Health Impacts from demographic, geographical and socio-economic challenges
There are a number of population health impacts facing the Western Isles arising from a combination of our ageing population, remote geography both from mainland centres and within the islands, and the comparatively low socio-economic position and dispersed rural deprivation of our communities.
The Western Isles already has one of the highest proportions of older people of any area in Scotland. With this expected to increase the impacts upon a range of chronic long term conditions are projected to be significant. The table below indicates the projected rise of prevalent cases within the population for selected conditions and those where there is a relationship to ageing have the largest expected increases eg. Dementia, CHD, COPD. These figures are based on the projected population figures and do not take account of improvements in healthcare, diagnosis, etc. which may expect further rises in numbers of persons living longer with a range of such conditions.
Projected Persons living with Long Term Health Conditions in Western Isles 2008-31
|
2008
|
2031
|
% change
|
CHD
|
1136
|
1510
|
32.81
|
COPD
|
567
|
724
|
27.72
|
Asthma
|
1337
|
1298
|
-2.88
|
Diabetes
|
1128
|
1365
|
20.98
|
Dementia
|
509
|
839
|
64.85
|
All selected LTCs
|
4676
|
5735
|
22.65
|
The impacts on healthcare delivery from such increasing prevalence levels among our ageing population based on current models of delivery are seen in the large rises in unscheduled hospital care for the elderly. In past 10 years the Western Isles has seen the highest increase of such admissions to hospital among its elderly population (see chart below). Such rates of emergency admissions will increase further with pressures described above from our ageing population. Alternative healthcare approaches are key to slowing down this unsustainable trend and are very much the focus of much of the work of the both the health and social services designed to intervene earlier in a person’s health problem so anticipating and avoiding acute crises that result in hospital admissions.
Ageing population and healthcare impacts – emergency care
4. The organization of the health care services in the Western Isles
4.1 Primary Healthcare
There are 10 GP practices run by independent contractors working to a national contract (with 36 (headcount) General Practitioners) throughout the Western Isles providing primary care services to the community. A number of GPs provide additional support in specialist areas such as Dermatology, Cardiology, Learning Disabilities, Child Protection, Public Health, Anaesthetics, General Surgery and Paediatric services, in partnership with the Western Isles Hospitals. The GPs and their staff work closely with a range of community health staff such as district nurses, community midwives, health visitors, Allied Health Professionals (Physiotherapy, Speech & Language Therapy, Occupational Therapy, Dietetics and Podiatry), community mental health services and health promotion services. Community based dental services are also provided across the islands
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