Executive Summary

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    1. Demography

    • For 2019, the population of Barnet is estimated to be 400,600 which is the largest of all the London boroughs. The borough’s overall population is projected to increase by around 5% by 2030, taking the number of residents to approximately 419,200.
    • The number of people aged 65 and over is projected to increase by 33% between 2018 and 2030, compared with a 2% decrease in the 0-19 age group and a 4% increase for working age adults aged 16-64.
    • Between 2018 and 2030, the greatest increase in the over 65 population will occur in wards in the west of the borough (Colindale 91%; West Hendon 37% and Burnt Oak 33%), which are also amongst the most deprived wards.
    • The borough will become increasingly diverse, driven predominantly by growth within the existing population. Meeting the diverse needs of these growing communities may be a key challenge, as Colindale, Burnt Oak and West Hendon have increasingly diverse populations that are more than 50% Black, Asian and Minority Ethnic (BAME).
    • Female life expectancy in Barnet (85.5 years) is significantly better than both London (84.3 years) and England (83.1 years).
    • Male life expectancy in Barnet (82.2 years) is significantly better than both London (80.5 years) and England (79.6 years).
    • Women in Barnet have a significantly higher life expectancy than men.
    • The life expectancy of people living in the most deprived areas of the borough are on average 7.6 years less for men and 7.9 years less for women than those in the least deprived areas, based on a comparison of the 10% most deprived and 10% least deprived areas in the borough.

    2. Socio-Economic and Environmental Context

    • The number of households in Barnet is predicted to increase from 157,000 in 2018 to 192,000 by 2030, a rise of 22%, which will have serious implications for services, infrastructure and budgets. Over the same period, the number of households in Outer London is estimated to increase by 19% and in England by 11%.
    • Housing affordability is a major concern with both rents and house prices in Barnet high compared to the national average.
    • Between 2008-9 and 2017-18, there was no significant change in the rate of statutory homelessness in Barnet, however in 2017-18, the rate of statutory homelessness in the borough was significantly higher than the England average.
    • Over three-quarters of older adults in Barnet are home owners, indicating that a substantial majority of this age group are living in their own homes in the community, against a background of limiting long term illness and possible social isolation.
    • The older population (aged 65+) in Barnet is predicted to increase by a third between 2018 and 2030. Although this age group varies considerably in terms of long term illness, mobility and independence, a variety of housing options will need to be available to meet the needs and expectations of this growing segment of the population.
    • As Nitrogen Dioxide (NO2) pollution within the borough is largely due to transport, areas of higher NO2 pollution are mainly concentrated around the main roads and junctions, including the A1, M1, A406 and A1000.
    • Over half of the journeys originating in Barnet are made by car (54%), which is twice the proportion of journeys made by active transport (cycling or walking), accounting for around 27% of trips started within the borough. This disparity clearly underlines the importance of promoting ways of reducing car dependency in Barnet and supporting active travel initiatives.
    • For the year to June 2018, both the employment and unemployment rates for Barnet are similar to both London and England, so there is still room for improvement.
    • The proportion of Barnet adults in contact with secondary mental health services in employment is significantly lower than the England average (between March 2017 and March 2018).
    • During 2017, 62.2% of economically active working age people in Barnet had an NVQ4 qualification or higher which was similar to London (58.1%), so there is still potential for further training and higher education for borough residents.
    • Median gross weekly earnings in Barnet have increased significantly between 2006 and 2018 and are significantly higher than the median for Great Britain. For 2018, gross weekly earnings in the borough (£674.10) are similar to the median earnings for London (£670.80).

    3. Barnet Customer Segments

    • The top five customer segments most likely to require health services are; “Low income couples”, “Financially restricted single students and friends,” “Struggling families,” “Low income singles” and “Penny-wise pensioners,” as they are the residents most likely to report less good health, to have a limiting long-term illness or a disability.
    • They are mostly living in the west of the borough, particularly Burnt Oak and Colindale and represent 13% of Barnet’s population (about 30,000 residents).
    • Penny-wise pensioners represent the largest of this group (about 14,500 residents) and are likely to have more complex health care needs due to their advanced age.

    4. Health

    • Mortality is considerably higher in the most deprived areas of the borough, compared to the least deprived. The life expectancy of people living in the most deprived areas of the borough are on average 7.6 years less for men and 7.9 years less for women than those in the least deprived areas.
    • For 2016/17, the recorded prevalence of coronary heart disease (CHD) for all ages in Barnet (2.5%) is significantly higher than the London average (2.0%). Compared with the other London boroughs, Barnet is ranked 7th highest on prevalence of CHD.
    • The recorded prevalence of stroke or transient ischaemic attacks (TIAs) in the Barnet GP registered population for 2016/17 is 1.3%, significantly higher than the London average (1.1%). This prevalence ranks Barnet 6th highest of the London boroughs. The rate of hospital admissions for stroke (all ages) in Barnet (177.8 per 100,000) for 2016/17 is significantly higher than the national (England) rate (169.2 per 100,000).
    • Only 31.3% of eligible people in Barnet received an NHS health check between Q1 2013/14 and Q4 2017/18. This proportion was the third lowest of all the London boroughs and significantly lower than the England average (44.3%).
    • Between 2015 and 2017, the cancer screening coverage in Barnet was significantly worse than the national (England) average for bowel, cervical and breast cancers.
    • In 2016/17, the recorded prevalence (all ages) of mental health problems (including schizophrenia, bipolar affective disorder and other psychoses) for Barnet is 1.01%, which is significantly higher than the rate for England (0.92%).
    • Between 2013-14 and 2016-17, the percentage of adult patients accessing dental care in Barnet was lower than both London and England.
    • For at risk individuals only 46.2% in Barnet received a flu vaccination during 2016/17, which was significantly lower than the averages for London (47.1%) and England (48.6%).

    5. Lifestyle

    • Although the prevalence of excess weight in Barnet is lower than the national average, over half of Barnet adults are either overweight or obese, so there is an ongoing need for interventions (such as healthy weight and active travel programmes), to promote healthy lifestyles and help reduce the number of borough residents with excess weight.
    • In recent years, obesity and excess weight in Barnet Reception Year and Year 6 children has either been significantly lower or similar to London and national averages. Ongoing monitoring of National Child Measurement Programme (NCMP) data will inform decision-making in this area.
    • The Chief Medical Officer (CMO) for England recommends that adults take at least 150 minutes of moderate physical activity per week. Based on this standard, the proportion of adults in Barnet who are physically active in Barnet (in 2016/17) is significantly lower than both the London and national averages.
    • Whilst the rates of hospital admissions and mortality due to alcohol related conditions in Barnet have been significantly lower than both London and England in recent years, the proportion of adults who abstain from alcohol in the borough is lower than the London average.
    • In recent years, a lower proportion of non-opiate users have successfully completed treatment in Barnet, compared to London. Investigation into the reasons underlying this trend may be required.
    • The adult smoking prevalence in Barnet did not change significantly between 2012 and 2017. However, over the same period there were significant falls in adult smoking prevalence in both London and England.
    • The relatively high proportion of 15 year olds in the borough who have either used or tried tobacco products other than cigarettes may have been reduced by recent borough initiatives on shisha, so further research in this area may be warranted.
    • The consistently lower prescription of LARCs by GPs in Barnet, compared to both London and England, in recent years, may need further investigation.
    • The consistently low rates of screening and detection of chlamydia in Barnet may require further attention.
    • The significant decrease in HIV coverage (the proportion of eligible new attendees to a specialist sexual health service who accept an HIV test), among Barnet females between 2010 to 2017, may require investigation.

    6. Primary and Secondary Care

    • There is a need for ongoing monitoring of life expectancy inequalities in Barnet, through the Health and Wellbeing Strategy, with a view to increasing life expectancies and healthy life expectancies, by decreasing gaps between wards and genders.
    • By the year 2035, the number of people in Barnet aged 65+ having a fall is expected to rise to 23,530 (52% higher than 2019) and the number of hospital admissions due to falls to increase to 2,973 (56% higher).
    • In recent years (between 2013/14 and 2017/18), there has been a significant rise in the rate of A&E attendances for Barnet, for people of all ages, under 18, aged 16-64 years, as well as older people aged 65+.
    • Despite a decreasing trend in recent years, the rate of outpatient attendance for older people (aged 65+) in Barnet for 2017/18, was significantly higher than both London and England, so requires on-going monitoring.
    • Between 2020 and 2035, the estimated number of older people (aged 65+) in Barnet living with a limiting long-term illness whose daily activities are limited a lot, is projected to increase from 12,538 to 18,842, a rise of 50%.
    • Given the substantial rises predicted in the number of older people in the borough with limiting long term illness, there is a clear need for integrated care systems within Barnet which promote independence in the elderly.
    • Reducing the number of emergency hospital admissions and effectively managing both long term conditions and co-morbidities will be a challenge that requires the modification of primary and secondary care systems to allow more co-ordinated and integrated working across the North Central London CCGs.
    • Within the North Central London CCG partnership, Barnet has been one of the first areas nationally to launch the new integrated urgent care model, which will on-going support.

    7. Children and Young People

    • At ward level, the highest population of children and young people (aged 0-19 years) in 2018, was predicted for Golders Green ward (6,900). However, by 2025, Colindale ward is projected to have the highest CYP population in Barnet (9,500), having experienced a 45% increase since 2018.
    • In general, the wards with the greatest increase in their CYP population between 2018 and 2025 are found in the west of the borough (e.g. Colindale, Mill Hill and Golders Green), largely coinciding with the areas of planned regeneration. In contrast, those with the greatest decrease in their 0-19 populations during this period are concentrated in the east of Barnet (e.g. Garden Suburb, Coppetts and Woodhouse).
    • Almost three-quarters of Barnet children (74%) achieved a good level of development by the end of the Reception Year in 2017/18, which was similar to the overall average for London (73.8%), however for a relatively affluent borough, it still has some work to do in the area of early years development, if it is to improve its ranking of 15th out of 32 London boroughs on this measure.
    • The proportion of 5 year old children in Barnet who had received two doses of MMR or the Hib / Men C vaccination booster during 2017/18 was significantly lower than both London and England. Vaccine coverage is a strong indicator of the amount of protection against communicable diseases and is linked to the level of these diseases within the population, so increasing the vaccine coverage for 5 year olds for both MMR and Hib / Men C in the borough may be warranted.
    • Based on data from the End Child Poverty Coalition, for July–September 2017, the highest proportions of children living in poverty in Barnet were found in Colindale, Burnt Oak, Woodhouse and Childs Hill, which all have a third or more of their children living in poverty after housing costs are considered. In contrast, less than a fifth of children in Finchley Church End, Totteridge, High Barnet and Garden Suburb were living in poverty during the same period. This disparity in the proportions of children living in poverty between different wards in the borough has important implications for health and wellbeing as well as service provision.
    • The local need for effective Child and Adolescent Mental Health Services (CAMHS) is underlined by the percentage of school age pupils with social, emotional and mental health needs in Barnet. For 2018, this percentage is 2.61% for Barnet, which is significantly higher than both London (2.41%) and England (2.39%). The percentage of primary school and secondary school pupils in the borough with social, emotional and mental health needs are also significantly higher than the national average, in each case.
    • Despite the relative low estimated prevalence for various mental disorders in the borough, hospital admissions due to self-harm for 10-24 year olds in Barnet have been significantly higher than London, since 2015/16.
    • According to the Crime Survey of England and Wales (CSEW), during the year ending March 2018, 7.9% of women and 4.2% of men experienced domestic abuse, so overall 6.1% of people aged 16-59 years experienced some domestic abuse in the previous year. At a local level, using these proportions, about 5,100 men and 9,400 women aged 16-59 years in Barnet experienced domestic abuse in the last year, a total of roughly 14,500 people. These figures show the magnitude of the problem in Barnet and emphasise the importance continued efforts to reduce domestic abuse.
    • Between April 2017 and April 2019, there were 5 domestic abuse homicide cases recorded in the Barnet and 37 in London as a whole. During this period, Barnet had a disproportionately high number of homicides related to domestic abuse when compared the rest of London. It may be helpful to have a deeper understanding of the reasons underlying the relatively high number of domestic abuse related homicides in the borough, over this period.
    • Since 2013/14, the recorded (QoF) prevalence of psychosis in Barnet has been consistently significantly higher than England and significantly lower than London. Shedding light on the underlying reasons for this pattern in the recorded prevalence of psychosis, may be useful for future service provision.
    • Based on figures from the Children’s Society, 4.5% of children and young people identify themselves as having a caring responsibility, which equates to around 4,200 young carers (aged under 18) in Barnet. Improved identification of young carers within the borough would have a range of benefits for both the young people providing the care and those receiving it.

    8.  Adult Social Care

    • As more people with complex needs survive into adulthood, there is a concerted effort to help them live independently within the community. To meet their requirements, requires effective, targeted, locally based provision, which places considerable pressure on support services, often operating within tight budgets. Against this background, the Care Act 2014 is the most significant reform of support and care in many years.
    • Between 2020 and 2035, the number of younger adults (aged 18-64) in Barnet with moderate to severe learning disability (LD) is projected to increase by 9%. In contrast, over the same period, the number of older people with LD at this level of severity, is predicted to increase by 44%. However, for older people in Barnet with LD, the numbers involved are smaller and the potential duration of care required shorter, compared to their younger counterparts.
    • In 2017-18, the rate of requests for support by new clients in Barnet was 2,410 per 100,000 adults, which was significantly lower than both London (2,735 per 100,000) and England (4,215 per 100,000). Similarly, for both younger and older adults in Barnet, the rates of requests for support were significantly lower than those for London and England respectively.
    • “Universal services” refer to any support or service for which national eligibility criteria (based on the Care Act 2014) are not relevant and “signposting” occurs when a client is not supported by either a local authority or a universal service. Over a third (38%) of new Barnet clients in 2017/18, passed to universal services or were signposted; this was higher than both London (24%) or England (29%). An understanding of the reasons underlying this disparity may be useful in the planning of future services.
    • With the growth of the older population in Barnet and the associated rise in the number of people living with long term conditions and living longer with disability, there is likely to be ongoing pressure on care provision within the borough.
    • On ASCOF indicator 1C1B (measuring the proportion of carers who receive self-directed support), Barnet scored 100% (compared to 82.5% in London and 83.4% in England) and was ranked joint 1st nationally, in 2017/18. The Council also performed well on the related ASCOF indicator 1C2B (assessing the percentage of carers receiving carer specific services who received self-directed support via direct payments. On this measure, Barnet also scored 100% (compared to 73.4% in London and 74.1% in England) and achieved a joint 1st ranking nationally.
    • Nearly two-thirds of carers in Barnet were assessed/reviewed separately from those they cared for, almost a quarter were assessed or reviewed jointly (24%) and 13% did not receive an assessment or review, during 2017-18.
    • In 2017-18, LBB spent £16.03M on short term care for adults, a 12.2% increase on the previous year. Of this gross expenditure, 92.2% was spent on younger adults aged 18-64.
    • The Council spent £68.84M on long-term care of adults during 2017-18, which represented a 5.6% fall compared to the previous year. In contrast, national spending on long term care rose by 2.7%, despite an ongoing decrease in the number of clients receiving long term care in England, since 2015-16.
    • In 2017-18, the borough had the 8th highest number of safeguarding concerns of all 33 London local authorities and the 9th highest number of Section 42 enquiries. However, in terms of conversion rate, Barnet was ranked 19th out of 33 local authorities in London and 10th out of 16 against its CIPFA comparators. An understanding of the reasons for this relatively low conversion rate, may yield useful insights into safeguarding within the borough.

    9.  Community Safety

    • Barnet remains a safe place to visit, live and work, however if it is to remain one of London’s safest boroughs against a background of reduced funding from central government, it is essential that the borough continues to work efficiently, effectively and imaginatively with its Safer Community partners and other organisations within the community and voluntary sector.
    • The estimated cost of crime in Barnet for the 2017/18 financial year was almost £99.3m, which represented a rise of nearly £4.5m on the previous year.
    • Violence and sexual offences accounted for the largest proportion of this total estimated cost (64%), followed by burglary (14%), vehicle crime (9%), robbery (6%) and “Other Theft” (3%).
    • Whilst the cost of violent and sexual offences and “other theft” changed little in 2017/18, the cost of robbery, burglary and vehicle crime rose by around £2.1m, £1.1m and £1.1m respectively, compared to the previous financial year.
    • Between January 2017 and November 2018, there was a 41% increase in the total number of recorded theft and handling offences in Barnet.
    • Theft from motor vehicles and interference / tampering with motor vehicles increased by 76% and 74% respectively, whilst there was a 210% rise in recorded theft involving taking a motor vehicle, between January 2017 and November 2018. Over the same period, there was a 68% increase in recorded theft from the person in Barnet.
    • When the 12 months to 0ctober 2018 is compared to the previous year, anti-Semitic hate crime in the borough rose by over a third (37%) and faith crime more generally by 7%.
    • In October 2018, there were 795 reported offences of Anti-Social Behaviour (ASB) in the Barnet, compared to 619 for the same month in 2017, which represents a 28% increase.
    • Local authorities play a vital role in preventing people from being drawn into terrorism and have responsibilities under the Counter Terrorism and Security Act 2015. The Barnet Prevent Strategy 2017-2020, also has an important role in keeping the people of Barnet safe, through early intervention, to protect and divert people away from terrorism and/or violent extremism.

    10. Community Assets

    • There is a firm foundation in Barnet for an asset based approach to improving communities, centred on strong social networks, satisfaction with the local area and a sense of belongingness. In this context, effective communication between the council and VCFS organisations is key.
    • Against a background of increased demand and tightening budgets, the traditional role of the council is changing, from one of service provider to one of “action enabler.” From this perspective, a different relationship develops where people take more responsibility for themselves, whilst the council retains its community leadership role. 
    • A detailed knowledge of the services provided by local VCFS organisations and their level of coverage, would assist the council in facilitating their activities and in the development of stronger, more resilient and mutually supportive relationships.
    • Building capacity in the VCFS to address the needs of its residents is a priority for Barnet Council, whilst helping to create active communities by encouraging individual and corporate volunteers. The council is also committed to forging strong relationships with both the Barnet Multi-Faith Forum and the Community Together Network (CTN), as well as providing access to a comprehensive community directory of local resources.
    • Close adherence by the council to the Barnet Together Action Plan is likely to facilitate the delivery of its Community Participation Strategy, aimed at increasing the level of community activity within the borough, by improving the support given to communities.
    • Demand for services from VCFS organisations within Barnet has increased in many cases, underlining the importance of information and training about funding sources and fundraising.
    • Based on feedback from the local VCFS, “funding, sustainability and forward planning,” “exploring alternative funding models” and “demonstrating impact” were identified as top training and development priorities. Tailor-made training courses in these areas may prove beneficial.
    • Accessibility to free or low-cost training to address gaps would be helpful to those in the VCFS, otherwise they may not be able to access such training.
    • The recruitment and retention of enough volunteers with the right skills represents an important challenge for organisations in the VCFS. Similarly, the capacity to manage and train volunteers were important factors for the sector. Supporting the VCFS in meeting these important challenges could yield tangible results.

    11. Resident Voice

    • Three quarters of residents feel that they strongly belong to the local area and the same proportion think that Barnet is a family friendly place to live. These and other markers indicate that there is strong community cohesion within Barnet, which if encouraged appropriately could foster a strong culture of volunteering and create a resilient partnership between Barnet Council and the Voluntary, Community and Faith Sector (VCFS).
    • The top three concerns for Barnet residents (namely; crime, lack of affordable housing and the condition of roads and pavements) remained the same between Spring and Autumn 2017. However, the order changed in the latest survey; crime became the number one concern for residents and lack of affordable housing rose by 10 percentage points to become number two.
    • The percentage of Barnet residents rating crime in their top three concerns has risen from 25% in Spring 2015 to 39% in Autumn 2017, reflecting declines in both the proportion of residents feeling safe after dark and satisfaction with the council and the police in dealing with anti-social behaviour (ASB). Initiatives to lessen fear of crime and target ASB may be productive.
    • There has been a recent decline in satisfaction with the way the council runs things, so that around two thirds of residents are satisfied, is a departure from pattern shown over the previous few years. The level of satisfaction with how the council runs things in Barnet is now in line with both London and national averages, where in the past it was significantly higher than both. Investigations into the reasons for this change may be warranted.
    • In Autumn 2017, 56% of residents thought that the council was efficient and well run, which was a fall of 10 percentage points from Spring 2017 (66%). This perception is linked to a number of variables including a fall in the percentage of residents who feel that the council is making the local area a better place to live from 67% to 62% between Spring and Autumn 2017.
    • Several drivers linked to the perception of Barnet Council as efficient and well run, have shown little change between Spring and Autumn 2017 e.g. the perception that the council is doing a good job, provides good value for money for the council tax paid and involves residents in decision making.
    • In the latest Residents’ Perception Survey, 38% of respondents agreed that the council “is doing a better job now than one year ago,” which represents an increase of five percentage points from Spring 2017 (33%) and brings this measure back in line with Spring 2016 wave (40%).
    • In terms of the core reputational measure for the council, two-thirds of residents (65%) were satisfied with the way Barnet Council runs things, which was a decrease of five percentage points from the previous survey conducted in Spring 2017. This was the only core reputational measure that showed a decline in the latest survey; the proportion of residents who believe that Barnet Council is trustworthy, gives good value for money and keeps residents informed about what they are doing remained in line with the Spring 2017 survey.

    12. Public Sector Finance

    • During 2017/18, Barnet Council managed a net budget of £277.2 million, which led to an actual (outturn) spend of around £285.1 million, resulting in an overspend of about £7.9 million (or 2.8% of the original net budget). An understanding of the council’s finances is important to give context to its objectives and priorities as well as providing clarity on how it works towards addressing needs within the borough.

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