Local context
This section outlines some of the local factors that shape the strategy and will determine its delivery.
Demography: people and place
Lincolnshire is the third largest council in England by area, shaped by its scale, geography and diverse communities. Beyond the city of Lincoln, people live in market towns, such as Grantham, Boston, and Gainsborough, and in rural villages. The county’s large size and dispersed population make Lincolnshire distinct from other rural areas, creating unique challenges in accessing health and social care services. Lincolnshire Health Intelligence Hub has significant detail.
Lincolnshire population overview
- Lincolnshire has an estimated population of approximately 768,000 people
- the county covers a large geographical area with a dispersed population
Age profile
- a higher proportion of residents are aged 65 and over compared to the national average
- by 2043, the population aged 65+ is projected to increase significantly
- the working‑age population is proportionally smaller than in England overall
Disability and long‑term conditions
- around one in five adults report a long‑term illness or disability
- a significant proportion of older residents live with multiple long‑term conditions
- dementia prevalence increases sharply in older age groups
Ethnicity
- the majority of the population identifies as White British
- small but growing minority ethnic communities are concentrated in urban areas
Wider determinants of health
- nearly one quarter of adults live in areas classified as deprived
- over one quarter of households experience fuel poverty
- housing quality and access to transport vary significantly by district
Health disparities are evident, particularly in deprived areas, including the east coast and in urban centres such as Lincoln and Gainsborough, where life expectancy is lower for people experiencing social inequalities. Addressing these challenges is crucial for the county’s health and social care services (Lincolnshire County Council, Director of Public Health Report 2022).
Health outcomes and life expectancy vary across the county, in large measure driven by differences in deprivation levels. While county-level deprivation rates are similar to the national average, significant deprivation exists in many communities, particularly in the north and east of the county. Deprivation drives health inequalities, with those in the most deprived areas more likely to experience poor health, develop multi-morbidity earlier, and die prematurely (Health Inequalities Dashboard). Small pockets of deprivation can exist within more affluent areas, sometimes masking the true scale of need.
Deprivation in Lincolnshire
- deprivation is unevenly distributed across the county
- East Lindsey, Boston and South Holland have the highest levels of deprivation
- Coastal towns such as Skegness and Mablethorpe are among the 10% most deprived areas nationally
- urban areas such as Lincoln and Gainsborough contain pockets of deprivation comparable to coastal areas
- approximately 17% of Lincolnshire residents live in the 20% most deprived communities in England
- western districts generally experience lower levels of deprivation
- east Lindsey, Boston & South Holland have high levels of deprivation
- resort towns, such as Skegness and Mablethorpe are among the 10% most deprived localities in England
- Lincolnshire’s towns and urban areas appear relatively affluent, but contain pockets of deprivation that are comparable to the coast, e.g. Lincoln and Gainsborough
- health deprivation mirrors overall deprivation, with the east coast and parts of Lincoln displaying high levels of health deprivation, and west Lincolnshire displaying the lowest
- 17% of Lincolnshire people live in the 20% most deprived communities nationally
Frailty, and conditions such as dementia and other long-term conditions, are placing greater pressure on services for older adults. In Lincolnshire, 27% of people aged over 65 struggle with everyday activities due to long-term illnesses, with most having two or more long-term conditions (Director of Public Health Annual Report 2023). Meeting these demands requires a holistic and integrated approach that combines early action, timely treatment and long term support in a way that is both person-centred and sustainable.
Life expectancy
- average life expectancy in Lincolnshire is approximately 78 years for males and 82 years for females
- the gap in healthy life expectancy between the most and least deprived areas exceeds 10 years
Health inequalities
- residents in deprived areas experience poorer health outcomes earlier in life
- people in deprived communities are more likely to die at a younger age
Disease burden
- the most common long‑term conditions include hypertension, depression, obesity, diabetes and asthma
- mental health needs and musculoskeletal conditions are significant contributors to demand for services
Joint Health and Wellbeing Strategy (JHWS)
The JHWS sets out the vision and focus for improving health and wellbeing for people in Lincolnshire and reducing health inequalities through establishing shared priorities and clear outcomes. Based on Lincolnshire’s Joint Strategic Needs Assessment (JSNA), the strategy identifies five key priorities: unpaid carers, healthy weight, homes for independence, mental health / dementia, and physical activity.
The strategy takes a life course approach, recognising that health inequalities are the product of many factors (including individual, socio-economic and environmental factors, maternal health, family and social networks) impacting on people throughout their lives. It seeks to promote and improve health at all ages, particularly as people get older, since evidence shows the need and demand for health and social care services increases with age. More information at: Joint Health & Wellbeing Strategy
Lincolnshire Integrated Care Partnership (ICP) Strategy
The Integrated Care Partnership Strategy sets out the key enablers the health and care system will focus integration efforts on to support delivery of the JHWS and its priorities, and the system’s overarching ambition and aims. This ICP strategy, also known as Better Lives Lincolnshire Strategy (Better Lives Lincolnshire Strategy) brings together our system thinking into one place, ensuring we have stronger connectivity between statutory bodies, the Voluntary, Community, Faith and Social Enterprise (VCFSE) and independent sector to maximise the capacity and capabilities available to the people of Lincolnshire.
The ICP strategy identifies 5 strategic enablers that will focus the minds of all partners in delivering our collective aims, ensuring that engagement and co-production is embedded into the delivery arrangements, which are: Prevention and Health Inequalities; Workforce and Skills in the health and care sector; Personalisation; Digital Technology; and Data & Intelligence.
Although the government has announced plans to abolish ICPs, as part of national changes to Integrated Care Boards (ICBs), we will continue to work with our partners to ensure effective approaches to integrating the design and delivery of care and support.
Better Care Framework
Through the Better Care Framework (2025), we are working with all partner organisations to develop Integrated Neighbourhood Health and Wellbeing services with the goals of: providing more care closer to home, increasing focus on prevention so that people are living healthier and more independent lives, and harnessing digital technology to transform care. The Council works collaboratively with the ICB and their commissioned community health and hospital service to ensure a seamless service experience for people in Lincolnshire.
The Better Care Framework sets out the guidance from DHSC on how the Council and the ICB jointly invest the Better Care Fund (BCF). The BCF is aimed at delivering integrated health and social care services for people with complex needs, to enable them to receive preventative treatment, care and support at home or in the community and avoid unnecessary admission to a hospital. The pooled BCF budget of £361.8m for 2025/26 supports these efforts, with Adult Social Care playing a key role in joint planning and delivery. We have recently reviewed the Lincolnshire BCF and will take forward improvements, guided by updated national guidance.