1. Hertfordshire Public Health Service
Workshops for Third Sector
Agencies
Older People Health Pack
February 2014
Jim McManus
Director of Public Health
Hertfordshire Public Health Service
Hertfordshire County Council
County Hall, Postal Point CH0231
Pegs Lane
Hertford SG13 8DE
Jim.mcmanus@hertfordshire.gov.uk
Thanks to Jo Mackenzie, Stephany Villanueva, Raj Nagaraj, Mark Jordan and
Joel Bonnet for developing these slides

2. Four workshops to explore the role the voluntary sector can play influencing
the development of public health policy and delivering services.
– Wednesday, 26 February, 14:00 – 16:30: Public Health and
Younger People
– Thursday, 6 March, 09:30 – 12:00: Public Health and Older
People
– Tuesday, 11 March, 14:00 – 16:30: Public Health and Long
Term Conditions
– Tuesday, 18 March, 09:30 – 12:00: Public Health and Mental
Health
Voluntary groups make an important contribution to improving and protecting
the health of the population – from targeted work with vulnerable people to
self-management and direct interventions. Public Health skills and capacity,
joined with the voluntary sector’s connections and “can do” mindset could
produce a major improvement in the health of Hertfordshire and also help
integrate care for people across all sectors.
The workshops will be an opportunity for the voluntary sector to contribute to
policy development, build relationships, and discuss new commissioning
arrangements.
Each workshop will consider four questions:
– What is the scope of public health, and what contribution can the
voluntary sector make to service delivery, policy development,
campaigning and tackling health inequalities?
– How can the voluntary sector help improve resilience, selfmanagement and secondary prevention, and so help reduce
unnecessary hospital admissions?
– How can the voluntary sector be better commissioned to deliver
public health interventions? How can relationships between the
voluntary sector and commissioners (DH, local public health
commissioners, GPs, and others) be improved?
–
What scope is there to apply commissioning innovations such
as payment by results or a Total Place approach to public health
commissioning?

3. A) Population
2012 Mid Year Estimate by Sex and Age Group- Hertfordshire and England
90+
Females
85-89
Males
England
80-84
75-79
70-74
65-69
60-64
55-59
Age Group
50-54
45-49
40-44
35-39
30-34
25-29
20-24
15-19
10-14
5-9
0-4
10.0
8.0
6.0
4.0
2.0
0.0
2.0
4.0
6.0
8.0
10.0
% of Total Population
Life expectancy at 65 (years)
B) Life Expectancy
Male and female life expectancy at 65,
Hertfordshire and East of England, 2004-06 to 2008-2010
22
21
20
19
18
17
2004-06
2005-07
2006-08
2007-09
2008-10
Hertfordshire: Female
East of England: Female
Hertfordshire: Male
East of England: Male
Source: ONS
Life expectancy in Hertfordshire from 2008-2010 for a man aged 65 was 19
years as compared to a woman also aged 65 at 21 years. For this “ageing
well” topic, disability free life expectancy was also examined in Hertfordshire
showing that from 2007-2009, the district average was 10.6 years for men and
11.1 years for women which is also similar to the East of England.

4. C) Population Projections
21% of people are aged 60 and over in Hertfordshire (similar to England at 22%).
There are more women than men aged 60 and over, particularly for the upper ages
(80 and over).
Rapid growth of population aged 65 and over is predicted for the next 20 years.
Hertfordshire: number and % increase in over 65s
350,000
80%
Hertfordshire total number of persons 65+
300,000
70%
% increase since 2010
60%
250,000
50%
200,000
40%
150,000
30%
100,000
20%
50,000
10%
0
0%
2010
2015
2020
2025
2030
2035
East & North Herts CCG:
Broxbourne: number and % increase in people aged 65 and over
2010 to 2035
70%
Broxbourne
% increase since 2010
25,000
60%
50%
20,000
40%
15,000
30%
10,000
20%
5,000
% increase since 2010
Number of people aged 65+
30,000
10%
0
0%
2010
2015
2020
2025
2030
2035
Year
Source: Population Projections Unit, ONS, March 2012
In Broxbourne, there is a 60% increase estimated between 2010 and 2035 (from
15,000 to 24,200) which is lower than for Hertfordshire (70%).
Broxbourne has 6 residential care homes for older people (1 with nursing care)
providing 220 bed spaces (22 with nursing care)*. This translates to 14 bed spaces
per 1,000 population aged 65+ (which is the lowest in the county).
* As at April 2013, Hertfordshire County Council

5. East Hertfordshire: number and % increase in people aged 65 and
over 2010 to 2035
100%
East Hertfordshire
% increase since 2010
40,000
90%
80%
35,000
70%
30,000
60%
25,000
50%
20,000
40%
15,000
30%
10,000
20%
5,000
% increase since 2010
Number of people aged 65+
45,000
10%
0
0%
2010
2015
2020
2025
2030
2035
Year
Source: Population Projections Unit, ONS, March 2012
In East Hertfordshire, there is a 90% increase estimated between 2010 and
2035 (from 20,900 to 39,900 people), higher than for Hertfordshire (70%).
East Hertfordshire has 13 residential care homes for older people (7 with
nursing care) providing 655 bed spaces (357 with nursing care)*. This
translates to 31 bed spaces per 1,00 population aged 65+ (2nd lowest in the
district).
In North Hertfordshire there is an estimated 81% increase between 2010 and 2035
(from 21,300 to 38,600) higher than for Hertfordshire (70%).
North Hertfordshire has 22 residential care homes for older people of which 9
provide nursing care. They provide a total of 996 bed spaces of which 444 are with
nursing care*. This translates to 46 spaces per 1,000 population aged 65+ (similar to
the Hertfordshire average).

6. In Stevenage there is an estimated 67% increase between 2010 and 2035
(from 11,800 to 19,700 people) similar to Hertfordshire (70%).
Stevenage has 6 residential care homes for older people of which 3 provide
nursing care. They provide a total of 458 bed spaces of which 258 are with
nursing care*. This translates to 39 spaces per 1,000 population aged 65+
(similar to the Hertfordshire average).
In Welwyn Hatfield there is an estimated 65% increase between 2010 and
2035 (from 17,300 to 28,500 people) lower than Hertfordshire (70%).
Welwyn Hatfield has 15 residential care homes for older people of which 5
provide nursing care. They provide a total of 871 bed spaces of which 464 are
with nursing care*. This translates to 51 spaces per 1,000 population aged
65+ (one of the highest in the County).

7. Herts Valleys CCG:
65% increase estimated between 2010 and 2035 (from 22,700 to 37,500
people) which is lower than Hertfordshire (70%).
Dacorum has 15 residential care homes for older people of which 3 provide
nursing are. They provide a total of 812 bed spaces of which 194 are with
nursing care*. This translates to 35 spaces per 1,000 population aged 65+
(one of the lowest in the County).
In Hertsmere, there will be an estimated 78% increase between 2010 and
2035 (from 16,000 to 28,500 people) higher than Hertfordshire at (70%).
Hertsmere has 18 residential care homes for older people of which 8 provide
nursing care. They provide a total of 997 bed spaces of which 566 are with
nursing care*. This translates to 61 spaces per 1,000 population (2 nd highest
in the country).

8. In St. Albans there will be an estimated 61% increase between 2010 and
2035 (from 20,500 to 33,000 people) less than Hertfordshire at (70%).
St. Albans district has 20 residential care homes for older people of which 5
provide nursing care. They provide a total of 831 bed spaces of which 237 are
with nursing care*. This translates to 38 spaces per 1,000 population aged
65+ (One of the lowest in the County).
In Three Rivers, there will be an estimated 74% increase between 2010 and
2035 (from 14,900 to 25,900 people) similar to Hertfordshire at (70%).
Three Rivers District has 16 residential care homes for older people of which
7 provide nursing care. They provide a total of 740 bed spaces of which 300
are with nursing care*. This translates to 50 spaces per 1,000 population aged
65+ (4th highest in the county).

9. In Watford, there will be an estimated 65% increase for people aged 65+
between 2010 and 2035 (from 11,000 to 18,200) less than for Hertfordshire
(70%).
Watford district has 14 residential care homes for older people of which 4
provide nursing care. They provide a total of 762 bed spaces of which 386 are
with nursing care*. This translates to 68 spaces per 1,000 population aged
65+ (highest in the County).
As at April 2013, Hertfordshire County Council
D) Long-term conditions
Around 78,000 people aged 65 and over (47%) are limited in daily activities by
a health problem or disability- lower than England (52%).
i) Dementia
People aged 65 and over predicted to have dementia, by
age, projected to 2020, Hertfordshire
18,000
16,000
14,000
90+
Number of people
12,000
85-89
10,000
80-84
8,000
75-79
6,000
70-74
4,000
65-69
2,000
0
2012
Source: www.poppi.org.uk
2014
2016
Year
2018
2020

10. The number of people estimated to have dementia in Hertfordshire in 2012
was over 13,000. This is expected to rise by a quarter to around 16,500 in
2020.
The number of people with dementia generally increases for each 5 year age
group because prevalence increases with age.
5,566 people registered with a GP practice in Hertfordshire had a recorded
dementia diagnosis in 2011/12. This suggests around 42% of people with
dementia have had a diagnosis recorded (similar to 44% for the UK*).
*alzheimers.org.uk
ii) Falls
• Over 5,000 hospital admissions due to falls in people aged 65 and over
living in Hertfordshire in 2010/11
•
Similar rate to East of England
3,000
East of England
Hertfordshire
2,500
2,000
1,500
1,000
500
Source: www.injuryprofiles.org.uk
Three Rivers
Welwyn Hatfield
St Albans
Dacorum
Hertsmere
E Hertfordshire
Watford
Broxbourne
N Hertfordshire
0
Stevenage
DSR per 100,000 population
Hospital admissions due to falls, 65 years and over,
directly standardised rate per 100,000 population,
Hertfordshire, by district 2010/11
District
E) Physical Activity
Physical activity decreases with age.
A survey of over 2,000 people aged 55 and over in Hertfordshire revealed
only 14% participated in sport and active recreation, at moderate intensity,
for 30 minutes on 3 or more days a week. This compares to 26% aged 3554 and 25% aged 16-34 years.
(source: Active People Survey 2011/12,
http://www.sportengland.org/research/active_people_survey.aspx)
* Page 3, activity and weight needs assessment update graph

11. F) Obesity
Projection of Older people with a BMI of 30+ [Hertfordshire]
100%
8.9%
9.1%
9.4%
9.9%
10.3%
12.3%
12.1%
12.0%
12.1%
11.9%
19.0%
18.5%
17.6%
17.6%
18.4%
90%
80%
70%
60%
50%
80-84
23.6%
24.0%
25.4%
28.4%
28.3%
40%
75-79
70-74
65-69
30%
20%
85+
36.2%
36.3%
35.5%
32.1%
31.1%
2012
2014
2016
2018
2020
10%
0%
Source: POPPI, 2012