Conclusion

The main health and wellbeing challenges in Devon are:

  • An ageing population which is also growing faster than the national average increasing future demand for health and care services
  • Increasing financial pressures affecting local authorities, Clinical Commissioning Groups and other agencies requiring changes to traditional patterns of service provision to ensure health and care services remain affordable
  • A sparse and predominantly rural population, creating additional challenges around access to health and care services and the need for sophisticated models of home-based care, outreach and work to reduce social isolation. The effective utilisation of local resources, voluntary / community organisations and community assets will be critical
  • Patterns of deprivation marked by isolated pockets and hidden need within communities and higher levels of rural deprivation, with groups experiencing health inequalities likely to be geographically dispersed. This creates additional challenges when addressing health inequalities and targeting services to those most in need
  • A configuration of local authority and health organisations more complex than most other counties, with two-tier local authorities, and Clinical Commissioning Groups crossing local authority boundaries. This creates extra challenges in terms of the continuity of services, planning and effective partnership working
  • Average earnings below the national average and house prices and cost of living above the national average which contribute to a number of issues including food poverty, housing-related health conditions, homelessness, mental health and wellbeing, and fuel poverty
  • The need for a focus on prevention at all stages of the life course aimed at improving health in later life for all, as well as narrowing the 10 to 15 year gap in health status between those living in the most and least deprived areas. This will be critical to addressing the demographic and financial pressures that local organisations are facing
  • The need for a focus on mental health and wellbeing throughout the life course with a particular emphasis on areas where outcomes are comparatively poor, and an understanding of the relationship between mental and physical health
  • Changing patterns of health-related behaviours including smoking, excess weight, physical activity, diet, alcohol and drug use and ensuring that the planning of services addresses changing patterns of behaviour and demand
  • The growing number of people with long-term conditions, sensory impairment, frailty, dementia, cancer and other health problems. This requires a particular focus on those living with multiple health conditions, as traditionally health systems have been largely configured for individual diseases rather than multi-morbidity
  • The Devon population is diverse in its needs and inequality can take many forms, resulting in differing health and care needs to which health and care commissioners need to respond.