Frailty (health and wellbeing needs in South Tyneside)

1. The needs of the South Tyneside population are increasing as the population ages. According to the Joint Strategic Needs Assessment of South Tyneside for 2012 - 2013 it is estimated that the population of South Tyneside will:

• Increase by 6% as a whole over the next 20 years.
• The number of individuals aged 65 and over will increase by 40%, while over 85 will increase by 70%. This is of significant relevance to the local population health needs.

Compared to the rest of England, South Tyneside has a slightly higher proportion of older people (21% compared with 19% across England and 20% across the North East).

It is therefore estimated that the number of instances of dementia in the older population will increase by 14% in the near future. These are then predicted to further increase by 46% by 2030. This is not entirely attributable to inevitable ageing, but is most likely related to increased risks of multimorbidity.

2. The current medical and social approach within South Tyneside is a 'reactive' rather than 'proactive' towards frailty. Provisions so far are struggling to meet with demand.

3. Frail individuals are often acutely and repeatedly admitted to inpatient units due to illness or breakdown in social care. They may then remain in medical establishments for extended periods, while awaiting appropriate care packages. The probability of their developing further acute medical complications, such as Hospital Acquired Pneumonia or Clostridium Difficile, is then higher, thus further complicating their recovery. More preventative measures are required to both reduce acute admissions and shorten, or dispense with altogether, stays within hospital care.

4. Within South Tyneside, there are greater prevalence and incidence of long-term conditions such as Cardiovascular disease, Stroke and Respiratory disease. Life expectancy in the local population is lower than the rest of the UK. In 2012 there were 27,000 people aged over 65 living in South Tyneside, 15,000 of whom were suffering a limiting long-term illness. According to a paper by Turner et al 2000 this creates emotional problems in terms of illness 'behaviours' and wellbeing, and and also leads to a generalised functional decline in terms of daily functioning due to the nature of the underlying chronic conditions.

5. Frailty is not an inevitable consequence of ageing and chronic disease. Evidence exists to show that making healthy lifestyle changes can delay frailty and aid healthy ageing. Schemes within South Tyneside such as 'A Better U' and 'Change 4 Life' are such examples of ways to promote more effective self-care. Encouraging a 'prevention rather than cure' attitude, along with enabling patients to take more responsibility for their healthcare will reduce the incidence and burden of frailty.

6. Frail patients are at significant risk of falling. This not only affects an individual's confidence, but also increases the risk of morbidity, mortality and has a negative impact on family and carers. The cost to the NHS of fall victims is estimated at £2.3 billion per year (College of Optometrists / British Geriatrics Society, 2011). Addressing the needs of those who fall in a proactive manner can save the NHS and individuals in terms of health, healthcare costs and quality of life.