1. Understanding the population who might require social care services
Section 4 sets out in detail the prevalence levels relating to vulnerable groups who are most
likely to receive social care services. An overview of Barnet identifies that the general population are
healthier and living longer, it is expected this trend is will be reflected in the disabled population, as a
result. Prevalence modeling using the Projecting Adult Needs and Service Information System
(PANSI) for Barnet estimates a 11% increase in prevalence for learning disability and mental
health client groups and an increase of 17% of people with a moderate of physical disability.
2008 2010 2015 2020 2025 %
increase
Total population aged 18-64 predicted
to have a learning disability
5,180 5,265 5,434 5,589 5,742 11%
Total population aged 18-64 predicted
to have a moderate or serious physical
disability
20,032 20,459 21,298 22,440 23,384 17%
People aged 18-64 predicted to have
depression
5,416 5,516 5,690 5,852 6,007 11%
People aged 18-64 predicted to have a
neurotic disorder
34,992 35,636 36,761 37,824 38,818 11%
People aged 18-64 predicted to have a
personality disorder
9,288 9,459 9,756 10,024 10,295 11%
People aged 18-64 predicted to have a
psychotic disorder
1,164 1,185 1,223 1,257 1,291 11%
The learning disability modelling in the PANSI model is based on the work on understanding
demand by Emerson and Hatton. This work furthers goes on to subdivide the population
predicted to have a learning disability to identify those known to specialist health and social
care learning disability services as set out in the table below.
2001 2011 2021
People known to
services (estimate)
Projected %
increased based
on Emerson and
Hatton model
Projected actual
increase from
2001
Projected %
increased based on
Emerson and Hatton
model
Projected actual increase
from 2001
20-59 718 7% 50 8% 57
60-79 154 36% 56 59% 91
80+ 7 58% 4 98% 7
Total 879 12% 105 16% 141
.
Whilst prevalence levels are increasing, the predicted numbers of people known to health and
social care services is predicted to rise at a greater rate due to an increase in the number of
young disabled individuals with complex health needs who are being identified through the
children’s service and transition as a result of people with complex disabilities surviving
childhood and as a consequence of population growth and people with a learning disability
living longer with increased physical healthcare needs. In addition, prevalence rates of learning
disability are higher amongst the south east asian community which is set to increase within
Barnet. In Learning Disability Services this will mean identifying service users at a young age;
assessing need and preferences; maintaining input at a level that supports independence and
responds to choice and providing services that are responsive and flexible; to a growing
population of people who are presenting with higher need; from a wider and divers community
base and are increasingly aware of their rights.

2. Adults with a physical disability
Effective management of long term conditions relating to a physical disability will require a
joined up approach across health and social care to ensure that people are supported to live as
independently as possible. Levels of need are predicted to increase significantly as a result of
the projected population increase in the number of people aged between 30 and 64 and
increasing numbers of people living with long term neurological conditions.
As the need for services increases with age and there will be an increase of 25% in the number
of people aged 50-64, who tend to have higher needs than those aged 20-50, we can expect
increase demand for health and social care services.
The time course of conditions also varies widely. The average time between diagnosis and
death for someone with motor neurone disease is 14 months, while someone with multiple
sclerosis may live with the condition for decades. Even within specific conditions, the needs of
individuals, for example for social care support, vary widely. The diagnosis or onset of a long
term neurological condition generally marks the beginning of profound changes in the life of the
person and the lives of their carer, family and friends. It may affect relationships, career
prospects, income and expectations for the future.
Neurological conditions nationally account for 20% of acute hospital admissions and are the
third most common reason for seeing a GP. Furthermore based on national prevalence data,
we can expect within Barnet at this time for there to be 1890 people with a neurological
condition requiring help with daily living and for there to be 4590 carers of people with a
neurological condition. The predicted increases in demand will mean it is essential that health
and social care organisations work within a Long Term Conditions management model to
provide effective whole systems support to enable people to live as independently as possible
in their own homes. Services will need to meet the needs of more diverse groups of people
and to accommodate services users accessing services through direct payments and
individualised budgets.
Adults with mental health problems
Barnet has average levels of mental illness in comparison to the English average. However
the number of people between the ages of 18 and 25 with mental health problems in Barnet is
predicted to rise steadily from 50,860 to 56,411 between 2008 and 2025 (source PANSI and
section 2)

3. Adults with mental health problems are the most disadvantaged and socially excluded group in
society. Addressing barriers to social inclusion forms the wider agenda for mental health
services (mental health and social exclusion report 2004). The Layard report 2005 (PM Policy
Unit) identified ‘mental health is the biggest social problem of our country as it affects people
with mild and moderate mental health problems’. The mental health agenda requires a broad
whole system focus which moves away from a focus on mental health specific policy targeted
at specialist mental health services. Although in development higher quality support is still
needed at home and this is reflected as a specific target within the Barnet LAA to take account
of the fact that Barnet has lower numbers of acute beds than neighbouring boroughs however
higher numbers of people are living in registered care.
The predicted demographic growth in people of 65 years and above within the Borough over
the next ten years is below the national average rate for older people. However the post war
generation (referred to as the baby boomer generation), will by the end of the period, begin to
feed into the 75+ age group resulting in a 25% growth in older people. This age group is where
there is known to be increased demand on health and social care services. Therefore
improvements in developing a more preventative approach over the next ten years will lay a
good foundation for managing a significant predicted growth in older people in the latter period
of this strategy and beyond.
Older people
Currently Barnet has the second largest population over 65 and over 85 in greater London.
Older people are more likely to suffer from chronic and long term conditions and are also more
likely to suffer from falls / factures which bring them into contact with health services. Older
people represent the largest proportion of users of NHS services, however can and do get
better after a period of rehabilitation and convalescence. It is vital that these episodes of acute/
medical treatment are used as opportunities for people to optimise their functioning and return
home safely.

4. It should be noted that it is possible that the projections in the table below overestimate the
percentage rate of increase in the Barnet population in view of the large scale residential
developments that will be providing new accommodation over the next ten to fifteen years and
which may be acquired more readily by younger age groups.
Percentage changes from
2007
ONS sub-national population
projections 2004
2008 2009 2014 2019 2024 2029
England 65+ 1.46% 3.20% 16.21% 26.12% 36.75% 50.64%
England 75+ 0.94% 1.87% 10.54% 22.39% 45.49% 59.97%
Barnet 65+ 0.89% 1.78% 10.69% 18.49% 28.95% 43.43%
Barnet 75+ 0.00% 0.00% 3.88% 9.48% 25.86% 37.93%
London 65+ 0.13% 0.39% 6.50% 11.70% 19.92% 33.17%
London 75+ -0.09% -0.26% 2.86% 6.88% 19.84% 28.83%
However the continued rise in the numbers of people living longer is likely to have an impact on
demand for social care services and in particular for positive interventions for people with
dementia as prevalence increases with age. The significant bulge predicted in the number of
people over 85 from 2017 onwards in Barnet, in common with the national picture, will greatly
increase the chances of demand on social care services. The older population will become
more ethnically and socially diverse, more consumer aware and this will have an increasing
impact on the demand for types of services. In addition there will be more single older person
households. In 2008 there were an estimated 3,549 persons with dementia in Barnet. By 2025
this number is expected to increase 10% and by 2015, 36%.