Figure 13: Breakdown of working age & lifelong disabled volume and spend by cohort
• LD Cohort Five: Individuals with low levels of need and whose packages of care are not changing in cost • LD Cohort Six: Individuals with high needs and whose packages of care are increasing significantly Individuals with a mental health condition: • MH Cohort One: Individuals with low levels of need whose package of care is not changing in cost • MH Cohort Two: Individuals with high levels of need whose packages of care are increasing slightly in cost • MH Cohort Three: Individuals with average levels of need whose packages of care are increasing significantly in cost Individuals with a physical disability: • PD Cohort One: 40–65-year-olds with average levels of need and whose packages of care are not changing in cost • PD Cohort Two: 40–65-year-olds with average levels of need and whose packages of care are increasing in cost • PD Cohort Three: 26–39-year-olds with higher levels of need and whose packages of care are increasing slightly in cost The proportion that each cohort makes up the total working age and lifelong disabled population receiving adult social care is illustrated in Figure 13. These cohorts can be of particular interest to those seeking to improve outcomes and the financial sustainability of support for these individuals because of the characteristics they share and the trends that are evident, particularly in relation to recent package costs.
There are some challenges using this data field: whilst they are consistent categories used for national returns for all authorities, they are not always applied in the same way by each. Some will have further breakdowns under categories (e.g. ‘Physical Support- Access and Mobility’ vs ‘Physical Support – Personal Care’), some will categorise the same condition differently (e.g. whether alcohol related brain impairment is under mental health or physical support), and some will capture ‘secondary support reason’ to allow recognition of comorbidities in individuals. However, primary support reason has been used throughout the cohorts given: • this is still largely how local authority operational teams are grouped into respective specialisms and therefore how an individual’s support is managed (i.e. LD specialists supporting those with an LD primary support reason, even with mental health needs) • the analysis consistently grouped these individuals into the same cohorts based on their statistical significance Cohorts of working age and lifelong disabled individuals Through the analysis the following cohorts were identified (these are shown below in order of the proportion they account for of the total volume of working age and lifelong disabled individuals in receipt of adult social care): Individuals with a learning disability: • LD Cohort One: Individuals with a very low level of need whose packages of care are not changing in cost • LD Cohort Two: 40+-year-olds with high needs and whose care packages are increasing slightly in cost • LD Cohort Three: 18–39-year-olds with high needs and whose care packages are increasing slightly in cost • LD Cohort Four: Individuals with low levels of need and whose package of care is escalating in cost
% of total package cost increases accounted for by cohort
% of working age & lifelong disabled volume
% of working age & lifelong disabled expenditure
Cohort
LD Cohort One: Individuals with a very low level of need whose package of care is not changing in cost LD Cohort Two: 40+-year-olds with high needs and whose care package is increasing slightly in cost LD Cohort Three: 18–39-year-olds with high needs and whose care package is increasing slightly in cost LD Cohort Four: Individuals with low levels of need and whose package of care is escalating in cost LD Cohort Five: Individuals with low levels of need and whose package of care is not changing in cost LD Cohort Six: individuals with high needs and whose packages of care are increasing significantly MH Cohort One: Individuals with low levels of need whose package of care is not changing in cost MH Cohort Two: Individuals with high levels of need whose packages of care are increasing slightly in cost MH Cohort Three: Individuals with average levels of need whose packages of care are increasing significantly in cost PD Cohort One: 40–65-year-olds with average levels of need and whose packages of care are not changing in cost PD Cohort Two: 40–65-year-olds with average levels of need and whose packages of care are increasing in cost PD Cohort Three: 26–39-year-olds with higher levels of need and whose packages of care are increasing slightly in cost
11.00%
1.90%
0.61%
11.00%
23.90%
10.82%
7.20%
19.70%
8.26%
6.60%
6.10%
13.58%
6.50%
4.03%
2.00%
2.60%
11.30%
41.11%
10.70%
6.60%
0.36%
3.40%
4.60%
3.18%
2.20%
1.60%
4.06%
14.00%
8.80%
3.70%
3.40%
2.50%
5.86%
2.80%
2.70%
2.66%
Other support reasons
18.60%
6.1 %
3.79%
Based on this data, of the 12 main cohorts into which working age and lifelong disabled adults have been categorised, there are six key cohorts (shown in orange and white in Figure 14) which appear to warrant particular attention for authorities seeking to improve outcomes and the financial sustainability of the support provided. These were prioritised due to the average package cost being greater than £1,500 per week and/or the rate of cost escalation being greater than £100 per year.
Priorities for improvement Figure 14 shows the relative average weekly package cost and the average yearly cost increase for each cohort, with the ‘bubbles’ indicating the relative size of total spend attributed to that cohort. LD Cohort Six has been excluded from the figure due to its substantial outlying package cost and growth, which reduces the visibility of the other cohorts.
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