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Morecambe Bay CCG Mini Summary Profile 2017/18 Author: Farha Abbas Public Health Knowledge & Intelligence Analyst Public Health Intelligence team Business Intelligence Date: September 2017
Morecambe Bay CCG Mini
Summary Profile 2017/18
Author: Farha Abbas Public Health Knowledge & Intelligence Analyst
Public Health Intelligence team
Business Intelligence
Date: September 2017
Lancashire North CCG Mini Summary Profile 2017/18
Morecambe Bay Clinical Commissioning Group (CCG)
Morecambe Bay CCG boundary encompasses the districts of Barrow-in-Farness, Lancaster and South Lakeland. It also includes parts of Copeland, Craven and Wyre districts. The CCG consists of 42 GP practices providing primary care to 360,784 patients. University Hospitals Morecambe Bay Foundation Trust is the main provider of secondary health care for the area operating four main sites: Furness General Hospital, Royal Lancaster Infirmary, Westmorland General Hospital and Queen Victoria Hospital. 42% of the registered population live within the district of Lancaster, 30% in South Lakeland and 19% in Barrow-in-Furness.
22% of registered patients are aged 65 or over, with 15% aged 15 or under.
Estimates based on Census 2011, suggest that 5% of resident population of three main districts are from a BME (including White non-British) background.
The district of Barrow-in-Furness is amongst the 20% most deprived districts in England
32% of the registered population live within LSOAs considered to be 40% most deprived neighbours nationally.
The aged 65+ resident population of Lancashire North CCG is estimated to increase by 14% over the next 10 years.
Appendix A provides a more detailed breakdown of these figures
Morecambe Bay CCG Mini Summary Profile 2017/18
Registered population on a page (April 2017)
Morecambe Bay CCG Mini Summary Profile 2017/18
If the CCG was a village of 100 people…..
The People Living in most deprived areas (20% most deprived nationally) 18 Children aged under 5 5 Children and young people aged 5-18 14 People aged 19-65 60 People aged 66-80 16 People aged over 80 5 60+ persons living in pension credit housholds 4 (Lancashire North, pre 4/17)
16-64 year olds Long term unemployed 2 (Lancashire North, pre 4/17)
Adults who are obese 18 (Lancashire North, pre 4/17)
Estimated 15+ smoking 15 (Lancashire North, pre 4/17)
Under 16 year olds in low income families 8 (Lancashire North, pre 4/17)
The Health
People aged 65+ with recorded dementia 1 (Lancashire North, pre 4/17)
People over 17 years diagnosed with diabetes 6 (Lancashire North, pre 4/17)
Additional people with undiagnosed diabetes 1
People with diagnosed CHD 4
People with diagnosed Asthma 7
People with diagnosed severe mental illness 1
People with diagnosed cancer 3
People who have had a stroke 2
People with diagnosed hypertension 15
Adults with diagnosed depression 8
Morecambe Bay CCG Mini Summary Profile 2017/18
District health Using Public Health England's (PHE) Health Profiles tool alongside the Quality and Outcomes Framework (QoF) disease registers it is possible obtain a good understanding of the key health issues affecting the main local authorities in the Morecambe Bay CCG area (Lancaster, Barrow-in-Furness and South Lakeland). Thereby, highlighting key areas public health, primary care and social are professionals may wish to address. Appendix B found at the end of this document provides a more detailed breakdown of the PHE health profile indicators, whilst appendix C provides a full breakdown of the latest QoF disease registers. It is important to note that some of these indicators may have been updated since the last refresh of this tool.
Our communities
Deprivation: Barrow-in-Furness is in the bottom quintile for deprivation in England (Quintile 5), while Lancaster falls in quintile 4. Placing these districts within the 40% most deprived districts in England.
Children in poverty (under 16s): Barrow-in-Furness has a significantly higher proportion of children living in low income families compared to England. Whilst Lancaster and South Lakeland both have a significantly smaller proportion compared to England.
GCSE achieved (5A*-C inc. Eng & Maths): A significantly smaller proportion of children from Barrow-in-Furness achieved five GCSE grades A*-C than the England average. However in South Lakeland a significantly larger proportion of children achieved 5 GCSE grades A*-C.
Violent crime (violence offences): There are significantly higher levels of violent crime in Barrow-in-Furness and Lancaster, compared to the England average.
Long term unemployment: Barrow-in-Furness has significantly high levels of Long term unemployment.
Children's and Young People's Health
Smoking status at time of delivery: Lancaster has a significantly higher proportion of women recorded as been a smoker at the time of delivery, compared to England.
Breastfeeding initiation: Both Barrow-in-Furness and Lancaster recorded a smaller proportion of new mothers breastfeeding within 48 hours of delivery than the England average.
Alcohol-specific hospital stays (under 18): Barrow-in-Furness, Lancaster and South Lakeland all have significantly higher rates of under 18 alcohol-specific hospital stays compared to England.
Adult Health & lifestyle
Smoking prevalence: In all three districts smoking prevalence is similar to the England average.
Percentage of physically active adults: A significantly smaller proportion of adults from Barrow-in-Furness are believed to be physical active, compared to England.
Excess weight in adults: Over three fifths (3/5) of adults living in Barrow-in-Furness, Lancaster and South Lakeland are estimated to be living with excess weight.
Morecambe Bay CCG Mini Summary Profile 2017/18
Disease & Poor Health
Hospital stays for self-harm: Both Barrow-in-Furness and Lancaster have significantly higher rate of hospital stays for self-harm compared to England.
Admission episodes for alcohol-related conditions (Narrow): Barrow-in-Furness and Lancaster have significantly higher rate of admission episodes for alcohol-related conditions compared to the England average.
QoF recorded disease prevalence: The Morecambe Bay CCG has significantly higher levels of recorded disease prevalence for the following conditions :
Atrial fibrillation Coronary heart disease Heart failure Hypertension Peripheral arterial disease Stroke and transient ischaemic attack Asthma Chronic obstructive pulmonary disease (COPD) Diabetes mellitus (17+) Palliative care Dementia Depression (18+) Epilepsy (18+) Rheumatoid arthritis (16+)
However it should be noted, that for certain conditions high recorded disease prevalence could be a reflection of effective diagnosis and screening practices.
Life Expectancy & Causes of death
Life expectancy at birth: Barrow-in-Furness and Lancaster have significantly low male and female life expectancy at birth estimates compared to England.
Under 75 mortality rate: cardiovascular: Barrow-in-Furness has a significantly high rate of premature cardiovascular mortality compared to England.
Killed and seriously injured on roads: Both Lancaster and South Lakeland have significantly higher rates of people reported killed or seriously injured on the roads compared to the national average.
CCG Outcomes ** Please note that at the time of publication, data was not available for the Morecambe Bay CCG and as such the figures presented are for the Lancashire North CCG area.
NHS England's CCG outcomes tool provides interactive access to key data for CCGs across five domains:
Domain 1 – Preventing people from dying prematurely
Domain 2 – Enhancing quality of life for people with long-term conditions
Domain 3- Helping people to recover from episodes of ill health or following injury
Domain 4 – Helping people to recover from episodes of ill health or following injury
Domain 5 – Treating and caring for people in a safe environment and protecting them from avoidable harm
Across the five domains Lancashire North CCG ranks within the worse quartile in England for the following indicators:
Morecambe Bay CCG Mini Summary Profile 2017/18
Indicator Notes D
om
ain
1
1.1 Potential years of life lost (PYLL) from causes considered amenable to healthcare - Female / male (2014)
The CCGs male rate is getting worse
1.3 Completion of cardiac rehabilitation following an admission for coronary heart disease (2013/14)
The CCGs rate is getting worse
1.5 Mortality within 30 days of hospital admission for stroke (2015/16)
The CCGs rate is getting worse
1.14 Maternal smoking at delivery (2016/17 Q2)
The CCGs rate is getting worse
1.21 All-cause mortality – 12 months following a first emergency admission to hospital for heart failure in people aged 16 and over (April 2012 to March 2015)
The CCGs rate is getting better
Do
ma
in 2
2.7 Unplanned hospitalisation for asthma, diabetes and epilepsy in under 19s (2015 - 2016 (Oct - Sep))
The CCGs rate is getting worse
2.8 Complications associated with diabetes (2012/13)
The CCGs rate is getting worse
2.10 Access to psychological therapies services by people from Black and Minority Ethnic (BME) groups (2015/16)
The CCGs rate is getting worse
2.11a Percentage of referrals to Improving Access to Psychological Therapies (IAPT) services which indicated a reliable recovery following completion of treatment (2015 - 2015 (Jan - Dec))
The CCGs rate is getting worse
2.11b Percentage of referrals to Improving Access to Psychological Therapies (IAPT) services which indicated a reliable improvement following completion of treatment (2015 - 2015 (Jan - Dec))
The CCGs rate is getting worse
2.15 Health-related quality of life for carers, aged 18 and above (2015/16)
The CCGs rate is getting worse
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ma
in 3
3.1 Emergency admissions for acute conditions that should not usually require hospital admission (2015 - 2016 (Oct - Sep))
The CCGs rate is getting worse
3.3 Elective groin hernia procedures - patient reported outcomes measures (PROMS) (2014/15)
3.4 Emergency admissions for children with lower respiratory tract infections (2015 - 2016 (Oct - Sep))
The CCGs rate is getting worse
3.5 People who have had a stroke who are admitted to an acute stroke unit within 4 hours of arrival to hospital (2015/16)
3.8 People who have a follow-up assessment between 4 and 8 months after initial admission for stroke (2015/16)
3.11 Hip fracture: collaborative orthogeriatric care (2015)
The CCGs rate is getting worse
Morecambe Bay CCG Mini Summary Profile 2017/18
3.12 Hip fracture: timely surgery (2015)
3.16 Unplanned readmissions to mental health services within 30 days of a mental health inpatient discharge in people aged 17 and over
The CCGs rate is getting worse
3.17 Percentage of adults in contact with secondary mental health services in employment (2015 - 2016 (Oct - Sep))
3.18 Hip fracture: care process composite indicator (2015)
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5.4 Incidence of Healthcare Associated Infection (HCAI) – C. difficile (Apr 2013 - Dec 2016)
Additional analysis found that the CCG has seen a significant decline in performance against the following indicators:
1.12 People with serious mental illness (SMI) who have received the complete list of physical checks (2014/15).
2.4 Percentage of people with diabetes who have received nine care processes (2015/16).
Emergency admission for children with lower respiratory tract infections (2016). Whilst on a positive note the CCG had shown significantly improvement against the below indicators:
1.17 Record of stage of cancer at diagnosis (2015).
3.7 People with stroke who are discharged from hospital with a joint health and social care plan (2015/16).
Cluster Analysis CCGs across England have been grouped into clusters of similar types, with the Lancashire North CCG falling into the sphere cluster defined as Areas with younger adults and university cities. The CCG was found to have a worse outcome than the cluster average, for 27 out of 67 indicators.
Local comparisons Looking at the indicator data for other five CCGs of Lancashire shows that all six CCGs recorded significantly worse rates than the England average for the following indicators :
1.21 All-cause mortality – 12 months following a first emergency admission to hospital for heart failure in people aged 16 and over (April 2012 to March 2015)
2.11a Percentage of referrals to Improving Access to Psychological Therapies (IAPT) services which indicated a reliable recovery following completion of treatment (2015).
2.11b Percentage of referrals to Improving Access to Psychological Therapies (IAPT) services which indicated a reliable improvement following completion of treatment (2015).
3.4 Emergency admissions for children with lower respiratory tract infections (2015 - 2016 (Oct - Sep)).
Morecambe Bay CCG Mini Summary Profile 2017/18
Lancashire North was the only CCG to record significantly high rates for the following areas :
1.3 Completion of cardiac rehabilitation following an admission for coronary heart disease (2013/14).
2.15 Health-related quality of life for carers, aged 18 and above (2015/16)
3.3 Elective groin hernia procedures - patient reported outcomes measures (PROMS) (2014/15).
3.8 People who have a follow-up assessment between 4 and 8 months after initial admission for stroke (2015/16).
Morecambe Bay CCG Mini Summary Profile 2017/18
Appendices
Appendix A: Morecambe Bay patient and population breakdown and projections plus deprivation scores
Morecambe Bay CCG Mini Summary Profile 2017/18
Appendix B: Summary of PHE 2017 district health profiles for the main Morecambe Bay CCG districts and comparators
Source: http://fingertips.phe.org.uk/profile/health-profiles
Morecambe Bay CCG Mini Summary Profile 2017/18
Appendix C : Morecambe Bay CCG Quality and Outcomes Framework (QOF) recorded disease prevalence, benchmarked against England
Condition
Number on
disease
register
Prevalence England
prevalence
Compared to the
England prevalence
AF - Atrial Fibrillation 7,809 2.18% 1.71% High
CHD - Coronary Heart
Disease 14,634 4.09% 3.20% High
HF - Heart Failure 3,516 0.98% 0.76% High
HYP - Hypertension 53,479 14.96% 13.81% High
PAD - Peripheral Arterial
Disease 3,252 0.91% 0.61% High
STIA - Stroke and Transient
Ischaemic Attack 7,988 2.23% 1.74% High
AST - Asthma 24,189 6.77% 5.91% High
COPD - Chronic Obstructive
Pulmonary Disease 7,818 2.20% 1.85% High
OB - Obesity (18+) 24,519 8.00% 9.45% Low
CAN-Cancer 10,369 2.90% 2.42% High
CKD-Chronic Kidney Disease
(18+) 13,806 4.71% 4.10% High
DM - Diabetes Mellitus (17+) 20,261 6.81% 6.55% High
PC - Palliative Care 2,718 0.76% 0.34% High
Dementia 3,718 1.04% 0.76% High
DEP - Depression (18+) 28,729 9.79% 8.26% High
EP - Epilepsy (18+) 2,734 0.93% 0.80% High
LD - Learning Disabilities 1,722 0.48% 0.46% -
MH - Mental Health 3,253 0.91% 0.90% -
OST - Osteoporosis (50+) 354 0.23% 0.31% Low
RA - Rheumatoid Arthritis
(16+)2,643 0.88% 0.73% High
Please note patients can appear on multiple disease registers and being significantly above
England, could be interpreted as a positive, depending on the condition.
Cardiovascular
Respiratory
Lifestyle
High dependency and other long term conditions
Mental health and neurology
Musculoskeletal
