According to the Department of Health, long-term conditions are ‘those conditions that cannot, at present be cured but which can be controlled by medication and other therapies’. A brief overview of these conditions and how many people are affected in Devon is supplied below.
Coronary Heart Disease (CHD)
Coronary Heart Disease (CHD) is when coronary arteries (the arteries that supply the heart muscle with oxygen-rich blood) become narrowed by a gradual build-up of fatty material within their walls. 30,687 people were on a GP disease register for the condition in Devon in 2015. The expected number of people with the condition is 44,634, suggesting that around 69% of the people who are likely to have the condition are on the GP disease register.
Heart Failure
Heart failure is a condition caused by the heart failing to pump enough blood around the body at the right pressure. It usually occurs because the heart muscle has become too weak or stiff to work properly. 6,466 people were on a GP disease register for the condition in Devon in 2015. The expected number of people with the condition is 13,552, suggesting around 48% of the people who are likely to have the condition are on the GP disease register.
Stroke
This definition includes stroke, a serious medical condition where one part of the brain is damaged by a lack of blood supply or bleeding into the brain from a burst blood vessel, and transient ischaemic attack (TIA), a temporary fall in the blood supply to one part of the brain, resulting in brief symptoms similar to stroke. 18,483 people were on a GP disease register for the condition in Devon in 2015. The expected number of people with the condition is 19,537, suggesting around 95% of the people who are likely to have the condition are on the GP disease register.
Chronic Kidney Disease (CKD)
Chronic Kidney Disease (CKD) is a long-term condition where the kidneys do not work effectively. 32,348 people aged 18 and over were on a GP disease register for the condition in Devon in 2015. The expected number of people with the condition is 74,576, suggesting around 43% of the people who are likely to have the condition are on the GP disease register.
Diabetes
Diabetes is a condition where the amount of glucose in blood is too high because the body cannot use it properly because the pancreas doesn’t produce any insulin, or not enough insulin, to help glucose enter your body’s cells, or the insulin that is produced does not work properly (known as insulin resistance). 42,998 people aged 17 and over were on a GP disease register for the condition in Devon in 2015. The expected number of people with the condition is 54,808, suggesting around 78% of the people who are likely to have the condition are on the GP disease register.
Asthma
Asthma is a common long-term condition that can cause coughing, wheezing, chest tightness and breathlessness. The condition is marked by attacks of spasm in the bronchi of the lungs, causing difficulty in breathing. It is usually connected to allergic reaction or other forms of hypersensitivity. 52,308 people are on a GP disease register for the condition in Devon. The expected number of people with the condition is 72,572, suggesting around 72% of the people who are likely to have the condition are on the GP disease register.
Chronic Obstructive Pulmonary Disease (COPD)
Chronic Obstructive Pulmonary Disease (COPD) is the name for a collection of lung diseases including chronic bronchitis, emphysema and chronic obstructive airways disease. People with COPD have difficulties breathing, primarily due to the narrowing of their airways, this is called airflow obstruction. 15,257 people are on a GP disease register for the condition in Devon. The expected number of people with the condition is 21,833, suggesting around 70% of the people who are likely to have the condition are on the GP disease register.
Epilepsy
Epilepsy is a neurological disorder marked by sudden recurrent episodes of sensory disturbance, loss of consciousness, or convulsions, associated with abnormal electrical activity in the brain. 5,600 people aged 18 and over were on a GP disease register for the condition in Devon in 2015. The expected number of people with the condition is 7,468, suggesting around 75% of the people who are likely to have the condition are on the GP disease register.
Age, Sex and Inequality Summaries
The above summary uses information from the GP registers and estimates of prevalence from national studies to provide a profile of long-term conditions in Devon. The following analysis is taken from the Long-Term Conditions Health Needs Assessment and uses data from a project in Somerset, to provide further information about the pattern and costs of long-term conditions across the health and social care system. The South West Academic Health Service Network launched the Symphony project in Somerset, which joins up health and social care data so usage and cost of services across the whole system can be analysed. The project is expected to be extended to cover Devon in due course, but the existing Somerset data can still deliver some useful insights for our local population. This can be done by applying the patterns seen by age, sex and social characteristics in Somerset to our local populations to estimate what we might expect to see in Devon.
Figure 9.32 provides an overview of each of our selected conditions from the Somerset Symphony project, applied by age, sex and deprivation to the Devon population. The column ‘estimated treated prevalence’ as the Symphony project captured the numbers recorded with disease either in primary care, secondary care or elsewhere in the health and social care system. The subsequent charts for each condition show the profile by sex, age and deprivation. Most conditions are more likely in males than females, in older age groups, and in more deprived areas. The following patterns are seen:
- For the pattern by sex, only Asthma has higher prevalence in females. The conditions where male rates are particularly higher are CHD (86% higher), CKD (52% higher) and Heart Failure (51% higher).
- The pattern by age, highlights an increasing pattern with age, with much lower likelihood of having the condition in younger age groups for cardiovascular diseases (CHD, Stroke and Heart Failure), along with CKD. A similar pattern is seen for COPD and diabetes but the peak in earlier in old age (80 to 84) and prevalence rates drop of more quickly for older age groups. Asthma peaks at an earlier age (20 to 24), whilst Epilepsy prevalence is much more even across adult age groups.
- For all conditions prevalence rates are higher in more deprived areas. The greatest differences are seen for COPD (134% higher), Epilepsy (81% higher) and Diabetes (78% higher).
Figure 9.32, Estimated number treated for selected long-term conditions in Devon, with summary breakdowns by age, sex and deprivation, 2013-14 (Somerset Symphony data applied to wider Devon, Plymouth and Torbay population profile)
Source: South West Academic Health Science Network, Symphony Project Data for Somerset modelled by age, sex and deprivation for the Devon population, 2014
| Box 5, Long-Term Conditions, Perceptions and Experiences
Healthwatch Devon undertook a survey of people living with long-term conditions in the county, which yielded 566 responses. The majority (63%) considered the care and support they received was good or excellent. “…a good combination of day-to-day care from GP practice, with well-defined routes to more specialist care as and when I need it.” Around two thirds were involved in decisions about their care, had enough information to manage their health, felt information provided was clear, had confidence in taking care of their own health or felt they had control over their care most of the time. “I am listened to when I have a problem with the existing regime of medication, but there is no systematic, regular review.” However, just under a fifth of respondents (18%) considered the care they received to be poor or very poor. Communication between mental and physical health services was highlighted as a particular area for concern, and concerns were also expressed about the sharing of information between health and social care services. “The support varies between average and poor. Both my carer and myself feel isolated at times in seeking information and support.” “More continuity would be good.” “Agencies do not seem to liaise with each other over my varying health problems, or keeping my family informed.” Two out of three respondents did not have a personal care plan, of which 95% had not talked it over with a professional. People highlighted communication, treating people as equal partners in their care, and holistic care were particularly important. “You are helped at first and then left to your own devices.” “Look at all aspects of my health and have a holistic plan where all health professionals involved work together.” Source Healthwatch Devon, ‘People Living with Long Term Conditions’ Report, December 2014 |