SERVICES closer to home for dementia and stroke patients, more healthcare in the community and extra work with children having problems at school are some of the priorities for the NHS in Norfolk over the next five years.

SERVICES closer to home for dementia and stroke patients, more healthcare in the community and extra work with children having problems at school are some of the priorities for the NHS in Norfolk over the next five years.

Older people are being promised �23m of new investment in healthcare in the community, especially for people with dementia, stroke or chronic lung disease (COPD). This is the single biggest pledge in cash terms in NHS Norfolk's five-year plan, its first strategic plan since the health trust was formed in 2006.

Another priority group is young men, who are less likely to use health services, and families of disadvantaged children, who will get �8m of improved services between them. Men aged 16-25 are being promised “services more appropriate to their needs”.

The idea is that if more work is done with children who are likely to have problems at school, it may be possible to stop them being expelled and taking up “risky behaviour” such as drugs, and ultimately change the course of their lives.

Healthcare in the community, costing �4m, may include more services at doctors' surgeries and market town-based “hubs” for diagnosis and treatment of more conditions.

But the challenge for NHS Norfolk is doing all of this without any extra money over the next few years. The finances of the NHS are due to become increasingly difficult, especially after next year. It means the cash will have to come from efficiency savings or reducing spending in other areas - although NHS Norfolk says no cuts are planned at the moment.

Director of finance David Stonehouse said: “In this challenging economic climate…the significant investments included in the strategic plan will not be funded from future growth, but from re-engineering of our �1bn budget, and working in close partnership with other agencies in NHS Norfolk.”

NHS Norfolk, which covers most of the county but not the Yarmouth area, says its four challenges are reducing inequalities, helping the elderly, giving equal services to people in rural areas and giving care closer to home. There is a gap of 19 years in life expectancy between men in the county's wealthiest wards and those in the poorest. Norfolk is the fifth worst county in England for child poverty. More than a fifth of the population is over 65, and the number is expected to grow by 57pc over the next 20 years. Half the population lives in rural areas.

GP and board member Ian Mack said: “Norfolk has a population that is getting older, and the purpose of this is to ensure that as we get older we have the services we want to help us remain at home if we want.

“We know there is under-diagnosis of dementia. We are working to improve dementia services and there will be more on this later this year. People will have the opportunity to have some kind of standardised assessment to see if they have problems with their memory.”