A rising and ageing population, more people living for longer in ill-health, and a shortage of workers to fill vital jobs are among the challenges the NHS in Devon faces.
Devon’s population is set to rise by 33,000 people – the equivalent of another Exmouth – over the next five years and the number of people over the age of 75 will increase by more than a third by 2030.
But there is a shortage of people employed to do the vital health and care jobs, with one in 10 nurse jobs and one in 12 social worker posts in Devon remaining vacant.
Already, 85 per cent of hospital beds are occupied by emergency patients, but this is growing by 2.5 per cent a year.
Of the remaining 15 per cent, more than half are for high-risk patients, and if emergency growth continues, then beds available for planned low-risk cases will disappear if nothing changes.
A local version of the NHS Long Term Plan, called ‘Better for you, Better for Devon’, is being developed, which sets out the direction for the NHS over the next decade.
The plan aims to make sure the NHS is fit for the future, provides high-quality care and better health outcomes for people and their families, through every stage of life.
The plan outlines that Devon’s healthcare service faces seven challenges:
- More people are living for longer in ill-health;
- Preventable illnesses are increasing;
- Vital health and care jobs remain unfilled;
- NHS funding is not keeping pace with demand;
- The NHS in Devon is does not always provide timely access to care;
- Devon’s population is rising;
- The overwhelming baby boomer effect.
Councillors on the Devon County Council Health and Adult Care Scrutiny Committee will next Monday hear a presentation from the Joint Associate Director of Commissioning (Devon County Council and NHS Devon CCG) and the Director of Commissioning (NHS Devon CCG) on the plan.
It follows an engagement exercise which took place earlier this year on a draft version of the plan, which was developed in partnership with those who know the NHS best – frontline health and care staff, patients and their families.
A report to next Monday’s meeting outlines some of the challenges that the NHS in Devon faces and what the long-term ambitions the plan aims to achieve are.
The report states: “The county’s population will rise by about 33,000 people – equivalent to the population of Exmouth – over the next five years and by 2030 there will be 36.5 per cent more people over 75 years compared to today.
“There are medical advances which mean people are living longer – something we celebrate – but people now often live with multiple illnesses, such as cancer, heart problems and type 2 diabetes and so we need to ensure services can provide what they need.
“Illnesses like type 2 diabetes are on the rise, and the amount of time people spend in good health has been decreasing since 2012.”
It adds there is a shortage of people employed to do the vital health and care jobs, with one in 10 nurse jobs and one in 12 social worker posts in Devon remaining vacant, while demand for services are increasing.
And while there have been increases in NHS funding, peoples’ needs for services are growing faster.
The number of people aged over-85 in Devon will double in the next 20 years, the report says, adding that the healthcare cost of someone older than 85 years is £4,500 a year – 10 times that of a child under 10 years old.
On average, a person will consume a third of lifetime healthcare costs in their last two years of life.
Among the growing demands that the Case for Change identifies is that prevalence of dementia is growing by one per cent at present, but this will rise to three per cent by 2029.
It says that 25 per cent children in Devon are overweight or obese, rising to 33 per cent by time they leave primary school, and that smoking, alcohol abuse, physical inactivity and poor diet are main causes of preventable disease which accounts for 40 per cent of premature deaths.
In total, 85 per cent of hospital beds are occupied by emergency patients, but this is growing by 2.5 per cent each year.
The report adds: “Of the remaining 15 per cent of elective beds, eight per cent are for high-risk patients, such as cancer or cardio vascular disease.
“If emergency growth continues at this rate, beds available for planned low risk cases will disappear if nothing changes.”
The four long-term ambitions that the plan aims to achieve are:
- Children and Young People – Invest in children and young people to have the best start in life, be ready for school, be physically and emotionally well and develop resilience throughout childhood and on into adulthood.
- Digital – Invest in a digital Devon where you only tell your story once and first contact will be digital.
- Integrated Care Model – There will systematic delivery of the integrated care model across Devon as defined in the ICM blueprint.
- The “Devon” deal – Establish a Devon deal to decrease gap in life expectancy, narrowing health inequalities across Devon. (A citizens-led approach to health and care).
Engagement on the Devon NHS Long Term Plan carried out earlier this year suggested that there was a preference for face-to-face hospital appointments.
A survey of people booking outpatient appointment found that half wanted to face-to-face appointments with only 47 per cent consider a digital appointment, while the newly-formed virtual voices panel found 54 per cent wanted face-to-face and only 41 per cent would consider digital.
The report says: “The stats show there is an appetite for technology but need to do more education, channel shift and reassurance to encourage best use.”
The surveys also that found that people are attending A&E departments because it is easier than accessing other services, people are willing to travel for care for up to an hour, but that they expect the provision to be available in Devon and Cornwall.
Across October, the plan will be reviewed and updated with narrative and technical information in response to feedback, before a final narrative Strategy Delivery plans is agreed with system leads and regional teams in November.
In early December, an aggregated national Strategic Implementation Plan is set to be published.
The NHS Long Term Plan describes the actions that will need to be taken at local, regional and national level to make its ambitious vision a reality:
▪ Joining up the NHS and social care so patients don’t ‘fall through the cracks’, such as by breaking down the barriers between GP services and those in the community.
▪ Helping individuals and families to help themselves, by taking a more active role in preventing ill-health, such as offering dedicated support to people to stop smoking, lose weight and cut down on alcohol.
▪ Tackling health inequalities by working with specific groups who are vulnerable to poor health, with targeted support to help homeless people, black and minority ethnic (BAME) groups, and those with mental illnesses or learning disabilities.
▪ Backing our workforce by increasing the number of people working in the delivery of NHS services, particularly in mental health, primary care and community services.
▪ Bringing the NHS into the digital age, rolling out technology such as new digital GP services that will improve access and help patients make appointments, manage prescriptions and view health records on-line.
▪ Spending extra investment wisely, making sure money goes where it matters most. The NHS will continue to reduce waste, tackle variations and improve the effectiveness of treatments.
Dr Rob Dyer, lead medical director for Devon, is working on the development of Better for You, Better for Devon, and said: “The NHS is one of our nation’s greatest achievements, and for 70 years dedicated NHS staff have been there for us in Devon and across the country.
“But more people are living longer, many with complex health conditions, so the NHS and local councils need to plan so they can work more smartly and effectively, deliver excellent care and attract and retain the best staff.”