Upper Valleys Cluster Public Health Profile V1

Transcription

1 Upper Valleys Cluster Public Health Profile V1 This profile aims to inform the development of the QOF Practice and Cluster Development Plans with local and national data relating to the three main priority areas chosen as a focus for Public Health in ABMU Health Board. These main areas are: Smoking Vaccination and immunisation Obesity and physical activity The profile also includes a snapshot of information in relation to screening. In addition, ABMU Health Board continues to focus on the health and well being of children and in particular the first 1000 days of a child s life (i.e. from conception to 2 years of age) will reap the greatest health gains and reduce inequalities. What does this profile tell you? Highlights variation within and between clusters Demonstrates achievements against national targets Identifies potential areas for improvement Contents: 1. Headlines from your cluster...page 2 2. Smoking...Page 4 3. Vaccination...Page 8 4. Obesity...Page Screening...Page 15

2 SMOKING in your cluster HEADLINES (N.B. Pharmacy L3 Smoking Cessation Service figures are approximate and up to the end of Feb 2017 and the Stop Smoking Wales figures cover the first three quarters of 2016/2017). In this time period in your cluster :- In this time period in your cluster:- The estimated number of smokers is 5,370 = 21% of your cluster population The number of smokers who accessed Stop Smoking Wales was 144 The number of smokers who accessed your L3 pharmacy service was pharmacies across ABM have been commissioned to deliver L3 service. Your cluster has 6 commissioned pharmacies, 5 of which actively delivered in 2016/2017 Cecil Jones (Glyn Yr Afon ) Pharmacy was the top performing pharmacy out of the 45 actively delivering the service across ABM, in terms of people seen in this time period (73) Key for the cluster:- Up to date smoking status for patients Increased referrals to both smoking cessation services VAC & IMMS in your cluster Has the lowest uptake for influenza vaccination in those 65 years and older at 60.5% against the Welsh Government target of 75% Has the lowest uptake for influenza vaccination in those under 65 years in clinical risk groups at 36.3% against the Welsh Government target of 75% Is ranked 9 th for influenza vaccine uptake in children aged 2 and 3 years. Uptake has greatly increased from 14.5% last season to 32.6% this year Uptake for scheduled childhood immunisations by 4 years is 91.3% against the Welsh Government target of 95% Uptake of MMR 1 by 2 years of age at 96.6% has exceeded the Welsh Government target of 95% 2

3 The only cluster in ABM UHB to achieve 95% uptake for 2 doses of MMR by age 4. Pontardawe Health Centre and Amman Tawe Partnership both achieved 96.1% uptake Key for the cluster: To increase vaccination rates to reach the Welsh Government targets and achieve safe levels of immunisation across all programmes OBESITY/PHYSICAL ACTIVITY in your cluster Due to the timing of these profiles required by ABM Health Board, most of the data for 2015/2016 is not yet available. N.B. these figures are only for the first 3 quarters of 2016/2017 In terms of NERS referral rates, of the 4 practices: 3 reduced 1 increased Key for the cluster: Increase referral rates to NERS In 2017 / 2018 The Local Public Health Team plan to: Continue to represent Public Health in a Primary Care setting both Public Health Wales and ABM Health Board Continue with a nominated Public Health Practitioner to attend cluster meetings and advise on your chosen Public Health priorities Work closely with a number of clusters on pilot projects under the tobacco, vac/imms and obesity/physical activity headings detailed in these profiles Provide refreshed data to clusters at key points each year (e.g. June for Welsh Health Survey data) If you require further information please contact either your cluster rep from the Public Health Team or Julie Davies Julie.davies46@wales.nhs.uk 3

4 1 Smoking National Context: The Welsh Government has set a population prevalence target of 16% by There is also an NHS Welsh Government smoking cessation target which states 5% of the smoking population should make a quit attempt through smoking cessation services with a COvalidated 4-wk quit rate of 40% or over. This equates to around 4,119 treated smokers in the ABM University Health Board area per year. Table 1: National and ABM University Health Board Level Prevalence Data Adults (aged 16+) Prevalence (%) (2014/15) Bridgend NPT Swansea ABMU Wales Current smoker* Females Males Least deprived* Not available 11 Most deprived* Source: Welsh Health Survey; Wales data = 2015; * age-standardised (later data not available from Welsh Health Survey until June 2017) 4

5 Figure 1: Figure 2: Source: ABM University Health Board Informatics The data for all persons aged 15 and over with a recorded smoking status gives an estimate of the variation in smoking prevalence by clusters. The data should be interpreted with caution as the completeness of smoking status varies across the clusters. 5

6 Table 2: Patients accessing Stop Smoking Wales and 4-week quitters Demand for service Outcomes Practice No. of contacts 2014/15 No. of contacts 2015/16 No. of contacts 2016/17* No. 4-wk quitters 2014/15 No. 4-wk quitters 2015/16 No. of 4-wk quitters 2016/17* Pontardawe Health Centre Vale of Neath General Practice Amman Tawe Partnership Dulais Valley Primary Care Centre Cwmllynfell (closed) St James Medical Centre (closed) Upper Valleys Cluster Estimated percentage of smoking population contacting Cluster 2.68% SSW in 2016/17* ABM Estimated percentage of smoking population making a Cluster 0.52% quit attempt via SSW in 2016/17* ABM Source: Stop Smoking Wales service data, QOF data. *2016/2017 data part year Q1 Q3 N.B: Estimated percentage of smoking population contacting SSW in 2016/17 and Estimated percentage of smoking population making a quit attempt via SSW in 2016/17 not comparable to previous years as data only for Q1-Q3 period; and due to different calculation method (using Welsh Health Survey data) required following changes to QOF recording Table 3: Upper Valleys Cluster Level three pharmacies (highlighted pharmacy has no record of delivery in 2016/2017) Davies Chemist Ltd Davies Chemist Ltd Dyffryn Pharmacy D R Cecil Jones & Son Ltd Lloyds Pharmacy Lloyds Pharmacy Resolven Ystalyfera Dyffryn Cellwen Glyneath Gwaun Cae Gurwen Herbert Street 6

7 2 Vaccination National context: There is an NHS Welsh Government target of 75% uptake for seasonal flu vaccination in the following groups: o Those aged 65 years and older o Aged six months to under 65 years in clinical at risk groups o Pregnant women. A target uptake of 50% for health care workers with direct patients has also been set. There is also a Welsh Government target for childhood vaccinations, of 95% uptake of all scheduled vaccinations for children by age 4. Although nationally the percentage uptake in those aged 65 years and older is almost the same as the previous season the number of individuals eligible for and receiving influenza vaccine has increased. Also, in ABMU HB uptake of influenza vaccine in children aged 2 and 3 years increased to 44% from 33.6% in 2015/16 Table 4: Influenza immunisation uptake (%) 2016/17 (as at 21/03/2017) Influenza immunisation uptake (%) 2016/17 and 2015/16 Practice Patients aged 65y and over Patients under 65y at risk Children aged 2-3 years 2016/ / / / / /16 Pontardawe Health Centre Vale of Neath Practice Amman Tawe Partnership Dulais Valley Primary Care Centre Bridgend NPT Swansea ABM Wales Source: Public Health Wales Vaccine Preventable Disease Programme, IVOR 2016/17 (data correct as at 21/03/2017) 7

8 Figure 3: Cluster summary influenza immunisations uptake: patients aged 65 and older (as at 21/03/2017) Figure 4: Cluster summary influenza immunisation uptake: patients under 65 years at risk (as at 21/03/2017) Figure 5: Cluster summary influenza immunisation uptake: children aged 2 & 3 years (as at 21/03/2017) 8

9 Table 5: Uptake of scheduled immunisations by age 4 (%) Jan-Dec 2016 Practice Uptake of scheduled immunisations age 4 (%) Jan-Dec 2016 Pontardawe Health Centre 90.8 Vale of Neath General Practice 91.8 Amman Tawe Partnership 90.0 Dulais Valley Primary Care Centre 92.6 Bridgend 88.0 NPT 87.0 Swansea 87.0 ABM 87.0 Source: Public Health Wales Vaccine Preventable Disease Programme, interactive COVER data Figure 6: Uptake of immunisations by age 4 (%) by cluster, Jan Dec 2016 Source: Public Health Wales Vaccine Preventable Disease Programme, interactive COVER data ** up to date refers to a completed 4 in 1 pre-school booster, Hib/MenC booster and second MMR dose by 4 years of age 9

10 Table 6: Uptake of selected immunisations in children by age 4 (%) Jan-Dec 2016 Uptake of selected immunisations in children by age 4 (%) Jan-Dec 2016 By 1 year of age By 2 years of age By 4 years of age Practice 5 in 1 MenC Hib/ MenC MMR1 PCV 4 in 1 (pre-school MMR (2 doses) Booster booster) Pontardawe Health Centre Vale of Neath General Practice Amman Tawe Partnership Dulais Valley Primary Care Centre Afan Bay Health Bridgend East Network Bridgend North Network Bridgend West Network City Health Cwmtawe Llwchwr Neath Penderi Upper Valleys Source: Public Health Wales Vaccine Preventable Disease Programme, interactive COVER data meets/exceeds Welsh Government target of 95% uptake and above 10

11 3 Obesity NB - Note Child Measurement Programme and WHS data not available until June so data below remains the latest as at date of publication National context: Physical activity guidelines issued by the Chief Medical Officer advise that everyone should do a minimum of 150 minutes a week of moderate-intensity aerobic exercise. The guidelines are based on a comprehensive review of the latest scientific evidence regarding physical activity and health. Public Health Wales launched 10 steps to a Healthy Weight guide in 2016, to help parents help their children to be a healthy weight by the time they reach school. Table 7: National and ABM University Health Board Level Prevalence Data Children and Young People (aged 4-5 years) Childhood obesity is measured in the Child Measurement Programme as 95 th centile and above. The clinical definition is 98 th centile and above Prevalence (%) (2014/15) Bridgend NPT Swansea ABMU Wales Overweight or obese Obese Females Males Least deprived Not available 8.6 Most deprived 13.2 Source: Public Health Wales Observatory, Childhood Measurement Programme Table 8: Adults (aged 16+) Prevalence (%) (2014&15) Bridgend NPT Swansea ABMU Wales Overweight & obese* Obese* Females Males Least deprived* Not available 17 Most deprived* Source: Welsh Health Survey; Wales data = 2014&15; * age-standardised 11

12 The QOF standards define obese patients as those patients with a BMI of greater than or equal to 30 kg/m 2 recorded by the GP practice in the previous 15 months. The QOF register does not measure prevalence but can give a crude indication of variation across the ABM University Health Board area 1. Figure 7: Patients with a recorded BMI 30+ which has been recorded within the last 15 Month (ending March 2016) (N.B. this data will not be updated until mid April 2017 due to coding lag) Source: ABM University Health Board Informatics 1 GP practices vary in the completeness of their data collection & recording. The proportion of the practice population for which a BMI has been measured is unavailable. 12

13 Table 9: Physical Activity and Healthy Eating Prevalence Data Adults (aged 16+) Physical activity guidance (more than 150 minutes per week)* Prevalence (%) (2014&15) Bridgend NPT Swansea ABMU Wales Females Not available 53 Males 64 Least deprived 65 Most deprived Fruit & Vegetable consumption (5+ portions per day)* Females Males Least deprived Not available 37 Most deprived Source: Welsh Health Survey; Wales data 2014&15; * age-standardised Table 10: Referrals by GP practice to the National Exercise Referral Scheme (NERS) Upper Valleys Cluster Total referrals to April 2016 (full year) Total Referrals to Dec 2017 (Q1 Q3) Pontardawe Health Centre Vale of Neath General Practice 20 9 Amman Tawe Partnership 0 1 Dulais Valley Primary Care 12 2 Centre 13

14 4 Screening National context: National adult screening programmes delivered locally are: Bowel screening (every 2 years between years) Cervical screening (every 3 years for women aged 29-49, every 5 years for women 50-64) Abdominal Aortic Aneurysm screening( one off screen for men aged 65 years) Breast screening (every 3 years in women aged between years. Table 11: Bowel Screening Uptake 2015/16 Cluster Eligible Tested Uptake 2015/16 (%) Uptake 2014/15 (%) Target 60% Afan Bay Health Bridgend East Network Bridgend North Network Bridgend West Network City Health Cwmtawe Llwchwr Neath Penderi Upper Valleys Wales Source: Screening Division Public Health Wales BSW Annual Statistical Report Figure 8: 14

15 Table 12: Cervical Screening Coverage as at 31/3/16 i Cluster Eligible Tested Coverage 2015/16(%) Coverage 2014/15 (%) Target 80% Afan Bay Health Bridgend East Bridgend North Bridgend West City Health Cwmtawe Llwchwr Neath Penderi Upper Valleys Wales Source: Screening Division Public Health Wales CSW coverage by GP Cluster Figure 9: 15

16 Table 13: AAA Screening Uptake 2015/16 Cluster Eligible Tested Uptake 2015/16(%) Uptake 2014/15 Target 80% Afan Bay Health Bridgend East Network Bridgend North Network Bridgend West Network City Health Cwmtawe Llwchwr Neath Penderi Upper Valleys Wales Source: Screening Division Public Health Wales AAA uptake by GP Cluster Figure 10: 16

17 Table 14: Breast Screening Uptake - Latest screening round per GP practice (1/11/2016) Cluster Invited Screened Uptake 2015/16 (%) Minimum Standard Uptake 2014/15 (%) Afan Bay Health Bridgend East Network Bridgend North Network Bridgend West Network City Health Cwmtawe Llwchwr Neath Penderi Upper Valleys Wales Source: Screening Division Public Health Wales BTW uptake by GP Cluster latest round as at November 2016 Figure 11: 17

18 i On a specified date, coverage shows the proportion of participants that are eligible for Cervical screening, that have attended for cervical screening and had an adequate test result issued within the last 5 years. 18