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Richmond upon Thames Public Health Anna Raleigh Consultant in Public Health June 2014
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Richmond upon Thames
Public Health
Anna Raleigh
Consultant in Public Health June 2014
Public healthPublic Health team Co located with council since 2012 Small team of PH Specialists (18wte)
PH Duties Advice and leadership Commissioning Public Health Programmes Commissioning Support to the NHS Oversight function Annual PH Report Health & Wellbeing Board
Richmond
Healthy, safe and rich in assets
BUT
Health inequalities Prevention opportunities
Hidden risks and harms
Increasing numbers of people with multiple LTCs
Healthy, safe and rich in assets
Residents live longer
75 75 76 76 76 77
8 8 9 10 1011
83.0 83.4 84.4 85.6 86.287.9
65
70
75
80
85
90
England London Richmond England London Richmond
Male Female
Age (
year
s)
Source: www.ons.gov.uk
• Both males and females aged 65 years in Richmond are expected to live longer than their similarly aged counterparts residing in London and England
• The greater number of years of disability experienced by Richmond’s older people than nationally creates an additional demand for health care services
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Richmond early deaths Early deaths Richmond
ranking among local authorities in England
Number of early deaths in three years 2009 to 2011
Overall 2nd of 150 LAs 1,097Cancer 4th of 150 LAs 481Heart disease and stroke
4th of 150 LAs 236
Lung 16th of 149 LAs 91Liver 41st of 149 LAs 68
•Overall: Richmond has second lowest overall rate of early (under 75 years) deaths of 150 local authorities in England (and lowest in London).
•Richmond has low rates of early deaths in the country for cancers, heart disease/stroke, and lung disease. Richmond also has better than average rates of early deaths for liver disease.
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Inequalities
Most deprived Borough
averageu Least deprived
Source: http://www.communities.gov.uk
Health Inequalities
• While overall the borough is affluent, ranked as the 42nd least deprived locality, there are pockets of deprivation.
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InequalitiesChildren living in poverty
Prevention Opportunities
Obesity in Reception and Year 6National Childhood Measurement Programme
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Diabetes prevalence12
National prevalence model suggests there are 4,400 people with
undiagnosed diabetes in Richmond
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Hidden risks and harms
Hidden risks and HarmsImmunisation uptake at 1, 2 and 5 years in Richmond (2012-13) and England (2011-12 )
Hidden risks and harmsSocial Isolation
Planning for increasing numbers of people with long term conditions
Multi-morbidity
00-04
05-09
10-14
15-19
20-24
25-29
30-34
35-39
40-44
45-49
50-54
55-59
60-64
65-69
70-74
75-79
80-84
85+0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
8+ 7 6 5 4 3 2 1 0
Number of chronic conditions by age, Richmond CCG 2013
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Multi-morbidity
asthma
depression
anxiety
cancer
epilepsy
hypertension
schizophrenia
bipolar
diabetes
atrial fibrillation
dementia
ihd
copd
stroke
heart failure
0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%
This condition only 1 other 2 others 3+ others
Percentage of patients who have other conditions, Richmond CCG 2013
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JSNA Service change Outcome for patients
Young people’s risky behaviour
Development of a service to prevent risk taking behaviour
• Increased protective factors such as self esteem and resilience in patients
Care homes GP led NHS and local authority nursing and care home group developed initiatives in partnership with Hounslow and Richmond Community Healthcare NHS Trust (HRCH)
• Reduced hospital admissions and improved quality and safety in care homes
End of life care Implementation of an electronic shared care record ‘Co-ordinate My Care’; development of financial incentive measure for quality outcomes in contract with HRCH
• More patients identified and care plans developed to help people to achieve their preferred place of care and death
Excess winter deaths
Joint local authority, NHS and voluntary sector campaign
• Reduced winter deaths
Examples – what has improved for patients?
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Useful links
APHR 2013/14http://www.richmond.gov.uk/annual_public_health_report_2013_14.pdf
JSNA http://www.richmond.gov.uk/jsna
HWB strategyhttp://www.richmond.gov.uk/health_and_wellbeing_strategy_april_13.pdf
Public Health Outcomes Framework (PHOF)http://www.phoutcomes.info
Contacts
Dr Dagmar Zeuner, Director of Public [email protected]
Anna Raleigh, Consultant in Public [email protected]
Anna Bryden, Consultant in Public [email protected]
