Adult social care early invention and prevention

Determining unmet needs for prevention in social care involves triangulating:

• the population sizes in "Level of Need",
• the evidence on how conditions, behaviours, and events relate to social care use in the short, medium and long term,
• and the evidence on the effectiveness of interventions weighted against the size of the local offer.
• Several categories of unmet needs emerged:

High risk to social care and effective interventions over short term

Falls - high quality evidence on how to prevent falls and a limited local offer. An estimated 8,834 65+ year olds fall each year who are not known to social care. There are 200 hip fractures per year in South Tyneside, 20% of which are predicted to require social care support.

Smoking - High quality evidence on how to help people quit smoking and a short term impact on social care use. The risk of heart attack drops and lung function improves within 3 months of a quit. Within 1 year, the risk of heart attack, heart disease and stroke is 50% less. Smokers are known to enter social care 9 years earlier than non-smokers and are twice as likely to need social care in their lifetimes. There is a full stop smoking service in South Tyneside, but large opportunities exist to integrate more closely with social care.

High risk to social care and effective interventions over long term

Stroke - an estimated 11% of the adult social care population require permanent social care because of a stroke or TIA. There is strong evidence to support reducing the risk of stroke in those with Atrial Fibrillation (AF) through identification and treatment. South Tyneside has a low rate of detection of AF compared to the predicted prevalence, though programmes are underway in primary care to detect more cases. The impact on social care is

High Risk to social care, but limited evidence on effective interventions over short and long term

Loneliness and isolation - over 10,000 people in South Tyneside over 65 are living alone. One-on-one, group and community level interventions have all reported local success, but schemes are not well evaluated and have not yet demonstrated effectiveness. Any locally introduced schemes should be implemented with caution robustly evaluated.

Physical Inactivity and Obesity - there are strong links between physical inactivity, obesity, and long term conditions (LTCs). LTCs are a major risk factor for social care and account for 70% of all spend. There is, however, limited evidence on how to cost effectively improve individuals levels of physical activity and how to reduce obesity levels.

Those eligible for Reablement - By definition, those eligible for reablement services are at immediate risk for social care. The evidence however on the effectiveness of reablement is inconclusive in regards to its ability to cost effectively prevent or reduce the need for social care. Reablement may, however, be a way of delaying the need for higher intensity services.