What do we mean by demographics?

Some of you will have heard politicians and council officers talking about demographics, particularly in relation to older people. So, I thought I would try and explain it and give some examples.

The definition from dictionary.com is "the statistical data of a population, especially those showing average age, income, education, etc. " often this relates to current data, but in the case of older people demographics is often used as part of the evidence base and in discussions around the forecasts for our ageing population.

I was shown this table the other day which provides a perfect example of demographics in Cambridgeshire in terms of increases in the older population.

Age	2012	2022	Increase
Total population aged 18-64	390,800	409,659	5%
People aged 65-69	33,700	35,608	6%
People aged 70-74	24,500	33,448	37%
People aged 75-79	19,700	28,175	43%
People aged 80-84	14,800	20,654	40%
People aged 85-89	9,200	13,234	44%
People aged 90 and over	5,500	9,502	73%
Total population 65 and over	107,400	140,620	31%
Total Cambridgeshire Population	498,200	550,279	10%

Let's be plain - this comes about largely (but not entirely) because people are living longer - that is a great thing.  But it also places a burden on social care services because we have to cope with an increasing  number of people who need support.  The challenge is how we deal with this in a world where we have less resource.  These demographics are also the reason why the need for urgent reform of Health and Social Care is being reinforced to Government.  Social Care is the biggest single item of spend in Cambridgeshire with a budget of around £188m.  This graph, known as the Barnet Graph of Doom, shows how by 2030 Barnet could have no money to spend on anything other than children and adults - so no highways, libraries or anything else!

I would challenge this slightly.  I believe there are ways we can get more efficient - for instance by making sure we are smarter with how we use technology to support vulnerable older people, and by being more preventative - for example by reducing isolation which has a huge impact on the health of older people (which is why our recently proposed Community Navigator scheme is important).

There are also bigger picture issues like better integration of health and social care to make it more seamless - which I think offers cost and service benefits (health care is provided via the NHS to provide support at home such as Occupational Therapy whereas Social Care provides basic services such as cleaning and is supported by the County Council and is sometimes charged for).

Interestingly, as I have been writing this I have been pointed to this interesting article about Health and Social Care, which explains some of the issues Nationally.

CPSN Launch at Sir Harry Smith CC and other things

I had the pleasure of attending the launch of the Cambridge Public Service Network today.  This is a real success story of the County, driving down cost by working with Virgin Media and others on broadband infrastructure for schools and other public sector organisations around the County (and indeed beyond).  A video about the project is here:

I was pleased they chose Sir Harry Smtih CC to do the launch - it is always good to see Senior Officers and members from Fenland and Cambridgeshire visiting Whittlesey.  The county's Leader, Cllr Nick Clarke and I used the opportunity to go on a short drive to show him some of the reasons why the Town would benefit from a bypass, in particular we went down Inhams Road, Station Road and over the railway crossing. He saw the crossing gates closing on Station Road and I would mischievously like to say that I hope he was also caught by Kings Dyke crossing on his way back to Shire Hall!!

On another note, this was sent out today as a press release from Shire Hall.  At a time when much of the public sector debate is around austerity and cuts,we need to remember to celebrate excellence in our services and our staff. (The website that the press release is on is a new creation from Cambridgeshire Conservatives aiming to improve our web presence and our communication with the public).

Review of partnership agreements for older peoples' services

The County Council's Cabinet agreed yesterday to changes to what we call the Section 75 agreements bwetween the County Council, the NHS and an NHS organisation called Cambridgeshire Community Services (CCS) who are responsible for the management of many aspects of care in Cambridgeshire.  The Section 75 agreement is effectively the contract that we have that underlies the working arrangements.

What we agreed was that,rather than have a three way contract, to take NHS Cambridgeshire out of the middle and to have a single Section 75 agreement with CCS.  The thinking behind this is to provide better accountability and management oversight in an area that, in the past, has been too complex and has a history of overspends.  This is not a criticism of either organisations and, in particular, I would say that the National changes to the NHS are resulting in huge improvements in local relationships; these S75 changes are more an evolution of arrangements that happened some years ago.

The important point in this is not the technicalities of this single change, but that it signals the start of a real process of change in Adult Social Care, of which more will come forward in the coming months.  We are trying to be innovative in dealing with the financial problems we face - to be more preventative, to be more radical in how we manage what we do and to use the changes in the NHS to the advantage of the residents of Cambridgeshire.  The last inspections showed that the level of care we provide is good, but we do need change and innovation in order to keep care affordable - but also to do more to prevent people needing it in the first place.

This afternoon I am at my first meeting of a Scrutiny sub-committee that is going to examine what we are doing with delayed discharges - another area of concern for Cambridgeshire - and I will be discussing further proposed changes there.

National Review of Adult Social Care

I am absolutely delighted that the New Year has started with so much media comment about the need to review our Social Care system.  Articles like this from the BBC are absolutely spot on.

What is most important is that words like "urgent" are being used, and the suggestion is that proposals will be published in spring.

What none of these articles do is correctly sum up the problem, which is huge concerns from some people as they get older about how the need to fund Social Care will impact on them financially, alongside an extremely difficult financial situation in local Government at a time when our population is aging and therefore demand for social care services is increasing.

In truth the previous Government should have dealt with the issue, but instead chose to put it in the too difficult pile and tried to blame Andrew Lansley when they were exposed.  It is an area where the Coalition has not been found wanting - having commissioned for the Dilnott review, the conclusions of which I believe identify much of what is needed to move forwards.

There are other areas which do help in this area, one of which is to be more preventative in our outlook.  In particular making sure older people have networks of friends and good social circles is known to have a positive effect on life expectancy and this is an area of work I hope to move further forwards with in Cambridgeshire this year in my role as Lead Member for Adult Services.

My Friends Cambridgeshire Lib Dems Again

Sometimes I despair.

Today during a discussion on the use of LPSA funding - for which an agreement has been reached with every District in Cambridgeshire with the exception of the City Council (again), the Leader of the Lib Dem group at the County Council made a plea to the Cabinet to rethink our position or face the decision being called in - making the point that he didn't want to create "unnecessary work."

If he recognises that the call-in would be unnecessary work - then don't call it in, otherwise it would be a blatant waste of public money.

There was some really good stuff at Cabinet today, including an excellent interim report on Domestic Violence presented by Cllr Samantha Hoy.  It was also the first time I had spoken at Cabinet in my new capacity as Cabinet Member for Adult Services, talking about progress since the last CQC assessment (completed in 2010) .  It was a good news story because the assessment judged us as performing well with excellent features, and the action plan created after the inspection has been delivered pretty well.