September Health & Wellbeing Strategy dashboard update and... · 2017. 10. 17. · Health &...

hertshealthevidence.org

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September 2017

Health & Wellbeing Strategy dashboard update Q1-2 2017/18

Key Messages

There have been some notable improvements in outcomes and how we compare with our

peer group of similar local authorities, as well as some areas in which outcomes

themselves or our peer group ranking has worsened.

Inter-district inequalities have increased for some indicators and reduced for others.

New data have not yet been released for all of the indicators.

How are we measuring outcomes of the Health & Wellbeing

Strategy?

A basket of statistical indicators has been selected for each of the four life stages covered by the

strategy. The Public Health Evidence & Intelligence Team have created a set of data indicator

dashboards (one for each life stage) to track changes in these indicators over the lifetime of the

strategy. The dashboards are updated quarterly with whatever new data are available at that time

(new figures for most indicators are only available on an annual basis, although the release dates for

new figures vary between indicators). The dashboards can be accessed at:

https://www.hertshealthevidence.org/data/hwb

About this update

This update highlights the most notable changes in the dashboard indicators since baseline,

irrespective of whether they are positive or negative. Statistically significant* changes in figures or

notable changes in peer group rankings are described, along with changes in the number of districts

whose figures are statistically significantly different from the Hertfordshire average. For each life stage,

a brief note from a member of the Health & Wellbeing Board adds context.

What do the latest figures show?

Starting Well

In the latest round of figures for this life stage there have been notable changes in:

• % take up of free early education entitlement among 2 years olds – this indicator

showed statistically significant* improvements since baseline (Jan-March 2015) and from Jan-

March 2016 to Jan-March 2017 (with Hertfordshire remaining 4th best out 11 in its peer

group)

• Year 1 pupils achieving the expected level in the phonics screening check – this

indicator showed a statistically significant* improvement between 2015 and 2016 (with

Hertfordshire remaining at the top of its peer group)

• Gap between free and non-free school meal children achieving a good level of

development – this indicator worsened between 2015 and 2016, although we don’t have the

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Health & Wellbeing Strategy dashboard update: Q2 2017/18 September 2017


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necessary data to calculate whether this change was statistically significant* (with

Hertfordshire dropping from 5th to 7th best out of 11 in its peer group)

• % children registered with a children’s centre within 2 months of their date of

birth – this indicator showed a statistically significant* improvement from baseline (April-June

2016) to Jan-March 2017

District variations

Compared with baseline figures, there are greater numbers of statistically significant* variations

between districts for:

• % children registered with a children’s centre within 2 months of their date of

birth (Watford has the lowest figure and East Hertfordshire has the highest)

• Overweight and obesity in children aged 4-5 (St Albans has the lowest figure and

Broxbourne has the highest)

• Hospital admissions for accidental and deliberate injuries in children aged 0-4

(Dacorum has the lowest figure and Stevenage has the highest)

Compared with baseline figures, there are fewer statistically significant* variations between districts

for:

• % take up of free early education entitlement for 2 year olds

• % take up of free early education entitlement for 3 and 4 year olds

Viewpoint

There has been a significant focus on take up of free early education and progress is being made.

Narrowing the gap for disadvantaged children is a key priority for Hertfordshire and is a focus for all

early years providers and nursery schools.

The transformation of the early childhood offer, with Family Centre procurement going live in autumn

2017, is designed to be more targeted to families’ needs and will extend the offer to mums-to-be and

children from before birth to age 19 in some circumstances.

Jenny Coles, Director of Children’s Services, Hertfordshire County Council

Developing Well


• Family homelessness – this indicator worsened between 2014/15 and 2015/16 (although

this change was not statistically significant*, Hertfordshire dropped from 10th best out of 11

to bottom in its peer group)

• Overweight and obesity in children aged 10-11 – this indicator worsened statistically

significantly* between 2014/15 and 2015/16 (with Hertfordshire remaining 4th in its peer

group)




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• First time entrants to the youth justice system – there was a non-statistically

significant improvement in this indicator between 2015 and 2016; however, Hertfordshire

dropped from 7th to 9th best out of 11 in its peer group)

District variations

Compared with baseline figures, there is a greater number of statistically significant* variations


• Overweight and obesity in children aged 10-11 (East Hertfordshire has the lowest

figure and Broxbourne has the highest)

There remain no statistically significant* variations between districts for:

• Alcohol-specific hospital admissions in under 18s

Viewpoint

Hertfordshire recently undertook a comprehensive questionnaire with children looked after as part of the

Coram ‘Bright Spots’ research – 14 other authorities took part. The results are more up to date that the

SDQ indicator here and have produced positive feedback on services and areas for improvement now in

an action plan.

Family homelessness is being closely monitored, with District Councils and preventative actions being

taken where possible. Intentionally homeless families have increased, although small in number, and

families with no recourse to public funds have increased.

Jenny Coles, Director of Children’s Services, Hertfordshire County Council

Living & Working Well


• People with a self-reported high anxiety score – this indicator showed a statistically

significant* improvement between 2014/15 and 2015/16 (with Hertfordshire moving from

the bottom to the top of its peer group)

• Participation in sport among adults – this indicator worsened statistically significantly*

between 2014/15 and 2015/16 (with Hertfordshire dropping from 4th to 6th best out of 11

in its peer group)

• Statutory homelessness – this indicator worsened between 2014/15 and 2015/16

(although this change was not statistically significant*, Hertfordshire dropped from 7th to

9th best out of 11 in its peer group)

District variations



• Statutory homelessness (East Hertfordshire has the lowest figure and Broxbourne has

the highest)




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Compared with baseline figures, there are fewer statistically significant* variations between districts

for:

• Alcohol-related hospital admissions (East Hertfordshire has the lowest figure and

Watford has the highest)

Viewpoint

Hertfordshire has made some good progress on a range of indicators, but as always there

remain persistent inequalities across the County. While there are some good areas of

performance, this update shows that we still have more to do to reduce avoidable morbidity,

disability and hence avoidable cost in the system.

We still have opportunities to improve outcomes while also saving cost, and early tackling of

variations in care outcomes remains less than optimal.

Jim McManus, Director of Public Health, Hertfordshire County Council

Ageing Well


• Injuries due to falls in people aged 65+ – this indicator improved between 2014/15 and

2015/16 (although this change was not statistically significant*, Hertfordshire rose from 8th

to 4th best out of 11 in its peer group)

• Hip fractures in people aged 65+ – this indicator improved between 2014/15 and

2015/16 (although this change was not statistically significant*, Hertfordshire rose from 4th

to 2nd best out of 11 in its peer group)

• Adult social care users who have as much social contact as they would like – this

indicator improved between 2014/15 and 2015/16 (although this change was not statistically

significant*, Hertfordshire rose from bottom to 7th best out of 11 in its peer group)

District variations



• Injuries due to falls in people aged 65+ (Broxbourne has the lowest figure and

Stevenage has the highest)

Compared with baseline figures, there are fewer statistically significant variations between districts for:

• Health related quality of life for older people (as a result of this change there are now

no statistically significant variations between districts for this indicator)

There remain no statistically significant* variations between districts for:

• Hip fractures in people aged 65+




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Viewpoint

The Hertfordshire and West Essex Sustainability and Transformation Plan (STP) includes a

workstream for ‘frailty’; a full review of the preventative and reactive services available for older

people who are assessed as being clinically frail and are therefore at risk of falls are being

reviewed, with a view to minimising falls and preventing further accidents.

The Care Act 2014 provided an opportunity to review services available to older people and

their carers in line with the county’s agreed Ageing Well Strategy. People said they wanted

something purposeful to do in the daytime and maintain their own local connections when they

were assessed as having social care needs. All voluntary sector services have been reviewed to

ensure they are targeted and ACS’ new practice principles and assessment methodology

promotes a ‘Community First’ approach to achieve this. Iain MacBeath, Director of Adult Care Services, Hertfordshire County Council

What does this mean?

The current round of new figures shows a mixed picture of change since the baseline for the Health &

Wellbeing Strategy indicators was set, with some notable improvements in outcomes and how we

compare with our peer group of similar local authorities, as well as some areas in which outcomes

themselves or our peer group ranking has worsened. Inter-district inequalities have increased for

some indicators and reduced for others.

At the moment, the picture is incomplete because new data have not yet been released for all of the

indicators in the dashboards. Also, due to time lags in the release of data, it will be a little longer

before we are able to assess how all outcomes have changed in the period since the 2016-2020

strategy went live.

* A certain amount of variation in figures will occur due to chance, so simply looking at whether there is a difference

between two figures can be misleading. In order to judge whether differences between two figures are statistically meaningful

we calculate 95% confidence intervals for each. Where those confidence intervals do not overlap we say that the difference

between the figures is statistically significant.


Overarching goal: Healthy mothers and healthy babies

1 - 1 0 5 equal districts

- 9 6.4 - 7.9

2014/15 2015/16 /8 /8 Surrey 3 - 3 0 4 equal districts

1 3 1 - Stevenage

4 - 69.5 - 86.9

2014/15 - /10 - Surrey 3 1 3 - St Albans

1 1 1 3 Broxbourne

8 7 73.6 - 87.8

Apr 16 to Jun 16 Jan 17 - Mar 17 - - - 3 1 3 0 Welwyn Hatfield

1 - 1 - -

- - - - -

2014/15 2016/17 - - - 3 - 3 - -

Overarching goal: Parenting for a bright future: All young children given a strong foundation

1 - 1 - -

- - - - -

2014/15 2015/16 /11 /11 Hertfordshire 3 - 3 - -

1 1 1 1 St Albans

9 8 16 - 22.5

2014/15 2015/16 /11 /11 Surrey 3 0 3 1 Broxbourne

1 1 1 0 Dacorum

9 8 72.2 - 141.9

2014/15 2015/16 /11 /11 Cambridgeshire 3 0 3 2 Stevenage

1 3 1 2 Hertsmere

5 7 62.6 - 87.2

Jan 15 - Mar 15 Jan 17 - Mar 17 /11 /11 Warwickshire 3 2 3 1 Stevenage

1 2 1 3 Three Rivers

1 4 80.7 - 94.2

Jan 15 - Mar 15 Jan 17 - Mar 17 /11 /11 Warwickshire 3 7 3 3 Stevenage

1 - 1 - Hertsmere

- - 13.2 - 30.4

2015 2016 /11 /11 Northamptonshire 3 - 3 - St Albans

Domestic abuse incidents recorded by the Police

where a child is present

7.81 % 7.04 %

77.64 %

77.86 % 82.73 %

2 2

% children registered with a children’s centre

within 2 months of their date of birth

Breastfeeding initiation

- -

-

103 %% take up of free early education entitlement for 3

and 4 year olds

90.32 % 90.06 %

11 11

106.26 per

10,000

82.56 %

4 2

Best/highest

neighbour

4 4

5 7

Inter-district range

Percentage of mothers smoking at time of delivery

Change from

previous

Change from

baseline

Baseline

neighbours rank

Latest neighbours

rank

Change from

previous

Best/highest

neighbour

Baseline district

variation

Latest district

variationIndicator (not all available at all geographies)

5.85 %

Latest Herts.

figure

Baseline Herts.

figure

Baseline district

variation

-5-

16.87 per 1,000

children

18.09 per 1,000

children-

Latest neighbours

rank

Change from

previous

Latest Herts.

figure

84.68 %

-

-

Change from

previous

Change from

baseline

Year 1 pupils achieving the expected level in the

phonics screening check

79.46 % 82.56 %

1

1

% take up of free early education entitlement for 2

year olds

64.9 % 77.58 %

Overweight and obesity in children aged 4-519.42 % 19.11 %

81 %

Hospital admissions for accidental and deliberate

injuries in children aged 0-4

117.62 per

10,000

Indicator (not all available at all geographies)Baseline Herts.

figure

16.56 %

4 4

Baseline

neighbours rank

Hertfordshire Health & Wellbeing Strategy 2016-2020 – Starting Well indicators dashboardClick here for user guide

Q2 2017/18

Latest district

variationInter-district range

18 %

Gap between free and non-free school meal

children achieving a good level of development at

ages 3-4

20.18 % 22.55 %

105.22 per

10,000

No change in ranking Decrease / worsening in

ranking

Statistically significantly lower

Statistically significantly higher

Statistically significant

improvement No statistically significant change Statistically significant

worsening

Districts compared to Hertfordshire

Statistically significantly worse

Statistically significant increase Statistically significant decrease No data / no updateNot statistically significantly different

Statistically significantly better

Increase / improvement in

ranking

https://www.hertshealthevidence.org/app/download/13477990434/HWBStrat_2016-2020_Dashboard_Guide.pdf


https://www.hertshealthevidence.org/data/hwb/

Overarching goal: Good mental health and wellbeing for children and young people

1 - 1 - -

- - - - -

2015/16 - /10 - Surrey 3 - 3 - -

1 - 1 - -

- - - - -

2014/15 - /11 - Buckinghamshire 3 - 3 - -

1 - 1 - -

- - - - -

2014/15 2015/16 /11 /11 Hampshire 3 - 3 - -

1 - 1 - North Hertfordshire

- - 36 - 145

2015/16 - - - - 3 - 3 - Welwyn Hatfield

1 2 1 - Hertsmere

5 - 14.2 - 48.9

31/03/2016 - - - - 3 3 3 - Stevenage

Overarching goal: Parenting for a bright future: All young children given a strong foundation

1 1 1 1 East Hertfordshire

8 7 23.9 - 36.6

2014/15 2015/16 /11 /11 Surrey 3 1 3 2 Broxbourne

1 - 1 - -

- - - - -

2016 - - - - 3 - 3 - -

1 0 1 0 St Albans

10 10 15.1 - 38.8

2012/13 - 14/15 2013/14 - 15/16 /11 /11 Buckinghamshire 3 0 3 0 Three Rivers

1 - 1 - -

- - - - -

2012/13 - 14/15 2013/14 - 15/16 /11 /11 Buckinghamshire 3 - 3 - -

1 - 1 - -

- - - - -

2015 2016 /11 /11 Surrey 3 - 3 - -

1 - 1 - -

- - - - -

2015 - /10 - West Sussex 3 - 3 - -

1 0 1 - Dacorum

10 - 29.6 - 53.9

31/03/2016 - - - - 3 0 3 - Hertsmere

1 0 1 - Watford

10 - 90.5 - 100

31/03/2016 - - - - 3 0 3 - Welwyn Hatfield

1 - 1 - -

- - - - -

2014 - /6 - Essex 3 - 3 - -

1 - 1 - -

- - - - -

2014 - /5 - Hertfordshire 3 - 3 - -

97.52 per

100,000

23.9 %

0.86 per 1000

--


ranking No change in ranking

14.6 % -

14.6 %1 -

Care leavers not in education, employment or

training (NEET)

40.54 % -

- -

4 -

Care leavers in suitable accommodation95.26 % -

People aged 16-25 who are insufficiently

physically active

-

3 3

First time entrants to the youth justice system

314.56 per

100,000

313.67 per

100,000 7 9

Alcohol-specific hospital admissions in under 18s

25.51 per

100,000

26.01 per

100,000

21.54 per

100,000

- --

3 3

Latest district


Overweight and obesity in children aged 10-1127.65 % 29.38 %

4 4

26.5 %


figure

Latest Herts.

figure

Change from

previous

Change from

baseline

Baseline

neighbours rank

Latest

neighbours rank

Change from

previous

Best/highest

neighbour

Rate of children looked after25.2 per 10,000 -

-

- -

- -

Latest district


% of looked after children considered 'of concern'

for emotional wellbeing

35.57 -

3 -

33.45


figure

Latest Herts.

figure

Change from

previous

Change from

baseline

Baseline

neighbours rank

Latest

neighbours rank

Change from

previous

Best/highest

neighbour

Family homelessness2.06 per 1000 2.11 per 1000

10 11

Child protection cases (new and repeat)794 -

Smoking at age 156.61 %

GCSE attainment for children looked after10.5 % -

-

People aged 16-25 who are physically inactive16.6 %

Hospital admissions due to substance misuse in

15-24 year olds

64.83 per

100,000

67.31 per

100,000

Children and young people who have been

bullied in the past two months (age 15)

55.6 % -

4 -

Q2 2017/18Click here for user guide

Hertfordshire Health & Wellbeing Strategy 2016-2020 – Developing Well indicators dashboard



worsening





Baseline district

variation

54.2 %

-

Baseline district

variation

-

8

46.1 per 100,000

-

-

10.5 %

Decrease / worsening in

ranking






Overarching goal: Good mental health and wellbeing for working age adults


5 3 1.2 - 5.4

2014/15 2015/16 /9 /11 Oxfordshire 3 3 3 4 Broxbourne

1 - 1 - -

- - - - -

2014/15 2015/16 /11 /11 Hertfordshire 3 - 3 - -

1 0 1 - St Albans

3 - 7 - 9.2

2013 - 15 - /11 - Hertfordshire 3 0 3 - Welwyn Hatfield

1 - 1 - -

- - - - -

Dec 2015 Aug 2016 /11 /11 Oxfordshire 3 - 3 - -

Overarching goal: Healthy lifestyles for working age adults

1 1 1 - Welwyn Hatfield

8 - 59.3 - 68.7

2013 - 15 - /11 - Oxfordshire 3 1 3 - Stevenage

1 0 1 0 Watford

10 10 11 - 45.9

2015 2016 /11 /11 Surrey 3 0 3 0 Three Rivers

1 0 1 - Stevenage

9 - 48.7 - 62.5

2015 - /11 - Buckinghamshire 3 1 3 - Hertsmere


7 8 438.5 - 613.8

2014/15 2015/16 /11 /11 Hampshire 3 0 3 1 Watford

1 - 1 - -

- - - - -

2014 - /11 - Cambridgeshire 3 - 3 - -

1 - 1 - -

- - - - -

2014 - /11 - Warwickshire 3 - 3 - -

1 - 1 - -

- - - - -

2014/15 2015/16 /11 /11 Surrey 3 - 3 - -

13.6 %

Participation in sport among adults50.99 % 49.91 %

54.32 %

10 -

4 6

Adults who are insufficiently physically active17.1 % -

Adults who are physically inactive24.4 % -

5 -

19.9 %

Proportion of the population meeting the

recommended '5-a-day’

55.3 % -

59.95 %

Alcohol-related hospital admissions

509.31 per

100,000

500.33 per

100,000

480.92 per

100,000

7 -

4 4

Change from

previous

Best/highest

neighbour

Smoking among adults in routine and manual

occupations

33.39 % 28.89 %

11 9

23.58 %

0.07 %

1 -

8 8

Baseline district

variation

Latest district


Overweight and obesity in adults62.83 % -

4 -

60.32 %


figure

Latest Herts.

figure

Change from

previous

Change from

baseline

Baseline

neighbours rank

Latest neighbours

rank

% of the working age population in long-term

unemployment

0.22 % 0.2 %

16.04 %

Suicide

6.57 per

100,000-

6.57 per 100,000

People with a self-reported high anxiety score21.28 % 16.04 %

11 1

Baseline district

variation

Latest district


Statutory homelessness2.49 per 1000 2.63 per 1000

7 9

1.2 per 1000


figure

Latest Herts.

figure

Change from

previous

Change from

baseline

Baseline

neighbours rank

Latest neighbours

rank

Change from

previous

Best/highest

neighbour

Click here for user guide

Q2 2017/18Hertfordshire Health & Wellbeing Strategy 2016-2020 – Living & Working Well indicators dashboard









worsening


ranking No change in ranking Decrease / worsening in

ranking




Overarching goal: Older people remaining physically active and independent

1 - 1 - -

- - - - -

2013/14 - /11 - Warwickshire 3 - 3 - -

1 - 1 - -

- - - - -

2014/15 2015/16 /11 /11 Surrey 3 - 3 - -

1 2 1 3 Broxbourne

6 5 1657.4 - 2708.2

2014/15 2015/16 /11 /11 Hampshire 3 2 3 2 Stevenage

1 0 1 0 Welwyn Hatfield

10 10 473.2 - 631.6

2014/15 2015/16 /11 /11 Hampshire 3 0 3 0 Stevenage

1 3 1 - Stevenage

4 - 20.2 - 22.7

2013 - 15 - /11 - Buckinghamshire 3 3 3 - Broxbourne

1 2 1 - Watford

7 - 17.8 - 20.2

2013 - 15 - /11 - Buckinghamshire 3 1 3 - St Albans

1 - 1 - -

- - - - -

2014 - /11 - Buckinghamshire 3 - 3 - -

1 - 1 - -

- - - - -

2014 - /11 - Cambridgeshire 3 - 3 - -

Overarching goal: Good support in older age and end of life

1 - 1 - -

- - - - -

2014/15 2015/16 /11 /11 Buckinghamshire 3 - 3 - -

1 0 1 - Broxbourne

10 - 17.6 - 50.5

Aug 2014 - Jul 2015 - /11 - Oxfordshire 3 0 3 - North Hertfordshire

1 0 1 0 Three Rivers

9 10 0.7 - 0.8

2014/15 2015/16 /11 /11 Surrey 3 1 3 0 East Hertfordshire

1 - 1 - -

- - - - -

2014/15 2015/16 /11 /11 Northamptonshire 3 - 3 - -

1 - 1 - -

- - - - -

2014/15 2015/16 /11 /11 Hampshire 3 - 3 - -

1 - 1 - -

- - - - -

2014/15 - /11 - Hertfordshire 3 - 3 - -

No data / no update

Decrease / worsening in

ranking



Not statistically significantly different




22.35 Years

46.8 %

0.77

23.54


worsening

Inter-district range

51.4 %

2429.69 per

100,000

Baseline district

variation

Latest district

variation

Best/highest

neighbour

-

7 8

8.7 per 100,000

21.62 Years -

7 -

4 2

Delayed transfers of care

12.9 per

100,000

15.8 per

100,000

Percentage of adult carers who have as much

social contact as they would like

46.8 % -

1 -

Health related quality of life for older people0.76 0.76

Adult social care users who have as much

social contact as they would like

40.1 % 46.2 %

11 7

Overall satisfaction of people who use services

with their care and support

63.4 % 63.3 %

67.6 %

7 7

6 8

-

11 -

Latest Herts.

figure

Change from

previous

Change from

baseline

Baseline

neighbours rank

Latest neighbours

rank

Change from

previous

3135.87 per

100,000 9 6

Excess winter deaths index34.55

Adults (65+) who are physically inactive42 % -

37.3 %

Adults (65+) who are insufficiently physically

active

15.8 % -

12.4 %

6 -

8 -


figure

Dementia emergency admissions (aged 65+)

3251.85 per

100,000

Life expectancy at 65 (Male)19.21 Years

7 -

19.8 Years

Injuries due to falls in people aged 65+

2212.94 per

100,000

2124.3 per

100,000

1952.72 per

100,000

Hip fractures in people aged 65+

560.93 per

100,000

538.37 per

100,000

489.65 per

100,000

8 4

Life expectancy at 65 (Female)

Baseline district

variation

Latest district


People aged 65+ offered reablement services

after discharge from hospital

2.19 % -

9 -

9.85 %


figure

Latest Herts.

figure

Change from

previous

Change from

baseline

Baseline

neighbours rank

Latest neighbours

rank

Change from

previous

Best/highest

neighbour


improvementNo statistically significant change

Statistically significant increase Statistically significant decrease

No change in rankingIncrease / improvement in

ranking

Q2 2017/18Click here for user guide

Hertfordshire Health & Wellbeing Strategy 2016-2020 – Ageing Well indicators dashboard




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