Health and physical disabilities

Overview and key messages

A significant proportion of the population aged between 18 and 64 who live in West Wales will not be accessing care and support directly to address specific needs. However, they will benefit from general public health information and programmes aimed at encouraging healthy lifestyles and reducing risks to their health brought about by factors such as smoking and obesity. More generally, adults in Wales will also benefit from combined approaches across sectors and within communities to improve the social, economic and cultural well-being of Wales in response to the Well-being of Future Generations (Wales) Act 2015.

Where people within this age range have specific needs because of physical disability or chronic health conditions, proportionate, person-centred and responsive care and support may be required to help them achieve positive personal outcomes and live as independently as possible.

A range of ‘accelerating factors’ within people’s environments might increase the likelihood of them developing an ongoing health condition, or aggravate the effects of existing conditions, and against which mitigating action should be taken. These include unemployment, low wages and poor housing conditions.

Effective promotion of public health, targeted care and support for those with specific needs and more general support for people particularly at risk should combine to optimise the quality of people’s lives and their participation within their communities.

Supporting people to live active and healthy lives will reduce their needs for care and support and lead to improved outcomes at an individual and community level. The contribution of care and support services must be complemented by a range of collaborative approaches to improve people’s social, economic, environmental and cultural well-being.

Public Health has an important role in providing the population with general information and advice on healthy life choices and support in areas such as diet and smoking cessation. This needs to start in the early years but should be sustained where possible across the range of age groups.

















Demographics and trends

  • 1,010 adults are in receipt of Incapacity Benefit or Severe Disability Allowance, 10.3% of the Wales total
  • 16,740 adults are entitled to Disability Living Allowance or PIP (personal independence payment), representing 12% of the all-Wales figure

Demographics and trends

  • There are currently 219,606 people aged between 18 and 64 in West Wales. This equates to around 70% of the adult population across the region, with the proportion being slightly lower in Pembrokeshire at 68% and that in Carmarthenshire and Ceredigion standing at 70% and 71%, respectively.
  • Of those adults aged between 18 and 64, 1,679 people are registered with a physical disability and a further 1,744 are registered as having physical and sensory disabilities. Together this represents around 1.1% of the total 18-64 population, which is in keeping broadly with the Welsh average of 1.02%
  • 3.14% of people between 18 and 64 do not have central heating (1.97% in Carmarthenshire, 3.47% in Pembrokeshire and 5.5% in Ceredigion), compared with a Welsh average of 1.84%
  • Among people living with severe health conditions 9,480 are in receipt of Employment Support Allowance (which is 0.4% of the Wales 18+ population). (Daffodil Cymru)
  • 25% of people aged between 16 and 64 with chronic disability have a neurological condition
  • 33% of disabled people living in residential care have a neurological condition
  • 10% of visits to Accident and Emergency Departments and 19% of hospital admissions are for a neurological problem
  • 7% of GP consultations are for neurological symptoms
  • Approximately 130 people admitted to hospital with head injury every year. Of these on average, 30 people per year require admission to a regional centre due to the significance of the presentation. In addition 10 people have anoxic brain damage every year in HD
  • Approximately 710 people living with cerebral palsy. For many this includes not only physical disability but also a learning disability and may result in significant care needs

The following charts provide further details of health related lifestyle factors in the 18+ population from the Welsh Health Survey:

Current care and support provision

There are a range of services and support available to the adult population to help them lead healthy and fulfilled lives; although a significant degree of responsibility for this falls on the individual and responsibility for services and support extends well beyond health and social care.
General services available to promote self-care and well-being include:
  • Universal services and amenities within the community
  • Prevention and early intervention services including information, advice and assistance
  • Third sector provision including a wide range of facilities including transport, social activities, help at home with domestic tasks such as finance management gardening and cleaning and various targeted support groups such as carers’ support; and
  • Leisure services, which can where appropriate be accessed via the National Exercise Referral Scheme (NERS) which is in place across the region.

For those with chronic and long term conditions and physical disability, a range of services are provided:
  • Chronic conditions management through district and specialist nurses
  • Social services support in residential settings and in the community
  • Community-based support to reduce risk of deterioration and promote independence
  • High level support through the provision of assistive technology, equipment, adaptations, direct payments and home care; and
  • Advocacy services to help people make informed decisions about how their needs can be met and to support or improve independence.

Gaps and Areas for Improvement

Although a drop in the number of people falling within this thematic group is predicted in the medium term, and the current number of people with specific care and support needs is small, it is vital that appropriate provision is in place to promote well-being and independence and prevent escalation of need. The following gaps and areas for improvement have been identified and are set out below against the core principles of the SSWB Act:
  • Developing appropriate access to a range of information, advice and assistance including Dewis Cymru and Infoengine, and advocacy services relevant to health and social care needs at all key life stages
  • Developing consistent, integrated regional services that are accessible and respond to population need
  • Improving the early identification, treatment and management of preventable and chronic conditions including diabetes, heart disease and respiratory illness, to improve long term well-being and reduce complications
  • Ensuring effective interventions and pathways for prevention, treatment and management of obesity and childhood obesity are routinely available and systematically implemented
  • Improving early identification and treatment of risk factors associated with health inequality
  • Strengthening transition arrangements between children and young people’s services and adult services
  • Developing community-based, user-led, co-produced services that prevent isolation, promote independence and support people to become more resilient and manage their own conditions
  • Increasing use of assistive technology, such as telecare to transform domiciliary care and supported living services
  • Improving flexibility to deliver step up and down provision to respond to changing needs