Joint Strategic Needs Assessment

Joint Strategic Needs Assessment ROTHERHAM May 2011 -2- Table of Contents What is a Joint Strategic Needs Assessment (JSNA)? ................................................... Why do we need a JSNA? .............................................................................................. 1. Demographic Profile 1. 1 1. 2 1. 3 1. 4 1. 5 1. 6 1. 7 1. 8 1. 9 1. 10 1. 11 1. 12 2. 6 6 Population Numbers .................................................................................. Age Profile ................................................................................................

Gender Profile ........................................................................................... Birth Rate .................................................................................................. Black and Minority Ethnic (BME) Population Profile .................................. Disability Profile ........................................................................................ Population by Religious Group .................................................................. Population by Migrant Status ....................................................................

Number of Households ............................................................................. Analysis of Areas of Deprivation ............................................................... Social Marketing Categories and Urban/Rural Classification .................... Sexuality ................................................................................................... 7 7 10 11 12 16 20 21 21 23 25 25 Social and Environmental Needs Assessment 2. 1 2. 2 2. 3 2. 4 2. 5 2. 6 2. 7 2. 8 2. 9 2. 10 2. 11 2. 12 2. 13 2. 14 2. 15 2. 16 2. 17 2. 18 2. 19 2. 20 2. 21 2. 22 2. 23 2. 24

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RMBC Strategic Housing Role .................................................................. Council Housing Stock .............................................................................. Private Sector ........................................................................................... Housing Tenure ............................................................................. ........... Ethnicity .................................................................................................... Overcrowding ............................................................................................

Living Alone .............................................................................................. Summary of Housing Demand in Rotherham ............................................ Condition of Stock ..................................................................................... Affordable Warmth and Fuel Poverty ........................................................ Energy ....................................................................................................... Empty Properties ......................................................................................

Affordability ............................................................................................... Household Income .................................................................................... Central Heating ......................................................................................... Access to Car or Van ................................................................................ Overall Employment Rate ......................................................................... Working Age People on Out-of-Work Benefits (NI 152) ............................

Number on Out-of-Work Benefits in Worst Performing Areas (NI153) ...... Contact with Mental Health Services whilst Employed (NI 150) ................ Unemployment Rate ................................................................................. Claimant Count ......................................................................................... Recent National Economic Down-Turn ..................................................... Average Incomes ...................................................................................... 26 26 27 27 28 29 30 31 33 34 36 37 38 40 42 3 44 46 47 47 48 49 49 50 -32. 25 2. 26 3. Smoking .................................................................................................... Eating Habits ............................................................................. ................ Alcohol ...................................................................................................... Physical Activity ........................................................................................ Obesity ......................................................................................................

General profile of burden of ill health ........................................................ Diabetes .................................................................................................... Circulatory Diseases ................................................................................. Cancer ...................................................................................................... Chronic Obstructive Pulmonary Disease (COPD) ..................................... Infectious Diseases ...................................................................................

Trauma ...................................................................................................... Musculoskeletal ........................................................................................ 70 84 88 97 108 109 114 115 Mental Health Needs Assessment 5. 1 Introduction ............................................................................................... 5. 2 National Picture ......................................................................................... 5. 3 Local Picture ............................................................................................. 5. 4

Differences in the Extent of Mental Health Problems ................................ 5. 5 Local Services ........................................................................................... 5. 6 Financial Costs - National Level ................................................................ 5. 7 Financial Costs - Local Level .................................................................... 5 . 8 User Involvement ...................................................................................... 5 . 9 Emerging Patterns ....................................................................................

Appendix 1 – Indices of Multiple Deprivation ....................................................... 6. 54 56 57 63 66 Burden of Ill Health 4. 1 4. 2 4. 3 4. 4 4. 5 4. 6 4. 7 4. 8 5. 51 53 Lifestyle and Risk Factors 3. 1 3. 2 3. 3 3. 4 3. 5 4. Access to Services .................................................................................... Satisfaction of People Over 65 with Home and Neighbourhood (NI 138) .. 118 119 120 131 141 147 147 151 152 153 Learning Disability Needs Assessment 6 . 1 6. 2 6 . 3 6. 4 6. 5 6. 6 6. 7 6 . 8 6. 9 6. 10 6. 11

Numbers of People with a Learning Disability ........................................... Expenditure for Learning Disabilities in Rotherham for 2009/10 ............... Local Analysis ........................................................................................... BME Population – National Analysis ......................................................... BME Population – Rotherham in 2010 ...................................................... Life Expectancy of People with Learning Disabilities ................................ Health of People with Learning Disabilities in Rotherham .........................

Employment .............................................................................................. Housing ..................................................................................................... Residential and Nursing Care in Rotherham ............................................. Community Based Services for People with Learning Disabilities ............ 154 155 156 160 160 161 161 164 165 166 167 -46. 12 7. 169 169 170 174 177 178 180 183 Early Access for Women to Maternity Services (NI 126) ........................... Number of People Accessing NHS Dentistry ............................................

Uptake Rates for Seasonal Flu Jab .......................................................... Screening for Breast Cancer ..................................................................... Access to GUM services ........................................................................... Long Acting Reversible Contraception Methods ....................................... Access to NHS Funded Abortions before 10 weeks? Gestation ................ 187 187 189 191 193 193 194 User Perspective on Social and Health Care 9. 1 9. 2 9. 3 9. 4 9. 5 9. 6 9. 7 9. 8 9. 9 9. 10 . 11 9. 12 10. National Profile of Need for Social Care .................................................... Promoting Independence and Developing Community Support ................ Rotherham Profile of Need for Adult Social Care ...................................... Informal Care Needs Analysis ................................................................... Home Care Services ................................................................................. Residential Care .......................................................................................

Intermediate Care ..................................................................................... Analysis of Community-Based Provision ................................................... Access To Health Services 8. 1 8. 2 8. 3 8. 4 8. 5 8. 6 8. 7 9. 168 Social Care Needs Assessment 7. 1 7. 2 7. 3 7. 4 7. 5 7. 6 7. 7 7. 8 8. Carers ....................................................................................................... Support Older People Receive in order to Live Independently at Home ... Respect and Dignity in their Treatment (NI128) ....................................... User Perspective on Social and Health Care – Neighbourhoods and Adult Services (NAS) Research ............................. Patient Survey Programme Findings for Local Institutions Patient Survey of Local Community Mental Health Services ..................... Patient Survey of Local Community Health Services ................................. Patient Survey of Local In-Patient Services – RFT .................................... Patient Survey on Access to Primary Care ................................................

Patient Survey on Choice to Primary Care ................................................. Black Minority Ethnic (BME) Mental Health Consultation Event ................. Consultation with Focus Groups and Individual Interviews ........................ Consultation at Fair? s Fayre ...................................................................... 198 198 198 207 208 209 210 211 213 213 213 219 Children and Young People’s Needs Assessment 10. 1 10. 2 10. 3 10. 4 10. 5 10. 6 General Health ..........................................................................................

Proportion of Children in Poverty .............................................................. Prevalence of Breast Feeding at 6 to 8 Weeks from Birth ......................... Teenage Pregnancy (Under 18 and Under 16 Conception rates) ............. Obesity among Primary School Age Children in Reception Year and Year 6 ........................................................................................................ Infant Mortality .......................................................................................... 221 222 223 225 227 229 -510. 10. 8 10. 9 10. 10 Uptake of Chlamydia Screening in Under 25s .......................................... Percentage DMFT in 5 Year Olds ............................................................. Children Killed or Seriously Injured on Roads (persons under 16 years) .. Proportion of Children who Complete Immunisation by Recommended Ages .......................................................................................................... 10. 11 Parental Experience of Services for Disabled Children ............................. 11. 229 229 230 233 234

Area Assembly Needs Profile 11. 1 11. 2 11. 3 11. 4 11. 5 11. 6 11. 7 Rother Valley South .................................................................................. Rother Valley West ................................................................................... Rotherham North ...................................................................................... Rotherham South ...................................................................................... Wentworth North .......................................................................................

Wentworth South ...................................................................................... Wentworth Valley ...................................................................................... 244 247 249 251 254 256 258 Glossary ........................................................................................................................ 261 -6- What is a Joint Strategic Needs Assessment (JSNA)? The Joint Strategic Needs Assessment (JSNA) establishes the current and future health and social care needs of a population, leading to improved outcomes and reductions in health inequalities.

The JSNA informs the priorities and targets set by Local Area Agreements, leading to agreed commissioning priorities that will improve outcomes and reduce health inequalities throughout the Borough. The JSNA marks the beginning of a process which will inform service reconfiguration, commissioning and decommissioning of services. The JSNA will evolve over the coming months and years as the demographic and health profile of the population changes. Information gathered in the Joint Strategic Needs Assessment will be used to create a needs profile for Rotherham.

It will be used to target resources at those in most need. Why do we need a JSNA? Since 1 April, 2008, Local Authorities and Primary Care Trusts are under a statutory duty under the Local Government and Public Involvement in Health Act to produce a Joint Strategic Needs Assessment (JSNA). The Operating Framework for the NHS in England 2008/2009 refers to the importance of the JSNA in informing PCT Operational Plans. The JSNA underpins a number of the World Class Commissioning competencies. The JSNA forms the basis of the new duty to co-operate.

This partnership duty involves a range of statutory and non-statutory partners, informing commissioning and the development of appropriate, sustainable and effective services. Joint Strategic Needs Assessment Core Dataset This document fully complies with the Department of Health’s JSNA Core Dataset, published on 1st August, 2008. It focuses on health and social care needs, breaking these down to Area Assembly level so a good understanding of these needs can be established for joint commissioning purposes. -7- 1. Demographic Profile 1. 1 Population Numbers

Rotherham is one of four metropolitan boroughs in South Yorkshire, covering an area of 118 square miles with a population of 253,900 (2009). The population of Rotherham has been rising by 1. 0% (2,600) since 2004 and 1. 8% (4,500) since 2002. Population projections suggest that the population of Rotherham will increase by 5. 1% to 266,900 by 2020 and by 9. 8% to 278,900 by 2030. The projected increase is the result of rising life expectancy, natural increase (more births than deaths) and migration into the Borough. The Borough is divided into 21 wards, grouped into 7 Area Assemblies as follows:

Rother Valley South – Dinnington, Anston & Woodsetts and Wales Rother Valley West – Brinsworth & Catcliffe, Holderness and Rother Vale Rotherham North – Rotherham West, Keppel and Wingfield Rotherham South – Boston Castle, Rotherham East and Sitwell Wentworth North – W ath, Swinton and Hoober Wentworth South – Rawmarsh, Silverwood and Valley Wentworth Valley. – Wickersley, Hellaby and Maltby About half of the population lives in and around the main urban area of Rotherham town. The remainder lives in satellite towns such as Wath, Dinnington and Maltby and in rural areas1.

Rotherham comprises a diverse and vibrant blend of people, cultures and communities. It is made up of a mix of urban areas and rura l villages, interspersed with large areas of open countryside. About 70% of the Borough area is rural, but it is well connected to all areas of the country by its proximity to the motorway network and intercity rail networks. Rotherham? s traditional steel and coal industries have largely given way to new industries in an economy which grew rapidly in the 1995 – 2005 period. 1. 2 Age Profile There are approximately 197,500 adults currently living in Rotherham (2009). 7,800 people are aged 60 and over (22. 8%), 102,800 are aged 30 to 59 years (40. 5%) and 37,000 are aged 18 to 29 years (14. 6%). In addition, there are 56,400 (22. 1%) children aged 0 to 17 years. The age profile of the Borough population is shown in Figure 1. 1. Rotherham has more people aged over 50 (1 in 3 people) than people under 16 (1 in 5 people). Rotherham has 90,200 people aged 50 or over which equates to 35. 5% of the total population and this proportion is rising. 1 RMBC 2007 Area Assembly Profiles (www. rotherham. gov. uk) -8Distribution of Older People

Figure 1. 1: Age Profile of Rotherham Rotherham 60 and over 22. 8% 30 to 59 40. 5% 18 to 29 14. 6% 5 to 17 0 to 4 0. 0% 16. 1% 6. 0% 5. 0% 10. 0% 15. 0% 20. 0% 25. 0% 30. 0% 35. 0% 40. 0% 45. 0% Rotherham Source: Mid Year Estimates 2009 The most significant demographic change occurring in Rotherham is the growth in the number of older people which is shown in Figure1. 2. The number of people over 65 will increase by more than a half by 2028, from 4 1,500 to 61,400. The number of people over 85 will almost double (+96%) from 5,000 to 9,800 by 2028.

Although people will tend to remain healthy for longer than they do now, the rising numbers of older people will have major implications for health and adult social care services, informal care and all services used by older people. Figure 1. 2: Projected Growth in the over 65 population from 2008 to 2028 18,000 16,000 2008 2028 Population 14,000 12,000 10,000 8,000 6,000 4,000 2,000 0 65 to 69 Source: 2008 Population Projections 70 to 74 75 to 79 80 to 84 85 and over -9Figure 1. 3: Projected Growth in over 65 population from 2008 to 2028 Population aged 65+ 65 60 Thousands 55 50 45 40 20 08 20 09 20 10 0 11 20 12 20 13 20 14 20 15 20 16 20 17 20 18 20 19 20 20 20 21 20 22 20 23 20 24 20 25 20 26 20 27 20 28 35 Source: 2008 Population Projections The number of people aged 65+ is projected to increase at a steady rate over the next twenty years. The number is projected to increase by 48% from 41,500 to 61,400. Figure 1. 4: Projected Growth in over 85 population from 2008 to 2028 Population aged 85+ 10. 0 9. 0 Thousands 8. 0 7. 0 6. 0 5. 0 20 08 20 09 20 10 20 11 20 12 20 13 20 14 20 15 20 16 20 17 20 18 20 19 20 20 20 21 20 22 20 23 20 24 20 25 20 26 20 27 20 28 4. 0 Source: 2008 Population Projections

The steady increase in the 65+ population hides a much faster rise in the population aged 85+ which is projected to increase by 96% between 2008 and 2028. The rate of increase is projected to rise after 2014, peaking between 2020 and 2025 when there will be 29% growth over 5 years. - 10 1. 3 Gender Profile In Rotherham, there are 129,400 (51%) females and 124,400 (49%) males, which is very similar to the national average. The age and gender distribution of Rotherham? s population is similar to the national profile, although Rotherham has a slightly lower proportion of young adults (20-34).

Figure 1. 3 shows the age and gender structure of Rotherham compared to England and Wales in 2009. Office of National Statistics data illustrates that up to the age of 72 years the number of males and females are fairly equal. From the age of 73 years the proportion of females to males increases significantly2. 2. 9% of the female population are over 85 years compared to 1. 4% for men. There are 3. 7 women for every man aged over 90 years. The rising population imbalance between males and females as old age progresses results from women? s higher life expectancy. 2% of the entire population are of working age, of these 51. 1% are under 40 years of age. Figure 1. 5 also shows a relatively low proportion of people aged 30-34 years which reflects the low birth rates from the mid to late 1970s. Likewise, the high proportion aged 40-45 reflects high birth rates in the early 1960s. Figure 1. 5: Age and gender profile Broken down by percentage of male/female population Rotherham 9. 0% 8. 0% 7. 0% 6. 0% 5. 0% Males 4. 0% Females 3. 0% 2. 0% 1. 0% 0. 0% 0 5 10 15 20 25 30 35 40 45 50 55 60 65 70 75 80 85 90 to to to to to to to to to to to to to to to to to to + 9 14 19 24 29 34 39 44 49 54 59 64 69 74 79 84 89 Age Group Source: Mid Year Estimates 2009 2 Office of National Statistics 2009 Live Births - 11 England and Wales 9. 0% 8. 0% 7. 0% 6. 0% 5. 0% Males 4. 0% Females 3. 0% 2. 0% 1. 0% 0. 0% 0 5 10 15 20 25 30 35 40 45 50 55 60 65 70 75 80 85 90 to to to to to to to to to to to to to to to to to to + 4 9 14 19 24 29 34 39 44 49 54 59 64 69 74 79 84 89 Age Group Source: Mid Year Estimates 2009 1. 4 Birth Rate The birth rate in Rotherham has been steadily increasing since 2002 (Figure 1. 6). Live births decreased from over 3,700 in 1991 to 2,730 in 2001.

Since then the numbers of births has increased each year to 3,300 in 2008 before dropping slightly in 2009 to 3,200. There has been an average increase of about 60 live births each year over the last eight years. This increase in birth rate reflects similar increases nationally. Figure 1. 6: Number of Births in Rotherham between 1959 to 2009 Source: Office of National Statistics 2998, Live Births The Total Fertility Rate (TFR) for 2009 shows an average of 1. 96 children per woman in England and Wales. This represents a small decrease in fertility from 1. 97 children in 2008.

This is the first annual decrease since 2001 when the TFR fell to 1. 63 from 1. 65 in 2000. The TFR for 2009 is still comparably high. In 2008 the TFR was at its highest point in 35 years. The provisional - 12 General Fertility Rate (GFR) for 2009 was 63. 7 live births per 1,000 women aged 15-44, a decrease compared with 63. 8 in 2008. In 2009, there were decreases in fertility rates for women aged under 30 and increases for women aged 35 and over, compared with 2008; fertility rates for women aged 30–34 remained unchanged. The largest percentage decrease (2. 7 per cent) occurred among women aged under 20.

For this age group the fertility rate fell from 26 live births per thousand women aged under 20 in 2008 to 25. 3 in 2009. The standardised average (mean) age of women giving birth increased slightly to 29. 4 in 2009 from 29. 3 in 2008. The figure for 2009 is the highest on record. The sex ratio at birth for 2007 was 1,052 live males per 1,000 live females born. There was a continued rise in the proportion of births to mothers born outside the UK: 24. 7 per cent in 2009 compared with 24. 1 per cent in 2008. In 1999, 14. 3 per cent of births were to non-UK born mothers. 1. 5 Black and Minority Ethnic (BME) Population Profile Rotherham? Black and Minority Ethnic (BME) population is relatively small but has been growing and becoming increasingly diverse. Rotherham MBC estimates that there are 19,000 people from BME communities in 2009 which equates to 7. 5% of the local population (5. 6% are non-white), with 92. 5% from the White British population3. By comparison in 2001, 4. 1% of the population were from BME communities, suggesting that the number of BME residents has almost doubled over the last eight years. BME residents are fairly evenly divided between those born in the UK and those born abroad, the latter being more likely to have limited English language skills.

Figure 1. 7: Projected BME Population Growth in Rotherham between 2005 and 2030 Source: BME Health Needs Assessment 2008, Black a nd Minority Ethnic Populations in Rotherham (page 12) In 2006, Yorkshire Futures produced population projections by ethnic group. Figure 1. 7 illustrates the projection for Rotherham which suggests a 61% increase in the non-White population between 2005 and 2030. Of the total of 3 Rotherham MBC Population Estimates by Ethic Group 2009 - 13 17,600 non-white residents projected for 2030, about 11,400 would be Asians. However, the fact that Rotherham? BME population more than doubled in the 13 year period 1991-2004, and that non-white residents already number about 14,000 suggests that this projection may underestimate the likely rate of growth. Immigration and natural increase means that Rotherham? s black and minority ethnic population has continued to grow in recent years, reaching 19,000 people. The white minority population (mainly European) was estimated to have a population of about 3,000 in 2004, rising to 4,000 in 2006 and an estimated at 5,000 in 2009. Most minority ethnic groups have young populations, notably the Kashmiri and Pakistani.

There is a growing mixed or dual heritage population, the majority of who are children and young people. The Irish community is an exception, being much older than average. Figure 1. 8: BME Population Breakdown in Rotherham – Mid-Year Estimates 2009 Source: Rotherham MBC Population Estimates by Ethnic Group 2009 The largest BME community is that from Pakistan and Kashmir which constitutes 3. 0% of the overall population, higher than the average of 1. 5% in England and Wales. The Kashmiri and Pakistani community is well established in Rotherham following initial migration in the 1960s and 1970s.

There are also much smaller established communities such as Chinese, Indian and Irish. The fastest growing population is the Black African community and other new communities, including migrant workers from Eastern Europe, have also settled in Rotherham which now has a Roma community of around 2,000 people. - 14 Figure 1. 9: Number of People in each Ethnic Group in Rotherham in 2009 Ethnic Group White British White Irish White Other White and Black Caribbean White and Black African White and Asian Other Mixed Indian Pakistani Bangladeshi Other Asian Black Caribbean Black African Black Other Chinese

Other Ethnic No. of People 234,900 1,100 3,900 400 100 700 400 700 7,600 100 700 200 1,500 200 600 800 Source: Rotherham MBC Population Estimates by Ethnic Group 2009 Figure 1. 9 shows the breakdown of the numbers of people from each BME community who are living in Rotherham. The largest number of people who are from minority ethnic groups are those from the Pakistani (and Kashmiri) community (7,600) which equates to 40% of the BME population in Rotherham. 3,900 people (20. 5%) are from the White Other ethnic group which includes EU migrant workers from other European countries such as Poland and Slovakia.

Further migration from European countries may result in continued growth in the years ahead. Figure 1. 10: Gender by Ethnic Origin of all Ethnic Groups in Rotherham in 2008 Source: BME Health Needs Assessment 2008, Black and Minority Ethnic Populations in Rotherham, p13 Figure 1. 10 provides a gender breakdown across all BME communities. It shows that white minority ethnic communities, Indian and Black groups have a larger number of men in contrast to women. People from Pakistani/Kashmiri origin have a similar gender balance to the White British population, whilst the Chinese community has a higher proportion of women.

The higher proportion of men amongst certain BME groups in - 15 Rotherham is likely to reflect economic migration with men moving to Rotherham to find employment. This trend is more significant amongst more recent migrant groups where two thirds are often male. Figure 1. 11: Population Structure of Different Ethnic Groups in Rotherham 2009 Ethnic Group Total Number 1,600 7,600 800 600 800 234,900 700 1,900 3,900 1,100 253,900 Mixed Pakistani Other Asian Chinese Other W hite British Indian Black W hite Other W hite Irish All People % Population aged 0-15 0. 39% 1. 18% 0. 08% 0. 04% . 12% 16. 86% 0. 04% 0. 16% 0. 47% 0. 04% 19. 38% % Population aged 16+ 0. 28% 1. 81% 0. 24% 0. 20% 0. 20% 75. 62% 0. 24% 0. 59% 1. 06% 0. 39% 80. 62% Source: Rotherham MBC Population Estimates by Ethnic Group 2009 Figure 1. 11 provides an insight into the children to adults for each of Rotherham? s BME population. Some BME communities have a significantly younger age profile than the general population of the Borough. The percentage of the Pakistani community under 15 years (1. 18%) is around 60% of the adult population total and the Mixed community have more children than adults.

This reflects a significantly higher birth rate for the Pakistani and Mixed ethnic groups. There is a big difference in the White British community where the adults outnumber the 0-15 population by approximately 5 to 1. In contrast, the Mixed and Pakistani ethnic groups have a much smaller proportion of their population aged 65 and over (less than one seventh of the general population). The largest non-White British community is Pakistani with an estimated 550 elders (55 years of age+)4. BME communities have a younger age profile compared to the general population.

The child population of Rotherham is far more ethnically diverse than that of the older population. Figure 1. 12: Percentage of BME pupils in each Area Assembly in Rotherham 60. 0% BME Pupils 50. 0% 40. 0% 30. 0% 20. 0% 10. 0% W es ot t he rh am N or R th ot he rh am So ut W h en tw or th N or W th en tw or th So W ut h en tw or th Va ll e y R ot he rV R R ot he rh Va lle y al le y So ut h 0. 0% Source: PLASC Data 2010 4 Rotherham State of the Borough 2008 A Statistical Portrait, p14 - 16 Figure 1. 12 provides a breakdown of the BME pupils by Area Assembly in 2010. This shows that 52% of BME pupils live in Rotherham South.

The distribution of pupils shows a similar pattern to the distribution of BME residents in the 2001 Census, 4,809 of who lived in the Rotherham South, 48% of the Borough? s BME population. Only three wards – Rotherham East, Rotherham West and Boston Castle – had significant minority ethnic populations in 2001, with 61% of Rotherham? s non-white population and 77% of the Pakistani and Kashmiri population. Data on pupil ethnicity shows that increasing numbers of BME families live in Sitwell ward. Rotherham North had the second largest BME population with 1,746 people (17%) in 2001.

In comparison, there were 562 people (6%) living in Wentworth North which had the smallest BME population5. Within Rotherham South, BME communities are particularly concentrated in Eastwood, Ferham, Masbrough, Wellgate and Broom Valle y which are mainly deprived areas close to the town centre. These are the original settlement areas for the Kashmiri and Pakistani community. Since 2001, there has been some movement of Pakistani and Kashmiri families to suburban areas in Broom. 1. 6 Disability Profile Sensory Impairment – Blind/Partially Sighted In 2008 there were 152,980 people in England and Wales registered blind.

This is a slight increase of 525 people (0. 3%) from March 2006. There were 10,300 new registrations in 2008, a fall of 5% compared to 20066. There were approximately 156,285 people in England registered as partially sighted, an increase of 1,085 people since 2006. There were approximately 13,200 new registrations in 2008, a fall of 8% compared to 20067. The leading cause of certifications for blindness is degeneration of the macula and posterior pole (57. 2%) which largely comprises Age-related Muscular Degeneration (AMD). This is the leading cause of blindness amongst older people, in particular for the age group 75 years and over.

Other common causes of certification are glaucoma (10. 9%), diabetic retinopathy (5. 9%), optic atrophy (3. 1%), hereditary retinal disorders (2. 8%) and cerebrovascular disease/accidents (2. 5%)8. Common causes of certification among partially sighted people are: degeneration of the macula and posterior pole (56%), glaucoma (10. 2%), diabetic retinopathy (7. 4%), cerebrovascular disease (4. 9%), hereditary retinal disorders (2%), optic atrophy (1. 9%), myopia (1. 9%) and retinal vascular occlusions (2%)8. Figure 1. 13 provides a national breakdown by age of the number of people on the blind and partially blind registers. Census 2001 BME Population National Statistics 2006 Registered Blind and Partially Sighted, p(i) 7 National Statistics 2008 Council Tables – Blind and Partially Sighted, pPS1 8 Public Medical Health 2009 Research and Development, Leading Causes of Blindness 6 - 17 Figure 1. 13: % of People on Blind or Partially Sighted (P/S) Register by Age Group in England 1994-2008 Category 1994 1997 2000 2003 2006 2008 0-4 Blind P/S 0 1 1 1 0 0 0 0 0 0 1 0 5-17 Blind P/S 2 2 2 2 2 2 2 3 2 3 3 3 18-49 Blind P/S 10 10 10 10 10 9 11 10 12 10 13 11 50-64 Blind P/S 8 8 8 8 8 8 9 8 10 9 10 9 65-74 Blind P/S 11 12 10 12 10 11 10 11 0 10 10 10 75 and Over Blind P/S 68 68 69 68 69 69 67 68 66 68 64 68 Source: National Statistics 2008, Council Tables - Blind and Partially Sighted, p6 Nationally the proportion of young people registered blind is increasing, in particular in the 18-49 age range. The number of blind people aged 75 and over is falling, with a 5% reduction in the last ten years from 69% to 64%. However, the local picture is different to the national one. In Rotherham there were 860 people on the blind register in 2008, a reduction of 325 people since 2006. This reduction may be due to recent data cleansing of the local register.

There are a total of 1,365 people who are on the partially sighted register, a decrease of 95 people since 20069. Information for this register is obtained by the completion of SSDA902 returns by all Councils with Adult Social Services Responsibilities (CASSRs) on an annual basis to capture the number of people who are blind or partially sighted under Section 29 of the National Assistance Act, 1948. Figure 1. 14: Number of people registered blind/partially sighted by age group in Rotherham in 2008 Blind Partially Sighted 3% 4% 13% 11% 0-18 years 10% 11% 18-49 years 50-64 years 65-74 years 63% 10% 64% 1% 75 and over Source: National Statistics 2008, Council Tables - Blind and Partially Sighted, pB1 Figure 1. 14 provides an age profile of those who are registered blind or partially sighted in Rotherham. Approximately 63% of blind/partially sighted people in Rotherham are over 75 years of age. There has been an increase in the number of people registered blind in the 65 to 74 age group. There has also been a reduction in the number of people registered blind between 18 and 49 years and 75 and over. In 2008 there were 95 new registrations for blind people compared to 85 new registrations in 2006.

Of these 16% were between 50 and 64 years, 11% between 65 and 74 years and 63% who are 75 years and over. There has been a larger increase in the number of new registrations by people between 50 and 64 years10. 9 National Statistics (2007), Deaf and Hard of Hearing, pPS1 National Statistics 2007, Deaf and Hard of Hearing, pB2 10 - 18 Figure 1. 15 shows the predicted future prevalence rates of people with a serious visual impairment who will require help with daily activities. These prevalence rates have been derived from ONS population projections. Figure 1. 15: No. f people projected to have a serious visual impairment and requiring help with daily living in Rotherham. 2010-2030 25 20 18 - 2 4 ye a rs 15 2 5 - 3 4 ye a rs 10 3 5 - 4 4 ye a rs 4 5 - 5 4 ye a rs 5 0 2010 2015 2020 2025 2030 Source: PANSI 2008, People predicted to have a serious visual impairment projected to 2025 Projecting Adult Needs and Service Information System (PANSI) predicts that there are 102 people with a serious visual impairment in Rotherham who require help with daily activities. It is predicted that this will slowly increase over the next 17 years, in particular in the age groups 55 -64 age group.

Deaf or Hard of Hearing There are approximately 9 million people who are deaf or hard of hearing in England. Around 688,000 people are severely or profoundly deaf 11. More than 50% of people over the age of 60 years have some degree of hearing loss, but only one in three older people has an hearing aid12. The commonest cause of hearing loss is ageing and three quarters of people who are deaf are aged over 60. More men become hard of hearing than women. Among people over the age of 80 years there are more women than men who are deaf or hard of hearing.

This is mainly attributable to the larger population of women in this age range. Common causes of deafness in adults and older people include; presbyacusis (age-related hearing loss known as senile deafness), side-effects of medication, acoustic neuroma and Meniere's disease. Com mon causes of deafness in children include inherited conditions, infection during pregnancy, meningitis, head injury and glue ear. In 2007 there were 54,500 people in England on the register of deaf people. Between March 2004 and March 2007 the number of people on the register has remained constant13.

However, during this same period the number of deaf people on the age profile of those on the register has changed significantly14. There are approximately 164,600 people in England on the register of hard of hearing. This is an increase of around 5,600 (4%) since March 2004 and an increase of 73% since March 1992. The large increase from 1992 could be partially attributed to improved systems of information capture or a failure to remove old registrations15. 11 RNID 2008, www. rnid. org. uk Public Medical Health 2008, Research and Development, Leading Causes of Blindness National Statistics 2007, Deaf and Hard of Hearing, p(iii) 4 Office of National Statistics 2004, Religion in Rotherham, p(iii) 15 National Statistics 2007, Deaf and Hard of Hearing, p3 12 13 - 19 Figure 1. 16 provides a breakdown of the number registered as deaf and hard of hearing by age group. Figure 1. 16: Age profile of people registered as deaf or hard of hearing (HofH) in England from 1992 to 2007 Category Number of People 1992 1995 1998 2001 2004 2007 % of People 1992 1995 1998 2001 2004 2007 All Ages Deaf H of H Under 18 Deaf H of H 18-64 Deaf H of H 65-74 Deaf H of H 75 or over Deaf H of H 41,800 45,500 50,100 50,300 55,000 54,500 95,300 125,900 139,500 44,600 158,900 164,600 3,800 4,400 4,200 4,000 4,100 3,400 2,100 3,500 2,800 2,900 3,000 4,100 24,200 26,000 27,100 27,200 29,200 28,700 16,000 21,900 25,100 25,400 29,800 30,500 4,900 5,000 5,800 6,400 8,300 6,400 18,400 23,800 22,300 24,700 24,400 23,100 8,900 10,100 13,000 12,600 13,400 16,000 58,800 76,700 89,300 91,300 101,700 106,900 100 100 100 100 100 100 100 100 100 100 100 100 9 10 8 8 7 6 2 3 2 2 2 2 58 57 54 54 53 53 17 17 18 18 19 19 12 11 12 13 15 12 19 19 16 17 15 14 21 22 26 25 24 29 62 61 64 63 64 65 Source: National Statistics 2007, Deaf and Hard of Hearing, p3 In 2007 more than half (52. %) of those on the deaf register were working age adults (18-64 years). The highest incidence of hearing loss occurred in the older age groups, particularly those over 75 years16. In Rotherham there are currently 280 people on the deaf register. 66% are in the age range 18 to 64 years, 13. 4% above the national average. There are currently 15 children (5%) on the register17. The high number of younger people on the register suggests under-reporting in the older age groups. There are a total of 980 people on the hard of hearing register. Almost two thirds (62%) are in the age groups 75 years and over18.

This is just under the national average of 64. 9%. Figure 1. 16 provides a local age profile of those who are registered deaf or hard of hearing. Information for this register is obtained by the completion of SSDA910 returns by all Councils with Adult Social Services Responsibilities (CASSRs) on an annual basis to capture the number of people who are deaf or hard of hearing under Section 29 of the National Assistance Act, 1948. Figure 1. 17: Number of people registered deaf/hard of hearing by age group in Rotherham in 2008 Deaf 18% Partially Sighted 2% 5% 19% 0-18 years 18-64 years

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