Working Well - Health
Long Term Conditions
Long-term conditions are defined as ‘those conditions that cannot, at present be cured but which can be controlled by medication and other therapies’ (Department of Health). People suffering with long term conditions represent 69% of health and care spend, 77% of inpatient bed days, 55% of GP appointments and 68% of hospital outpatient and emergency department appointments (Department of Health 2010).
Care for long term conditions covers many agencies across social care, community care and health care. Care for long term conditions is being complicated by the increasing number of people who have multiple long term conditions.
As many long term conditions develop over time, there is a disproportionate representation of older people within the long term condition population. As the proportion of older people in the wider population increases, the proportion of the wider population living with long term conditions will also increase. This means that the management of long term conditions, both financially and physically, will make a growing contribution to the overall cost of care and burden of disease. These two factors are intrinsically link as an increase in disease burden is accompanied by a requirement for more social care support, and therefore more financial outlay.
Long term care
The gap in employment rate between those with a long term condition and the overall employment rate for Hartlepool for 2017/18 is 20.1%. This is the second highest in England.
Hartlepool's rate of 20.1% in 2017/18 was a considerable increase on the 2016/17 rate of 15.1%. At the same time the England average fell from 12.1% to 11.5%, increasing the gap between Hartlepool and the England average from 3% to 8.6%.
Hartlepool's rate of 20.1% is considerably larger than at any other point in the five year reporting period and 2017/18 represents the largest gap in rates between Hartlepool and England as a whole.
The proportion of people in Hartlepool reporting long term mental health problems in 2017/18 is 12.5%. This is the 5th highest rate in England.
Hartlepool's 2017/18 rate of 12.5% is more than double the 2016/17 rate of 5.7%.
Hartlepool's increase in 2017/18 followed a three year period of stability, where the rate move no more than 0.7% in any single year. However Hartlepool's increase in 2017/18, whilst more extreme in its size, mirrors the trend of England as a whole, as it saw an increase of 59% on its 2016/17 rate, increasing from 5.7% to 9.1%. The gap between Hartlepool and England's rates is 3.4%, which is more than nearly three times the size of any other year's gap. Hartlepool's increase in 2017/18 followed a three year period of stability, where the rate move no more than 0.7% in any single year. However Hartlepool's increase in 2017/18, whilst more extreme in its size, mirrors the trend of England as a whole, as it saw an increase of 59% on its 2016/17 rate, increasing from 5.7% to 9.1%.
Adult social care service users in Hartlepool in 2017/18 had a long term care issue 74.3% of the time. Those with multiple long term care issues accounted for 25.9% of all adult social care service users in 2017/18.
Where a long term health condition was recorded for adult social care service users in 2017/18, physical conditions, such as injuries, COPD and cancer, were recorded 3754 times. This is more than two and a half times the size of the next largest category.
People with Long Term Conditions may face many barriers to living a fulfilling and independent life. Not only do they have the practical problems of everyday life they often have to face the negative public perceptions and problems gaining access to everyday facilities and services. The support required for people with Long Term Conditions may be multi-dimensional and therefore need to be tailored to address their specific individual needs.
Some people with Long Term Conditions may need help with day-to-day tasks at home, and may be eligible for help from the council to help meet their care costs. If eligible the council can provide people with services or a personal budget to pay for this support.
Personal Budgets can be managed in ways that suit the individual. The amount of money in a personal budget is worked out by the council based on a needs assessment. The amount that a person is expected to contribute towards the cost of the care is done through a financial assessment known as a means-test, which looks at income, savings and other capital assets.
People can then chose how they want to use their personal budget to meet their eligible needs. It can be used in one of three ways:
- the council can manage an account.
- a third party can manage an account.
- the person can manage a direct payment.