West Cumbria Opportunities & Challenges 2025 60 61 ACCESS TO SERVICES There are several hospitals across West Cumbria including West Cumberland Hospital, and community hospitals based in Cockermouth, Keswick, Maryport, Millom, Wigton, and Workington.44 However, for some mental and physical health conditions, appropriate support is not available locally. Rather service provision is based elsewhere, either in region within Cumberland or out of region in locations such as Newcastle or Lancaster. For example, patients with rare cancers, those requiring very specialist radiotherapy and children and young people with cancer are referred to the Freeman Hospital in Newcastle. For those living in Allerdale and Copeland, this can present practical, financial and emotional difficulties, particularly for those who live in rural areas with limited access to transport. Access to dentistry services and GP services is a growing area of concern at both national and local levels. The proportion of adults aged 18+ seen by an NHS dentist in the last 24 months (November 2024) in England stands at 39.2%. The proportion of children aged less than 18 years old seen by an NHS dentist in the last 12 months is 54.9%. While those under the care of the North East and North Cumbria Integrated Care Board fare slightly better than the rest of the country, at 41.6% for adults and 55.3% for children, these figures remain concerning.45 In relation to GP access, the 2024 GP Patient Survey for the North East and North Cumbria ICS46 provides useful data regarding patient perceptions regarding GP access and satisfaction levels. For example, when asked the question ‘generally, how easy or difficult is it to contact your GP practice on the phone?’, 22% and 15% of patients found it either fairly difficult or very difficult respectively. By contrast satisfaction levels regarding the experience of GP practices were high with 46% and 31% rating their experiences as either very good or fairly good respectively. REFUGEE AND ASYLUM SEEKER HEALTH Refugees and asylum seekers are likely to have complex health needs that could have been influenced either by experiences prior to leaving their home country, during transit to the UK, or after arrival in the UK. Common health challenges can include untreated communicable diseases, poorly controlled chronic conditions, maternity care, mental health and specialist support needs. A lack of access to care, either in their home country, or during transit to the UK, can lead to the poor control of chronic conditions such as hypertension or diabetes, and can cause untreated wounds, dental issues and eye problems to worsen, leading to pain, discomfort, impairment and/or disability. Additionally, refugees and asylum seekers are at risk of exploitation, trafficking and modern slavery, and may have experienced torture or other forms of mental, physical and/or sexual violence, which can require specialist treatment.43 43Refugees and Asylum Seekers in Cumbria: Health Needs Assessment: Cumberland Council, 2023. 44https://www.ncic.nhs.uk/locations 45Fingertips Public Health Data: Department of Health and Social Care, 2024, https://fingertips.phe.org.uk/search/dentist#page/1/gid/1/pat/223/par/E40000012/ati/221/are/ nE54000050/iid/94062/age/173/sex/4/cat/-1/ctp/-1/yrr/1/cid/4/tbm/1/page-options/car-do-0 46The 2024 GP Patient Survey is available at https://www.gp-patient.co.uk/surveysandreports 47https://cpag.org.uk/sites/default/files/2023-08/Poverty%20in%20the%20pandemic-%20The%20impact%20of%20coronavirus%20on%20low-income%20families%20and%20children.pdf 48Health Survey for England 2021 Part 2: NHS, 2021, https://digital.nhs.uk/data-and-information/publications/statistical/health-survey-for-england/2021-part-2/loneliness-and-wellbeing 49Our Health: The price we will pay for the cost-of-living crisis: Royal Society for Public Health, 2022, https://www.rsph.org.uk/our-work/campaigns/our-health-the-price-we-will-pay-forthe-cost-of-living-crisis.html 50Further information is provided on page 24. 51The North East and North Cumbria Integrated Care System (ICS) is a partnership of organisations that provide health and care across the region. ICSs have two parts: Integrated Care Boards (ICBs) and Integrated Care Partnerships (ICPs). ICBs replaced clinical commissioning groups (CCGs) in the NHS in England from 1 July 2022. The relevant ICB for West Cumbria is the NHS North East North Cumbria which works collectively, joining up resources and expertise to provide the best health and care for local communities. In addition, The Integrated Care Partnership (ICP) is a committee of the NHS, ICB and the 14 local authorities from across the North East and North Cumbria. ICPs can also include representatives from public health, social care, housing services, and VCSE organisations. ICPs focus on wider public and social care issues, https://northeastnorthcumbria.nhs.uk; and https://www.kingsfund.org.uk/insight-and-analysis/data-and-charts/integrated-care-systems-health-and-care-act IMPACT OF COVID-19 AND THE COST-OF-LIVING CRISIS Several studies have indicated that the Covid-19 pandemic has played a part in generating rising rates of poor mental and physical health. Disruption to mental health support services, lower levels of physical activity, poor sleep quality, and social isolation and loneliness caused by societal restrictions are amongst the factors commonly cited.47 Indeed, when asked for the Health Survey for England 2021, 62% of adults who reported either ‘bad’ or ‘very bad’ health stated that they felt lonely at least some of the time; this is far higher than the values seen for those reporting ‘fair’ health (35%), or ‘good’ or ‘very good’ health (18%).48 In addition, the cost-of-living crisis has impacted on the ability of many households to heat their homes, provide enough food and socialise with others. All of these factors can also have a negative impact on physical and mental health.49 The increasing cost-of-living and reduced spending power of income can also lead to the inability to afford transportation to medical appointments, including screening services and medical treatment. The Covid-19 pandemic and the cost of living have undoubtedly exacerbated existing health problems and presented new challenges across West Cumbria. Employees and volunteers from across the public, private and VCSE sector have not been immune from these difficulties. There are current and future labour market shortages, including within the NHS and the care sector50 as well as growing concerns regarding the mental health of both staff and volunteers. In addition, worsening mental and physical health conditions are placing increasing strains on carers, including young carers, who are struggling to balance the demands of looking after loved ones with work, education, other family commitments and financial wellbeing. Finally, changes to the local institutional landscape have recently taken place, resulting in a reorganisation of public health services across West Cumbria.51 The Covid 19 pandemic and the cost of living have undoubtedly exacerbated existing health problems and presented new challenges across West Cumbria.
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