1. Older People- Predicting Need
According to GLA projections the borough’s 80+ population will rise by 13% over the next
decade. Within this, the comparatively small 90+ age group is set to increase by 1,100
(46%). Those aged 75 to 79 will decrease by 400. The 40-54 age group will increase by
17,000 (25%).
The reasons for the differences are:
• Those now aged between 75-79 were born around 1931 when birth rates were probably
normal despite the depression. By 2018, 75 to 79 year olds will have been born in the
middle of WW2 when birth rates were presumably low because of male conscription.
• With the 90+ population, in 2008 many of them had been born in WW1 and the
following ‘flu outbreak so their numbers are artificially low. By 2018 the 90+ population
will have been born in 1928 – back to normal birth rates. Key features affecting the
population include the increase in single person households, including quite a dramatic
increase from 2011 and the increase in diversity for the population which is shown
below in terms of ethnicity, both feature captured on the table below.
Single person households
DCLG 2004 based household prjections, January 2007
25000
20000
65+
15000
75+
10000
85+
5000
0
2001 2004 2006 2011 2016 2021
15508 15491 15436 16002 17557 19258
65+
9468 9556 9677 9775 10069 10892
75+
3249 3097 3249 3529 3837 4110
85+

2. One of the key features of change for the older population is
We know that income is linked to deprivation and deprivation has an impact on a range of
health outcomes affecting demand for social care. This map shows the greatest numbers
of older people in terms of the percentage of each area’s older population claiming means
tested benefits. This varies from a low of 3% to a high in one area of 43% - which is within
the 3% most deprived areas nationally on this measure. We know that we also need to
take into account current factors affecting personal wealth; we are likely to see average
savings decrease as a result of changes in pension arrangements, changes in house
values and more peoples working lives will extend beyond the age of 65.
Targeted work can be undertaken to ensure supplementary pension benefits are claimed
to help reduce: depression, poor nutrition, hypothermia and social isolation.
Equality issues are a major theme for older people as it is recognised that not only are
older people as a group discriminated against in society; but also many face additional
discrimination because of their race, gender, mental frailty etc. The Employment Equality
(Age) Regulations 2006 came into force in England, Wales and Scotland two years ago.
While it does not currently apply to goods and services, the campaign against age
discrimination is at the forefront of current national debate.
One of our key priorities in the commissioning strategy of older people is to tackle
inequalities and social exclusion that lead to poor health and improve access to services
for vulnerable people.

4. Responding to Changing Need
The direction of travel over the next ten years needs to ensure a robust continuum of care
is developed for older people. The reason for this approach is to better support older
people at an earlier stage based on the principle that early intervention leads to better
prevention, enabling a much higher level of self managed care. This builds on the lesson
learnt from the Expert Patient Programme and research on the benefits of better
management of people with long term chronic health conditions. Greater independence
can be promoted by ensuring that older people can exercise increased choice and control,
and find their own solutions to many of the problems that they face in older age. This
approach requires a rethink in the way services are planned. Traditionally, social care and
health managers have managed services. They decided who received services and
ensured delivery to time, cost and quality. With services increasingly purchased from the
private and voluntary sectors, managers need to take a wider perspective; understanding
the complex nature of demand and the options to meet it. Events that lead to major
expenditure for one agency, such as hospital or care home admission may have their
antecedents in the work of another. For example, lower health service physiotherapy
provision may impact a person’s capacity to recover from a stroke, leading to increased
social care provision. The absence of an early social care intervention may impact health
services through hospital admission. Current information systems have been designed to
meet the needs of service managers. Information to answer questions on the choice of
service or the consequences of delays is often not available or not collated. Key areas
which require a joined up approach1 are
• Incontinence
• Dehydration
• Dentures
• Falls
• Housing
• Podiatry
• Stroke Recovery
• Mental Health
Key Messages
• There is evidence to suggest that by adopting positive approaches to mental health in
older people, this will impact on the use of specialist and acute services later on
(reducing dependence) and therefore on this basis it needs to be a public health priority.
• Stigma and discrimination remain powerful forces and although many older people
remain independent and make an active contribution to their families and to their
Demand Forecasting and Capacity Planning Configuring Future Services Toolkit A Structured Approach to
1
Delivering Better Outcomes for Older People Version 1.0 October 2007

5. neighbourhoods well into their 90s and beyond, the view prevails that older people are
only recipients of care services. The local authority and the PCT have a clear role to
challenge this view and develop effective channels for the voices of older people to be
heard.
• We know that to address health and well being in later life we need to pay attention to
ageing, the practical impact on people’s lives and how communities and
neighbourhoods can be more ‘geared up’ to independence. Developing initiatives
around health and well being should achieve better inclusion for older people;
promotion of physical activity including walking, ‘age-proofing’ the local environment
through influence of planning priorities, more active civic involvement of older people.
• Recognise the benefits for the whole population of using the wisdom and experience of
many older people, and how the place shaping role of the local authority can be used to
promote intergenerational activity for example via schools - all promoting health & well
being.
• Older people are more likely to suffer from chronic and long term conditions and are
also more likely to suffer from falls / factures which bring them into contact with health
services. Older people represent the largest proportion of users of NHS services,
however can and do get better after a period of rehabilitation and convalescence. It is
vital that these episodes of acute/ medical treatment are used as opportunities for
people to optimise their functioning and return home safely.
• For the increasing number of people living longer in their own homes, with shorter and
shorter hospital admissions time, there can be a greater impact of families and carers.
We also recognise that many carers are older people themselves. The development of
the carer’s strategy and building a better infrastructure to respond to carers’ needs is
vital to militate against the strain on carers.
• Most older people in Barnet are home owners and we need ensure all advice and
information is geared to this large and significant segment in the borough. The LBB
private sector housing strategy is developing this approach. Timely access to practical
help for home owners through approaches such as the Care and Repair or Handyman
services are critical factors in supporting older people to live in their own homes and
promote peace of mind.
• The use of telecare initiatives is growing and needs more research on the impact and in
how to use technology to greater effect to empower older citizens. There are still
challenges of linking up customer information across different agencies and this
challenge will become greater as wider choice involves a greater number of agencies.