1. Do not use fonts other than Arial for your presentations Joint Strategic Needs Assessment 2011-12 Carlisle Locality Stakeholder Panel Thursday 10 th November

2. Do not use fonts other than Arial for your presentations Content Introduction to the JSNA Background & context Demand on health and social care system Long-term conditions Mental health & well-being Living conditions & health inequalities Lifestyle & behaviours Summary

3. Do not use fonts other than Arial for your presentations Welcome Welcome to the JSNA locality stakeholder panel Purpose – to begin the process of developing an enhanced JSNA for Cumbria This is the responsibility of the Health and Wellbeing Board Plan to have this in place by April 2012 Feeds in to the Joint Health and Wellbeing Strategy (June 2012)

4. Do not use fonts other than Arial for your presentations What is a JSNA? Describes health and wellbeing in Cumbria Describes strategic direction of services Based on wide range of current information and evidence JSNA products, county and locality narratives, online information

5. Do not use fonts other than Arial for your presentations Who is involved? Cumbria County Council NHS Cumbria Cumbria Intelligence Observatory District Councils Third Sector LINKs Probation, police and other partners

6. Do not use fonts other than Arial for your presentations Why do we need a JSNA? Current JSNA needs to be updated Important role in the Health and Social Care Bill HWWB role in Joint Health and Wellbeing Strategy and JSNA JSNA supports the Joint Health and Wellbeing Strategy (JHWBS) Commissioning Plans 2013 need to take account of JHWBS

7. Do not use fonts other than Arial for your presentations What are the challenges? Ageing Population Mental health and alcohol issues Health of children and young people Health inequalities

8. Do not use fonts other than Arial for your presentations What do we want from you? Your ideas and feedback on the information presented Views on local needs and priorities Information on local strengths and assets Help to develop a local narrative for JSNA

9. Do not use fonts other than Arial for your presentations Overall Deprivation Score Source: Indices of Deprivation 2010

10. Do not use fonts other than Arial for your presentations Health Deprivation Score Source: Indices of Deprivation 2010

11. Do not use fonts other than Arial for your presentations Life Expectancy Source: Office for National Statistics Life ExpectancyHealthy Life Expectancy

12. Do not use fonts other than Arial for your presentations Rurality England Cumbria Carlisle Source: Office for National Statistics, 2010

13. Do not use fonts other than Arial for your presentations Rurality Aged 65+ England Cumbria Carlisle Source: Office for National Statistics, 2010

14. Do not use fonts other than Arial for your presentations Barriers to Services & Housing Source: Indices of Deprivation, 2010

15. Do not use fonts other than Arial for your presentations Carlisle Population Source: Office for National Statistics “Known”Forecasted

16. Do not use fonts other than Arial for your presentations Median Household Income (£) Source: CACI Paycheck, 2011

17. Do not use fonts other than Arial for your presentations People and Communities STRENGTHSWEAKNESSES There has been significant recent growth in population and aggregate employment But average earnings are relatively low Average levels of unemployment and measures of worklessness are relatively low But there are geographical concentrations of worklessness in some urban wards Average educational standards are comparable with the average for the NW region But achievements are very low in urban wards where worklessness is also prevalent The University of Cumbria attracts students to Carlisle But high level qualifications are still less prevalent in the population as a whole

18. Do not use fonts other than Arial for your presentations Business and Enterprise STRENGTHSWEAKNESSES There was a growth in employment up to 2008 in public services, business services, transport and construction But these sectors are now very vulnerable to changes in the economy Carlisle has many urban and rural tourism assets and visitor numbers / levels of spend have grown since 2001 But growth has not been as high as in other areas of Cumbria and employment in hotels and restaurants has been fairly static Businesses in Carlisle show higher survival rates compared to UK averages But the rate of new business starts is relatively low

19. Do not use fonts other than Arial for your presentations Infrastructure & Environment STRENGTHSWEAKNESSES Carlisle has an attractive urban core for shopping and leisure activities and a historic quarter But recent trends indicate a fall in employment in retailing and wholesale activities since 2005 There has been significant growth in the number of dwellings in Carlisle There is a residual amount of housing stock in the private sector of poor quality Carlisle’s rural areas contain outstanding natural landscapes and attractive market towns and dispersed settlements But some rural settlements experience poor access to services Carlisle has good road and rail communications and a plentiful supply of employment land But east-west routes need further improvement and there are gaps in supply of land in terms of geography, quality and product type

20. Do not use fonts other than Arial for your presentations Community Safety Levels of crime have fallen by 4.3%, but levels remain high for compared to Cumbria as a whole Levels of drug crime and domestic violence are on the rise There has also been a rise in the number of people admitted to hospital with alcohol related conditions. The typical offender in Carlisle is most likely to be aged 18-30 years and male Crime and disorder is most prevalent in deprived areas. Levels of crime are particularly high in the wards of Castle and Currock in Carlisle

21. Do not use fonts other than Arial for your presentations Housing The mean average house price in Carlisle is £144,690, less than the county average of £167,455 The mean housing affordability ratio for the district is 4.5, less than the county average of 5.2 20.9% of households in Carlisle are fuel poor, compared to 24.1% in Cumbria

22. Do not use fonts other than Arial for your presentations Demand on the Health and Social Care System Per 1000 the population Health Demand CarlisleActualCarlisleCumbriaCarlisle Calls to Cumbria Health on Call 31,965292250 More calls than Cumbria Admissions to hospital 12,578115 Same number of admissions as Cumbria Calls to the Ambulance Service 11,941109108 More calls than Cumbria

23. Do not use fonts other than Arial for your presentations Demand on the health and Social Care System Adults 3,679 adult social care service users accessing 12,659 services 2377 new referrals to adult social care services, with 1277 resulting in a full assessment Children 133 looked after children 246 core assessments completed

24. Do not use fonts other than Arial for your presentations Demand on the Health and Social Care System 71% (2,597) of the adult service users are aged 65 and over Over 1,100 safeguarding alerts come into adult social care every year Adult Social Care

25. Do not use fonts other than Arial for your presentations Demand on the Health and Social Care System Housing need (Adults) Source: Planning 4 Care

26. Do not use fonts other than Arial for your presentations Demand on the Health and Social Care System – Learning Disabilities 2010-30 People aged 18 and over predicted to have a learning disability (Source: PANSI and POPPI based on Emerson and Hatton)

27. Do not use fonts other than Arial for your presentations Demand on the Health and Social Care System – Dementia Figure 14: 2010-2030 The number of people aged over 65 years predicted to have dementia (Source: POPPI)

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30. Long-term Conditions, Chronic Illness and Disabilities Years of life lost from Cancer Source: National Centre for Health Outcomes Development, 2007-2009

31. Do not use fonts other than Arial for your presentations Years of life lost from Circulatory Disease Long-term Conditions, Chronic Illness and Disabilities Source: National Centre for Health Outcomes Development, 2007-2009

32. Do not use fonts other than Arial for your presentations % of working age population with a disability Long-term Conditions, Chronic Illness and Disabilities Source: Annual Population Survey, 2011

33. Do not use fonts other than Arial for your presentations % of children (0-16years) entitled to Disability Living Allowance Long-term Conditions, Chronic Illness and Disabilities Source: Annual Population Survey, 2011

34. Do not use fonts other than Arial for your presentations % happy or very happy with life Mental Health and Well Being Source: Quality of Life Survey, 2006

35. Do not use fonts other than Arial for your presentations % satisfied with local area Mental Health and Well Being Source: Place Survey Tracker 2009

36. Do not use fonts other than Arial for your presentations Estimated neurotic disorder per 1000 Mental Health and Well Being Source: North East Public Health Observatory, 2008

37. Do not use fonts other than Arial for your presentations Admissions for deliberate self harm per 100,000 Mental Health and Well Being Source: North West Public Health Observatory, 2009-10

38. Do not use fonts other than Arial for your presentations Years of life lost from suicide Mental Health and Well Being Source: National Centre for Health Outcomes Development, 2009-10

39. Do not use fonts other than Arial for your presentations Infant mortality per 1000 births Living Conditions and Health Inequalities Source: National Centre for Health Outcomes Development, 2009

40. Do not use fonts other than Arial for your presentations % born with low birth weight (<2.5kg) Living Conditions and Health Inequalities Source: National Centre for Health Outcomes Development, 2009

41. Do not use fonts other than Arial for your presentations Teenage pregnancy rate Living Conditions and Health Inequalities Source: Office for National Statistics, 2007-2009

42. Do not use fonts other than Arial for your presentations % children living in poverty Living Conditions and Health Inequalities Source: HMRC, 2009

43. Do not use fonts other than Arial for your presentations Claimant to vacancy ratio Living Conditions and Health Inequalities Source: Office for National Statistics, 2011

44. Do not use fonts other than Arial for your presentations % working age adults with level 4 or greater education Living Conditions and Health Inequalities Source: Annual Population Survey, 2010

45. Do not use fonts other than Arial for your presentations % working age adults with disabilities in employment Living conditions and Health Inequalities Source: Annual Population Survey, 2010

46. Do not use fonts other than Arial for your presentations Excess winter deaths Living conditions and Health Inequalities Source: North West Public Health Observatory, 2006-2009

47. Do not use fonts other than Arial for your presentations % of people who agree they can influence decisions in their area Living Conditions and Health Inequalities Source: Place Survey Tracker, 2009

48. Do not use fonts other than Arial for your presentations Estimated smoking prevalence Lifestyle and Behaviours Source: North West Public Health Observatory, 2009-2010

49. Do not use fonts other than Arial for your presentations Smoking during pregnancy per 100 maternities Lifestyle and Behaviours Source: North West Public Health Observatory, 2009-2010

50. Do not use fonts other than Arial for your presentations Hospital admissions due to alcohol Lifestyle and Behaviours Source: Local Alcohol Profiles for England, 2009-2010

51. Do not use fonts other than Arial for your presentations % reporting drunk and rowdy behaviour as a problem Lifestyle and Behaviours Source: Place Survey, 2008

52. Do not use fonts other than Arial for your presentations Estimated prevalence of drug misuse (crack and opiates) per 1,000 people Lifestyle and Behaviours Source: North West Public Health Observatory, 2008-2009

53. Do not use fonts other than Arial for your presentations % of people engaging in moderate intensity sport and recreation Lifestyle and Behaviours Source: North West Public Health Observatory, 2009-2010

54. Do not use fonts other than Arial for your presentations Healthy eating among adults Lifestyle and Behaviours Source: North West Public Health Observatory, 2006-2008

55. Do not use fonts other than Arial for your presentations % of children participating in PE Lifestyle and Behaviours Source: North West Public Health Observatory, 2009-2010

56. Do not use fonts other than Arial for your presentations % of year six children obese Lifestyle and Behaviours Source: National Child Measurement Programme, 2009-2010