Midlothian Health and Social Care Partnership

Consultations

• Consultation and Engagement report for the Strategic Plan 2022-25 - Physical Disability and Sensory Impairment (PDF)
• Consultation and Engagement report for the Strategic Plan 2022-25 - Learning Disability (PDF)
• Consultation on Wheelchair Housing 2022 (PDF)

Impact Assessments

• Impact Assessment for Deaf Action contract (PDF)

Data

Physical disability

Under the Equality Act 2010 a physical disability is defined as a physical or mental impairment that has a ‘substantial’ and ‘long-term’ negative effect on your ability to do normal daily activities. This can affect equity of access to education, employment, appropriate housing, and financial support as well as to being an active member of a local community which all have an impact on health and wellbeing.

The National Records of Scotland report that in Midlothian 6.9% identified themselves as living with a physical disability that had lasted or was expected to last at least 12 months. This was close to the Scottish average of 6.7%.

In Midlothian in 2023, records show that 3,179 adults (18 and over) known to the Adults and Social Care team have a physical disability recorded as their primary care group, 5,681 people have a blue badge and 1,200 people are recorded as wheelchair users (Midlothian Council, 2023).

There is 1 registered care home in Midlothian to support adults with a physical disability and 1 care home in Edinburgh which supports a number of Midlothian residents (Midlothian Council, 2023). There is no dedicated respite facility. There is an increase in support being provided in alternative ways with 27.7% of all funded respite requests in 2020 using options 1,2 or 4 of Self-Directed Support (Midlothian Council, 2023).

 

Learning disability

As a population, people with learning disabilities are experiencing increased life expectancy.  As life expectancy has increased, more people with learning disabilities are experiencing multi-morbidities and increased complexity in their health and social care needs. People with learning disabilities die, on average, 20 years earlier than people in the general population, often from causes that could be prevented or treated (Scottish Learning Disability Observatory, 2023).

785 adults with a Learning Disability are known to Social Care service in Midlothian (Midlothian Council, 2023).

By July 2023 all HSCPs in Scotland implemented a Dynamic Support Register as a local record of all adults who have complex care needs and a learning disability whose discharge will require significantly higher levels of input and coordination from a range of skilled professionals within health and social care. The Dynamic Support Register will identify and record all relevant individuals who are currently in hospital, in an out-of-area placement, or who are at risk of breakdown of current support arrangements. Midlothian has a higher prevalence rate of adults with a Learning Disability known to Social Care (6.3 per 1,000) in comparison to the Scottish average (Scottish Commission for Learning Disability, 2019). Learning disabilities is the highest area of spend in Midlothian based on client group and spend per head.

Currently, approximately 20 people (14–18-year-olds) have been identified as having significant support needs and who are transitioning between children and adult services (Midlothian Council, 2023). Many of this group will require highly specialist services.

In Midlothian, 53.2% of adults with learning disabilities live in mainstream accommodation without support (Scottish Commission for Learning Disability, 2019). compared to 43.1% in Scotland as a whole. The high number of adults with a learning disability living alone in Midlothian might warrant some exploration including consideration of the theme of loneliness.

 

Autism Spectrum Disorders

Autism is a lifelong neurodevelopmental difference in the way a person communicates, interacts and processes the world around them. Every autistic person has skills, talents and aspirations. Whilst some people will have subtle differences in their thinking and processing styles, others will have more complex needs requiring more intensive support.

Autism is more prevalent amongst males than females with sex ratios typically ranging from around 2.5 – 6.0: 1 (Scottish Government, 2018). Nationally it is recorded that there is a high frequency of mental health problems experienced across the autism spectrum, particularly in relation to the prevalence of anxiety and depression (Scottish Learning Disability Observatory, 2023). Other common conditions which are known to concur with ASD, include epilepsy, attention deficit, hyperactivity disorder (ADHD), schizophrenia, obsessive compulsive disorder (OCD) and Tourette’s Syndrome.

The prevalence of autism and intellectual disability for Midlothian is 918 people (adults and children) (Scottish Government, 2018). This is 1.4% of the population. This figure is consistent with the estimated prevalence of autism in Scotland.

 

Sensory Impairment

Sensory impairment is the common term used to describe deafness, blindness, visual impairment, hearing impairment and deaf blindness. Nationally it is estimated that 1 in 6 of the population have a hearing loss while significant sight loss is estimated to affect 1 in 30 of the population. We do not have accurate information on the numbers of people with sight or hearing loss in Midlothian.

Older people are most likely to experience some degree of hearing loss and the vast majority of those with sight loss are in the older age range. Between 40 to 50% of older adults with visually impairing eye disease limit their activities due to a fear of falling. It was noted that this protective strategy puts older people at potential risk for social isolation and disability. People with learning disabilities are 10 times more likely to have some degree of sight lost, again not always recognised. Sensory impairment can remain hidden for people who have had a stroke or live with dementia.

Hearing impaired adults with untreated hearing loss were more likely to report depression, anxiety, and paranoia and were less likely to participate in organized social activities, compared to those who wear hearing aids. 

Hearing Loss

At the last census 233 people in Midlothian were British Sign Language users and 5,656 people reported a hearing impairment.

Percentage of Midlothian’s population (by town) reporting deafness or partial hearing loss at last census
Data source: National Records of Scotland.