Integrated Strategic Needs Assessment: Summary

Size: px
Start display at page:

Download "Integrated Strategic Needs Assessment: Summary"

Transcription

1 Integrated Strategic Needs Assessment: Summary January 2014 Page 1 of 31

2 Contents Executive Summary... 4 Introduction Census: headline results for Cheshire West and Chester... 7 Life expectancy and mortality rates... 9 Starting well... 9 Breastfeeding Excess weight in 4-5 year olds Excess weight in year olds Living and working well Lifestyles Smoking Alcohol Adult healthy weight Diet and healthy eating Physical activity Drug misuse Hypertension (Raised blood pressure) Mental health and wellbeing Adults with learning disabilities Deaths from preventable causes Cancer mortality (under 75 years) Cardiovascular mortality Liver disease mortality Respiratory disease mortality (under 75 years) Ageing Well Dementia Page 2 of 31

3 Older people aged over Wider determinants of health The local area Local economic assessment Housing Crime Page 3 of 31

4 Executive Summary Since 2007, there has been a statutory duty on local authorities and the NHS to jointly produce a strategic needs assessment for the local area. This Joint Strategic Needs Assessment (JSNA) presents information about the current and future health and wellbeing needs of the local population. Understanding the needs of local people ensures health and wellbeing services develop in an effective and efficient way. The JSNA is a tool used to underpin service development and commissioning decisions. It is also the basis for setting priorities and developing the Joint Health and Wellbeing Strategy. It is the role of the Health and Wellbeing Board to shape and direct the JSNA. Statutory members of the Board include Directors from Adult Social Care, Public Health and Children s services, an elected member and a representative from the Commissioning Consortia and local Healthwatch. The key responsibilities of the Health and Wellbeing Board are to: Oversee the production of the JSNA. Develop the Joint Health and Wellbeing Strategy. Develop joint commissioning plans and ensure these plans reflect the needs identified by the JSNA and priorities in the Joint Health and Wellbeing Strategy. Monitor progress of the Joint Health and Wellbeing Strategy objectives though the Public Health Outcome Framework. In Cheshire West and Chester, the JSNA is called the Integrated Strategic Needs Assessment (ISNA). This is to reflect the intention to integrate assets, strengths and capacities of local communities into the assessment rather than focus only on need. An exercise is currently being undertaken across the four localities of Cheshire West and Chester to develop an asset-based approach. The ISNA tool is a suite of products containing our collective intelligence about the local population s health and wellbeing to support strategic planning of both local authorities and NHS commissioning. A life course approach is taken to organise products and summarise data: Population Starting Well Living and Working Well Ageing Well Page 4 of 31

5 This document provides a brief snapshot of the health and wellbeing information currently available; highlighting key topics. The ISNA is continually changing and refined as new information and intelligence is developed and made available. ISNA products therefore are best accessed online or for further information research@cheshirewestandchester.gov.uk. Page 5 of 31

6 Summary: key findings of the Integrated Strategic Needs Assessment Introduction Joint strategic needs assessments (JSNAs) analyse the health needs of populations to inform and guide commissioning of health, well-being and social care services within local authority areas. The JSNA underpins the Health and Wellbeing Strategies and commissioning plans. The main goal of a JSNA is to assess accurately the health needs of a local population in order to improve the physical and mental health and well-being of individuals and communities. The JSNA is a tool to support the identification of priorities. It provides: An analysis of current and future health and wellbeing outcomes An understanding of what people need from their services A view of the future, predicting and anticipating potential or new unmet need JSNAs continue to evolve. In the past, most JSNAs have focused on a deficit approach based on indicators of mortality and illness. This is now changing as more JSNAs are beginning to include the assets, strengths and capacities of local communities. The Joint Strategic Needs Assessment for Cheshire West and Chester Council is referred to locally as the 'Integrated Strategic Needs Assessment' (ISNA). This is because Cheshire West and Chester Council recognise that a good JSNA needs to include not only information about the deficits (needs) of the borough, but also the assets, strengths and capacities of local communities, that is, it needs to be integrated. For Cheshire West and Chester, it is early days in developing an asset-based approach, however, there is test-bed work happening across the four localities in the borough (Chester; Ellesmere Port; Northwich and Winsford; Rural). The ISNA has been developed as a suite of on-line products that support decision making at differing levels of detail. They currently include high level thematic reports, key outcome indicator summaries and children s centre and locality dashboards. These are accessible through the Key Statistics section of the Council website. Developing the ISNA is an iterative process and is continually updated and refined as new information and intelligence is developed. This document is a summary of the key findings of the on-line products. It highlights the most recent information we have for the borough on a range of health topics as well as the wider determinants of health. Note: In recent years, there has been considerable organisational and geographical boundary change across Cheshire. Local government restructuring in 2009 resulted in the creation of Cheshire West and Chester Council and Primary Care Trusts ceased to exist from April These changes are reflected in the way that information is reported in this ISNA: inevitably, some data is reported using previous organisational and geographical boundaries, although care has been taken to minimise this. Page 6 of 31

7 2011 Census: headline results for Cheshire West and Chester The Census is a key source of statistics on our local populations, and for many statistics and geographies, the 2011 Census is the first source of data we have had since the 2001 Census. The first results, released in July 2012, were basic population and household statistics. Population The 2011 Census population was 329,608: 17.6% (58,135) were aged 0-15 (19.9% in 2001) 63.8% (210,373) were aged (63.7% in 2001) 18.5% (61,100) were aged 65+ (16.4% in 2001) Households, accommodation and families 326,236 people lived in 141,442 households, giving an average household size of 2.3. Of all households: 13.2% (18,652) were pensioners living alone (14.3% in 2001) 16.4% (23,189) were non-pensioners living alone (13.1% in 2001) 65.0% (91,940) were one family households (67.6% in 2001) 6.4% (9,071) were lone parent households with dependent children (5.5% in 2001) 70.8% (100,105) were owner occupied (74.8% in 2001) 7.4% (10,482) were rented from the Local Authority 12.5% (17,734) were privately rented (5.7% in 2001) 18.6% (26,297) had no car or van (20.3% in 2001) 41.6% (58,893) had one car or van (43.2% in 2001) 39.8% (56,252) had more than one car or van (36.6% in 2001) 2.1% (2,989) had no central heating (8.1% in 2001). There were 3,372 residents and staff living in 291 communal establishments. Household spaces A household space is the accommodation used or available for use by an individual household. There may be more than one household space in a dwelling as households can share dwellings. In 2011 there were 147,746 household spaces of which: 29.6% (43,673) were in a detached dwelling (30.7% in 2001) 35.8% (52,927) were in a semi-detached dwelling (36.7% in 2001) 21.7% (32,082) were in a terrace (22.1% in 2001) 12.2% (18,045) were in a flat, maisonette or apartment (9.8% in 2001) 0.7% (1,019) were in a caravan or other mobile / temporary structure (0.7% in 2001) 4.3% (6,304) of household spaces were vacant (3.2% in 2001) Page 7 of 31

8 Cultural background Of all usual residents: 94.7% (312,013) were White British (including Northern Irish) (96.5% in 2001) 0.7% (2,337) were White Irish 0.1% (213) were Gypsies or Irish Travellers 2.0% (6,462) were from other White groups 0.9% (3,050) were from mixed / multiple ethnic groups 1.2% (4,097) were Asian / Asian British (includes Chinese) 0.3% (908) were Black / African / Caribbean / Black British 0.2% (528) were from other ethnic groups 4.9% (15,987) of all residents were born outside of the UK (3.7% in 2001). 1.0% (3,249) were born in EU Accession countries. 2.3% (7,426) of residents moved into the UK between 2001 and % (1,746) of households had no people for whom English was a main language. 70.1% (231,126) of people said they were Christian (80.7% in 2001). 1.1% (3,560) belonged to other major world religions. 22.0% (72,649) stated they had no religion (11.5% in 2001). 6.5% (21,419) chose not to answer this question. Health Most of the population 81.5% (268,744) were in very good or good health, however, 5.5% (18,260) were in bad or very bad health. 8.8% (29,098) of residents said their day to day activities were limited a lot because of a long term health problem or disability (includes problems related to old age), 9.7% (31,897) were limited a little. 11.3% (37,121) of the population provides one hour or more of unpaid care per week (10.9% in 2001). 4.0% (13,180) of the population provide 20 or more hours of unpaid care per week (3.4% in 2001). Economic Activity 3.7% (8,949) of people aged were unemployed. (1.4% (3,351) were long-term unemployed (they had not been in work since 2009 or earlier)). 63.2% (153,704) were in employment (excluding any full time students who also worked). Of all those who were in employment (including students): 1.5% (2,437) worked in the Primary sector (agriculture, forestry and fishing and mining and quarrying) 19.4% (31,025) worked in the Manufacturing and Construction sector 79.1% (126,676) worked in the Service sector. Qualifications 29.4% (79,712) of people aged were qualified to HNC level or higher (including HND or degree). 21.0% (56,940) of people aged had no qualifications. Page 8 of 31

9 Life expectancy and mortality rates Life expectancy is improving in men and women in Cheshire West and Chester, men faster than women. However, the rate of improvement has been less in our more deprived areas. Health inequalities are therefore widening. Introduction Life expectancy at birth is an overarching indicator of the health of a population. It is an estimate of the average number of years a new-born baby would survive if he or she experienced a particular area s age specific mortality rates for that time period throughout his or her life. Mortality rates are useful locally to highlight and monitor issues. Key messages Life expectancy in Cheshire West and Chester compares well to the England average with men significantly higher at 79.2 years compared to 78.6 and women slightly lower at 82.3 compared to 82.6 though the difference is not significant. Women have a significantly higher life expectancy than men. Life expectancy in women however is lower than the female national average in Winsford & Rural East and Ellesmere Port Life expectancy has been increasing faster in men than in women, narrowing the gender gap. Life expectancy has been increasing in both deprived and affluent areas but the rate of improvement is slower in more deprived areas. About a third of our population live in these areas. The internal gap in life expectancy within Cheshire West and Chester is therefore widening for men and women. The internal gap in life expectancy is widest for men. Improvement in life expectancy has not been slowest in our very deprived areas but in those areas that are slightly more deprived than the national picture. Heart disease and stroke are the key diseases that contribute to inequalities in men while respiratory disease and cancers, particularly lung cancer, are as important in women. Average life expectancy is significantly higher than the national average in men in Western Cheshire CCG but significantly lower than the national average in women in Vale Royal CCG. At Area Programme Board level both Ellesmere Port and Winsford and Rural East Area Partnership Boards have lower female life expectancies. The Life Expectancy section of the ISNA will be updated in 2014 to reflect the new locality geographies. Starting well Giving every child the best start in life and supporting children and young people, together with their families and carers, to realise their full potential is key to reducing inequalities. This section provides an overview of the key issues in early life for Cheshire West and Chester. Further information can be found on the Children s Centre dashboards, Page 9 of 31

10 Breastfeeding Breastfeeding benefits both mother and child. Breast fed babies have less risk of developing chest and ear infections, diarrhoea and vomiting, eczema and becoming obese and developing diabetes later in life. For mothers breastfeeding reduces the risk of breast and ovarian cancer. Increases in breastfeeding initiation and prevalence are expected to reduce illness in young children, which will in turn reduce hospital admissions of the under 1s (and the costs to the NHS that are associated with this). In the longer term, infants who are not breastfed are more likely to become obese in later childhood, develop type 2 diabetes and tend to have slightly higher levels of blood pressure and blood cholesterol in adulthood. In 2011/12, across Cheshire West and Chester, 41% of babies were being breastfed at 6-8 weeks. This is significantly lower than the England average of 47%. We do not have a complete picture at the locality or children's centre level, but the information we have suggests that breastfeeding rates are lower in Vale Royal compared to West Cheshire CCG. Within West Cheshire, Ellesmere Port and Neston has the lowest breastfeeding rates. Looking at children's centres, Stanlaw Abbey and Portside in Ellesmere Port, Over in Winsford and Blacon in Chester have the lowest breastfeeding rates at 6-8 weeks. Nearly 70% of babies were initially breastfed at birth and so 3 out of 10 mothers give up by 6-8 weeks, whilst 3 out of 10 do not attempt to breastfeed. Excess weight in 4-5 year olds Excess weight (overweight and obesity) in children often leads to excess weight in adults, and this is recognised as a major determinant of premature mortality and avoidable ill health. In 2011/12 one quarter of Cheshire West and Chester children in their school reception year were an unhealthy weight. Almost one in ten children in the age group were obese. Almost 98% of our eligible children participated in the national child measurement programme for 2011/12, a higher uptake rate than the England average. In Cheshire West and Chester 25.3% of children are overweight or obese, which is a significantly higher prevalence than the England average of 22.6%. The proportion of children considered obese (9.6%) is similar to England (9.5%) with a significantly higher proportion of overweight children (15.7% compared to 13.1% for England). Within Cheshire West and Chester, Vale Royal CCG has a slightly higher prevalence of excess weight in 4-5 year olds than West Cheshire CCG but both are significantly higher than England. There are some differences across the authority however with our more deprived areas experiencing a significantly higher proportion than our less deprived areas. Differences are also evident when looking at Children Centre areas that range from 16% (Chester Victoria Children s Centre) to 34% (Winsford Over Children s Centre) of 4-5 year olds with excess weight. Since 2007/08 the proportion of 4-5 year olds who are overweight or obese in Cheshire West and Chester has increased by 6% compared to a stable England position. Excess weight increased twice as fast in our less deprived areas compared to our more deprived. In England, boys experience a higher prevalence of excess weight than girls and this pattern is reflected locally but only by a smaller margin. Compared to the other girls in England, a significantly higher proportion of our girls are overweight or obese. Page 10 of 31

11 Excess weight in year olds In 2011/12 just over one third of Cheshire West and Chester children in their final year at junior school were an unhealthy weight. One in five children in this age group were obese. Over 95% of our eligible children took part in the annual national child measurement programme, a higher uptake than the England average. 35% of children were either overweight or obese, making Cheshire West and Chester higher than the England average of 34%, but not significantly so. 20.3% of these children are obese, levels of obesity therefore more than double between the reception year and final year of junior school. There are differences within Cheshire West and Chester. West Cheshire CCG has a slightly higher proportion of children in this age group with excess weight than Vale Royal CCG but the difference is not significant. There are however significant differences in levels of excess weight for children in our more deprived areas. With levels of excess weight at 40% for year old children living in our more deprived areas, the proportion is significantly higher than in our less deprived areas. As with 4-5 year olds, excess weight is more prevalent in our year old boys. In 2011/12 this difference was significant with 37% of our boys compared to 32% of our girls having excess weight. The percentage of year olds who are overweight or obese in Cheshire West and Chester has increased by 4.5 percentage points between 2007/08 and 2011/12. The majority of this increase was due to rising numbers of obese children, whilst the number overweight rose only slightly. Living and working well Lifestyles Smoking It is estimated that around 19.5% of adults in Cheshire West and Chester smoke. This is slightly lower than the England average of 20% and means that there are approximately 54,000 adult smokers living in the borough. Amongst routine and manual workers, it is estimated that 30% smoke locally. Smoking prevalence varies markedly between areas within Cheshire West and Chester with parts of Winsford, Ellesmere Port and Blacon having estimated prevalence rates of at least 30%. In Cheshire West and Chester Council, it is estimated that smoking causes 562 deaths (18% of all deaths) per year and about 2,243 hospital admissions. It is a major cause of inequalities in life expectancy. The impact on society is huge given the early loss of life and economic productivity through ill-health. The borough of Cheshire West and Chester is served by two NHS smoking cessation services. In 2010/11 the service in Western Cheshire CCG area helped 1,857 smokers to give up at four weeks, while in Vale Royal CCG area, the service helped 765 smokers to give up smoking.. An analysis of both services shows that 30% of clients and quitters were classified as routine and manual workers, which matches the Cheshire West and Chester population estimate for this group of 30%. This shows that the services are reaching this target group. Page 11 of 31

12 Alcohol The impact of alcohol misuse is wide ranging encompassing alcohol related illness and injuries as well as significant social impacts including crime and violence, loss of productivity in the workplace and homelessness. For the NHS alone, the estimated financial burden of alcohol misuse is around 2.7 billion per year in hospital admissions, attendance at A&E and in primary care. The overall cost to society of alcohol-related harm is estimated at 21 billion. Over the last 20 years, alcohol consumption has increased, with more women and children drinking, and more alcohol being purchased from off-licences and supermarkets for consumption at home. However, national surveys also show a lack of awareness of sensible drinking guidelines, and the harm that drinking in excess of these limits can cause. In England, 1 in 4 adults now drink above recommended limits with a corresponding increase in alcohol-related problems4. Latest estimates (2009) suggest that around 87% of the Cheshire West and Chester residents aged 16+ drink alcohol (236,000 people). This is a higher percentage of people than the England average which is 85%. Of those that drink alcohol, 72.5% engage in lower risk drinking (fewer than 22 units per week for men or fewer than 15 units per week for women). The next level are the increasing risk drinkers (men who drink units and women who drink units per week) who account for 20.7% of people who drink alcohol. The remaining 6.8% of people are classed as higher risk drinkers. A higher risk drinker is defined as a man who drinks more than 50 units of alcohol per week, or a woman who drinks more than 35 units of alcohol per week. There are an estimated 75,000 people who are increasing or higher risk drinkers in Cheshire West and Chester. The percentage of increasing risk drinkers locally (20.7%) is higher than the England average (20%); the percentage of higher risk drinkers is lower, although neither is statistically significant. People who are higher risk drinkers are at a significantly greater risk of developing alcohol related ill health. Postcode level estimates of drinking behaviours have been calculated by the Alcohol Learning Centre across Cheshire West and Chester. These data suggest that the highest proportion of higher risk drinkers are located in Ellesmere Port (15%, n=7,300). The lowest percentage of people is in Rural locality (1% n=700). Locally, 23.5% of people aged 16+ are estimated to be binge drinkers. This is significantly higher than the England average of 20.1%. This equates to around 63,000 binge drinkers in Cheshire West and Chester. The locality with the highest proportion was Chester (27% n=16,500). Ellesmere Port, Northwich and Winsford and Rural localities all had binge drinking estimates of around 22%. All four localities had rates that were significantly higher than the England average. There were approximately 7,500 admissions for alcohol-attributable harm by Cheshire West and Chester residents in 2012/13. This equates to a rate of 1,780 per 100,000 people aged 18+. This is significantly lower than the England rate of 1,931. In 2002/03 the rate of alcohol-attributable hospital admissions in Cheshire West and Chester was 1,037 per 100,000, showing an overall increase of 68% by 2012/13. However the peak for these admissions was in 2010/11, and the rate fell by 11% between 2010/11 and 2012/13. Page 12 of 31

13 Alcohol-specific hospital admissions (where alcohol is causally implicated in all cases of the conditions) account for around a quarter (27%) of total attributable admissions, this is similar to the England average (29%). Locally, alcohol-specific admissions fell by 11% between 2011/12 and 2012/13. This follows a plateau of around 570 admissions per 100,000 (n=1,900) between 2009/10 and 2011/12. A third of alcohol-specific admissions in Cheshire West and Chester are women (34%), similar to the England average of 32%. Other alcohol related deaths (see also the Section on Liver disease mortality) Data from Cheshire Fire and Rescue Service suggest that one in three dwelling fire-related deaths are alcohol related. Locally, alcohol remains a significant cause of death on our roads, with over a quarter (28.6%) of road deaths attributed to alcohol in Alcohol related crime Nationally 71% of alcohol-attributable crimes were violent. Estimates suggest that there were 1,693 crimes in Cheshire West and Chester than were attributable to alcohol in 2011/12. 1,316 of these crimes were classified as alcohol-attributable violent crimes (77%). In addition, 28 sexual crimes were attributable to alcohol in Cheshire West and Chester. The alcohol-attributable crime rate of 5.17 crimes per 100,000 people was significantly lower than the England rate of 7.02 per 100,000. The rates for alcohol-attributable violent and sexual crimes were also significantly lower than England. Adult healthy weight Key issues Being overweight or obese is now the norm amongst adults. We estimate that 23% (or 61,500) are obese and at least 37% (99,000) are overweight. High levels of unhealthy weight are apparent across all socio economic groups within the population. The estimated prevalence of obesity in Cheshire West and Chester is slightly lower than the England average (24%) but the difference is not statistically significant. 8 Middle Super Output Areas are in the worst 25% nationally four of these are in Ellesmere Port while the other two are in Blacon and Winsford areas. From GP practice registers, we estimate that over 6,000 patients are morbidly obese (defined as a BMI 40). Nationally, the proportion of people with an unhealthy weight has been increasing over the last 20 years although the rate of increase has slowed in the 2000s compared to the 1990s. By 2020, regional predictions suggest that 59% of women and 78% of men will have an unhealthy weight. Across CW&C the number of people with diabetes has been increasing by around 750 per year since 2004/05 and is set to continue in line with trends in obesity and an ageing population. Diet and healthy eating Key issues Eating a nutritious, balanced diet is important in maintaining health and reduces the risk of a number of diseases including cardiovascular disease, diabetes and cancer, promotes maintenance of Page 13 of 31

14 a healthy weight whilst preventing conditions such as anaemia and rickets. It is estimated that 72% of adults in Cheshire West and Chester do not eat the recommended 5 portions of fruit and vegetables each day which is in line with the England average of 71%. However there are variations within the area with more deprived areas seeing lower levels of fruit and vegetable consumption. Nationally the population are eating higher levels of saturated fat than recommended guidelines and lower levels of minerals and oily fish than current recommendations. National evidence suggests that certain groups, for example, low income households; ethnic minority groups; pregnant women; adults with learning disabilities and older adults (in the community and in residential care) are more likely to have poor diets compared to others and warrant a more targeted approach. Physical activity Key issues Being physically active has a positive impact on health and wellbeing. The benefits are important for people of all ages. Just under three quarters of adults in Cheshire West and Chester do not participate in at least 30 minutes of moderate intensity activity at least three times a week. This is however better than the North West and England average (22.5% and 21.9% respectively). 46% of adults are inactive (i.e. do less than 30 minutes of moderate intensity activity per week). Physical activity levels decrease with age and differ between genders, ethnicity and socio economic status. Drug misuse Key issues Drug use matters to society given the impact this has on individuals, families, and communities. Drugs have a negative impact, from the crime impact on local neighbourhoods, the health impact on the individual, the social impact on families to the effect of international organised crime. Drug addiction goes hand in hand with poor health, homelessness, family breakdown, and offending. Almost all clients engaged in treatment are for opiates and/or crack misuse (93% West Cheshire, 92% all Cheshire). The treatment system appears to miss those from the AACCE profile (amphetamines, alcohol, cannabis, cocaine, ecstasy), with just 5% of the treatment population in this category, and only 2% highlight alcohol use in addition to their primary drug use. A significant proportion of new treatment journeys for clients that had not been in treatment before, are not using opiates and/or crack; 38% compared to just 8% of those who have been in treatment. The treatment system must be able to cater for non-opiate and crack-only users if it is to engage these clients effectively. Emerging trends and substances such as performance and image enhancing drugs (PIEDs/- steroids), legal highs, prescription only medicine and over the counter demand will need to be met. Far fewer clients (6% West Cheshire, 8% Cheshire) are referred via the criminal justice system compared regionally and nationally (34% and 30% respectively). An Integrated Offender Management system (IOM) will continue to support the identification and support of priority offenders, including drug misusing offenders, and divert them away from drug use and crime. Page 14 of 31

15 Over a half of clients say they want to be drug free within a year but over half of the in-treatment population have been engaged in specialist treatment for over two years (60% West Cheshire, 55% rest of Cheshire). The proportion of clients who have been in-treatment for at least 2 years has increased over the last 3 years. There is a need to focus on assisting clients in the 2-4 year and 4 year plus cohorts to move forward in their treatment journey and ultimately leave treatment. The model of care needs to move towards a recovery-orientated system. Cheshire has a heavily medically assisted drug treatment system (adults). The vast majority of clients are receiving prescribing interventions (86%), while the level of psychosocial intervention provision is exceptionally low (0.3%). However, it is recognised that Cheshire & Wirral Partnership Trust community drug teams do not accurately report all of their activity in terms of all the interventions they provide, this is particularly true for psychosocial interventions that complement prescribing interventions. Service providers have highlighted difficulty in accessing psychosocial therapies via the Increasing Access to Psychological Therapies initiative. Stakeholders have identified that there is a gap locally in provision and support for families/carers across Cheshire. This is an area of work that has seen the development of a local safeguarding protocol between Children s Social Care and drug and alcohol services in 2011/12. The protocol outlines the agreed responsibilities of workers within each service area to ensure the risk management and safeguarding of children when working with parents with substance misuse issues. Hypertension (Raised blood pressure) Key issues Raised blood pressure is a significant public health issue. In Cheshire West and Chester, General Practices have identified that there are 51,170 (14.4% of total population) patients with hypertension on their practice lists as at the end of March 2010/11. 82% of these patients are considered to have their blood pressure under control. It is estimated that just over 20,100 (nearly 6%) of all adults in Cheshire West and Chester have undiagnosed hypertension. This is a higher proportion than expected nationally. The level of undiagnosed hypertension is significant in all areas but presently the gap is greatest in Ellesmere Port & Neston and least in Vale Royal. The gap varied from 2.9% to 8.4% between all General Practices. About 28% of adults in Western Cheshire CCG have not had their blood pressure checked in the last 5 years. Men are less likely to have a blood pressure reading. Around 18% (9,100) of patients diagnosed with hypertension are not controlled. This is better than the England average. The level of control was greatest in Vale Royal and least in Chester and Ellesmere Port & Neston. The level of control varied from 71% to 91% between all general practices. Mental health and wellbeing Mental health, or mental wellbeing, is more than the absence of mental illness. It also encompasses good mental functioning and how we think, feel and behave. Page 15 of 31

16 The Our Community Survey carried out in 2011 showed that Western rural areas had the highest wellbeing score, followed by Northwich and the surrounding rural area. Both areas had average scores above that of the borough average. Ellesmere Port was the area with the lowest proportion of respondents classified as having a high level of mental wellbeing. Over two thirds (67%) of those living in western areas said they felt happy over the last four weeks, whilst those living in Ellesmere Port were significantly less likely to say this than respondents from other areas. Those living in Ellesmere Port faired worst in relation to feeling optimistic about the future and feeling useful; a significantly higher proportion said I have been feeling optimistic about the future and I ve been feeling useful none of the time or rarely compared to those from other areas. The North West Mental Health Survey was carried out in 2011/12. Data for Cheshire West and Chester Council was subsequently received at the end of In 2014 we will update the mental health and wellbeing section of the ISNA to reflect this more recent data. Adults with learning disabilities Adults with learning disabilities are, in general, more likely to experience poorer levels of health, shorter life expectancies and greater inequalities than the general population. Many people who have learning disabilities may have a number of have unmet needs, either as a consequence of a failure in diagnosis or difficulties in accessing services, lost during transition phases or being excluded from services due to different criteria. It is difficult to determine how many individuals this concerns or where they are located and therefore this issue concerns a wide cross-section of services and not solely those designed to meet specific needs of people with learning disabilities. Using national data is it estimated that approximately 1,250 adults should be known to services locally, this is slightly more than recognised locally (about 1,000 adults) but still represents a higher proportion of our total population compared England. The England estimates also suggest that, similarly to elsewhere, there are possibly 4,600 people who are living within the community independently without receiving special help. This is more likely to be those with mild learning disabilities. Whilst local population projections identify a relatively static or slightly declining population of people with moderate to severe learning disabilities in the next 5-20 years, the predicted populations of people with learning disabilities in the older (65+) age groups is anticipated to increase significantly. This highlights a shift in the type of service provision that may be required to support a changing client demographic. Deaths from preventable causes Cancer mortality (under 75 years) Cancer is the highest cause of death in England in under 75s. To ensure that there continues to be a reduction in the rate of premature mortality from cancer, there needs to be concerted action in both prevention and treatment. Page 16 of 31

17 In Cheshire West and Chester more than 400 people under the age of 75 die every year from cancer. The death rate is similar to the England average but there are significant differences within the local population. Death rates are significantly higher in our more deprived population. Cancer death rates have decreased in all socio-economic groups over the last decade but the faster decrease in the less deprived areas has contributed to a widening inequality gap. Ellesmere Port locality has a significantly higher rate whilst Rural West locality is significantly lower than England. During , cancer caused 43% of all deaths under the age of 75 in Cheshire West and Chester. Of these cancer deaths, lung cancer accounted for over a fifth making it the biggest single cancer killer in the under 75s. Lung cancer deaths have decreased over the last decade for men but have been increasing for women in our more deprived areas. Lung cancer rates increased slightly in Vale Royal CCG during Upper gastrointestinal (oesophagus, stomach and pancreas) cancers account for the second largest proportion of cancer deaths and have been increasing in Vale Royal CCG whilst decreasing in West Cheshire CCG. Vale Royal CCG has higher rates than the Cheshire West and Chester average in upper gastrointestinal and in cancers grouped under other cancers. Rates of death from colorectal cancer have increased in recent years across Cheshire West and Chester. Six out of ten local cancer deaths are considered to be avoidable either through prevention or healthcare interventions such as screening and treatment. Lung and colorectal cancers account for half of the avoidable cancer deaths in Cheshire West and Chester. Cardiovascular mortality Cardiovascular disease (CVD) is one of the major causes of death in under 75s in England. There have been huge gains over the past decades in terms of better treatment for CVD and improvements in lifestyle, but to ensure that there continues to be a reduction in the rate of premature mortality from CVD, there needs to be concerted action in both prevention and treatment. During , around 225 people under the age of 75 died each year in Cheshire West and Chester. Of these deaths, over half were from coronary heart disease (CHD). Cheshire West and Chester has significantly lower death rates from cardiovascular diseases (54 per 100,000) than the England average (62 per 100,000) and is amongst the best 25% of Local Authorities in the country. There have been considerable reductions in CVD mortality across Cheshire West and Chester but to different degrees within the local population. Vale Royal CCG has higher rates of CVD deaths than West Cheshire CCG with stroke death rates being significantly higher. Rural West locality has a significantly lower rate than England and Cheshire West and Chester. Death rates have been slower to fall in our more deprived areas resulting in rates more than double those in our less deprived areas. Cardiovascular diseases account for the largest proportion (31%) of the local mortality inequality gap in men. Page 17 of 31

18 Liver disease mortality Liver disease is one of the top causes of death in England and people are dying from it at younger ages. Most liver disease is preventable and much is influenced by alcohol consumption and obesity prevalence, which are both amenable to public health interventions. During the 3 year period deaths from liver disease accounted for 6% of all deaths in people aged under 75 in Cheshire West and Chester. There were 183 deaths, an average of 61 each year. Compared to an annual average of 43 during , deaths have increased. The CW&C death rate of 16.8 per 100,000 is similar to the England average of 14 per 100,000, but there are significant differences within the local population. The death rate from liver disease is significantly higher amongst our more deprived population and has been increasing at a faster rate. The death rate in our more deprived areas is 2.4 times higher than our less deprived areas. Ellesmere Port locality has a significantly higher rate than England and Cheshire West and Chester. Rates are almost twice as high for men than for women. Liver disease disproportionately affects younger age groups. The main causes of liver disease (alcohol, obesity, Hepatitis B and C) can all be prevented or treated effectively Respiratory disease mortality (under 75 years) Respiratory disease is one of the top causes of death in England in under 75s and smoking is the major cause of chronic obstructive pulmonary disease (COPD), one of the major respiratory diseases. This indicator focuses public health attention on the prevention of smoking and other environmental factors that contribute to people getting respiratory disease. During in Cheshire West and Chester, 314 people aged under 75 died from respiratory diseases, an average of 105 each year. Almost half of these (48%) of these were caused by COPD. Other respiratory deaths include influenza and pneumonia. The death rate for Cheshire West and Chester (26 per 100,000) is similar to the England average (23.4 per 100,000) but there are significant differences within the local population. Vale Royal CCG is significantly higher (31.7 per 100,000) than the England rate and has been generally increasing over the last decade. Vale Royal CCG is above average for both COPD and other respiratory deaths but the increasing rate in Vale Royal CCG is due to increasing deaths from causes grouped as other respiratory deaths. The localities of Ellesmere Port and Northwich & Winsford also have significantly higher death rates than England. Rates have increased in our more deprived areas with the death rate for COPD 4 times higher in our more deprived areas compared to our less deprived areas. Page 18 of 31

19 Ageing Well Key issues Enabling older people to lead healthy and fulfilling lives is key to ensuring that longer life expectancy is matched by longer, health quality of life. Our Community Survey (2011) found that: generally, respondents aged 65 and over were significantly more likely to be satisfied with their home as a place to live compared to younger age groups the proportion of respondents who stated that they strongly belonged to their immediate neighbourhood increased as age increased. Older age groups were significantly more likely to say they strongly belonged to their local area compared to younger age groups, with those aged 85 and over reporting the highest levels of belonging generally, the proportion of respondents who felt that older people in their local area get the services and support they need to live at home for as long as they want to increased as age increased, with nearly half (49%) of those aged 75 to 84 and 59% of respondents aged 85 and over answering yes a higher proportion of participants aged 75 and over said that they participated in activities like eating out, going on social outings, attending live performances, visiting museums, galleries and heritage attractions less than once a year or never those aged 85 and over were the age group with the highest proportion of respondents who had taken part in the following less than once a year or never: o Attend a sports event o Attend a day or evening class o Take part in sports or physical activities o Take part in arts or creative activity. The Adult Social Care Survey for was sent to a variety of service users but we have analysed the results for those aged over 85 years. Overall the results are positive with the results for those in residential care generally more favourable. Key issues identified however include that 15% do not feel they had enough social contact, a third don t spend enough time or don t do anything they value or enjoy and many experiencing difficulties getting to places in the local area that they want to. These highlight the importance of building stronger mutual support networks within communities. The headlines are that: 93% of service users were satisfied with 2% dissatisfied 67% felt they had a good quality of life with 4% saying they had a bad quality of life 86% felt they had as much control or adequate control over their daily life 98% felt clean and able to present themselves 82% feel as safe as they want Whilst 85% had adequate or as much social contact as they would like, 10% had some but not enough and 5% had very little and felt socially isolated Whilst 67% of service users are able to spend their time doing things they value and enjoy, 33% do some things but not enough or don t do anything they value or enjoy 40% of service users felt their health was good with 10% feeling their health was bad in general Only 19% felt they can get to all the places in the local area that they want while 28% are unable to get to these places and 43% do not leave their home. Page 19 of 31

20 Dementia Key issues According to GP registers, there were 1,900 patients with dementia in 2010/11. This is similar to the number predicted to have severe or moderate dementia using national estimates. There remains therefore potentially just over 2,300 people who have dementia but are not identified on GP registers. The overall estimate is around 4,200. This means that only 45% of people with dementia have been diagnosed. The level of diagnosis has not particularly increased in recent years as the % prevalence has remained at 0.5% of the total population. The All-Party parliamentary Group on Dementia recommends utilising existing opportunities for identification of people with dementia. It recommends that primary care workers and other health and social care professionals in contact with people with an established risk of dementia, should routinely ask questions to identify symptoms of dementia. The number of people with dementia will increase as the population ages but also as the diagnosis rate improves. At current rates of diagnosis there will be 500 more people with dementia by 2021 (from around 2,000 to 2,550), but if all those estimated to have dementia are diagnosed, this number would increase to 1,320 (from just over 4,000 to 5,700). We estimate that there may be 3,500 carers looking after people with dementia locally. Most care and support is not provided through structured organisations but individuals in the community. Assessing the needs of carers and supporting them is a key issue. In 2011/12, non-elective hospital admissions rates in the over 75s with a secondary diagnosis of dementia was low compared nationally. This may indicate that dementia is not being systematically recorded. On the other hand, for those with a secondary diagnosis of dementia people are staying in hospital 3 days longer than other patients. The difference is slightly larger than seen nationally particularly in Vale Royal People living with dementia said that loneliness, isolation, anxiety and depression are commonly experienced and three-quarters said they feel society is not geared up to deal with people with dementia. There is a need to create dementia friendly communities where people with dementia and their carers will be encouraged to seek help and will be supported by their communities. People with dementia need to feel included in their community, be more independent and have more choice and control over their life. This can be achieved by raising awareness around dementia, building stronger communities and re-orientating the model of care from a deficit-based to an assetbased model. Older people aged over 85 Key issues Many older people are assets within their communities that can help build more resilient and sustainable communities. People with complex multiple conditions need holistic assessment and integrated care People with complex multiple needs want personalised care wrapped around their individual needs Page 20 of 31

21 High use of acute hospital care in an emergency in West Cheshire CCG High use of nursing home care with increasing complexity and length of time spent in care homes Increasing demand on most intensive type of care may indicate system gaps in lower intensity type of care The number of over 85s will increase by 44% between 2011/12 and 2021/22 the current service model is unsustainable in the face of rising demand, reducing resources and high use of high-intensity care In 2012, 8,222 patients aged over 85 were registered with the two CCGs practices. Chester locality has the greatest number of over 85s registered with their practices whilst the Rural locality has the highest proportion. Most people aged 85 and over are living at home. We estimate that 14% of our over 85s are living in a care setting. Within the CCG localities geographies, Chester locality and Vale Royal locality have the highest number of people living in a residential or nursing home setting whilst Vale Royal has the highest proportion (16.8%). Most older people aged over 85 have multiple long-term conditions which means they have a combination of physical, social, mental and emotional wellbeing needs. A recent multi-morbidity study found that 82% of over 85 year olds had multi-morbidity (2 or more conditions) and 31% had physical and mental co-morbidity. The prevalence of multi-morbidity did not vary by deprivation in this age group. In England we estimate that 6-13% of older people feel lonely. Local surveys have found that although our older people have a strong sense of belonging to their immediate neighbourhood, they are likely to feel less useful and go on. Adult Social Care currently commission services to approximately 1,600 customers aged % of these customers are in permanent long term care and 60% are receiving services in the community. The community service for which there is most demand from customers aged 85+ is home care. The overall number of people aged 85+ receiving social care services has been reducing but there is evidence that the remaining customers have more complex needs, for example Elderly Mentally Infirm and nursing compared to standard residential care needs, and are staying for a longer period in a long term care setting. The number of customers in residential care per 100,000 population was low whereas for nursing care it was high compared regionally and with the CIPFA comparator group in 2011/12. In 2011/12, there were 4,326 emergency admissions in people aged over 85. This is 12.6% of all emergency admissions for all ages. The most common reason for emergency admission is general symptoms and signs. Overall emergency rates of admissions in the over 85s are high compared with England. This hides a different picture between the two CCGs with rates in West Cheshire CCG, particularly in Ellesmere Port and to a lesser extent Chester being high (560 per 1,000) compared to being average in Vale Royal (537 per 1,000). Two key causes for high emergency rates in West Cheshire CCG were in relation to general symptoms and signs; circulatory and respiratory conditions, head injuries and symptoms & signs with cognition/perception problems. Vale Royal CCG had high rates of admission for general symptoms and signs. Page 21 of 31

JSNA: LIVING WELL POPULATION

JSNA: LIVING WELL POPULATION JSNA: LIVING WELL POPULATION In the Census 2011 219,300 Bolton residents (79.3%) reported their health as being very good or good. However, of the 116,370 households in Bolton there are 33,300 (28.7%)

More information

BOLTON GPFEDERATION. Farnworth/Kearsley NEIGHBOURHOOD PLAN

BOLTON GPFEDERATION. Farnworth/Kearsley NEIGHBOURHOOD PLAN BOLTON GPFEDERATION Farnworth/Kearsley NEIGHBOURHOOD PLAN Summary Highlights Taken as a neighbourhood, Farnworth/Kearsley typical age range population for Bolton but suffers from significantly lower life

More information

Of those with dementia have a formal diagnosis or are in contact with specialist services. Dementia prevalence for those aged 80+

Of those with dementia have a formal diagnosis or are in contact with specialist services. Dementia prevalence for those aged 80+ Dementia Ref HSCW 18 Why is it important? Dementia presents a significant and urgent challenge to health and social care in County Durham, in terms of both numbers of people affected and the costs associated

More information

Men Behaving Badly? Ten questions council scrutiny can ask about men s health

Men Behaving Badly? Ten questions council scrutiny can ask about men s health Men Behaving Badly? Ten questions council scrutiny can ask about men s health Contents Why scrutiny of men s health is important 03 Ten questions to ask about men s health 04 Conclusion 10 About the Centre

More information

Joint Strategic Needs Assessment: Health Profile for Lancashire North

Joint Strategic Needs Assessment: Health Profile for Lancashire North Joint Strategic Needs Assessment: Health Profile for Lancashire North Introduction This health profile forms part of a Joint Strategic Needs Assessment process for NHS Lancashire North CCG. Specifically

More information

Joint Strategic Needs Assessment (JSNA) Picture of Lewisham - Part A 2018

Joint Strategic Needs Assessment (JSNA) Picture of Lewisham - Part A 2018 Joint Strategic Needs Assessment (JSNA) Picture of Lewisham - Part A 2018 2 What is a JSNA? The JSNA Process in Lewisham The Borough Contents The JSNA is a process by which the current and future health

More information

Cardiovascular disease profile

Cardiovascular disease profile Background This chapter of the Cardiovascular disease profiles focuses on risk factors for cardiovascular disease and is produced by the National Cardiovascular Intelligence Network (NCVIN). The profiles

More information

Public Health Outcomes Framework Key changes and updates for Peterborough: November 2017

Public Health Outcomes Framework Key changes and updates for Peterborough: November 2017 Public Health Outcomes Framework Key changes and updates for Peterborough: November 2017 Introduction and overview The Department of Health first published the Public Health Outcomes Framework (PHOF) for

More information

GOVERNING BODY REPORT

GOVERNING BODY REPORT GOVERNING BODY REPORT DATE OF MEETING: 20th September 2012 TITLE OF REPORT: KEY MESSAGES: NHS West Cheshire Clinical Commissioning Group has identified heart disease as one of its six strategic clinical

More information

Draft Falls Prevention Strategy

Draft Falls Prevention Strategy Cheshire West & Chester Council Draft Falls Prevention Strategy 2017-2020 Visit: cheshirewestandchester.gov.uk Visit: cheshirewestandchester.gov.uk 02 Cheshire West and Chester Council Draft Falls Prevention

More information

Locality Health Improvement Plan

Locality Health Improvement Plan Locality Health Improvement Plan North Devon 2012/13 Public Health Annual Report 2011-12 The Northern Locality health improvement and tackling health inequalities plan is a mechanism for monitoring and

More information

SOUTHWARK OLDER PEOPLE S JSNA

SOUTHWARK OLDER PEOPLE S JSNA SOUTHWARK OLDER PEOPLE S JSNA March 2012 1 Southwark s JSNA for Older People: Overview and Recommendations Factsheet: The older population Factsheet 2: Wider determinants of Health in Older People (Income,

More information

DRAFT DRAFT. Camden s Joint Health and Wellbeing Strategy : Living well, working together

DRAFT DRAFT. Camden s Joint Health and Wellbeing Strategy : Living well, working together Camden s Joint Health and Wellbeing Strategy 2016-18: Living well, working together October 2015 Content Executive summary 4 Introduction 6 Achieving our vision 8 Our priorities 10 1 Healthy weight, healthy

More information

The National perspective Public Health England s vision, mission and priorities

The National perspective Public Health England s vision, mission and priorities The National perspective Public Health England s vision, mission and priorities Dr Ann Hoskins Director Children, Young People and Families Public Health England May 2013 Mission Public Health England

More information

Public Health Profile

Public Health Profile Eastern Wakefield Primary Care Trust Public Health Profile 2005/06 Introduction Eastern Wakefield Primary Care Trust () is situated within the West Yorkshire Strategic Health Authority Area. The PCT commissions

More information

Table 1. Synthetic Estimate for Abstaining from Drinking in Shropshire. Abstaining from Drinking Proportion

Table 1. Synthetic Estimate for Abstaining from Drinking in Shropshire. Abstaining from Drinking Proportion 1 Adult Alcohol Misuse in Shropshire 2013/14 Prevalence of Drinking in Shropshire Who abstains from drinking in Shropshire? Table 1 shows the synthetic estimate of the percentage of the population of Shropshire

More information

Summary of the Health Needs in Rugby Borough

Summary of the Health Needs in Rugby Borough Rugby Borough Summary of the Health Needs in Rugby Borough Domain Indicator Rugby Borough 2010 Trend Warwickshire England Data Communities Children's and young people Adult's health and lifestyle Disease

More information

Health Board Date of Meeting: 30 th March 2017 Agenda item: 2 vii Development of Wellbeing Objectives

Health Board Date of Meeting: 30 th March 2017 Agenda item: 2 vii Development of Wellbeing Objectives SUMMARY REPORT ABM University Health Board Health Board Date of Meeting: 30 th March 2017 Agenda item: 2 vii Subject Development of Wellbeing Objectives Prepared by Approved by Presented by Purpose Joanne

More information

GOVERNING BODY MEETING in Public 22 February 2017 Agenda Item 3.4

GOVERNING BODY MEETING in Public 22 February 2017 Agenda Item 3.4 GOVERNING BODY MEETING in Public 22 February 2017 Paper Title Purpose of paper Redesign of Services for Frail Older People in Eastern Cheshire To seek approval from Governing Body for the redesign of services

More information

Guideline scope Smoking cessation interventions and services

Guideline scope Smoking cessation interventions and services 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 Topic NATIONAL INSTITUTE FOR HEALTH AND CARE EXCELLENCE Guideline scope Smoking cessation interventions and services This guideline

More information

Hull s Adult Health and Lifestyle Survey: Summary

Hull s Adult Health and Lifestyle Survey: Summary Hull s 211-212 Adult Health and Lifestyle Survey: Summary Public Health Sciences, Hull Public Health April 213 Front cover photographs of Hull are taken from the Hull City Council Flickr site (http://www.flickr.com/photos/hullcitycouncil/).

More information

JSNA Stockport Digest Smoking. JSNA Digest Smoking. December JSNA Digest for Smoking

JSNA Stockport Digest Smoking. JSNA Digest Smoking. December JSNA Digest for Smoking JSNA Digest Smoking December 2007 JSNA Digest for Smoking 1 This digest aims to provide information on the key lifestyle issue of smoking; describing current patterns within Stockport and anticipated future

More information

Community Needs Analysis Report

Community Needs Analysis Report Grampians Medicare Local Community Needs Analysis Report Summary October 2013 2 Contents Introduction 3 Snapshot of results 4 Stakeholder feedback 5 Health status of residents 6 Health behaviour of residents

More information

Director of Public Health Annual Report Heywood, Middleton and Rochdale Primary Care Trust (HMRPCT)

Director of Public Health Annual Report Heywood, Middleton and Rochdale Primary Care Trust (HMRPCT) Director of Public Health Annual Report Heywood, Middleton and Rochdale Primary Care Trust (HMRPCT) June 2007 Baseline Assessment of Health Inequalities in the Borough CONTENTS CONTENTS page FOREWORD

More information

Joint Health and Wellbeing Strategy for Rochdale Borough

Joint Health and Wellbeing Strategy for Rochdale Borough Joint Health and Wellbeing Strategy for Rochdale Borough 2012 2015 Co-operating in Rochdale for Better Health & Wellbeing Contents 1. FOREWORD... 3 2. EXECUTIVE SUMMARY... 4 3. VISION AND WAYS OF WORKING...

More information

Mental Health Strategy. Easy Read

Mental Health Strategy. Easy Read Mental Health Strategy Easy Read Mental Health Strategy Easy Read The Scottish Government, Edinburgh 2012 Crown copyright 2012 You may re-use this information (excluding logos and images) free of charge

More information

LOTHIAN HEALTH & LIFESTYLE SURVEY 2010 COMMUNITY HEALTH PARTNERSHIP FINDINGS: REPORT

LOTHIAN HEALTH & LIFESTYLE SURVEY 2010 COMMUNITY HEALTH PARTNERSHIP FINDINGS: REPORT LOTHIAN HEALTH & LIFESTYLE SURVEY 2010 COMMUNITY HEALTH PARTNERSHIP FINDINGS: REPORT Directorate of Public Health & Health Policy NHS April 2013 1 AUTHORS Pat Boreham John Forbes Annette Gallimore Laura

More information

Addiction and Substance misuse pathways

Addiction and Substance misuse pathways Addiction and Substance misuse pathways Gordon Morse Chief Medical Officer Turning Point UK Gordon Morse statement of interests Sole employer Turning Point Some unpaid advisory work to the Hepatitis C

More information

They are updated regularly as new NICE guidance is published. To view the latest version of this NICE Pathway see:

They are updated regularly as new NICE guidance is published. To view the latest version of this NICE Pathway see: Strategy,, policy and commissioning to delay or prevent ent of dementia, bring together everything NICE says on a topic in an interactive flowchart. are interactive and designed to be used online. They

More information

Contents [HEALTH PROFILES - QUARTERLY UPDATE BRIEFING AUGUST 2016] M.Foxcroft. Performance & Intelligence Team

Contents [HEALTH PROFILES - QUARTERLY UPDATE BRIEFING AUGUST 2016] M.Foxcroft. Performance & Intelligence Team M.Foxcroft Performance & Intelligence Team HEALTH PROFILES - QUARTERLY UPDATE BRIEFING AUGUST 2016 Public Health England has recently published a quarterly update to its Health Profiles, which provide

More information

Dual Diagnosis. Themed Review Report 2006/07 SHA Regional Reports East Midlands

Dual Diagnosis. Themed Review Report 2006/07 SHA Regional Reports East Midlands Dual Diagnosis Themed Review Report 2006/07 SHA Regional Reports East Midlands Contents Foreword 1 Introduction 2 Recommendations 2 Themed Review 06/07 data 3 Additional information 13 Weighted population

More information

Health and Wellbeing Strategy 2016 to 2021 Summary Document

Health and Wellbeing Strategy 2016 to 2021 Summary Document Health and Wellbeing Strategy 2016 to 2021 Summary Document 1 Health and Wellbeing Strategy 2016-2021 Summary document Introduction The Doncaster Health and Wellbeing Board is a formal Board which was

More information

Showcasing the work of the Alcohol & Drugs Community of Improvement

Showcasing the work of the Alcohol & Drugs Community of Improvement Showcasing the work of the Alcohol & Drugs Community of Improvement Andy Collins, Public Health Co-ordinator, Doncaster Council Jez Mitchell, Public Health Principal, Wakefield Council Liz Butcher, HWB

More information

14. HEALTHY EATING INTRODUCTION

14. HEALTHY EATING INTRODUCTION 14. HEALTHY EATING INTRODUCTION A well-balanced diet is important for good health and involves consuming a wide range of foods, including fruit and vegetables, starchy whole grains, dairy products and

More information

The South Derbyshire Health and Wellbeing Plan

The South Derbyshire Health and Wellbeing Plan The South Derbyshire and Wellbeing Plan 2013-16 1. Vision and Aim A healthier and more active lifestyle across all communities. (c. Our Sustainable Community Strategy for South Derbyshire 2009-2029) The

More information

Public Health Outcomes Framework. Summary for East Sussex. Indicators at a glance (February 2017)

Public Health Outcomes Framework. Summary for East Sussex. Indicators at a glance (February 2017) Public Health Outcomes Framework Indicators at a glance (February 2017) Notes: - Value cells are shaded red, amber or green to show significance compared to England, or where the value can be benchmarked

More information

Public Health Outcomes Framework. Summary for Sefton. Indicators at a glance (May 2017)

Public Health Outcomes Framework. Summary for Sefton. Indicators at a glance (May 2017) Public Health Outcomes Framework Indicators at a glance (May 2017) Notes: - Value cells are shaded red, amber or green to show significance compared to England, or where the value can be benchmarked against

More information

BOARD REPORT AGENDA ITEM NO: WCCCGB/12/05/52 DATE OF BOARD MEETING: Health

BOARD REPORT AGENDA ITEM NO: WCCCGB/12/05/52 DATE OF BOARD MEETING: Health BOARD REPORT DATE OF BOARD MEETING: TITLE OF REPORT: KEY MESSAGES: Clinical Commissioning Priority Update: Alcohol Related Ill Health West Cheshire Clinical Commissioning Group has identified alcohol related

More information

POTENTIAL YEARS OF LIFE LOST (PYLL) SOUTH DEVON AND TORBAY 2009 to

POTENTIAL YEARS OF LIFE LOST (PYLL) SOUTH DEVON AND TORBAY 2009 to SOUTH DEVON AND TORBAY 2009 to 2014 1 Background Potential years of life lost (PYLL) represents the estimated number of potential years not lived by people who die before reaching a given age due to lack

More information

BARNSLEY METROPOLITAN BOROUGH COUNCIL

BARNSLEY METROPOLITAN BOROUGH COUNCIL BARNSLEY METROPOLITAN BOROUGH COUNCIL This matter is a Key Decision within the Council s definition and has been included in the relevant Forward Plan Report of the Executive Director (People) to Cabinet

More information

The links between physical health in mental health

The links between physical health in mental health The links between physical health in mental health A holistic approach to managing mental and physical health is needed. Physical and mental health are inextricably linked 1 What is the problem? It is

More information

JSNA Data Refresh 2013/4 Dementia Barnet

JSNA Data Refresh 2013/4 Dementia Barnet JSNA DATA REFRESH 2013/4 DEMENTIA BARNET 1 JSNA Data Refresh 2013/4 Dementia Barnet Dementia is a clinical syndrome characterised by a widespread loss of mental function, including memory loss, language

More information

You said we did. Our Healthier South East London. Dedicated engagement events

You said we did. Our Healthier South East London. Dedicated engagement events Our Healthier South East London You said we did This report summarises the deliberative events carried out in June and other engagement activities we have undertaken so far in developing the South East

More information

Beyond the Diagnosis. Young Onset Dementia and the Patient Experience

Beyond the Diagnosis. Young Onset Dementia and the Patient Experience Beyond the Diagnosis Young Onset Dementia and the Patient Experience November 2017 1 Contents Executive Summary... 4 Recommendations... 4 1. Introduction... 6 2. Background & Rationale... 6 3. Methodology...

More information

Health and Community. Directorate Health Health and and Wellbeing Community in Halton

Health and Community. Directorate Health Health and and Wellbeing Community in Halton Health and Community Directorate Health Health and and Wellbeing Community in Halton Directorate HeaHealth and Wellbeing in Halton Joint Strategic Needs Assessment for Halton 2008 Contents Tables... 5

More information

Item Number: 6 NHS VALE OF YORK CLINICAL COMMISSIONING GROUP GOVERNING BODY MEETING. Meeting Date: 7 November Report Author: Report Sponsor:

Item Number: 6 NHS VALE OF YORK CLINICAL COMMISSIONING GROUP GOVERNING BODY MEETING. Meeting Date: 7 November Report Author: Report Sponsor: Item Number: 6 NHS VALE OF YORK CLINICAL COMMISSIONING GROUP GOVERNING BODY MEETING Meeting Date: 7 November 2013 Report Sponsor: Dr Emma Broughton Clinical Lead for Primary Care Programme Report Author:

More information

East Sussex Children & Young People s Trust Children and Young People s Plan

East Sussex Children & Young People s Trust Children and Young People s Plan East Sussex Children & Young People s Trust Children and Young People s Plan 2015 2018 Page 1 of 14 Contents 1. Introduction: The CYPP and Child Poverty 2. Priorities for 2015-2018 3. Financial context

More information

JSNA Substance Misuse

JSNA Substance Misuse JSNA Substance Misuse Introduction 9.1. Substance misuse causes less damage to health in absolute population terms than tobacco or alcohol. However, its association with crime and antisocial behaviour

More information

Healtheast CCG - developing an understanding of health and wellbeing needs. Public Health NHS Norfolk and Waveney Cluster and Norfolk County Council

Healtheast CCG - developing an understanding of health and wellbeing needs. Public Health NHS Norfolk and Waveney Cluster and Norfolk County Council Healtheast CCG - developing an understanding of health and wellbeing needs Public Health NHS Norfolk and Waveney Cluster and Norfolk County Council Acknowledgements Norfolk County Council Children s Services

More information

Suicide Prevention. Cherry Jones, Director of Public Health, Swindon Borough Council

Suicide Prevention. Cherry Jones, Director of Public Health, Swindon Borough Council Name of Author: Sponsoring Director and/or Clinician: Locality Affected: Practices Affected: Cherry Jones, Director of Public Health, Swindon Borough Council 1. Purpose and Reasons 1.1 1.2 1.3 Suicide

More information

Wiltshire Children and Young People s Health and Wellbeing Survey 2015: Risky behaviours

Wiltshire Children and Young People s Health and Wellbeing Survey 2015: Risky behaviours Wiltshire Children and Young People s Health and Wellbeing Survey 2015: Risky behaviours Document Prepared by Simon Hodsdon Public Health Analyst Public Health Intelligence Team E-Mail: Simon.Hodsdon@wiltshire.gov.uk

More information

Estimated number of people with hypertension. Significantly higher than the. Proportion. diagnosed with. hypertension

Estimated number of people with hypertension. Significantly higher than the. Proportion. diagnosed with. hypertension Hypertension profile Background Diagnosis and control of hypertension in * This profile compares with data for, authorities in the South East region and the Office for National Statistics (ONS) group of

More information

Annual Report and. Business Plan Summary. Greater Manchester Health and Social Care Partnership

Annual Report and. Business Plan Summary. Greater Manchester Health and Social Care Partnership Annual Report and Business Plan Summary 2016-17 2017-18 Greater Manchester Health and Social Care Partnership Our first year and beyond In April 2016, devolution gave Greater Manchester control of its

More information

Lincolnshire JSNA: Stroke

Lincolnshire JSNA: Stroke Lincolnshire JSNA: Stroke What do we know? Summary Around 2% of the population in Lincolnshire live with the consequences of this disease (14, 280 people) in 2010 Over 1,200 people were admitted for stroke

More information

Health & Wellbeing Strategy. Lorna Payne Group Director Adults & Health

Health & Wellbeing Strategy. Lorna Payne Group Director Adults & Health Health & Wellbeing Strategy Lorna Payne Group Director Adults & Health Statutory Duty Local authority and CCG, through HWB, joint duty under Health and Social Care Act 2012 to prepare a Health and Wellbeing

More information

Service Specification: Bristol and South Gloucestershire Specialist Substance Misuse Treatment Service January 2016

Service Specification: Bristol and South Gloucestershire Specialist Substance Misuse Treatment Service January 2016 This specification is an annex to the Service Specification for the provision of Child and Adolescent Mental Health Services. It must be read along with the overarching specification which applies to all

More information

Alcohol, Harm and Health Inequalities in Scotland

Alcohol, Harm and Health Inequalities in Scotland Alcohol, Harm and Health Inequalities in Scotland Penny Rogers August 2017 Abstract: In Scotland alcohol-related harm follows a social gradient, meaning that deprived communities often experience more

More information

Worcestershire's Autism Strategy

Worcestershire's Autism Strategy Worcestershire Health and Well-being Board Worcestershire's Autism Strategy 2014-17 Fulfilling and Rewarding Lives for adults with autism spectrum conditions Find out more online: www.worcestershire.gov.uk/healthandwellbeingboard

More information

Adult Obesity. (also see Childhood Obesity) Headlines. Why is this important? Story for Leeds

Adult Obesity. (also see Childhood Obesity) Headlines. Why is this important? Story for Leeds Adult Obesity (also see Childhood Obesity) Headlines raise awareness of the scale, complexity and evidence base in relation to this issue, including promotion of the Change4Life campaign contribute to

More information

AUTISM ACTION PLAN FOR THE ROYAL BOROUGH OF GREENWICH

AUTISM ACTION PLAN FOR THE ROYAL BOROUGH OF GREENWICH AUTISM ACTION PLAN FOR THE ROYAL BOROUGH OF GREENWICH NATIONAL CONTEXT Fulfilling and Rewarding Lives (2010) is the Government s strategy for adults with Autistic Spectrum Disorders. It sets out the Government

More information

Diabetes. Ref HSCW 024

Diabetes. Ref HSCW 024 Diabetes Ref HSCW 024 Why is it important? Diabetes is an increasingly common, life-long, progressive but largely preventable health condition affecting children and adults, causing a heavy burden on health

More information

Funding Opportunity. Developing an Effective Response to Health Inequalities in South East Edinburgh

Funding Opportunity. Developing an Effective Response to Health Inequalities in South East Edinburgh Funding Opportunity Developing an Effective Response to Health Inequalities in South East Edinburgh Developing a Community Health Response in South East Edinburgh This funding opportunity is for the development

More information

Substance Misuse in Older People

Substance Misuse in Older People Substance Misuse in Older People Dr Tony Rao Consultant Old Age Psychiatrist, SLAM NHS Foundation Trust Visiting Researcher, Institute of Psychiatry, Neurology and Neuroscience Chair of Substance Misuse

More information

(Much of our health improvement activity is noted in individual Planning Frameworks. This section should be read in conjunction with them.

(Much of our health improvement activity is noted in individual Planning Frameworks. This section should be read in conjunction with them. 17. HEALTH IMPROVEMENT FRAMEWORK (Much of our health improvement activity is noted in individual Planning Frameworks. This section should be read in conjunction with them.) 17.1 Analysis of Local Position

More information

Hull Alcohol Strategy

Hull Alcohol Strategy Hull Alcohol Strategy 2016-20 Contents: Audit Alcohol Screening Tool 02 Foreword 03 Hull s Alcohol Strategy 04 on a page Introduction 05 What are the issues? 06 The national picture 06 What about Hull?

More information

Hypertension Profile. NHS High Weald Lewes Havens CCG. Background

Hypertension Profile. NHS High Weald Lewes Havens CCG. Background NHS High Weald Lewes Havens Background Hypertension Profile Diagnosis and control of in NHS High Weald Lewes Havens * This profile compares NHS High Weald Lewes Havens with data for, a group of similar

More information

NHS Health Check: Tackling health inequalities in community settings

NHS Health Check: Tackling health inequalities in community settings NHS Health Check: Tackling health inequalities in community settings Andrea Hare: Health and Wellbeing Leader, PHE (Feb 27 th 2014) Andrea.hare@phe.gov.uk Aim of the workshop: To gain an understanding

More information

Health Inequalities. Additional tables to accompany the 2016 Director of Public Health Annual Report

Health Inequalities. Additional tables to accompany the 2016 Director of Public Health Annual Report Health Inequalities Additional tables to accompany the 2016 Director of Public Health Annual Report June 2017 Director of Public Health, Annual Report 2016 Supplementary Data Table no. OVERVIEW 1.1 Life

More information

Equalities Analysis. Tobacco Control Plan for England Towards a Smokefree Generation

Equalities Analysis. Tobacco Control Plan for England Towards a Smokefree Generation Equalities Analysis Tobacco Control Plan for England Towards a Smokefree Generation July 2017 Contents 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. Introduction... 3 Engagement and Involvement... 3 Policy

More information

People in Norfolk and Waveney with Autistic Spectrum Disorder

People in Norfolk and Waveney with Autistic Spectrum Disorder People in Norfolk and Waveney with Autistic Spectrum Disorder Linda Hillman Public Health Consultant, March 2011 The national strategy to improve the lives of adults with Autism, Fulfilling and Rewarding

More information

Barnet Scrutiny Committee report 13 th October Barnet Sexual Health Strategy Dr Andrew Howe, Director of Public Health

Barnet Scrutiny Committee report 13 th October Barnet Sexual Health Strategy Dr Andrew Howe, Director of Public Health Barnet Scrutiny Committee report 13 th October 2015 Title Report of Wards Status Urgent Key Enclosures Officer Contact Details Barnet Sexual Health Strategy 2015-2020 Dr Andrew Howe, Director of Public

More information

Analysis of Wirral Stop Smoking Service clients using Mosaic Public Sector. Produced by Wirral Council Performance & Public Health Intelligence Team

Analysis of Wirral Stop Smoking Service clients using Mosaic Public Sector. Produced by Wirral Council Performance & Public Health Intelligence Team Analysis of Wirral Stop Smoking Service clients using Mosaic Public Sector Produced by Wirral Council Performance & Public Health Intelligence Team February 2015 Introduction Mosaic is a geo-demographic

More information

Hertfordshire Young People s Substance Misuse Strategic Plan

Hertfordshire Young People s Substance Misuse Strategic Plan Hertfordshire Young People s Substance Misuse Strategic Plan 2014 15 1 1. Introduction and context Young people misusing substances can cause harm to our communities through crime and antisocial behaviour,

More information

Peterborough City Council Cardiovascular Disease Joint Strategic Needs Assessment SUMMARY. Section Number Section Page Number

Peterborough City Council Cardiovascular Disease Joint Strategic Needs Assessment SUMMARY. Section Number Section Page Number Cardiovascular Disease Joint Strategic Needs Assessment Summary 2015 1 Contents - Section Number Section Page Number 1 Introduction and Background to the CVD JSNA 3 1.1 Joint Strategic Needs Assessments

More information

1. Introduction. Background

1. Introduction. Background Glasgow City Alcohol and Drug Partnership Prevention and Recovery Strategy 2011-2014 1. Introduction 1.1 Glasgow City needs to take action to address major issues around alcohol and drug misuse. The City

More information

KEY QUESTIONS What outcome do you want to achieve for mental health in Scotland? What specific steps can be taken to achieve change?

KEY QUESTIONS What outcome do you want to achieve for mental health in Scotland? What specific steps can be taken to achieve change? SCOTTISH GOVERNMENT: NEXT MENTAL HEALTH STRATEGY Background The current Mental Health Strategy covers the period 2012 to 2015. We are working on the development of the next strategy for Mental Health.

More information

Cambodian CHRNA (Community Health Resources and Needs Assessment)

Cambodian CHRNA (Community Health Resources and Needs Assessment) Cambodian CHRNA (Community Health Resources and Needs Assessment) Between 2013 and 2015, the Center for the Study of Asian American Health (CSAAH) and Mekong NYC collected 100 surveys in the Cambodian

More information

The Coventry Wellbeing Report

The Coventry Wellbeing Report The Coventry Wellbeing Report 2011 Authors: Rebecca Putz; Aileen Clarke, Sarah Stewart-Brown Understanding mental wellbeing in Coventry: Inequalities, levels, and factors associated Why address well-being?

More information

BROMLEY JOINT STRATEGIC NEEDS ASSESSMENT Substance misuse is the harmful use of substances (such as drugs and alcohol) for non-medical purposes.

BROMLEY JOINT STRATEGIC NEEDS ASSESSMENT Substance misuse is the harmful use of substances (such as drugs and alcohol) for non-medical purposes. 13. Substance Misuse Introduction Substance misuse is the harmful use of substances (such as drugs and alcohol) for non-medical purposes. The term substance misuse often refers to illegal drugs, but, some

More information

Statistics on Drug Misuse: England, 2007

Statistics on Drug Misuse: England, 2007 Statistics on Drug Misuse: England, 2007 Summary For the first time, this annual statistical bulletin presents information on drug misuse among both adults and children. The topics covered include: Prevalence

More information

- Value cells have a box shaded Red, Amber or Green to show significance compared to England, or where the value can be benchmarked against a goal.

- Value cells have a box shaded Red, Amber or Green to show significance compared to England, or where the value can be benchmarked against a goal. Public Health Outcomes Framework at a glance Notes Value cells have a box shaded Red, Amber or Green to show significance compared to England, or where the can be benchmarked against a goal. In the change

More information

NATIONAL INSTITUTE FOR CLINICAL EXCELLENCE SCOPE. Dementia: the management of dementia, including the use of antipsychotic medication in older people

NATIONAL INSTITUTE FOR CLINICAL EXCELLENCE SCOPE. Dementia: the management of dementia, including the use of antipsychotic medication in older people NATIONAL INSTITUTE FOR CLINICAL EXCELLENCE 1 Guideline title SCOPE Dementia: the management of dementia, including the use of antipsychotic medication in older people 1.1 Short title Dementia 2 Background

More information

NHS TRAFFORD CLINICAL COMMISSIONING GROUP GOVERNING BODY

NHS TRAFFORD CLINICAL COMMISSIONING GROUP GOVERNING BODY Agenda Item No: Part 1 X Part 2 NHS TRAFFORD CLINICAL COMMISSIONING GROUP GOVERNING BODY 25.4.17 Title of Report Purpose of the Report Public Health Update This report provides an update to the Clinical

More information

Local Authorities and the Challenges ahead

Local Authorities and the Challenges ahead Local Authorities and the Challenges ahead Jean Arrowsmith Business Manager - Health Coventry City Council Coventry 19 th largest Local Authority in England Almost 316,000 citizens Largest age group 20

More information

Homeless Health Needs Audit. North East Regional Homelessness Group

Homeless Health Needs Audit. North East Regional Homelessness Group Homeless Health Needs Audit 2015 Regional Homelessness Group Executive Summary The Homeless Health Needs Audit 2015, commissioned by the Regional Homeless Group, develops an understanding of the health

More information

Alcohol (Minimum Pricing) (Scotland) Bill. Chest Heart & Stroke Scotland

Alcohol (Minimum Pricing) (Scotland) Bill. Chest Heart & Stroke Scotland Alcohol (Minimum Pricing) (Scotland) Bill Chest Heart & Stroke Scotland Chest Heart & Stroke Scotland (CHSS) aims to improve the quality of life for people in Scotland affected by chest, heart and stroke

More information

Draft Dementia Strategy

Draft Dementia Strategy Cheshire West & Chester Council Draft Dementia Strategy 2017-2020 Visit: cheshirewestandchester.gov.uk Visit: cheshirewestandchester.gov.uk 02 Cheshire West and Chester Council Draft Dementia Strategy

More information

OP- JSNA Factsheet 3: Mortality

OP- JSNA Factsheet 3: Mortality OP- JSNA Factsheet 3: Mortality Summary The death rate in Southwark has been reducing for the last seventeen years. The gap between Southwark and London and England has also narrowed greatly. In the last

More information

Aspirations Programme Quarterly Report Q3 (01 October 31 December 2018)

Aspirations Programme Quarterly Report Q3 (01 October 31 December 2018) Aspirations Programme Quarterly Report Q3 (01 October 31 December 2018) Page 1 of 18 Page 2 of 18 INDEX Resident Journey 4 Referral and Moving In 5 Personal Development 6 Complex Needs 7 Health and Wellbeing

More information

Part 1 - Open to the Public. REPORT OF Director of Public Health

Part 1 - Open to the Public. REPORT OF Director of Public Health Part 1 - Open to the Public ITEM NO. REPORT OF Director of Public Health TO Joint Lead Member Briefing for Adult Services, Health & Wellbeing ON Wednesday 5 October 2016 Public Health Monthly Briefing

More information

Dianne Johnson / Lee Panter / Sarah McNulty

Dianne Johnson / Lee Panter / Sarah McNulty Cardiovascular Disease (heart disease and stroke) READER INFORMATION Need Identified Lead Author Cardiovascular Disease Dianne Johnson / Lee Panter / Sarah McNulty Date completed 07/02/11 Director approved

More information

PUBLIC HEALTH GUIDANCE FINAL SCOPE

PUBLIC HEALTH GUIDANCE FINAL SCOPE NATIONAL INSTITUTE FOR HEALTH AND CLINICAL EXCELLENCE PUBLIC HEALTH GUIDANCE FINAL SCOPE 1 Guidance title How to stop smoking in pregnancy and following childbirth. 1.1 Short title Quitting smoking in

More information

Excess Winter Deaths. June 2017

Excess Winter Deaths. June 2017 Excess Winter Deaths June 2017 1 Excess Winter Deaths Background Excess winter deaths are defined by the Office for National Statistics (ONS) as the difference between the number of deaths during the four

More information

Appendix 1. Cognitive Impairment and Dementia Service Elm Lodge 4a Marley Close Greenford Middlesex UB6 9UG

Appendix 1. Cognitive Impairment and Dementia Service Elm Lodge 4a Marley Close Greenford Middlesex UB6 9UG Appendix 1 Mr Dwight McKenzie Scrutiny Review Officer Legal and Democratic Services Ealing Council Perceval House 14 16 Uxbridge Road Ealing London W5 2HL Cognitive Impairment and Dementia Service Elm

More information

National study. Closing the gap. Tackling cardiovascular disease and health inequalities by prescribing statins and stop smoking services

National study. Closing the gap. Tackling cardiovascular disease and health inequalities by prescribing statins and stop smoking services National study Closing the gap Tackling cardiovascular disease and health inequalities by prescribing statins and stop smoking services September 2009 About the Care Quality Commission The Care Quality

More information

Promoting Drug Users Respiratory Health

Promoting Drug Users Respiratory Health Promoting Drug Users Respiratory Health Lloyd Baron IAD Research Assistant, Centre for Public Health, Liverpool John Moores University L.R.Baron@ljmu.ac.uk Outline Background terminology and COPD explanation

More information

Dual Diagnosis Pathway

Dual Diagnosis Pathway Dual Diagnosis Pathway Document level: Trustwide (TW) Code: CP23 Issue number: 7 Lead executive Authors details Type of document Target audience Document purpose Medical Director Consultant Psychiatrist

More information

Mental Health Summary Profile. Common Mental Health Disorders and Serious Mental Illness

Mental Health Summary Profile. Common Mental Health Disorders and Serious Mental Illness Mental Health Summary Profile Common Mental Health Disorders and Serious Mental Illness Specialist Public Health, January 216 Contents Common mental health disorders (CMHD)... 2 Summary key points... 2

More information

The Scottish Health Survey 2014 edition summary A National Statistics Publication for Scotland

The Scottish Health Survey 2014 edition summary A National Statistics Publication for Scotland The Scottish Health Survey 2014 edition summary A National Statistics Publication for Scotland INTRODUCTION The Scottish Health Survey (SHeS) is commissioned by the Scottish Government Health Directorates

More information