are tending to live longer than expected. The information on prevalence comes from a range of sources and is not necessarily fully complete. Recorded prevalence is generally the prevalence of people who are on a learning disabilities register. This usually relates to those people with moderate or severe learning disabilities (i.e. are known to services). True prevalence reflects both the recorded prevalence plus those who generally have milder learning disabilities and are not always known to services.
 

In general as people with learning disabilities get older they will have increasingly complex health and social care needs. Therefore more support will be needed to help people with learning disabilities remain independent and living in their own homes. A more detailed report and needs analysis for people with learning disabilities is available here.  
 
In summary:
 
In Merton there would appear to be a fewer people in their late 20's and 30's than would be expected but more people with learning disabilities who are over 45. This is predicted to continue over time.
 
In Sutton there are fewer people with Learning disabilities in their 30's than would be expected but significantly more people with learning disabilities who are over 40. This is predicted to continue over time.  
 

 

Chart Age profile of people with learning disabilities

 
 
Chart Trends in prevalence for people with learning disabilities
 

Key Commissioning Implications for People with Learning Disabilities
Commissioners of services for People with learning disabilities need to ensure:

  • access to general medical services and social services that can be tailored to meet the specific needs of people with learning disabilities. In particular service providers need to have the right level of communication skills to ensure that people with learning disabilities are treated and followed up appropriately
  • availability of housing and supported housing that can support an ageing population of people with learning disabilities who are likely to have increasingly complex social and health needs
  • availability of services within the framework of personalisation that can support an ageing population of people with learning disabilities with increasingly complex health and social care needs
  • when commissioning services that findings of recent national reports such as Six Lives: The provision of public services to people with learning disabilities (2008) are taken into account
 
Key Facts for people with Physical Disabilities (Vision and Mobility)
Information on visual and physical disabilities tends to focus on older people (on which we have more information).
 
Evidence suggests 8% of 65-74 year olds, and 24% of men and women aged 75 and over are unable to manage on their own for at least one of the mobility activities listed*
 
The number of people aged 65+ predicted to be unable to manage at least one mobility activity on their own, by age groups 65-74 and 75+ projected to 2025. Mobility activities include:
  • 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.
 
Chart 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.

 

Chart People with Limiting Long term Illness
 
Chart People with Limiting Long term Illness by age and ethnicity

 

Chart 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.

   

 

Chart Tables of information on Children with Disabilities

 

 
Key Commissioning Implications for Children with Disabilities
One 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.