Canterbury & Coastal
Clinical Commissioning Group
Canterbury & Coastal Clinical Commissioning Group
Health & Demographic Profile
2014
Contributors;
Dr Faiza Khan Consultant in Public Health Kent County Council
Jack Baxter Public Health Information Officer Kent & Medway Public Health Observatory
Contents Links to other useful documents/ plans ...... 3 Summary of Findings ...... 4 Introduction ...... 5 Geography ...... 6 Demography ...... 10 Population Breakdowns ...... 10 Population Projections ...... 11 Population Distribution Maps- ONS 2013 Mid-year estimates ...... 13 Health Inequalities ...... 21 Indices of Multiple Deprivation (IMD) 2010 ...... 23 Children ...... 30 Life Expectancy from Birth ...... 30 Infant Mortality ...... 33 General Fertility Rate ...... 35 Low Birth Weight ...... 36 Breastfeeding ...... 37 Children’s Centres ...... 37 Child Wellbeing Index 2009 ...... 39 Immunisation & Vaccination ...... 41 National Child Measurement Programme (NCMP) ...... 45 Child and Adolescent Mental Health Services ...... 46 Sexual Health ...... 49 Older People ...... 51 Chronic Diseases ...... 52 Risk Factors for Chronic Diseases ...... 52 Smoking Prevalence ...... 52 Adult Obesity Prevalence ...... 53 Alcohol Misuse ...... 55 Local Alcohol Profiles for England ...... 56 Canterbury LAPE Profile (2012 Update) ...... 57 Chronic Disease Patterns ...... 59 King’s Fund 10 Priorities for Commissioners ...... 59 Long Term Conditions ...... 60 Cancer Registrations ...... 60 Quality Outcomes Framework (QOF) ...... 63 Diabetes ...... 64 Coronary Heart Disease ...... 68 Stroke or Transient Ischaemic Attacks ...... 72 Hypertension ...... 76 Chronic Obstructive Pulmonary Disorder (COPD) ...... 79 Mental Health ...... 83 Page | 2
Dementia ...... 83 Mental Illness Needs Index 2000 ...... 85 Falls ...... 90 Hospital Activity: A&E Attendances and Admissions ...... 96 Canterbury & Coastal CCG A&E Attendance Rates ...... 96 Emergency admission rates in Canterbury & Coastal CCG, 2012/13 ...... 110 Elective admission rates in Canterbury & Coastal CCG for older people, 2012/13 ...... 124 Outpatient attendance rates in Canterbury & Coastal CCG for older people, 2012/13 ...... 128
Links to other useful documents/ plans Healthy Lives, Healthy People: Our strategy for public health in England https://www.gov.uk/government/publications/healthy-lives-healthy-people-our-strategy-for-public- health-in-england Kent Joint Strategic Needs Assessment 13/14 Update http://www.kmpho.nhs.uk/jsna/ Kent Alcohol Strategy 2014-2016 http://www.kmpho.nhs.uk/EasysiteWeb/getresource.axd?AssetID=379439&type=full&servicetype=Att achment Canterbury City Council corporate plan 2011-2016 https://www.canterbury.gov.uk/media/924768/corporate-plan-2012.pdf Canterbury & Coastal CCG plans, reports and strategies http://www.canterburycoastalccg.nhs.uk/about-us/our-plans-reports-and-strategies/ NHS England five year forward view http://www.england.nhs.uk/wp-content/uploads/2014/10/5yfv-web.pdf Public Health England marketing strategy: 2014 to 2017 https://www.gov.uk/government/publications/public-health-england-marketing-strategy-2014-to-2017
Page | 3
Summary of Findings 1. The CCG area is made up of 34 electoral wards. 2. The CCG has 22 GP practices with 13 branch practices. 3. It has a total registered population of 111,269 females and 104,016 males as of 31/12/2014. 4. It has a higher proportion of registered patients aged 65+ and 85+ compared to the Kent average. 5. The most deprived areas are in Gorrell, Davington Priory, Heron, Wincheap, Barton, Greenhill & Eddington, Seasalter, Watling, Northgate, Westgate and Abbey wards. 6. Canterbury & Coastal CCG has no GP practices that serve patients in the 20%-40% most deprived areas nationally. 7. Canterbury CCG has the third highest life expectancy from birth of all Kent CCG’s at 81.9 years. 8. Canterbury CCG has the second highest infant mortality rate of all CCGs in Kent for 2011-2013. 9. Canterbury CCG has a slightly lower General Fertility Rate than Kent for the period 2009-2013. 10. The CCG has a lower percentage of low birth weight babies compared to Kent and England. 11. It has a 6-8 week breastfeeding prevalence of 45% with a coverage of 83.3% for 2013/14. 12. It has 10 Children’s Centres. 13. There are a number of practices failing to reach the minimum target of 90% immunisation for vaccinations in Canterbury CCG practices at quarter 2 in 2014/15. 14. Canterbury CCG has the third lowest admission rate in 2013/14 of all Kent CCGs for deliberate and unintentional injuries for 0-19 year olds. 15. There is a high prevalence of obesity for Year R & 6 children in Northgate and Little Stour wards. 16. Canterbury CCG has a lower teenage conception rate than Kent for the year 2012. 17. Canterbury CCG has the third highest life expectancy once you reach the age of 65 of all Kent CCGs at 20.3 years for the period 2009-2013. 18. Approximately 16% of adults in Canterbury district are obese compared to 21.2% in Kent and 23% in England (Active People Survey 2012). 19. Canterbury CCG has had a higher admission rate due to alcohol-specific admissions compared to Kent since 2007/08 for all ages, it has remained significantly higher since 2012/13. 20. Alcohol specific admission rates for the under 20’s have remained significantly higher than Kent in Canterbury CCG since 2007/08. 21. The cancer registration rate in Canterbury CCG is higher than Kent for the period 2008-2012. 22. The prevalence of diabetes in Canterbury CCG practices is 5.75%, compared to 5% in Kent. 23. Both elective and emergency admissions rates due to diabetes have increased year on year in Canterbury CCG and Kent since 2006/07. 24. There is a prevalence of 3.28% for Coronary Heart Disease in Canterbury CCG which is similar to England (3.29%) but higher than Kent (3.08%), there are potentially 2,972 patients undiagnosed. 25. Emergency admission rates for CHD have plateaued since 2010/11 and remain higher than elective admission rates for the condition in Canterbury CCG and Kent. 26. The prevalence of Stroke in Canterbury CCG is 1.87% compared to 1.7% for Kent and England, there are potentially 381 patients who could have the condition but are unaware. 27. Canterbury CCG’s emergency admission rate due to a Stroke has been erratic since 2006/07 and had a higher rate than Kent had in 2011/12 and 2013/14; the elective rates for the condition have also risen above Kent since 2008/09. 28. The prevalence of Hypertension in Canterbury CCG is 13.82% compared to 14.4% in Kent and 13.7% in England, there are potentially 24,613 patients who are unaware they have the condition. 29. Age-standardised admission rates for Hypertension have seen a year on year increase both electively and as an emergency in Kent and Canterbury CCG. 30. The prevalence of COPD in Canterbury CCG is 1.7% compared to 1.8% in Kent and England, there is a potential 1,863 patients who are unaware they have the condition in the CCG. 31. COPD admission rates have also seen a year on year increase in Canterbury CCG and Kent with the CCG remaining lower than Kent since 2006/07 for elective admissions but higher than Kent for emergency admissions. 32. Emergency admission rates due to dementia have remained above those of Kent in Canterbury CCG since 2006/07 apart from the year 2011/12. 33. Emergency admission rates as a result of a fall have remained lower than Kent in Canterbury CCG since 2007/08. Page | 4
Introduction
NHS Canterbury & Coastal CCG was created in 2012 and became fully operational on 1 April 2013. It has a total GP registered population of 202,389 as of 31/12/2014; whereas the total resident population equalled 202,389 in 2013 (ONS mid-year estimates)
The CCG’s vision is to work together with the patients and public to improve the health and wellbeing of the local communities to enable them to live long and healthy lives.
The CCG’s mission is to secure the highest quality, cost effective and compassionate care, as close to home for patients as possible.
The CCG’s values describe their commitment to patients:
Integrity
We can be trusted to champion the needs of our patients and be honest about the decisions we make.
Work as one
We know the best healthcare is delivered when we work together – clinicians, patients and public. We will work as one.
Listen
We will listen to our patients, be responsive and ensure their thoughts shape our decisions.
Quality and promise
We take pride in securing quality and value for money services.
Compassion
We hold our patients’ respect, privacy and dignity as our bedrock. We will strive to ensure all patients have the best experience of the NHS.
Page | 5
Geography Figure 1- Kent & Medway district authorities with CCG outlines.
There are eight Clinical Commissioning Groups in the Kent & Medway area and thirteen districts. Page | 6
Figure 2- Electoral Wards within Canterbury & Coastal CCG
There are 34 electoral wards that make up the Canterbury & Coastal CCG area; the CCG is comprised of Canterbury district, the eastern wards in Swale district and the north-westerly wards in Dover district.
Page | 7
Figure 3- Approximate location of GP Practices in Canterbury & Coastal CCG
There are 22 GP practices in the Canterbury CCG area with 13 branch practices. Geographically the practices are spread out evenly across the patch, even in more rural areas such as Chilham, Boughton, Ash and Bridge
Page | 8
Table 1- Key to Figure 3
*Letter suffix (e.g. 2a) denotes a Branch practice of a partnership group (see below). Key Practice Code Partnership Name Practice Name 1 G82004 FAVERSHAM H CENTRE A & Part The Faversham Health Centre (Cross Lane) 2 G82012 COSSINGTON HOUSE SURGERY AT Cossington House Surgery 3 G82027 Dr LOGAN LC & Partners Faversham Health Centre 4 G82029 Dr GARROD PJ & Partners The Coach House Surgery 5 G82039 NEWTON PLACE SURGERY A & Pa Newton Place Surgery 6 G82060 NORTHGATE MEDICAL PRACTICE Northgate Medical Practice 6a G82060 7 G82061 Dr JOHNSON LF & Partner Chartham Surgery 8 G82063 MARKET PLACE SURGERY A & Pa Market Place Surgery 8a G82063 9 G82071 9a G82071 Dr RIBCHESTER JM & Partners Whitstable Health Centre 9b G82071 10 G82082 Dr MOLONY JP & Partners Sturry Surgery 10a G82082 11 G82090 11a G82090 ST ANNES GROUP PRAC A & Par St Annes Group Practice 11b G82090 12 G82115 Dr JONES GL & Partners Dr Jones G L & Partners 13 G82119 Dr SIGURDSSON RG & Partners The Park Surgery 13a G82119 14 G82138 Dr SMITH A & Partners Ash Surgery 15 G82140 UNI MEDICAL CENTRE A & Part University Medical Centre 16 G82148 THE BUTCHERY SURGERY A & Pa The Butchery Surgery 17 G82179 BOUGHTON MEDICAL CTR A Boughton Medical Centre 18 G82204 Dr MANGI QM & Partner William Street Surgery 18a G82204 19 G82228 19a G82228 CANTERBURY MEDICAL PRACTICE Canterbury Medical Practice 19b G82228 20 G82726 Dr Shar M B & Partner Dr SHAR MB & Partner 20a G82726 Seasalter Surgery 21 G82790 Dr KINNERSLEY DS The Old School Surgery 21a G82790 22 G82802 Dr SIMMONDS R & Partner Canterbury Health Centre
Page | 9
Demography Population Breakdowns Figure 4-
The registered population for Canterbury & Coastal CCG at 31/12/2014 was 215,285 compared to a resident population of 202,389. The large difference between the two is likely to be due to the transient student population who are transferred to the local university practice population register whilst attending but may not be included in the resident population figures. This explains why there is a much larger percentage of 15-24 year olds compared to the Kent average in the CCG and causes the 0-14 and 30-59 age-groups to represent a Page | 10 slightly smaller proportion of the total CCG population. Population Projections Figure 5- Population projections - Males
The predicted trends for males aged 65+ and 85+ are what you’d expect as they’re showing a gradual increase in numbers over the next 24 years and a massive percentage increase of 71.5% and 210.5% respectively. This will require innovative service planning for the future in order to cope with the needs and demands of the ageing population; approximately one quarter of the Canterbury & Coastal CCG male population will be aged over 65 by 2037, the population of 16-64s (working age) will make up just over half (57.4%) of the total population in the CCG by 2037 compared to 63.4% in 2013. The 0-4 age group is set to reduce by 6.5% over this time whilst the 5-19s are set to increase by 6.7% in the same period however, as with the 16-64s their proportional representation of the total population will be decreasing while the 65+ age group is inflated as a result of the baby boom after the Second World War. Male Population Projection % of total population Age Predicted Difference from % Change 2013 2017 2021 2025 2029 2033 2037 Group 2013-2037 (thousands) from 2013 0-4 -0.35 -6.5% 5.4% 5.2% 5.0% 4.7% 4.5% 4.4% 4.3% 5-19 1.26 6.7% 19.1% 18.7% 18.7% 18.8% 18.4% 17.8% 17.2% 16-64 4.29 6.9% 63.4% 62.1% 60.7% 60.0% 59.1% 58.1% 57.4% 65+ 13.03 71.5% 18.6% 20.1% 21.4% 22.7% 24.3% 25.9% 27.0% 85+ 4.19 210.5% 2.0% 2.3% 2.7% 3.2% 3.8% 4.8% 5.3%
All of these projections are published by the Office for National Statistics and are available at: http://www.ons.gov.uk/ons/rel/snpp/sub-national-population-projections/2012-based-projections/rft- open-population-ccg.zip
Page | 11
Figure 6- Population projections - Females
The projected female population for Canterbury & Coastal CCG follows the same pattern as males with the exception of a couple of small differences; the 65+ population already overtook the number of 5-19 year olds five years ago whereas with males this happened in 2014. A similar overlap occurs between the 0-4s and 85+ in the year 2023 whereas males aren’t expected to do this until 2031. The large increase in the 65+ age group is likely to be the same across the whole of England due to the aforementioned baby boom after the Second World War (anyone born between 1945 and 1950 will all be 65 by the year 2015). This helps explain why the percentage increase and proportional representation of the total population are significantly higher in these age groups compared to the younger age bands, it is also connected to the fact people are living longer, healthier lives as well as fewer babies being born each year.
Female Population Projection % of total population Age Predicted Difference from % Change 2013 2017 2021 2025 2029 2033 2037 Group 2013-2037 (thousands) from 2013 0-4 -0.27 -5.5% 4.8% 4.8% 4.6% 4.4% 4.2% 4.1% 4.1% 5-19 1.25 6.9% 17.5% 17.5% 17.5% 17.7% 17.5% 17.0% 16.6% 16-64 -0.36 -0.6% 61.9% 60.4% 59.0% 58.0% 56.9% 55.6% 54.6% 65+ 13.13 57.6% 22.1% 23.5% 24.8% 26.1% 27.7% 29.6% 30.9% 85+ 4.65 116.8% 3.9% 4.1% 4.3% 4.8% 5.5% 6.8% 7.4%
Page | 12
Population Distribution Maps- ONS 2013 Mid-year estimates Figure 7- Population Distribution 0-4s
Top 5 highest wards Bottom 5 lowest wards 1 Barton (582) 30 Davington Priory (127) 2 Heron (578) 31 Harbledown (107) 3 Herne and Broomfield (552) 32 North Nailbourne (100) 4 Wincheap (497) 33 East Downs (96) 5 Westgate (481) 34 Blean Forest (92) Page | 13
Figure 8- Population Distribution 0-19s
Top 5 highest wards Bottom 5 lowest wards 1 Blean Forest (2914) 30 Harbledown (611) 2 Barton (2791) 31 North Nailbourne (611) 3 Westgate (2383) 32 Little Stour (599) 4 Herne and Broomfield (2162) 33 Barham Downs (598) 5 Heron (2005) 34 East Downs (597)
Page | 14
Figure 9- Population Distribution 16-64s
Top 5 highest wards Bottom 5 lowest wards 1 St Stephens (8546) 30 East Downs (1617) 2 Westgate (7646) 31 Sturry North (1605) 3 Barton (7591) 32 North Nailbourne (1536) 4 Wincheap (6481) 33 Harbledown (1521) 5 Blean Forest (5751) 34 Davington Priory (1508)
Page | 15
Figure 10- Population Distribution 65+
Top 5 highest wards Bottom 5 lowest wards 1 Reculver (2698) 30 Barham Downs (649) 2 Chestfield & Swalecliffe (2630) 31 East Downs (603) 3 Seasalter (2291) 32 Blean Forest (600) 4 Heron (2167) 33 Davington Priory (580) 5 Sandwich (1885) 34 Marshside (540)
Page | 16
Figure 11- Population Distribution 85+
Top 5 highest wards Bottom 5 lowest wards 1 Heron (502) 30 Sturry North (75) 2 Reculver (448) 31 Barham Downs (75) 3 Chestfield & Swalecliffe (400) 32 Blean Forest (72) 4 Seasalter (308) 33 Davington Priory (69) 5 Westgate (292) 34 East Downs (49)
Page | 17
Figure 12- Population Density
Top 5 highest wards Bottom 5 lowest wards 1 Heron (63.1) 30 Chartham and Stone Street (1.1) 2 Harbour (47.5) 31 Little Stour (0.9) 3 St Stephens (46.1) 32 Boughton and Courtenay (0.9) 4 Westgate (45.1) 33 Barham Downs (0.7) 5 St Ann's (45) 34 East Downs (0.4)
Page | 18
Figure 13- Proportion of CCG registered practice populations aged 65+ and 85+
Canterbury & Coastal CCG has a higher proportion of registered patients aged 65+ and 85+ compared to the Kent average. These proportions represent the percentage of patients that make up their total registered population. As you can see from the chart Canterbury & Coastal has the third highest proportion of 65+ and 85+ year olds out of all 7 of Kent’s CCGs. Page | 19
Figure 14- Ethnicity in Canterbury & Coastal CCG (Census Based)- Broad Ethnic Groups (excluding White)
The wards with the highest percentage of people of Asian ethnicity are Barton, Blean Forest, St Stephens, Northgate and Westgate. Those with the highest percentage of Black ethnicity are Blean Forest, Northgate, St Stephens and Westgate. Page | 20
Health Inequalities The Health and Social Care Act 2012 now places a new statutory duty on health services to reduce inequalities in health. Demonstrating this intention is also a requirement of CCGs for the purposes of authorisation by the NHS National Commissioning Board. Inequalities-in-health is primarily a socio-economic relationship. The poorer people are, the greater the likelihood of early onset disability, chronic disease and a shorter life span. In contrast, those who are of a higher status are expected to have a much greater disability-free life span and live a lot longer. People with low socio-economic status are at greater risk of behaviours causing ill health. They will have higher smoking rates, a poorer diet; have less opportunity to take part in social activities and poorer mental health. Whilst it is undeniable that individual behaviour is a significant driver of ill health, it is wrong to attribute all causes of premature poor health and early death to personal behaviour. If such behaviour was eliminated, people with the lowest socio-economic status would certainly live longer, but would continue to die prematurely relative to the mainstream society. Addressing health inequalities as a strategic response requires CCGs to commit to partnership working with other statutory agencies whose capacity to address the wider determinants of health is core to their purpose. Accordingly Canterbury & Coastal CCG must support the actions of Kents’ Public Health Team, working with local authorities to address the root causes of disadvantages in society, whether through the Kent Health Inequalities Strategy, through Canterbury & Coastal Borough Council’s Corporate Plan or through the work of Local Children’s Trusts. In addition the British Medical Association through the Presidency of Professor Sir Michael Marmot has identified a range of actions that doctors can implement directly.
Doctors can help by intervening with individual patients, their families and contacts, using clinical tools including social prescribing and brief interventions. They can work within communities, for example, by commissioning measures including health promotion and ill-health prevention that will affect changes to the social determinants and are effective in the whole community including those who are traditionally hard to reach; such as gypsy and traveller communities.
Doctors can use evidence and influence to have a positive impact on health inequalities. Doctors can use their position and their expertise to advocate for change to areas outside traditional medical areas and to promote the generation of research, especially on the efficacy of prevention measures.
Source: BMA Publications 2011
Page | 21
Figure 15- Outline of the HINST Intervention Model
National SupportTeam)
HINST(Health Inequalities
Bentley (2007) C SystematicallyAddressing InequalitiesHealth
Source: The direct actions that clinical services need to focus upon include:
A) Partnership, vision and strategy, leadership and engagement This requires ‘seamless’ partnership working between local authorities and CCGs. The CCG has a statutory duty to collaborate with social services. Public Health has a major leadership role but cannot deliver on its own. There is a need for a detailed strategy or action plan which shows how local inequality targets can be achieved. B) Systematic and scaled interventions by frontline services Primary care services will need to play a central role requiring organisational capacity to be addressed by some practices if they are to work more effectively on this agenda. There is a need for training systematically to ensure effective brief interventions, referral pathways, and performance monitoring which should at least cover smoking, alcohol problems and obesity. C) Systematic community engagement The CCG and local authorities should have joint systems for reaching vulnerable patients at highest risk who may be demotivated and not in meaningful contact with services. Such systems should be of sufficient scale to make a difference. A comprehensive engagement system is needed to interact not only with community groups but also with socially excluded individuals and families, e.g. through health trainers. D) Frontline service engagement with the community Many local areas have large portions of the population that are seldom seen, seldom heard. This can be addressed through the systematic use of practice registers and outreach staff to draw people in to services. Outreach strategies need to be targeted and scaled up appropriately in order to have impact across whole communities. The NHS workforce needs to be integrated effectively. The voluntary sector has great potential to bridge across from service into community provided that that sector is supported to develop its infrastructure to function at a strategic level.
Page | 22
Indices of Multiple Deprivation (IMD) 2010 Figure 16- Deprivation- IMD Score Overall
Summary of IMD
There is due to be an update to this in summer 2015.
The English Indices of Deprivation 2010 use 38 separate indicators, organised across seven distinct domains of deprivation which can be combined using appropriate weights, to calculate the Index of Multiple Deprivation 2010 (IMD 2010).
This is an overall measure of multiple deprivations experienced by people living in an area and is calculated for every Lower layer Super Output Area (LSOA) in England.
The IMD 2010 can be used to rank every LSOA in England according to their relative level of deprivation.
Source: https://www.gov.uk/government/uplo ads/system/uploads/attachment_dat a/file/6871/1871208.pdf
This analysis describes the distribution of residents of the Canterbury & Coastal CCG area by reference to their socio-economic status. The majority of the most deprived LSOAs are found in Heron ward in Herne Bay and in Canterbury in Northgate, Barton, Wincheap and Westgate as well as pockets of deprivation in Abbey, Chestfield & Swalecliffe (Swalecliffe), Barham Downs, Gorrell, Seasalter and Teynham and Lynsted wards. The least deprived LSOAs are found in Herne & Broomfield, Blean Forest, Sturry, Reculver, Seasalter and Chestfield and Swalecliffe (Chestfield). Page | 23
Figure 17- Income Deprivation
Income Deprivation Domain
This domain measures the proportion of the population in an area experiencing deprivation related to low income. A combined count of income deprived individuals per LSOA is calculated by summing the following five indicators; Adults and children who are; In income support families. In income-based jobseekers allowance families. In pension credit (Guarantee) families. In child tax-credit families whose collective income is below 60% of the median before housing costs. -And Asylum seekers in England in receipt of subsistence support, accommodation support or both.
The wards which are the most deprived in terms of their income are very similar to those highlighted for their overall IMD Score. Watling ward presents one LSOA in the least deprived and one in the most deprived as does Seasalter, which highlights the issue of health inequalities. The most deprived areas are found in the following wards; Gorrell, Davington Priory, Wincheap, Northgate and Seasalter wards. The least deprived areas are in Seasalter, Chestfield and Swalecliffe, North Nailbourne, Westgate and Blean Forest wards.
Page | 24
Figure 18- Employment Domain
Employment Domain
This domain measures employment deprivation in an area conceptualised as involuntary exclusion of the working age population from the labour market.
A combined count of employment deprived individuals per LSOA is calculate d by summing seven indicators.
Please follow the link on page 23 for a more detailed insight into how this is calculated.
The most deprived areas based on the employment domain are very similar to the overall IMD score. The most deprived areas are in Heron, Davington Priory, Gorrell, Greenhill and Eddington, Seasalter and Wincheap wards. The least deprived areas are located in North Nailbourne, St Stephens, Chestfield and Swalecliffe, Westgate and Blean Forest wards.
Page | 25
Figure 19- IDACI
Income Deprivation Affecting
Children Index
In addition to the income deprivation index (Figure 17) there are two supplementary indices also produced;
Income Deprivation Affecting Children Index Income Deprivation Affecting Older People Index.
The IDACI represents the proportion of children aged 0-15 living in income deprived households .
The picture for IDACI highlights all the usual suspects for the most deprived areas but presents a slightly different outlay for the least deprived areas which includes Tankerton, Barham Downs, Barton, Harbledown and Westgate wards.
Page | 26
Figure 20- IDAOPI
Income Deprivation Affecting Older People Index
The IDAOPI represents the proportion of older people aged 60 and over living in income deprived households respectively.
For a more in depth definition of any of these indicators please follow the link below.
Source: https://www.gov.uk/governmen t/uploads/system/uploads/attac hment_data/file/6871/1871208. pdf
The prime measure here is the extent to which there are sufficient concentrations of older people whose primary dependency is upon state pensions alone. The lack of income in later years is a useful proxy for identifying people at greater risk of early onset chronic disease. St Anns and Wincheap contain LSOAs in the least and most deprived quintiles which presents priority areas regarding health inequalities. The most deprived areas lie within Gorrell, Barton, Heron, Northgate and Davington Priory. The least deprived areas are found in Chestfield and Swalecliffe (Chestfield), Seasalter, St Stephens, North Nailbourne and Blean Forest. Page | 27
Figure 21- Living Environment
Living Environment Deprivation Domain This domain measures the quality of individuals’ immediate surroundings both within and outside the home. The indicators fall into two sub-domains: the ‘indoors’ living environment, which measures the quality of housing, and the ‘outdoors’ living environment which contains two measures relating to air quality and road traffic accidents.
Four indicators are combined to calculate this domain:
Sub-domain: The indoors living environment
Social and private housing in poor
condition
Houses without central heating.
Sub -domain: The outdoors living environment Air quality Road traffic accidents.
Source: https://www.gov.uk/government/uploads/s ystem/uploads/attachment_data/file/6871/ 1871208.pdf
This IMD indicator highlights many of the rural larger LSOAs in the 20% most deprived areas compared to the other indicators with the most deprived areas being found in Heron and Harbour wards as well as Boughton and Chartenay, Abbey, Northgate and Eastry. The least deprived areas are situated in Seasalter, Davington Priory, Reculver, Chestfield & Swalecliffe and St Anns wards.
Page | 28
Living Environment Domain
This domain from the Index of Multiple Deprivation measures the physical and financial accessibility of housing and key local services. The indicators fall into two sub-domains: ‘geographical barriers’ which relate to the physical proximity of local services and ‘wider barriers’ which include issues relating to access to housing such as affordability. Seven indicators are combined to calculate this domain.
Wider barriers: • Household overcrowding – the proportion of households within an LSOA which are judged to have insufficient space to meet the household’s needs; • Homelessness – the rate of acceptances for housing assistance under the homelessness provisions of the 1996 Housing Act (at local authority district level); • Difficulty of access to owner-occupation (local authority district level) – proportion of households aged under 35 whose income means they are unable to afford to enter owner occupation.
Geographical barriers: • Road distance to a GP surgery; • Road distance to a supermarket or convenience store; • Road distance to a primary school’ • Road distance to a post office.
What therefore is being measured is the extent of spatial and service isolation and thus factors which may have some dilatory influence on positive mental health. This analysis offers a perspective that is counter to many of the other cartographic descriptions of deprivation but not all. Housing issues such as overcrowding and homelessness are both still found in all of the major centres of populations. On the other hand, the distance from location of basic services and amenities is also reflected in the extensive rural parts of the Canterbury & Coastal CCG area
Table 2- Practice Deprivation by IMD 2010 20% Most 40% Most Between 40% Most Deprived 40% Least 20% Least CCG Deprived Deprived & 40% Least Deprived Deprived Deprived NHS Ashford CCG 1 9 4 NHS Canterbury & Coastal CCG 10 11 1 NHS Dartford, Gravesham & Swanley CCG 3 12 12 7 NHS South Kent Coast CCG 1 11 10 9 NHS Swale CCG 4 3 8 5 NHS Thanet CCG 4 7 5 4 NHS West Kent CCG 1 3 27 31 Kent 9 25 49 77 43 Source: IMD 2010 by GP Practice Canterbury & Coastal CCG has no practices who serve patients that live in the 40% most deprived areas in England. It has 1 practice where the majority of its patients live in the 20% least deprived areas and 11 practices where the majority of patients live in the 40% least deprived areas for the whole of England.
The GP Practice IMD is estimated by taking a weighted average of the IMD scores for each LSOA in which a given practice has patients registered. The weights are the % of the practice's registrations in each LSOA.
The GP Practice IMD scores are provided by the Public Health Observatories on behalf of the Department of Health
Page | 29
Children Life Expectancy from Birth Figure 22- Life Expectancy from birth by CCG in Kent
The Canterbury & Coastal CCG area has a life expectancy of 81.9 years making it higher than the Kent & England averages; Kent (81.5) England (81.1). However it should be noted that the England value is for the period 2010-2012 and is the midpoint of the male and female life expectancy as data for both sexes is not produced, unfortunately 5-year data for LE also isn’t produced nationally so a three year average is the best available as a comparator. The highest life expectancy from birth is in Blean Forest ward at 85.6 years, there are 23 wards in Canterbury & Coastal CCG with a significantly higher life expectancy compared to Kent and 6 wards are significantly worse than the England average. The ward with the lowest life expectancy is Heron at 78.1 years; 3.4 years lower than the Kent average.
Page | 30
Figure 23- Life expectancy from birth by Ward in Canterbury & Coastal CCG, 2009-2013
Page | 31
Figure 23.1- Map of Life expectancy from birth by Ward in Canterbury & Coastal CCG, 2009-2013
Page | 32
Infant Mortality Figure 24- Infant Mortality Trend 2006-2013
The infant mortality trend for Canterbury & Coastal CCG fell from 6.6 to 2.2 per 1,000 live births between 2008 and 2011 however 2012 saw it rise higher than the England rate only to come back down to 2.8 per 1,000 live births in 2013; equal to the Kent average. Page | 33
Figure 25- Infant Mortality rate by CCG, 2011-2013
Canterbury & Coastal CCG had the second highest infant mortality rate of all the CCGs in Kent for the period 2011-2013 with 3.4 per 1,000 live births, this is higher than the rate for Kent (3) but lower than the 2013 value for England (4). Page | 34
General Fertility Rate Figure 26- GFR 2009-2013 by Electoral Ward
The general fertility rate for Canterbury & Coastal CCG is marginally lower than the Kent rate. The wards with the highest fertility rates are East Downs, Heron, St Ann’s, Marshside and Harbour wards; which all have a higher rate than Kent overall. The wards with the lowest rates are North Nailbourne, Westgate, Northgate, St Stephens and Blean Forest. Figure 27- GFR 2009-2013 Map
Page | 35
Low Birth Weight Figure 28- Percentage of low birth weight (<2500g) babies born by electoral ward 2011-2013.
The Canterbury & Coastal area overall has a lower percentage of babies born weighing less than 2500grams compared to Kent and England, however the following wards present higher figures than the national and county comparators; Davington Priory, Tankerton, Marshside, Sturry North and Herne and Broomfield wards. Figure 29- LBW Babies Born 2011-2013 Map
Page | 36
Breastfeeding Table 3- 6-8 Week breast feeding status 2013/14 Number of Number of Number of Number of Infants Number of Prevalence Coverage Clinical Commissioning Groups Breastfed Part Breastfed Infants Not where status is Maternities % % Infants Infants Breastfed unknown Ashford 1,447 371 161 561 354 36.8% 75.5% Canterbury & Coastal 1,870 611 230 717 312 45.0% 83.3% Dartford, Gravesham & Swanley 3,321 763 459 1,531 568 36.8% 82.9% South Kent Coast 2,079 481 220 882 496 33.7% 76.1% Swale 1,444 255 115 648 426 25.6% 70.5% Thanet 1,617 296 135 712 474 26.7% 70.7% West Kent 5,333 1,867 676 1,938 852 47.7% 84.0% Kent 17,111 4,644 1,996 6,989 3,482 38.8% 79.7% Source: Child Health Computer Table three shows the breastfeeding prevalence and coverage for all CCGs in Kent for the 2013/14 financial year. Canterbury & Coastal CCG had a breastfeeding prevalence of 45% and a coverage of 83.3% which denotes the percentage of the population where the breastfeeding status is known, there were 312 cases in the CCG where there had not been a 6-8 week check recorded for new- borns. Canterbury & Coastal performed better than Kent overall for 2013/14 with Kent recording a prevalence of 38.8% and a coverage of 79.7% for the year. Children’s Centres The monitoring of child health is in accordance with the national Healthy Child programme. This programme is conceived in two parts: birth to age five and five to 19. There is internationally-based evidence to show that over the life course, a person’s health is fundamentally influenced by influences in the first few months of life and a child’s early years (0-3). The delivery of this programme falls significantly to the role of the health visitor working in conjunction with a range of providers of children’s services. In recent years there has been a transformation of early year’s provision through the establishment of children’s centres with a view that primary childcare is not something which should be medicalised. The current policy of the Government is to re-build the profession of health visitors and expand their numbers. Locally the importance of health visitors has been consistently recognised and in the short term the delivery of the health visitor programme will fall to the NHS Commissioning Board and, at the completion of the programme (2015) the commissioning of these services will be transferred to local authorities re-confirming a historic position (pre-1974). Health visitor practise is seen to be crucial in the context of the role of children’s centres and thus health visitors will primarily be based in such centres. It is essential that there is effective liaison between health visitors, children’s centres and primary care teams and therefore a requirement that each practice has a named health visitor.
Page | 37
Figure 30- Approximate location of children’s’ centres
Key Children's Centre Name 1 Little Hands Children's Centre (Wincheap) 2 Riverside Children's Centre (Canterbury) 3 The Tina Rintoul Centre 4 Apple Tree Children's Centre 5 Swalecliffe Children's Centre 6 Joy Lane Children's Centre 7 Poppy Children's Centre (Parkside) 8 Briary Children's Centre 9 Bysing Wood Children's Centre 10 St Mary of Charity Children's Centre Page | 38
Child Wellbeing Index 2009 Figure 31- Health & Disability Score This is a mapped overall summary of children’s health drawn from a specific field of children’s indicators of wellbeing based on a variant of the Index of Multiple Deprivation as published in 2007. It covers for this purpose:
• All emergency admissions to hospital for children aged 0-18 as a proportion of all children aged 0-18 in each LSOA. (Source: Hospital Episode
Statistics for England, 2005/6); • All outpatient hospital attendances for children aged 0-18 as a proportion of all children aged 0-18 in each LSOA. (Source: Hospital Episode Statistics for England, 2005/6); • The proportion of children aged 0-16 receiving Disabled Living Allowance. (Source: DWP, 2005).
Particular attention should be drawn to a greater proportion of children with poor health and disability found in the Wincheap, St Stephens, Westgate, Barton, St Ann’s and Greenhill and Eddington wards. Page | 39
Figure 32- Material Well-being Score – Child well-being Index 2009 This map describes material wellbeing for children as analysed by a variant of the Index of Multiple Deprivation 2007.
Particular note should be taken of the three northern LSOAs in Barton ward as this area contains LSOAs in both the best and worst quintile for the Material Well-being score and highlights the health inequalities in the area, this is also apparent in Davington Priory, Watling and St Ann’s wards. Other areas in the worst quintile are Wincheap, Gorrell, Northgate and Greenhill and Eddington wards. Children born into poverty are more likely to:
• Die in the first year of life; • Be born small, or born early, or both; • Be bottle fed; • Die from an accident in childhood; • Smoke and/ or have a parent who smokes; • Have poor nutrition; • Become a lone parent; • Have or father children younger; • Suffer from mental health problems; • Die in an accident; • Die younger.
Page | 40
Key WHO Targets Immunisation & Vaccination > 95% Figure 33- 2014/2015 Quarter 2 Practice level vaccinations to 1st birthday 90% - 95% < 90%
GP # children reaching Up to 1st Birthday Practice Practice Name 1st birthday during DTaP/IPV/Hib MenC PCV Code Quarter 2 # Vaccinated % Uptake # Vaccinated % Uptake # Vaccinated % Uptake G82004 The Faversham Health Centre (Cross Lane) 6 6 100.0% 6 100.0% 6 100.0% G82012 Cossington House Surgery 15 14 93.3% 15 100.0% 14 93.3% G82027 Faversham Health Centre 20 19 95.0% 20 100.0% 19 95.0% G82029 The Coach House Surgery 3 3 100.0% 3 100.0% 3 100.0% G82039 Newton Place Surgery 44 40 90.9% 41 93.2% 41 93.2% G82060 Northgate Medical Practice 51 49 96.1% 50 98.0% 49 96.1% G82061 Chartham Surgery 12 12 100.0% 12 100.0% 12 100.0% G82063 Market Place Surgery 12 12 100.0% 12 100.0% 12 100.0% G82071 Whitstable Health Centre 89 84 94.4% 86 96.6% 84 94.4% G82082 Sturry Surgery 38 34 89.5% 36 94.7% 34 89.5% G82090 St Annes Group Practice 36 32 88.9% 34 94.4% 32 88.9% G82115 Dr Jones G L & Partners 22 20 90.9% 21 95.5% 20 90.9% G82119 The Park Surgery 51 25 49.0% 39 76.5% 26 51.0% G82138 Ash Surgery 12 10 83.3% 10 83.3% 10 83.3% G82140 University Medical Centre 7 7 100.0% 7 100.0% 7 100.0% G82148 The Butchery Surgery 4 4 100.0% 4 100.0% 4 100.0% G82179 Boughton Medical Centre 4 1 25.0% 1 25.0% 1 25.0% G82204 William Street Surgery 7 6 85.7% 7 100.0% 6 85.7% G82228 Canterbury Medical Practice 27 25 92.6% 25 92.6% 25 92.6% G82726 Dr Shar M B & Partner 5 5 100.0% 5 100.0% 5 100.0% G82790 The Old School Surgery 15 15 100.0% 15 100.0% 15 100.0% G82802 Canterbury Health Centre 21 21 100.0% 21 100.0% 21 100.0% Canterbury & Coastal CCG 501 444 88.6% 470 93.8% 446 89.0% Kent 4394 3870 88.1% 4114 93.6% 3914 89.1%
Page | 41
Key WHO Targets
> 95% nd Figure 34- 2014/2015 Quarter 2 Practice level vaccinations to 2 birthday 90% - 95% < 90%
GP # children reaching Up to 2nd Birthday Primaries Up to 2nd Birthday Boosters Practice Practice Name 2nd birthday during DTaP/IPV/Hib MMR MenC Infant Hib/MenC PCV Code Quarter 2 # Vaccinated % Uptake # Vaccinated % Uptake # Vaccinated % Uptake # Vaccinated % Uptake # Vaccinated % Uptake G82004 The Faversham Health Centre (Cross Lane) 20 20 100.0% 18 90.0% 20 100.0% 18 90.0% 18 90.0% G82012 Cossington House Surgery 15 13 86.7% 14 93.3% 12 80.0% 14 93.3% 15 100.0% G82027 Faversham Health Centre 24 23 95.8% 22 91.7% 23 95.8% 23 95.8% 21 87.5% G82029 The Coach House Surgery 14 13 92.9% 13 92.9% 14 100.0% 13 92.9% 13 92.9% G82039 Newton Place Surgery 43 41 95.3% 41 95.3% 40 93.0% 41 95.3% 41 95.3% G82060 Northgate Medical Practice 36 35 97.2% 34 94.4% 34 94.4% 34 94.4% 34 94.4% G82061 Chartham Surgery 3 3 100.0% 3 100.0% 3 100.0% 3 100.0% 3 100.0% G82063 Market Place Surgery 21 18 85.7% 17 81.0% 18 85.7% 18 85.7% 18 85.7% G82071 Whitstable Health Centre 81 77 95.1% 72 88.9% 74 91.4% 71 87.7% 69 85.2% G82082 Sturry Surgery 36 34 94.4% 31 86.1% 34 94.4% 31 86.1% 31 86.1% G82090 St Annes Group Practice 34 33 97.1% 31 91.2% 31 91.2% 31 91.2% 31 91.2% G82115 Dr Jones G L & Partners 27 27 100.0% 25 92.6% 27 100.0% 27 100.0% 25 92.6% G82119 The Park Surgery 41 35 85.4% 36 87.8% 32 78.0% 36 87.8% 32 78.0% G82138 Ash Surgery 8 7 87.5% 6 75.0% 7 87.5% 5 62.5% 5 62.5% G82140 University Medical Centre 6 6 100.0% 6 100.0% 6 100.0% 6 100.0% 6 100.0% G82148 The Butchery Surgery 12 12 100.0% 11 91.7% 12 100.0% 11 91.7% 11 91.7% G82179 Boughton Medical Centre 2 2 100.0% 0 0.0% 2 100.0% 0 0.0% 0 0.0% G82204 William Street Surgery 9 9 100.0% 9 100.0% 9 100.0% 9 100.0% 8 88.9% G82228 Canterbury Medical Practice 24 24 100.0% 23 95.8% 22 91.7% 23 95.8% 23 95.8% G82726 Dr Shar M B & Partner 6 6 100.0% 6 100.0% 6 100.0% 6 100.0% 6 100.0% G82790 The Old School Surgery 6 6 100.0% 6 100.0% 6 100.0% 6 100.0% 6 100.0% G82802 Canterbury Health Centre 13 11 84.6% 11 84.6% 9 69.2% 11 84.6% 11 84.6% Canterbury & Coastal CCG 481 455 94.6% 435 90.4% 441 91.7% 437 90.9% 427 88.8% Kent 4625 4323 93.5% 4069 88.0% 4291 92.8% 4094 88.5% 3891 84.1% Source: Child Health Computer
Page | 42
Figure 35- 2014/2015 Quarter 2 - Practice level vaccinations to 5th birthday GP # children reaching Up to 5th Birthday Primaries Practice Practice Name 5th birthday during DT/Pol MMR Hib MenC Pertussis PCV Code Quarter 2 # Vaccinated % Uptake # Vaccinated % Uptake # Vaccinated % Uptake # Vaccinated % Uptake # Vaccinated % Uptake # Vaccinated % Uptake G82004 The Faversham Health Centre (Cross Lane) 13 13 100.0% 13 100.0% 13 100.0% 12 92.3% 13 100.0% 13 100.0% G82012 Cossington House Surgery 9 7 77.8% 6 66.7% 7 77.8% 6 66.7% 7 77.8% 6 66.7% G82027 Faversham Health Centre 25 23 92.0% 23 92.0% 23 92.0% 23 92.0% 23 92.0% 22 88.0% G82029 The Coach House Surgery 20 20 100.0% 20 100.0% 20 100.0% 20 100.0% 20 100.0% 20 100.0% G82039 Newton Place Surgery 43 41 95.3% 41 95.3% 41 95.3% 41 95.3% 41 95.3% 41 95.3% G82060 Northgate Medical Practice 49 49 100.0% 49 100.0% 49 100.0% 49 100.0% 49 100.0% 48 98.0% G82061 Chartham Surgery 17 16 94.1% 16 94.1% 16 94.1% 15 88.2% 16 94.1% 15 88.2% G82063 Market Place Surgery 20 19 95.0% 19 95.0% 19 95.0% 19 95.0% 19 95.0% 19 95.0% G82071 Whitstable Health Centre 82 77 93.9% 76 92.7% 77 93.9% 76 92.7% 77 93.9% 76 92.7% G82082 Sturry Surgery 40 37 92.5% 37 92.5% 37 92.5% 37 92.5% 37 92.5% 37 92.5% G82090 St Annes Group Practice 46 44 95.7% 43 93.5% 44 95.7% 44 95.7% 44 95.7% 44 95.7% G82115 Dr Jones G L & Partners 24 21 87.5% 20 83.3% 21 87.5% 21 87.5% 21 87.5% 21 87.5% G82119 The Park Surgery 58 56 96.6% 53 91.4% 56 96.6% 56 96.6% 56 96.6% 56 96.6% G82138 Ash Surgery 8 8 100.0% 8 100.0% 8 100.0% 8 100.0% 8 100.0% 8 100.0% G82140 University Medical Centre 12 12 100.0% 12 100.0% 12 100.0% 10 83.3% 12 100.0% 11 91.7% G82148 The Butchery Surgery 13 13 100.0% 13 100.0% 13 100.0% 13 100.0% 13 100.0% 13 100.0% G82179 Boughton Medical Centre 3 3 100.0% 3 100.0% 3 100.0% 3 100.0% 3 100.0% 3 100.0% G82204 William Street Surgery 17 15 88.2% 15 88.2% 15 88.2% 16 94.1% 15 88.2% 15 88.2% G82228 Canterbury Medical Practice 43 41 95.3% 41 95.3% 41 95.3% 40 93.0% 41 95.3% 40 93.0% G82726 Dr Shar M B & Partner 4 4 100.0% 4 100.0% 4 100.0% 4 100.0% 4 100.0% 4 100.0% G82790 The Old School Surgery 19 18 94.7% 17 89.5% 18 94.7% 17 89.5% 18 94.7% 18 94.7% G82802 Canterbury Health Centre 20 19 95.0% 19 95.0% 19 95.0% 18 90.0% 19 95.0% 19 95.0% Canterbury & Coastal CCG 585 556 95.0% 548 93.7% 556 95.0% 548 93.7% 556 95.0% 549 93.8% Kent 4752 4526 95.2% 4464 93.9% 4529 95.3% 4442 93.5% 4529 95.3% 4463 93.9%
GP # children reaching Up to 5th Birthday Boosters Practice Practice Name 5th birthday during DTaP/IPV Hib/MenC MMR PCV Code Quarter 2 # Vaccinated % Uptake # Vaccinated % Uptake # Vaccinated % Uptake # Vaccinated % Uptake G82004 The Faversham Health Centre (Cross Lane) 13 9 69.2% 13 100.0% 9 69.2% 12 92.3% G82012 Cossington House Surgery 9 5 55.6% 5 55.6% 5 55.6% 6 66.7% G82027 Faversham Health Centre 25 23 92.0% 23 92.0% 23 92.0% 22 88.0% G82029 The Coach House Surgery 20 17 85.0% 20 100.0% 17 85.0% 20 100.0% G82039 Newton Place Surgery 43 31 72.1% 41 95.3% 31 72.1% 41 95.3% G82060 Northgate Medical Practice 49 47 95.9% 48 98.0% 47 95.9% 47 95.9% G82061 Chartham Surgery 17 15 88.2% 16 94.1% 14 82.4% 16 94.1% Key WHO Targets G82063 Market Place Surgery 20 17 85.0% 17 85.0% 18 90.0% 16 80.0% > 95% G82071 Whitstable Health Centre 82 76 92.7% 77 93.9% 75 91.5% 73 89.0% G82082 Sturry Surgery 40 32 80.0% 37 92.5% 32 80.0% 34 85.0% 90% - 95% G82090 St Annes Group Practice 46 41 89.1% 43 93.5% 40 87.0% 43 93.5% G82115 Dr Jones G L & Partners 24 18 75.0% 21 87.5% 17 70.8% 19 79.2% < 90% G82119 The Park Surgery 58 48 82.8% 55 94.8% 46 79.3% 55 94.8% G82138 Ash Surgery 8 7 87.5% 8 100.0% 7 87.5% 8 100.0% G82140 University Medical Centre 12 12 100.0% 12 100.0% 12 100.0% 12 100.0% G82148 The Butchery Surgery 13 13 100.0% 13 100.0% 13 100.0% 13 100.0% G82179 Boughton Medical Centre 3 0 0.0% 3 100.0% 0 0.0% 3 100.0% G82204 William Street Surgery 17 14 82.4% 16 94.1% 15 88.2% 13 76.5% G82228 Canterbury Medical Practice 43 35 81.4% 39 90.7% 35 81.4% 40 93.0% G82726 Dr Shar M B & Partner 4 4 100.0% 4 100.0% 4 100.0% 3 75.0% G82790 The Old School Surgery 19 17 89.5% 17 89.5% 16 84.2% 17 89.5% Source: Child Health Computer G82802 Canterbury Health Centre 20 15 75.0% 18 90.0% 14 70.0% 19 95.0% Canterbury & Coastal CCG 585 496 84.8% 546 93.3% 490 83.8% 532 90.9% Kent 4752 3958 83.3% 4372 92.0% 3910 82.3% 4241 89.2% Page | 43
National Childhood Immunisation Programme The national Childhood Immunisation programme is an essential part of protecting children’s health. Low vaccine up-take puts children at risk. The right to be offered immunisation is enshrined in the NHS Constitution. A national support team reviewed lower than acceptable levels of immunisation in east Kent in 2010 and made 29 detailed recommendations. The strategic aim is: • To achieve herd immunity (95 %+) in the population through increased uptake of immunisation; • To ensure immunisation services are equitable and accessible; • To provide a high quality standardised immunisation service; • To ensure the implementation of NICE guidance relating to immunisation. Overall Canterbury & Coastal CCG practices perform very similarly to the Kent average across all three ages, there are several GP practices which are failing to meet the 90% target rate set by WHO (World Health Organisation) which have been identified using the RAG rating (any practice failing to reach a 90% uptake in vaccinations will appear with a red background). The worst uptake rates are recorded for the 2nd birthday boosters and 5th birthday boosters with Canterbury & Coastal CCG failing to meet the recommended target of 95% immunisation for their population. This highlights the need to keep a focus on the implementation of effective immunisation after the child’s second birthday to help achieve optimal rates. Figure 36- Age-standardised admission rates for deliberate and unintentional injury for 0-19s
Canterbury & Coastal CCG has shown a steady downward trend since 2006/07 for hospital admissions due to deliberate self-harm and unintentional injuries and has always remained lower than the rate for Kent despite the visibly sharp rise that occurred in 2013/14. Useful tip: if the orange error bars do not overlap then statistically they are significantly different, for example the 2013/14 Kent value is significantly lower than the 2006/07 Kent value.
Page | 44
National Child Measurement Programme (NCMP) Figure 36.5- NCMP Reception Year Obesity Prevalence 2012/13
Figure 36.51- NCMP Year 6 Obesity Prevalence 2012/13
The areas in Canterbury & Coastal CCG with the highest obesity prevalence are mainly in the central Canterbury wards for year R and 6 children. There is a noticeable relationship between deprivation and high levels of obesity prevalence in England with prevalence in the most deprived 10% of the population being approximately twice that of the least deprived 10% (HSCIC, NCMP). Little Stour and Northgate wards have high obesity prevalence in both year groups.
Page | 45
Child and Adolescent Mental Health Services Figure 37- Age-specific 0-18s CAMHS contact rates 2010/11 Data.
Overall Canterbury & Coastal CCG had a contact rate of 22.4 per 1,000 for children and young people in contact with mental health services in 2010/11. The wards with the highest rates are Northgate, Davington Priory and Eastry.
The development of CAMHS began in 1995 when two key documents; ‘A Handbook on Child and Adolescent Mental Health’ and ‘Together We Stand’ laid the foundations for a four-tiered framework for the planning, commissioning and delivery of child and adolescents mental health services.
For more information please visit: (http://www.youngminds.org.uk/training_services/policy/policy_in_the_uk/camhs_policy_in_england)
The government published a mental health strategy in February 2011- ‘No Health Without Mental Health: a Cross-Government Outcomes Strategy for People of All Ages’
This strategy aims to improve mental health in all ages, and people from all backgrounds. It has six objectives:
1. More people will have good mental health 2. More people with mental health problems will recover 3. More people with mental health problems will have good physical health 4. More people will have a positive experience of care and support 5. Fewer people will suffer avoidable harm 6. Fewer people will experience stigma and discrimination
Page | 46
Figure 38- Teenage conception rate (<18), 2010-2012
Figure 39- Graph of teenage conception rates by ward 2010-2012
For the period 2010 – 2012 (pooled data) the Canterbury & Coastal CCG area had 14 wards with a higher teenage conception rate than England and Kent (data for 2012). To protect confidentiality all counts and rates based on fewer than 5 occurrences have been suppressed, as a result of this we Page | 47 are unable to calculate a CCG specific rate as we don’t know the number of conceptions in 10 of the wards so we have used the Canterbury district rate as a comparator instead. The areas with the highest rate of teenage conceptions in Canterbury & Coastal CCG were Heron, West Bay, Teynham and Lynsted, Harbour and St Ann’s wards; all of which (except Harbour ward) contain an LSOA in the 20% most deprived quintile for the area based on the IMD 2010. Figure 40- Teenage conception rates in Kent local authorities 2010 - 2012
The Canterbury district area has seen a welcome reduction in the rates of teenage pregnancy since the national programme commenced in1998. The national programme finished in 2011 but the Kent strategy is to reduce the rate of teenage conceptions in all districts to fewer than 40 per 1,000 young women under the age of 19 by 2015. Current figures provided by ONS displayed in the above chart show that most local authorities had already achieved this by 2010 with Shepway achieving this in 2011 and Thanet in 2012.
Successful reductions in teenage pregnancy rates are the result of a strategy that combines the availability of sexual health services with working on the wider determinants of good health – largely a partnership issue. Fundamentally the phenomenon of teenage pregnancy is a product of poor aspiration and self-regard amongst young people. The sustained downward trends in rates cannot be presumed to continue as the current national economic situation makes this a very difficult time for young people.
Page | 48
Sexual Health The following charts have been created using data from the Sexual and Reproductive Health Profile data on the Public Health England website (http://fingertips.phe.org.uk/). Figure 41- Diagnosed HIV rate among persons aged 15 to 59 years by district, 2013
Figure 42- % of HIV diagnoses with CD4 count below 350mm³, 2011-2013
Page | 49
Figure 43- Rate of diagnosed chlamydia for 15-24s, 2013
Canterbury & Coastal had the forth-lowest rate of diagnosed HIV of all the districts in Kent at 0.93 per 1,000 15-59 year old, this rate is significantly lower than the rate for Kent, England and the South East. Canterbury & Coastal had a slightly higher percentage of late HIV diagnoses compared to Kent, England and the South East; this is calculated by looking at the number of CD4 cells counted within 91 days of the diagnosis. CD4 cells are a type of white blood cell that help protect your body from illness, by measuring the count of these cells doctors are able to identify what stage the HIV infection has reached and whether or not the patient should have been identified earlier. The only district in Kent with a significantly lower percentage of late diagnoses compared to England, the South East and Kent is Dover district, which indicates there is good management of the disease in that area. Canterbury & Coastal district had significantly lower rates of diagnosed chlamydia in all settings compared to Kent, England and the South East with a rate of 1,199 per 100,000 people compared to 1,563 for Kent.
Here is a list of other sexual health indicators which are also available at district level from (http://fingertips.phe.org.uk/):
Rate of syphilis diagnoses per 100,000 population Rate of gonorrhoea diagnoses per 100,000 population Proportion of population aged 15 to 24 screened for chlamydia, measured separately in GUM and non-GUM settings (PHOF indicator 3.02ii) Rate of first episode genital warts diagnoses per 100,000 population Uptake of HIV testing among men who have sex with men (MSM) measured in GUM Uptake of HIV testing among women measured in GUM Uptake of HIV testing among men measured in GUM Pelvic inflammatory disease (PID) admissions Sexual offences (PHOF indicator) Page | 50
Older People As the population ages the need for health care increases as people are living longer and managing better with long term conditions The proportion of the Canterbury & Coastal CCG population aged 65+ is 20.14% with 2.89% over the age of 85. These are both higher than the averages for Kent at 19.3% and 2.6% respectively. Figure 44- Life Expectancy at 65 at ward level, 2009-2013
The population of Canterbury & Coastal CCG who reach 65 years can expect to live a further 20.3 years compared to 19.8 years for Kent. Canterbury & Coastal CCG has the third highest life expectancy at 65+ of all CCGs for the years 2009-2013. There are 20 wards in the CCG with a life expectancy greater than that for Kent. Figure 44.1- Life Expectancy at 65 in Kent CCGs, 2009-2013
Page | 51
Chronic Diseases Risk Factors for Chronic Diseases Smoking Prevalence Figure 45- Smoking Prevalence
Figure 46- Smoking Prevalence by GP 2013/14 QOF data
The prevalence estimates for smoking are calculated by dividing the number of people on the smoking register in to the practice list size of 15+ year olds to give a percentage.
Page | 52
The register figure does not represent all patients who smoke, but represents a count of patients noted as smoking within the last 12 months, who also have any or any combination of the following conditions: coronary heart disease, stroke/TIA, hypertension, diabetes, COPD, asthma. (A patient with more than one of these conditions is only counted once.) Approximately 28% of residents in Canterbury & Coastal are smokers compared to 29.6% of adults in the whole of England and 29.4% in Kent. For more accurate information on smoking and tobacco control there is a useful tool published by Public Health England to view areas by region/ PHE Centre and then broken down further by the following geographical levels: Primary Care Trust County/ Unitary Authority District/ Unitary Authority level This is available at: http://www.tobaccoprofiles.info/
Adult Obesity Prevalence Figure 47- Modelled Obesity Prevalence
These Lifestyle estimates were originally calculated by the office for national statistics at middle layer super output area level but have recently realigned this data to ward level. Unfortunately the 2006- 2008 data is still the most recent available and there is currently no indication of when a new release is likely to be published. The active people survey provides more recent information at a district level.
Page | 53
Figure 48- Active People Survey 2012, Prevalence of different weight classes in Kent districts
The Active People Survey is a large telephone survey of sport and active recreation commissioned by Sport England. In January 2012 questions on height and weight were added to provide data for the adult excess weight indicator in the Public Health Outcomes Framework. The APS collects self-reported height and weight from adults aged 16 and over. Height and weight data have been adjusted at individual level to correct for the reporting bias in self-report data. The new data provide robust prevalence estimates and will allow local areas to monitor annual trends in excess weight prevalence among their adult population. The APS data displays nearly 1 in 6 adults (16%) in Canterbury district are obese compared to 1 in 5 in Kent (21.2%). As a county Kent has a lower prevalence of obese adults compared to the overall figure for England (23%).
Page | 54
Alcohol Misuse Figure 49- Age-standardised admission rates for alcohol specific admissions in D.G.S CCG by sex, 2006/07 – 2013/14, all ages
Figure 50- Age-standardised alcohol-specific admission rates in Canterbury & Coastal CCG and Kent, 2006/07 – 2013/14, all ages
Page | 55
Since 2006 there has been a steady increase in the rate of alcohol-specific admissions to hospital for all ages across the whole of Kent with Canterbury & Coastal CCG having significantly higher rates in 2010/11 and the two most recent contract years, the steady upward trend highlights the need for closer monitoring in the coming years. There are nearly twice as many Male admissions compared to Females due to alcohol-specific conditions in both Kent and Canterbury & Coastal CCG. Figure 51- Under 20’s alcohol-specific admission rates, 2006/07 – 2013/14
The trend for under 20’s alcohol-specific admissions tells a different story for Kent with rates of admission seeing a welcome reduction since the baseline of 2006/07 however the rate for Canterbury & Coastal CCG has remained significantly higher than Kent since 2007/08. The most likely reason for this anomaly is due to the large student population residing in the area attending either of the two universities, this is a population group known to partake in excessive drinking, especially those who have moved away from home (and their parents’ jurisdiction) for the first time. Local Alcohol Profiles for England A more detailed area profile focusing on indicators relating to alcohol is available for every local district in England, the main link for the South East section of the website is: http://www.lape.org.uk/LAProfile.aspx?reg=X25004AE
You can then use the drop down box underneath where it says ‘Change Profile Area’ to select your preferred local authority.
There is also the option to download the data as a PDF if required
Page | 56
Canterbury LAPE Profile (2012 Update)
Page | 57
LAPE table with values
Page | 58
Chronic Disease Patterns Multi-Morbidity An ageing population and increased prevalence of chronic diseases requires a service re-orientation away from the current emphasis on acute and episodic care, towards prevention, self-care, more consistent standards of primary care and care that is well co-ordinated and integrated. The King’s Fund has identified 10 priorities for action: King’s Fund 10 Priorities for Commissioners
Active support for self-management Primary prevention Secondary prevention Managing ambulatory care sensitive conditions Improving the management of patients with both mental and physical health needs Care co-ordination through integrated health and social care teams Improving primary care management of end-of-life care Effective medicines management Managing elective activity – referral quality Managing emergency activity – urgent care
A common feature of all 10 priorities is the degree to which they are dependent upon a change within primary care services and the way in which such services relate to the rest of health and social care. Clinical practise conventionally treats and thus measures individual diseases. Such an approach is increasingly challenged by the scale of service demands facing the NHS (and is also a worldwide problem) through the concept of multi-morbidity. In essence patients with chronic conditions often have more than one such condition simultaneously. It is the challenge of managing the complexities of co-morbid and multi-morbid conditions that gives rise to complications, often leading to high cost, unplanned, unscheduled care. A landmark Scottish study (Barnett et al 2012) has examined the distribution of multi-morbidity and of co-morbidity of physical and mental health disorders in relation to both age and socio-economic deprivation. In a cross sectional study data from 40 morbidities relating to 1,751,841 people registered with 314 medical practices in Scotland as of March 2007 was analysed according to the number of morbidities, disorder type (physical or mental), age, sex and socio-economic status. Multi- morbidity for the purpose of this study was defined as the presence of two or more disorders. 42.2% of all patients had one or more morbidity. 23.2% were multi-morbid. Although the prevalence of multi-morbidity increased substantially with age and was present in most people aged 65 and older, the absolute number of people with multi-morbidity was higher in those younger than 65 (210,500 v 194,196). Onset multi-morbidity occurred 10-15 years earlier in people living in the most deprived areas compared to the most affluent. The presence of a mental health disorder increased as the number of physical morbidities increased and was much greater in more deprived than in less deprived people. The authors recommend that generalist clinicians provide personalised, comprehensive continuity of care since the single disease framework on which most health care research and indeed medical education is based is profoundly challenged by this study. An ageing population and increased prevalence of chronic disease requires a strong re-orientation away from the current emphasis on acute and episodic care, towards prevention, self-care and more consistent standards of primary care that are well co-ordinated and integrated. The King’s Fund (2011) has identified 10 priorities for action and most of these demand a change within primary care and in the way in which primary care relates to the rest of the health care system.
Page | 59
The Canterbury & Coastal CCG Health & Well-being Board through its leadership need to enable: The systematic and pro-active management of chronic disease within primary care. This will improve health outcomes, manage down inappropriate use of hospital services but will also make a significant and positive contribution to reducing health inequalities; The empowerment of patients. Patients are arguably the greatest untapped resource within the NHS. The active engagement of patients is a common thread throughout the 10 priorities identified by the King’s Fund; A population-based approach to commissioning. This presents a dichotomy in relation to the primary care clinician’s role as advocate for the individual patient but also in shifting a focus from patients that present in practice to the wider population needs and disease patterns. The presentation of this needs assessment, keeping separate the population- based patterns from practice-based patterns of disease, is illustrative of the conceptual challenge of this task; More integrated models of care. The aim is to improve the quality of care for patients and reduce waste, especially as CCGs are being tasked with providing leadership within the NHS at a time of financial constraint in which the burden of disease is growing, driven in part by demographic change, yet medical advances offer increasing opportunities to treat disease. Long Term Conditions Cancer Registrations Figure 52- Crude cancer registration rates at ward level 2008-2012 for all cancers, All ages
Cancer registrations are collected by the National Cancer Registration Service and cover all ages. The registration rate in Canterbury & Coastal is higher than Kent overall and has 23 wards with a higher rate than Kent for the period 2008-2012. The crude rate was calculated by dividing the total number of cancer registrations between 2008 and 2012 and dividing it into the total population figure for each ward using the combined 2008-2012 ONS mid-year resident population estimates. Page | 60
Figure 52.5-
Figure 53- Crude cancer registration rates for Kent CCG’s 2008-2012, All Ages
Canterbury & Coastal CCG had the third highest registration rate of Males, Females and Persons of all ages across the 7 Kent CCGs. The wards with the highest cancer registration rates are Reculver, Chestfield and Swalecliffe, Tankerton, Sandwich and Sturry South wards.
Page | 61
Figure 54- Crude cancer registration rates for Kent CCG’s, 2008-2012, Under 75s
For the under 75’s Canterbury & Coastal CCG also had the third highest cancer registration rate for Males, Females and Persons across the whole of Kent for the period 2008-2012. Figure 55- Map of under 75s Mortality due to cancer 2009-2013 by Electoral Ward
Page | 62
The wards with the highest rates of mortality due to cancer are Marshside, Little Stour and Ashstone, Sturry South, Watling and Herne and Broomfield. Those with the lowest rates are St Stephens, Davington Priory and Tankerton wards (all under 100 per 100,000 people). Quality Outcomes Framework (QOF) What is the QOF? (Extracted from: http://www.nice.org.uk/aboutnice/qof/qof.jsp) Introduced in 2004 as part of the General Medical Services Contract, the QOF is a voluntary incentive scheme for GP practices in the UK, rewarding them for how well they care for patients. The QOF contains groups of indicators, against which practices score points according to their level of achievement. NICE's role focuses on the clinical and public health domains in the QOF, which include a number of areas such as coronary heart disease and hypertension. The QOF gives an indication of the overall achievement of a practice through a points system. Practices aim to deliver high quality care across a range of areas, for which they score points. Put simply, the higher the score, the higher the financial reward for the practice. The final payment is adjusted to take account of the practice list size and prevalence. The results are published annually here: http://www.hscic.gov.uk/qof usually around October each year. Other useful link: QOF 2013/14 data explained: http://qof.hscic.gov.uk/ Disease Registers on QOF Due to the nature of the QOF and the way patient data is collected and registered on the GP’s I.T system, you can’t fully rely on the prevalence data at any level being 100% accurate as it doesn’t account for those patients who are unaware they have the disease and therefore haven’t sought advice from their doctor. I.e. the patient is only recognised by the system once they have been to see their GP who has then subsequently diagnosed them with the condition and input it onto their system. It is for this reason that we use APHO Modelled estimates for prevalence of certain disease indicators on the QOF register which are found at: http://www.apho.org.uk/diseaseprevalencemodels to roughly estimate the number of people who are unidentified at practice or local authority level. **PLEASE NOTE: As of 1st April 2013 London Road Surgery (G82040) patient list merged with Bridge Health Centre (G82228). London Road Surgery is now closed so no longer appears on published QOF data, as a result of this I have merged the calculated prevalence estimates for the 2 practices.
Page | 63
Diabetes Figure 56- Prevalence of Diabetes in Canterbury & Coastal Practices, QOF Register 2013/14
The recorded prevalence of diabetes varies between practices from 0.63% to 8.2%. The prevalence for the CCG is 5.75%, higher than Kent & Medway but lower than England overall, it has the second lowest prevalence of the 7 CCGs in Kent. Figure 57- Prevalence of Diabetes in Kent CCGs, QOF Register 2013/14
Page | 64
Figure 58- Modelled expected prevalence of Diabetes Vs Observed Prevalence 2013/14
We are currently reviewing the way we calculate this indicator due to flaws within the APHO define your own area tool which doesn’t account for individual practice deprivation break- downs based on the residential location of their patients. We hope to re-introduce this figure in due course.
Figure 59- Correlation between diabetes and obesity prevalence QOF 2013/14 data
Please note the R² value is equal to 0.36 and while this does denote a positive correlation it should be made clear that it is a very mild positive correlation which holds very little significance.
Page | 65
Figure 60- Elective and Emergency hospital admission rates for diabetes 2006/07-2013/14
The trend in elective and emergency admission rates for diabetes has seen a year on year increase since 2006/07 for Kent patients overall as well as being similarly represented by the Canterbury & Coastal CCG rates. Since 2006/07 Canterbury & Coastal and Kent have had a lower elective admission rate compared to emergency admissions which suggests there could’ve been a better management of the condition at practice level to ensure there are fewer emergency admissions compared to elective. Figure 61- Map of age-standardised emergency admission rates for diabetes 11/12 – 13/14
Page | 66
The wards with the highest emergency admission rates for diabetes are Reculver (2583.3 per 100,000), West Bay (2375.9), Sturry South (2272.8), Little Stour (2272.8) and Barton (2019.3). Figure 62- Mean cost per hospital spell for diabetes 2006/07 – 2013/14
Data for this indicator does not currently contain a geographical code. We have contacted our data providers who have assured us they will be added within 1-2 months.
Figure 63- Total annual expenditure on hospital spells for diabetes 2006/07 – 2013/14
Data for this indicator does not currently contain a geographical code. We have contacted our data providers who have assured us they will be added within 1-2 months.
Page | 67
Coronary Heart Disease Figure 64- Prevalence of CHD in Canterbury & Coastal Practices, QOF 2013/14
Figure 65- Prevalence of Coronary Heart Disease in Kent CCGs, QOF 2013/14
The prevalence of coronary heart disease varies between practices from 0.25% to 4.8%. The prevalence for the CCG is 3.28% which is the same as England but slightly higher than the Kent and Medway area team. Page | 68
Figure 66- CHD: Expected prevalence (APHO 2011) Vs Observed prevalence (QOF 2013/14)
In 2013/14 there were 7,087 people recorded on the Coronary Heart Disease register at practices in Canterbury & Coastal CCG, this equates to 70.5% of the total expected number of patients with CHD according to the APHO 2011 modelled prevalence estimates for CHD. This leaves potentially 2,972 patients in Canterbury & Coastal CCG who are unaware they have the condition. Figure 67- Elective & Emergency admission rates for Coronary Heart Disease 2006/07-2013/14
Page | 69
Both elective and emergency admission rates present an upward trend for coronary heart disease in Kent and Canterbury & Coastal CCG. This is another condition that could potentially be managed better at a practice level in order to identify patients who are at risk before they require an emergency admittance to hospital. It should be noted that Canterbury CCG has remained higher than Kent for Emergency admissions since 2006/07. Figure 68- Mean cost per hospital spell for Coronary Heart Disease 2006/07-2013/14
Data for this indicator does not currently contain a geographical code. We have contacted our data providers who have assured us they will be added within 1-2 months.
Figure 69- Total annual expenditure on hospital spells for CHD 2006/07-2013/14
Data for this indicator does not currently contain a geographical code. We have contacted our data providers who have assured us they will be added within 1-2 months.
Page | 70
Figure 70- Age-standardised emergency admission rates for Canterbury & Coastal CCG residents for acute myocardial infarction 2011/12-2013/14 by electoral ward
The wards with the highest emergency admission rates for acute myocardial infarction are Northgate (248 per 100,000), Heron (228.3), West Bay (219.7), Barton (219.6) and Sturry South (215). Figure 71- Age-standardised emergency admission rates for Canterbury & Coastal CCG residents for revascularisation 2011/12-2013/14 by electoral ward
Page | 71
The highest emergency admission rates for revascularisation are found in North Nailbourne (52.6 per 100,000), Blean Forest (50.9), Heron (44.4), Sandwich (42.5) and Boughton & Courtenay (42.3). Stroke or Transient Ischaemic Attacks Figure 72- Prevalence of Stroke or Ischaemic Transient Attacks in GP practices, QOF 2013/14
Figure 73- Prevalence of Stroke & Ischaemic Transient Attacks by CCG, QOF 2013/14
The prevalence for Stroke or Ischaemic Transient Attacks ranges between practices from 0.16% to 2.48%. The CCG has a prevalence of 1.87%, slightly higher than the Kent and England average (both 1.7%). Page | 72
Figure 74- Stroke: Expected prevalence (APHO 2011) Vs Observed prevalence (QOF 2013/14)
There were 4,041 patients registered on the Stroke or Transient Ischaemic Attack register in 2013/14 out of an expected estimate of 4,422 (91.4%). This leaves a potential 381 patients unidentified who may have -or be at risk of getting- the condition. Figure 75- Elective & Emergency hospital admission rates for Stroke 2006/07-2013/14
Page | 73
The admission rates for Stroke in Kent have remained relatively stagnant over the last 8 years for both emergency and elective admissions however; Canterbury & Coastal CCGs emergency admission rate has presented an erratic year-on-year trend over the last eight years. Overall Canterbury & Coastal and Kent present slight upward trends for both elective and emergency admissions. As you would expect the elective admission rates are very low for this condition. Figure 76- Mean cost per hospital spell for Stroke 2006/07-2013/14
Data for this indicator does not currently contain a geographical code. We have contacted our data providers who have assured us they will be added within 1-2 months.
Figure 77- Total annual expenditure on hospital spells for Stoke 2006/07-2013/14
Data for this indicator does not currently contain a geographical code. We have contacted our data providers who have assured us they will be added within 1-2 months.
Page | 74
Figure 78- Age standardised emergency admission rates for Stroke 2011/12-2013/14
The highest emergency admission rates for Stroke are found in Heron (239.7 per 100,000), Northgate (236.7), St Stephens (230.7), Watling (207.4) and Herne & Broomfield (206.8) wards. Figure 79- Age standardised mortality rates for under-75 circulatory disease 2009-2013
The highest rates of mortality due to circulatory conditions in Canterbury & Coastal are found in Northgate (157.5 per 100,000), Heron (138.1), Sturry North (129.6) and Teynham & Lynsted (118.8) wards. Page | 75
Hypertension Figure 80- Prevalence of Hypertension in GP practices QOF 2013/14
Figure 81- Prevalence of Hypertension by CCG, QOF 2013/14
The prevalence of hypertension in practices ranges from 1.3% to 21.3%. The CCG has a value of 13.8% for Hypertension which is higher than the average for England (13.7%) but lower than the average for the Kent & Medway area team (14.4%). Page | 76
Figure 82- Hypertension: Expected (APHO 2011) Vs Observed prevalence (QOF 2012/13)
In 2013/14 there were 29,838 patients registered with Hypertension out of an estimated 54,451 according to the APHO prevalence estimates. This means 54.8% of the expected number of patients have been identified with 24,613 potentially unaware they have the condition. Figure 83- Elective and emergency admission rates for Hypertension 2006/07-2013/14
Page | 77
Admission rates for Hypertension have shown a dramatic increase since 2006/07 for both Kent and Canterbury & Coastal CCG. Since 2011/12 Canterbury & Coastal has had lower rates than Kent for elective admissions whereas emergency admissions have remained higher than Kent since 2006/07. A higher elective admission rate compared to that for an emergency since 2012/13 suggests that patients with hypertension in Kent overall are being identified and managed well in a primary care setting. Figure 84- Mean cost per hospital spell for hypertension 2006/07-2013/14
Data for this indicator does not currently contain a geographical code. We have contacted our data providers who have assured us they will be added within 1-2 months.
Figure 85- Total annual expenditure on hospital spells for hypertension 2006/07-2013/14
Data for this indicator does not currently contain a geographical code. We have contacted our data providers who have assured us they will be added within 1-2 months.
Figure 86- Age standardised emergency admission rates for hypertension 2011/12-2013/14
The highest emergency admission rates for Hypertension are found in Little Stour (4519.8 per 100,000), St Stephens (4384.8), Northgate (3943.2), Heron (3828.2) and Herne & Broomfield (3789.4) wards.
Page | 78
Chronic Obstructive Pulmonary Disorder (COPD) Figure 87- Prevalence of COPD in practices, QOF 2013/14
The prevalence of COPD in practices ranges from 0.11% to 3.26% in Canterbury & Coastal CCG, as a CCG they have an overall prevalence of 1.72% just below the Kent & Medway Area Team and England at 1.8% and 1.78% respectively. Figure 88- Prevalence of COPD by CCG, QOF 2013/14
Page | 79
Figure 89- COPD: Expected prevalence (APHO 2011) Vs Observed prevalence (QOF 2013/14)
In 2013/14 in Canterbury & Coastal CCG there were 3,711 patients registered as having COPD out of an estimated 5,574. With 66.6% of the expected number of patients identified this leaves a potential 1863 patients who could be unaware they have the condition. Figure 90- Elective and Emergency admission rates for COPD 2006/07-2013/14
Page | 80
There is an upward trend in admission rates for both elective and emergency admissions in Kent and Canterbury & Coastal CCG. In order to try and reduce the number of emergency admissions there should be an initiative to raise awareness of the condition and its symptoms amongst the general population as the majority of people who develop these symptoms often disregard them as a ‘smokers cough’. Figure 91- Mean cost per hospital spell for COPD 2006/07-2013/14
Data for this indicator does not currently contain a geographical code. We have contacted our data providers who have assured us they will be added within 1-2 months.
Figure 92- Total annual expenditure on hospital spell for COPD 2006/07-2013/14
Data for this indicator does not currently contain a geographical code. We have contacted our data providers who have assured us they will be added within 1-2 months.
Figure 93- Age-standardised emergency admission rates for COPD 2011/12-2013/14
The highest emergency admission rates for COPD are found in West Bay (1745.7 per 100,000), Chestfield & Swalecliffe (1702.6), Harbledown (1572.7), Barton (1486.4) and Little Stour and Ashstone (1475.1).
Page | 81
Figure 94- Age standardised emergency admission rates for Asthma 2011/12-2013/14
The highest emergency admission rates for Asthma are in West Bay (1597.6 per 100,000), Harbledown (1572.4) Chestfield & Swalecliffe (1386.9) Sturry South (1364) and Barton (1202.7) wards. Figure 95- Age standardised mortality rates for all respiratory diseases 2009-2013.
High rates of mortality due to respiratory conditions are found in Heron (72 per 100,000 people), Northgate (59.3), Eastry (49.6), Teynham & Lynsted (45.2) and Gorrell (43.2) wards, the lowest rates are found in Tankerton, Watling and Harbledown (All under 10 per 100,000) Page | 82
Mental Health Dementia Figure 96- Prevalence of Dementia in practices, QOF 2013/14
Figure 97- Prevalence of Dementia by CCG, QOF 2013/14
Page | 83
The prevalence of Dementia in practices ranges from 0.02% to 1.14%, the prevalence in Canterbury & Coastal is slightly higher than Kent & Medway and England; 0.66% compared to 0.59% and 0.62% respectively. Figure 98- Emergency admission rates for Dementia diagnoses 1-3, 2006/07-2013/14
The emergency admission rate for Dementia (with ICD10 code appearing in the first 3 diagnosis fields) has seen a year on year increase in Kent and Canterbury & Coastal CCG since 2006/07. Apart from 2010/11 to 2011/12, the CCG has had a higher admission rate than Kent. Recent years figures suggest the rates have reached a plateau at Kent level. Figure 99- Mean cost per emergency hospital spell for Dementia diagnoses 1-3, 2006/07 - 2013/14
Data for this indicator does not currently contain a geographical code. We have contacted our data providers who have assured us they will be added within 1-2 months.
Figure 100- Total annual expenditure on hospital spells for dementia diagnoses 1-3, 2006/07- 2013/14
Data for this indicator does not currently contain a geographical code. We have contacted our data providers who have assured us they will be added within 1-2 months.
Page | 84
Mental Illness Needs Index 2000 In different types of areas, people are more or less likely to incur common mental illnesses. To some extent this can be predicted from characteristics of the population measured by the census or other types of survey. Mental health needs indices estimate by how much. A needs index of 0.8 suggests that there will be 20% less illness in an area than in the country as a whole, an index of 1.2 suggests 20% more Figure 101- Mental Illness Needs Index 2000
Page | 85
Figure 102- Prevalence of Mental Illness in practices, QOF 2013/14
Figure 103- Prevalence of Mental Illness by CCG, QOF 2013/14
The prevalence of Mental Illness in practices ranges from 0.5% to 1.5%, Canterbury & Coastal CCG has the second highest prevalence of all the Kent CCGs at 0.8% but is still lower than the England average (0.86%). This QOF indicator includes a register of patients who have schizophrenia, bipolar affective disorder or any other psychoses as well as any other patients on lithium therapy. Page | 86
Figure 104- Adult (ages 15-64) mental illness patient contact rates, 2012-2013
Figure 105- Elderly (aged 65+) mental illness patient contact rates, 2012-2013
Page | 87
Figure 106- Number of older people receiving enablement or active care, August 2013
Figure 107- Older people with a mental health problem living in residential or nursing homes
Page | 88
Figure 108- Older people who receive domiciliary/ community support services care
Figure 109- Older people who are in receipt of day care
Page | 89
Falls Figure 110- Emergency admission rates as a result of a fall, 2006/07-2013/14
Emergency hospital admission rates as a result of a fall display a slight upward trend at CCG and Kent level over the last 8 years, however rates appear to have reached a plateau since 2011/12. Figure 111- Mean cost per hospital spell due to a fall, 2006/07-2013/14
Data for this indicator does not currently contain a geographical code. We have contacted our data providers who have assured us they will be added within 1-2 months.
Figure 112- Total annual expenditure on hospital spells due to falls, 2006/07-2013/14
Data for this indicator does not currently contain a geographical code. We have contacted our data providers who have assured us they will be added within 1-2 months.
Page | 90
Figure 113- Age-standardised emergency admission rates due to a fall, 2011/12-2013/14
The highest rates of emergency admission as a result of a fall are found in St Stephens (997.5 per 100,000), Seasalter (969.4), Little Stour (927.8), Blean Forest (926.7) and St Ann’s (922.1). The lowest rates are found in Harbledown, Sturry North, Marshside, Abbey and Harbour wards. Figure 114- Age-standardised elective admission rates for 65+, 2011/12-2013/14
Page | 91
The highest elective admission rates for persons aged 65 and over are found in Herne & Broomfield (47,452.4 per 100,000 65+ year olds), Sturry South (46,947), Marshside (45,033) and St Stephens (43,945) wards. The lowest rates are found in Northgate, Harbour, Little Stour, Harbledown and Tankerton wards. Figure 115- Age-standardised emergency admission rates for 65+, 2011/12-1013/14
The highest emergency admission rates for persons aged 65 and over are found in Sturry North (32,649 per 100,000 65+ year olds), Heron (32,406), Northgate (31,623.4), Barton (31,330.8) and West Bay (30,400.6) wards. The lowest rates are found in Barham Downs, Teynham & Lynsted, Eastry, Sandwich and Chartham & Stone Street. .
Page | 92
Figure 116- Age-standardised emergency admission rates due to fractured neck of femur, 2011/12-2013/14
The highest emergency admission results due to fractured neck of femur are found in St Ann’s (203.7 per 100,000), St Stephens (202.6), Blean Forest (196.6), Seasalter (188) and Sturry South (182.1). The lowest rates are found in West Bay, Barton, Abbey, Marshside and Harbledown. Figure 117- Age-standardised emergency admission rates due to hip or knee replacement, 2011/12-2013/14
Page | 93
The highest emergency admission rates due to a hip or knee replacement are found in Sturry South (49 per 100,000), Boughton & Courtenay (44.2), St Ann’s (40.1), Davington Priory (39.1) and St Stephens (26.3) wards. The wards with the lowest rates are Chartham & Stone Street, Barham Downs, Harbour, Marshside and Harbledown wards (all with a rate of 0). Figure 118- Age-standardised mortality rates for all age, all cause 2009-2013
The highest rates for all age, all cause mortality are found in Harbledown (1270.4 per 100,000), Heron (1239.6), Abbey (1196.3), Harbour (1174.2) and Little Stour (1141.8). The wards with the lowest mortality rates for all age all cause are Tankerton, St Stephens, Chartham & Stone Street, East Downs and Blean Forest.
Page | 94
Page | 95
Hospital Activity: A&E Attendances and Admissions Canterbury & Coastal CCG A&E Attendance Rates Figure 119- Accident & Emergency attendance rates for children aged 0-4 years.
There are high rates of A&E admissions in Barham Downs, Wincheap, Little Stour & Ashstone, Teynham & Lynsted and West Bay wards, the lowest rates are found in Little Stour, Tankerton, East Downs, Sturry North and Harbledown.
For GP practices the highest rates are at Dr Kinnersley D S & Partner, Dr Q M Mangi & Partner, Dr Smith A & Partners, The Butchery Surgery and Dr Grice D J P & Partners. The lowest rates are found in The Faversham Health Centre, Dr Johnson L F & Partner, Dr Garrod P J & Partners, University Medical Centre and Boughton Medical Centre.
Page | 96
Ward Rates GP Practice Rates
Rate Ward Name 0-4 Rate GP Surgery 0-4 29UCGC Barham Downs 289.7 G82790 Dr Kinnersley D S & Partner 335.6 29UCHC Wincheap 243.8 G82204 Dr Q M Mangi & Partner 264.7 29UEGQ Little Stour and Ashstone 225.4 G82138 Dr Smith A & Partners 248.8 29UMHA Teynham and Lynsted 221.0 G82148 The Butchery Surgery 248.6 29UCHA West Bay 210.4 G82060 Dr Grice D J P & Partners 219.9 29UCGQ Marshside 197.4 G82063 Market Place Surgery 209.2 29UCGR North Nailbourne 186.4 G82012 Cossington House Surgery 179.9 29UMGG Davington Priory 179.3 G82119 Dr Sigurdsson R G & Partners 174.9 29UCGG Chestfield and Swalecliffe 177.0 G82090 St Annes Group Practice 165.2 29UEHB Sandwich 171.1 G82027 Dr Logan L C & Partners 163.9 29UCGE Blean Forest 164.8 G82039 Newton Place Surgery 163.2 29UCGJ Greenhill and Eddington 163.7 G82115 Dr Jones G L & Partners 143.1 29UMHB Watling 161.8 G82726 Dr Shar M B & Partner 130.4 29UCHB Westgate 160.4 G82071 Dr Ribchester J M & Partners 125.2 29UCGD Barton 159.9 G82802 Dr Simmonds R & Partner 124.1 29UCGM Herne and Broomfield 156.4 G82082 Dr Molony J P & Partners 123.9 29UCGN Heron 153.7 G82228 Canterbury Medical Practice 120.6 29UCGT Reculver 152.8 G82004 The Faversham Health Centre 118.2 29UMGC Abbey 147.5 G82061 Dr Johnson L F & Partner 117.3 29UMGU St Ann's 142.0 G82029 Dr Garrod P J & Partners 116.9 29UEGN Eastry 139.4 G82140 University Medical Centre 97.6 29UCGL Harbour 133.5 G82179 Boughton Medical Centre 67.8 29UCGY Sturry South 129.3 29UCGH Gorrell 127.2 29UCGU St Stephens 111.4 29UCGS Northgate 109.0 29UCGW Seasalter 108.6 29UMGE Boughton and Courtenay 105.8 29UCGF Chartham and Stone Street 105.4 29UCGP Little Stour 104.5 29UCGZ Tankerton 97.3 29UMGH East Downs 90.9 29UCGX Sturry North 65.4 29UCGK Harbledown 51.5
Page | 97
Figure 120- Accident & Emergency attendance rates for children aged 5-19 years
The highest A&E attendance rates for 5-19 year olds are found in Wincheap, Seasalter, East Downs, Herne and Broomfield and Chartham and Stone Street wards, the lowest rates are located in St Stephens, Westgate, Sturry South, Harbledown and Blean Forest.
The GP practices with the highest rates are Dr Shar M B & Partner, Dr Jones G L & Partners, Dr Kinnersley D S & Partner, The Butchery Surgery and The Faversham Health Centre, the lowest rates are found in Dr Smith A & Partners, Cossington House Surgery, Canterbury Medical Practice, Boughton Medical Centre and University Medical Centre.
Page | 98
Ward Rates GP Practice Rates
Ward Code Ward Name 5-19 GP Code Practice Name 5-19 29UCHC Wincheap 137.5 G82726 Dr Shar M B & Partner 112.8 29UCGW Seasalter 115.6 G82115 Dr Jones G L & Partners 96.5 29UMGH East Downs 114.3 G82790 Dr Kinnersley D S & Partner 92.7 29UCGM Herne and Broomfield 103.6 G82148 The Butchery Surgery 91.0 29UCGF Chartham and Stone Street 95.5 G82004 The Faversham Health Centre 89.3 29UCGQ Marshside 94.9 G82119 Dr Sigurdsson R G & Partners 89.1 29UCGX Sturry North 94.3 G82060 Dr Grice D J P & Partners 87.7 29UCGT Reculver 84.9 G82029 Dr Garrod P J & Partners 86.5 29UMGE Boughton and Courtenay 82.9 G82039 Newton Place Surgery 78.8 29UMHB Watling 82.7 G82204 Dr Q M Mangi & Partner 77.8 29UMGC Abbey 80.8 G82802 Dr Simmonds R & Partner 76.0 29UMGU St Ann's 78.3 G82090 St Annes Group Practice 75.6 29UEGN Eastry 77.1 G82071 Dr Ribchester J M & Partners 75.1 29UCGG Chestfield and Swalecliffe 76.6 G82082 Dr Molony J P & Partners 74.7 29UMHA Teynham and Lynsted 75.6 G82027 Dr Logan L C & Partners 74.6 29UCHA West Bay 75.0 G82063 Market Place Surgery 72.3 29UCGP Little Stour 73.5 G82061 Dr Johnson L F & Partner 57.3 29UMGG Davington Priory 73.4 G82138 Dr Smith A & Partners 53.4 29UCGS Northgate 71.9 G82012 Cossington House Surgery 52.5 29UCGJ Greenhill and Eddington 70.4 G82228 Canterbury Medical Practice 48.0 29UCGL Harbour 69.1 G82179 Boughton Medical Centre 46.3 29UCGN Heron 68.1 G82140 University Medical Centre 40.5 29UCGC Barham Downs 67.6 29UEHB Sandwich 67.0 29UCGD Barton 66.1 29UCGH Gorrell 64.2 29UEGQ Little Stour and Ashstone 63.8 29UCGZ Tankerton 56.3 29UCGR North Nailbourne 48.0 29UCGU St Stephens 48.0 29UCHB Westgate 46.0 29UCGY Sturry South 45.1 29UCGK Harbledown 42.8 29UCGE Blean Forest 41.4
Page | 99
Figure 121- Accident & Emergency attendance rates for people aged 20-44 years
Wards with the highest rates for people aged 20-44 are Heron, Sturry North, Little Stour, Marshside and Davington Priory wards, the lowest rates are found in Barton, Harbledown, Westgate, Blean Forest and St Stephens wards.
The practices with the highest rates are Dr Q M Mangi & Partner, St Annes Group Practice, Dr Sigurdsson R G & Partners, Dr Smith A & Partners and Dr Logan L C & Partners, the lowest rates are found in Dr Simmonds R & Partner, Dr Molony J P & Partners, Newton Place Surgery, Boughton Medical Centre and University Medical Centre.
Page | 100
Ward Rates GP Practice Rates
Ward Code Ward Name 20-44 GP Code Practice Name 20-44 29UCGN Heron 271.9 G82204 Dr Q M Mangi & Partner 250.9 29UCGX Sturry North 262.1 G82090 St Annes Group Practice 213.7 29UCGP Little Stour 242.2 G82119 Dr Sigurdsson R G & Partners 208.4 29UCGQ Marshside 238.2 G82138 Dr Smith A & Partners 196.6 29UMGG Davington Priory 237.4 G82027 Dr Logan L C & Partners 194.2 29UCGT Reculver 236.7 G82071 Dr Ribchester J M & Partners 189.2 29UCGW Seasalter 230.7 G82029 Dr Garrod P J & Partners 183.1 29UCHA West Bay 229.9 G82148 The Butchery Surgery 183.0 29UCGH Gorrell 227.1 G82726 Dr Shar M B & Partner 179.7 29UEGN Eastry 215.0 G82060 Dr Grice D J P & Partners 178.5 29UCGM Herne and Broomfield 213.8 G82115 Dr Jones G L & Partners 177.9 29UMGU St Ann's 210.0 G82012 Cossington House Surgery 175.0 29UCGY Sturry South 204.5 G82063 Market Place Surgery 170.8 29UCGG Chestfield and Swalecliffe 200.9 G82004 The Faversham Health Centre 169.7 29UEGQ Little Stour and Ashstone 199.4 G82228 Canterbury Medical Practice 166.4 29UMGC Abbey 193.3 G82061 Dr Johnson L F & Partner 166.3 29UMGH East Downs 191.8 G82790 Dr Kinnersley D S & Partner 164.4 29UCGJ Greenhill and Eddington 190.8 G82802 Dr Simmonds R & Partner 158.2 29UMHA Teynham and Lynsted 188.3 G82082 Dr Molony J P & Partners 154.6 29UCGL Harbour 183.0 G82039 Newton Place Surgery 152.8 29UCGC Barham Downs 182.8 G82179 Boughton Medical Centre 134.9 29UCGR North Nailbourne 181.8 G82140 University Medical Centre 43.2 29UMHB Watling 176.7 29UMGE Boughton and Courtenay 175.3 29UEHB Sandwich 165.1 29UCHC Wincheap 161.3 29UCGZ Tankerton 161.1 29UCGF Chartham and Stone Street 160.2 29UCGS Northgate 156.4 29UCGD Barton 132.5 29UCGK Harbledown 132.1 29UCHB Westgate 122.2 29UCGE Blean Forest 82.1 29UCGU St Stephens 80.7
Page | 101
Figure 122- Accident & Emergency attendance rates for people aged 45-64 years
The highest ward rates for A&E attendances for people aged 45-64 are in Northgate, Abbey, Reculver, West Bay and Davington Priory wards, the lowest rates are found in East Downs, Little Stour, Sandwich, Harbledown and North Nailbourne.
The highest GP attendance rates are at Dr Q M Mangi & Partner, Dr Simmonds R & Partner, Dr Grice D J P & Partners, Dr Logan L C & Partners and Dr Molony J P & Partners, the lowest rates are found in Dr Kinnersley D S & Partner, The Faversham Health Centre, Canterbury Medical Practice, The Butchery Surgery and University Medical Centre.
Page | 102
Ward Rates GP Practice Rates
Ward Code Ward Name 45-64 GP Code Practice Name 45-64 29UCGS Northgate 400.4 G82204 Dr Q M Mangi & Partner 360.5 29UMGC Abbey 377.6 G82802 Dr Simmonds R & Partner 354.7 29UCGT Reculver 347.2 G82060 Dr Grice D J P & Partners 354.6 29UCHA West Bay 333.3 G82027 Dr Logan L C & Partners 328.5 29UMGG Davington Priory 324.5 G82082 Dr Molony J P & Partners 303.4 29UCGH Gorrell 312.4 G82039 Newton Place Surgery 293.4 29UCGD Barton 311.7 G82090 St Annes Group Practice 292.3 29UCHC Wincheap 307.3 G82138 Dr Smith A & Partners 287.6 29UCGQ Marshside 304.6 G82029 Dr Garrod P J & Partners 284.6 29UCGY Sturry South 295.4 G82119 Dr Sigurdsson R G & Partners 281.1 29UCGN Heron 295.3 G82726 Dr Shar M B & Partner 279.0 29UCGU St Stephens 294.1 G82115 Dr Jones G L & Partners 274.8 29UMGU St Ann's 288.6 G82061 Dr Johnson L F & Partner 271.1 29UCHB Westgate 284.6 G82071 Dr Ribchester J M & Partners 258.3 29UCGG Chestfield and Swalecliffe 284.0 G82012 Cossington House Surgery 247.6 29UCGX Sturry North 283.2 G82179 Boughton Medical Centre 245.8 29UCGM Herne and Broomfield 282.1 G82063 Market Place Surgery 235.9 29UCGJ Greenhill and Eddington 280.2 G82790 Dr Kinnersley D S & Partner 231.8 29UEGQ Little Stour and Ashstone 272.9 G82004 The Faversham Health Centre 230.3 29UCGC Barham Downs 271.8 G82228 Canterbury Medical Practice 229.2 29UMGE Boughton and Courtenay 271.4 G82148 The Butchery Surgery 218.8 29UMHA Teynham and Lynsted 266.2 G82140 University Medical Centre 212.2 29UCGF Chartham and Stone Street 264.2 29UMHB Watling 261.9 29UEGN Eastry 254.9 29UCGZ Tankerton 254.5 29UCGE Blean Forest 244.1 29UCGW Seasalter 241.0 29UCGL Harbour 239.1 29UMGH East Downs 231.8 29UCGP Little Stour 204.0 29UEHB Sandwich 203.4 29UCGK Harbledown 200.3 29UCGR North Nailbourne 191.2
Page | 103
Figure 123- Accident & Emergency attendance rates for people aged 65-84 years
The highest attendance rates at ward level are found in Abbey, Herne and Broomfield, Barton, Sturry South and West Bay wards, the lowest are situated in Chartham and Stone Street, East Downs, Tankerton, Eastry and Harbledown wards.
The highest attendance rates broken down by GP practice are at Dr Simmonds R & Partner, Dr Grice D J P & Partners, Dr Smith A & Partners, Cossington House Surgery and Dr Sigurdsson R G & Partners, the lowest rates are found in Canterbury Medical Practice, Market Place Surgery, Dr Shar M B & Partner, University Medical Centre and Boughton Medical Centre.
Page | 104
Ward Rates GP Practice Rates
Ward Code Ward Name 65-84 GP Code Practice Name 65-84 29UMGC Abbey 784.4 G82802 Dr Simmonds R & Partner 733.3 29UCGM Herne and Broomfield 776.1 G82060 Dr Grice D J P & Partners 683.0 29UCGD Barton 767.9 G82138 Dr Smith A & Partners 675.0 29UCGY Sturry South 719.1 G82012 Cossington House Surgery 672.0 29UCHA West Bay 716.4 G82119 Dr Sigurdsson R G & Partners 671.4 29UCGT Reculver 712.2 G82029 Dr Garrod P J & Partners 659.4 29UCGJ Greenhill and Eddington 699.5 G82090 St Annes Group Practice 646.6 29UCHC Wincheap 693.6 G82027 Dr Logan L C & Partners 644.6 29UMHB Watling 692.3 G82039 Newton Place Surgery 629.2 29UCGX Sturry North 690.6 G82082 Dr Molony J P & Partners 606.5 29UCGN Heron 689.9 G82061 Dr Johnson L F & Partner 593.0 29UCGQ Marshside 683.0 G82204 Dr Q M Mangi & Partner 591.8 29UCGR North Nailbourne 672.9 G82790 Dr Kinnersley D S & Partner 590.0 29UEGQ Little Stour and Ashstone 665.1 G82115 Dr Jones G L & Partners 588.5 29UCGE Blean Forest 653.0 G82071 Dr Ribchester J M & Partners 574.9 29UMGU St Ann's 653.0 G82148 The Butchery Surgery 565.8 29UCGS Northgate 645.9 G82004 The Faversham Health Centre 550.3 29UMGG Davington Priory 641.5 G82228 Canterbury Medical Practice 536.1 29UCGW Seasalter 630.3 G82063 Market Place Surgery 525.0 29UCGC Barham Downs 622.4 G82726 Dr Shar M B & Partner 523.9 29UEHB Sandwich 613.8 G82140 University Medical Centre 464.6 29UCGG Chestfield and Swalecliffe 613.1 G82179 Boughton Medical Centre 430.0 29UMHA Teynham and Lynsted 612.8 29UCGL Harbour 611.0 29UMGE Boughton and Courtenay 605.7 29UCGH Gorrell 591.1 29UCGU St Stephens 586.3 29UCGP Little Stour 582.3 29UCHB Westgate 555.3 29UCGF Chartham and Stone Street 545.3 29UMGH East Downs 537.5 29UCGZ Tankerton 527.6 29UEGN Eastry 503.2 29UCGK Harbledown 492.9
Page | 105
Figure 124- Accident & Emergency attendance rates for people aged 85+ years
The highest attendance rates for persons aged 85 and over are found in Sturry South, Sturry North, Herne and Broomfield, Abbey and Seasalter wards, the lowest rates are found in Davington Priory, Teynham and Lynsted, Little Stour and Ashstone, Little Stour and Westgate wards.
The practices with the highest rates are Dr Shar M B & Partner, Dr Simmonds R & Partner, Dr Garrod P J & Partners, Dr Molony J P & Partners and Dr Q M Mangi & Partner, the lowest rates are found in The Butchery Surgery, Dr Smith A & Partners, Boughton Medical Centre, Canterbury Medical Practice and University Medical Centre.
Page | 106
Ward Rates GP Practice Rates
Ward Code Ward Name 85+ GP Code Practice Name 85+ 29UCGY Sturry South 1442.9 G82726 Dr Shar M B & Partner 1437.5 29UCGX Sturry North 1323.9 G82802 Dr Simmonds R & Partner 1323.9 29UCGM Herne and Broomfield 1220.9 G82029 Dr Garrod P J & Partners 1247.7 29UMGC Abbey 1157.9 G82082 Dr Molony J P & Partners 1152.3 29UCGW Seasalter 1156.5 G82204 Dr Q M Mangi & Partner 1127.5 29UMGU St Ann's 1144.4 G82039 Newton Place Surgery 1095.1 29UCHA West Bay 1117.6 G82790 Dr Kinnersley D S & Partner 1058.8 29UCHC Wincheap 1098.2 G82061 Dr Johnson L F & Partner 1040.0 29UMHB Watling 1054.9 G82119 Dr Sigurdsson R G & Partners 1026.5 29UCGN Heron 1054.3 G82115 Dr Jones G L & Partners 974.6 29UCGQ Marshside 1037.5 G82071 Dr Ribchester J M & Partners 952.1 29UMGH East Downs 981.8 G82090 St Annes Group Practice 951.6 29UCGT Reculver 977.0 G82060 Dr Grice D J P & Partners 941.3 29UCGH Gorrell 964.7 G82004 The Faversham Health Centre 894.4 29UCGG Chestfield and Swalecliffe 961.6 G82027 Dr Logan L C & Partners 869.4 29UCGS Northgate 947.4 G82012 Cossington House Surgery 869.2 29UMGE Boughton and Courtenay 941.7 G82063 Market Place Surgery 822.3 29UEGN Eastry 923.6 G82148 The Butchery Surgery 820.5 29UCGF Chartham and Stone Street 917.5 G82138 Dr Smith A & Partners 753.5 29UCGZ Tankerton 917.0 G82179 Boughton Medical Centre 708.3 29UCGJ Greenhill and Eddington 910.6 G82228 Canterbury Medical Practice 695.8 29UCGL Harbour 910.4 G82140 University Medical Centre 631.6 29UCGR North Nailbourne 898.1 29UCGD Barton 896.7 29UCGC Barham Downs 873.2 29UCGK Harbledown 804.9 29UEHB Sandwich 797.1 29UCGU St Stephens 788.6 29UCGE Blean Forest 740.7 29UMGG Davington Priory 740.7 29UMHA Teynham and Lynsted 738.3 29UEGQ Little Stour and Ashstone 707.4 29UCGP Little Stour 693.7 29UCHB Westgate 673.1
Page | 107
Figure 125- Accident & Emergency attendance rates for people of all ages
For A&E attendance rates for people of all ages the highest ward rates are in Reculver, West Bay, Heron, Sturry North and Chestfield & Swalecliffe. wards, the lowest are found in Northgate, Harbledown, Westgate, St Stephens and Blean Forest.
St Annes Group Practice has the highest attendance rates of GP practices, Dr Q M Mangi & Partner, Dr Garrod P J & Partners, Dr Smith A & Partners and Dr Sigurdsson R G & Partners also have high rates. Those with the lowest rates are The Faversham Health Centre, Canterbury Medical Practice, Dr Molony J P & Partners, Boughton Medical Centre and University Medical Centre.
Page | 108
Ward Rates GP Practice Rates
Ward Code Ward Name All Ages GP Code Practice Name All Ages 29UCGT Reculver 389.1 G82090 St Annes Group Practice 340.7 29UCHA West Bay 369.7 G82204 Dr Q M Mangi & Partner 334.7 29UCGN Heron 350.7 G82029 Dr Garrod P J & Partners 332.7 29UCGX Sturry North 342.9 G82138 Dr Smith A & Partners 326.0 29UCGG Chestfield and Swalecliffe 341.5 G82119 Dr Sigurdsson R G & Partners 313.3 29UCGW Seasalter 337.2 G82027 Dr Logan L C & Partners 306.5 29UCGY Sturry South 336.1 G82060 Dr Grice D J P & Partners 305.3 29UMGC Abbey 333.5 G82726 Dr Shar M B & Partner 303.5 29UCGM Herne and Broomfield 317.4 G82071 Dr Ribchester J M & Partners 293.6 29UMGG Davington Priory 312.5 G82115 Dr Jones G L & Partners 279.2 29UCGZ Tankerton 304.3 G82039 Newton Place Surgery 274.4 29UCGQ Marshside 300.3 G82148 The Butchery Surgery 274.1 29UCGC Barham Downs 297.1 G82063 Market Place Surgery 270.5 29UEGQ Little Stour and Ashstone 296.8 G82012 Cossington House Surgery 267.6 29UMHB Watling 295.6 G82790 Dr Kinnersley D S & Partner 264.9 29UCGR North Nailbourne 294.3 G82061 Dr Johnson L F & Partner 254.2 29UCGH Gorrell 293.8 G82802 Dr Simmonds R & Partner 253.2 29UMGU St Ann's 289.7 G82004 The Faversham Health Centre 251.4 29UCGJ Greenhill and Eddington 282.6 G82228 Canterbury Medical Practice 247.7 29UEHB Sandwich 280.3 G82082 Dr Molony J P & Partners 229.3 29UMHA Teynham and Lynsted 275.9 G82179 Boughton Medical Centre 228.7 29UCHC Wincheap 275.7 G82140 University Medical Centre 56.8 29UCGP Little Stour 274.4 29UMGE Boughton and Courtenay 273.2 29UEGN Eastry 269.6 29UMGH East Downs 264.2 29UCGL Harbour 245.8 29UCGF Chartham and Stone Street 239.8 29UCGD Barton 236.9 29UCGS Northgate 227.4 29UCGK Harbledown 227.3 29UCHB Westgate 205.1 29UCGU St Stephens 177.1 29UCGE Blean Forest 135.2
Page | 109
Emergency admission rates in Canterbury & Coastal CCG, 2012/13 Figure 126- Emergency admission rates for children aged 0-4 years
Canterbury & Coastal CCG has 4 wards with an emergency admission rate for 0-4s higher than 65; Sandwich, Barham Downs, West Bay and Little Stour & Ashstone wards. The lowest rates are in Westgate, Teynham and Lynsted, Sturry North, East Downs and Harbledown.
The GP practices with the highest rates are The Butchery Surgery, Dr Kinnersley D S & Partner, Market Place Surgery, Dr Q M Mangi & Partner and Dr Smith A & Partners, the lowest rates are in Dr Johnson L F & Partner, Dr Molony J P & Partners, The Faversham Health Centre, Dr Simmonds R & Partner and Boughton Medical Centre.
Page | 110
Ward Rates GP Practice Rates
Rate Ward Name 0-4 Rate GP Surgery Name 0-4 29UEHB Sandwich 75.7 G82148 The Butchery Surgery 121.4 29UCGC Barham Downs 74.8 G82790 Dr Kinnersley D S & Partner 93.4 29UCHA West Bay 67.1 G82063 Market Place Surgery 77.4 29UEGQ Little Stour and Ashstone 66.5 G82204 Dr Q M Mangi & Partner 75.6 29UMGG Davington Priory 62.1 G82138 Dr Smith A & Partners 65.7 29UCGQ Marshside 57.0 G82027 Dr Logan L C & Partners 51.2 29UMHB Watling 50.4 G82726 Dr Shar M B & Partner 50.7 29UMGU St Ann's 49.3 G82140 University Medical Centre 48.8 29UCGG Chestfield and Swalecliffe 47.2 G82119 Dr Sigurdsson R G & Partners 47.6 29UCGJ Greenhill and Eddington 43.9 G82012 Cossington House Surgery 42.3 29UCGD Barton 42.4 G82039 Newton Place Surgery 42.3 29UCGR North Nailbourne 42.4 G82060 Dr Grice D J P & Partners 36.8 29UCGN Heron 41.6 G82029 Dr Garrod P J & Partners 30.3 29UCGZ Tankerton 37.8 G82090 St Annes Group Practice 30.3 29UMGC Abbey 36.9 G82071 Dr Ribchester J M & Partners 29.8 29UCGE Blean Forest 33.0 G82228 Canterbury Medical Practice 26.8 29UCGU St Stephens 32.2 G82115 Dr Jones G L & Partners 25.5 29UCGH Gorrell 31.8 G82061 Dr Johnson L F & Partner 22.3 29UCHC Wincheap 29.2 G82082 Dr Molony J P & Partners 19.2 29UCGW Seasalter 27.2 G82004 The Faversham Health Centre 15.2 29UCGT Reculver 26.8 G82802 Dr Simmonds R & Partner 7.3 29UCGY Sturry South 25.9 G82179 Boughton Medical Centre 0.0 29UMGE Boughton and Courtenay 25.5 29UCGM Herne and Broomfield 24.2 29UCGP Little Stour 22.4 29UCGS Northgate 21.8 29UCGF Chartham and Stone Street 21.6 29UCGL Harbour 20.9 29UEGN Eastry 15.9 29UCHB Westgate 15.4 29UMHA Teynham and Lynsted 10.9 29UCGK Harbledown 0.0 29UCGX Sturry North 0.0 29UMGH East Downs 0.0
Page | 111
Figure 127- Emergency admission rates for children aged 5-19 years
For emergency admission rates for people aged 5-19 the highest rates are found in Sturry North, Little Stour, Wincheap, East Downs and Seasalter, the lowest rates are found in Harbour, Heron, Little Stour and Ashstone, Harbledown and St Stephens.
The GP practices with the highest admission rates are Dr Shar M B & Partner, The Butchery Surgery, Dr Grice D J P & Partners, Dr Jones G L & Partners and Newton Place Surgery. The lowest rates are in Dr Q M Mangi & Partner, University Medical Centre, Dr Logan L C & Partners, Boughton Medical Centre and Dr Johnson L F & Partner.
Page | 112
Ward Rates GP Practice Rates
Ward Code Ward Name 5-19 GP Code Practice Name 5-19 29UCGX Sturry North 27.5 G82726 Dr Shar M B & Partner 26.0 29UCGP Little Stour 24.5 G82148 The Butchery Surgery 23.8 29UCHC Wincheap 24.1 G82060 Dr Grice D J P & Partners 23.7 29UMGH East Downs 23.6 G82115 Dr Jones G L & Partners 19.2 29UCGW Seasalter 23.4 G82039 Newton Place Surgery 19.1 29UCGT Reculver 22.6 G82063 Market Place Surgery 15.9 29UCGR North Nailbourne 22.1 G82228 Canterbury Medical Practice 14.9 29UCGD Barton 21.9 G82090 St Annes Group Practice 14.4 29UCGQ Marshside 20.2 G82012 Cossington House Surgery 14.4 29UCGC Barham Downs 19.9 G82802 Dr Simmonds R & Partner 14.1 29UEGN Eastry 16.4 G82082 Dr Molony J P & Partners 14.1 29UEHB Sandwich 16.3 G82790 Dr Kinnersley D S & Partner 13.9 29UCGS Northgate 16.1 G82071 Dr Ribchester J M & Partners 12.7 29UMHB Watling 15.9 G82004 The Faversham Health Centre 12.1 29UCGF Chartham and Stone Street 15.3 G82119 Dr Sigurdsson R G & Partners 12.1 29UMGE Boughton and Courtenay 13.2 G82029 Dr Garrod P J & Partners 11.2 29UMHA Teynham and Lynsted 12.4 G82138 Dr Smith A & Partners 9.9 29UCGH Gorrell 12.3 G82204 Dr Q M Mangi & Partner 9.7 29UMGG Davington Priory 11.9 G82140 University Medical Centre 8.2 29UMGU St Ann's 11.6 G82027 Dr Logan L C & Partners 6.7 29UMGC Abbey 10.6 G82179 Boughton Medical Centre 4.6 29UCGJ Greenhill and Eddington 10.5 G82061 Dr Johnson L F & Partner 0.0 29UCHA West Bay 10.5 29UCHB Westgate 10.3 29UCGE Blean Forest 10.3 29UCGM Herne and Broomfield 10.0 29UCGG Chestfield and Swalecliffe 9.9 29UCGZ Tankerton 9.9 29UCGY Sturry South 7.8 29UCGL Harbour 7.7 29UCGN Heron 7.6 29UEGQ Little Stour and Ashstone 7.1 29UCGK Harbledown 5.6 29UCGU St Stephens 4.0
Page | 113
Figure 128- Emergency admission rates for people aged 20-44 years
The highest admission rates for wards can be found in Sturry North, Davington Priory, Heron, Marshside and Reculver wards. The lowest rates are found in Sandwich, Watling, Blean Forest, Tankerton and St Stephens wards.
The highest rates at GP level are found at Dr Q M Mangi & Partner, Dr Shar M B & Partner, Dr Jones G L & Partners, Cossington House Surgery and Dr Grice D J P & Partners. The lowest rates are at Dr Kinnersley D S & Partner, Newton Place Surgery, Market Place Surgery, Boughton Medical Centre and University Medical Centre.
Page | 114
Ward Rates GP Practice Rates
Ward Code Ward Name 20-44 GP Code Practice Name 20-44 29UCGX Sturry North 71.2 G82204 Dr Q M Mangi & Partner 65.4 29UMGG Davington Priory 67.0 G82726 Dr Shar M B & Partner 50.1 29UCGN Heron 58.8 G82115 Dr Jones G L & Partners 45.3 29UCGQ Marshside 57.1 G82012 Cossington House Surgery 45.2 29UCGT Reculver 55.6 G82060 Dr Grice D J P & Partners 44.7 29UCGS Northgate 55.3 G82082 Dr Molony J P & Partners 43.1 29UMGU St Ann's 51.2 G82090 St Annes Group Practice 42.8 29UCHA West Bay 49.5 G82119 Dr Sigurdsson R G & Partners 42.0 29UCGP Little Stour 47.5 G82027 Dr Logan L C & Partners 40.6 29UCGR North Nailbourne 46.3 G82228 Canterbury Medical Practice 39.2 29UCGY Sturry South 41.9 G82138 Dr Smith A & Partners 34.3 29UCGM Herne and Broomfield 41.1 G82802 Dr Simmonds R & Partner 34.2 29UCGC Barham Downs 40.6 G82029 Dr Garrod P J & Partners 31.9 29UCGH Gorrell 40.6 G82004 The Faversham Health Centre 30.6 29UCGG Chestfield and Swalecliffe 40.2 G82061 Dr Johnson L F & Partner 30.4 29UCHC Wincheap 39.4 G82071 Dr Ribchester J M & Partners 30.4 29UCGW Seasalter 36.4 G82148 The Butchery Surgery 28.6 29UEGQ Little Stour and Ashstone 35.2 G82790 Dr Kinnersley D S & Partner 26.7 29UCGD Barton 34.9 G82039 Newton Place Surgery 26.4 29UCHB Westgate 34.4 G82063 Market Place Surgery 24.5 29UMGC Abbey 33.7 G82179 Boughton Medical Centre 16.3 29UCGJ Greenhill and Eddington 33.4 G82140 University Medical Centre 12.0 29UMHA Teynham and Lynsted 31.6 29UMGH East Downs 31.4 29UCGL Harbour 31.4 29UCGK Harbledown 28.3 29UMGE Boughton and Courtenay 26.0 29UCGF Chartham and Stone Street 25.6 29UEGN Eastry 25.5 29UEHB Sandwich 24.9 29UMHB Watling 21.3 29UCGE Blean Forest 20.4 29UCGZ Tankerton 18.9 29UCGU St Stephens 16.1
Page | 115
Figure 129- Emergency admission rate for people aged 45-64 years
The highest emergency admission rates for persons aged 45-64 in Canterbury & Coastal are found in Northgate, Abbey, Marshside, West Bay and Davington Priory wards. The lowest rates are found in Tankerton, Harbledown, Watling, Sandwich and North Nailbourne wards.
The highest rates at GP level are Dr Simmonds R & Partner, Dr Grice D J P & Partners, Dr Shar M B & Partner, Dr Q M Mangi & Partner and Newton Place Surgery, the lowest rates are found in Canterbury Medical Practice, The Faversham Health Centre, Market Place Surgery, Dr Kinnersley D S & Partner and Boughton Medical Centre.
Page | 116
Ward Rates GP Practice Rates
Ward Code Ward Name 45-64 GP Code Practice Name 45-64 29UCGS Northgate 123.7 G82802 Dr Simmonds R & Partner 103.3 29UMGC Abbey 119.0 G82060 Dr Grice D J P & Partners 81.7 29UCGQ Marshside 79.7 G82726 Dr Shar M B & Partner 75.8 29UCHA West Bay 76.2 G82204 Dr Q M Mangi & Partner 75.6 29UMGG Davington Priory 75.2 G82039 Newton Place Surgery 68.5 29UCGN Heron 73.5 G82029 Dr Garrod P J & Partners 67.9 29UCHC Wincheap 70.9 G82082 Dr Molony J P & Partners 67.7 29UCGH Gorrell 69.9 G82027 Dr Logan L C & Partners 67.4 29UCGT Reculver 69.4 G82090 St Annes Group Practice 65.5 29UCHB Westgate 67.5 G82061 Dr Johnson L F & Partner 64.8 29UCGD Barton 65.9 G82119 Dr Sigurdsson R G & Partners 54.6 29UCGU St Stephens 63.7 G82115 Dr Jones G L & Partners 52.1 29UCGJ Greenhill and Eddington 59.5 G82138 Dr Smith A & Partners 50.4 29UCGY Sturry South 56.9 G82148 The Butchery Surgery 50.3 29UCGG Chestfield and Swalecliffe 55.0 G82071 Dr Ribchester J M & Partners 50.2 29UEGQ Little Stour and Ashstone 53.5 G82140 University Medical Centre 48.7 29UCGC Barham Downs 53.0 G82012 Cossington House Surgery 46.1 29UMHA Teynham and Lynsted 52.1 G82228 Canterbury Medical Practice 45.1 29UMGE Boughton and Courtenay 50.4 G82004 The Faversham Health Centre 39.4 29UCGW Seasalter 48.9 G82063 Market Place Surgery 37.5 29UCGM Herne and Broomfield 48.3 G82790 Dr Kinnersley D S & Partner 34.7 29UCGF Chartham and Stone Street 46.5 G82179 Boughton Medical Centre 23.9 29UCGX Sturry North 46.1 29UCGE Blean Forest 46.0 29UEGN Eastry 45.7 29UCGL Harbour 45.4 29UMGU St Ann's 43.2 29UMGH East Downs 42.9 29UCGP Little Stour 40.8 29UCGZ Tankerton 40.1 29UCGK Harbledown 36.8 29UMHB Watling 36.7 29UEHB Sandwich 31.2 29UCGR North Nailbourne 28.9
Page | 117
Figure 130- Emergency admission rates for people aged 65-84 years
The highest emergency admission rates are found in Abbey, Barton, Sturry North, Heron and West Bay wards, the lowest rates are found in Chartham and Stone Street, Sandwich, Harbledown, Teynham and Lynsted and Eastry wards.
The highest GP rates are found in Dr Grice D J P & Partners, St Annes Group Practice, Dr Simmonds R & Partner, Cossington House Surgery and Dr Shar M B & Partner, the lowest rates are found in Canterbury Medical Practice, Dr Kinnersley D S & Partner, The Butchery Surgery, Boughton Medical Centre and University Medical Centre.
Page | 118
Ward Rates GP Practice Rates
Ward Code Ward Name 65-84 GP Code Practice Name 65-84 29UMGC Abbey 263.0 G82060 Dr Grice D J P & Partners 207.1 29UCGD Barton 254.2 G82090 St Annes Group Practice 201.3 29UCGX Sturry North 249.6 G82802 Dr Simmonds R & Partner 195.2 29UCGN Heron 230.4 G82012 Cossington House Surgery 190.7 29UCHA West Bay 226.7 G82726 Dr Shar M B & Partner 189.4 29UCGS Northgate 224.5 G82061 Dr Johnson L F & Partner 188.4 29UCGT Reculver 214.1 G82119 Dr Sigurdsson R G & Partners 186.2 29UCGL Harbour 208.3 G82029 Dr Garrod P J & Partners 184.4 29UCGJ Greenhill and Eddington 207.3 G82115 Dr Jones G L & Partners 177.1 29UCHC Wincheap 206.9 G82082 Dr Molony J P & Partners 169.5 29UCGY Sturry South 194.0 G82071 Dr Ribchester J M & Partners 168.9 29UCGW Seasalter 190.1 G82027 Dr Logan L C & Partners 168.7 29UMHB Watling 183.9 G82204 Dr Q M Mangi & Partner 167.9 29UCGH Gorrell 183.2 G82039 Newton Place Surgery 165.3 29UMGG Davington Priory 178.2 G82138 Dr Smith A & Partners 160.7 29UCGM Herne and Broomfield 171.2 G82004 The Faversham Health Centre 160.1 29UCGE Blean Forest 170.3 G82063 Market Place Surgery 117.0 29UCHB Westgate 169.1 G82228 Canterbury Medical Practice 113.4 29UCGR North Nailbourne 165.4 G82790 Dr Kinnersley D S & Partner 100.7 29UCGZ Tankerton 161.9 G82148 The Butchery Surgery 91.3 29UCGG Chestfield and Swalecliffe 159.2 G82179 Boughton Medical Centre 78.5 29UMGU St Ann's 156.6 G82140 University Medical Centre 70.8 29UCGQ Marshside 152.3 29UCGC Barham Downs 151.8 29UEGQ Little Stour and Ashstone 146.2 29UCGP Little Stour 138.6 29UCGU St Stephens 137.9 29UMGE Boughton and Courtenay 135.5 29UMGH East Downs 132.4 29UCGF Chartham and Stone Street 130.6 29UEHB Sandwich 118.2 29UCGK Harbledown 113.9 29UMHA Teynham and Lynsted 111.7 29UEGN Eastry 109.0
Page | 119
Figure 131- Emergency admission rates for people aged 85+ years
The wards with the highest emergency admission rates for people aged 85 and over are Sturry North, West Bay, Herne and Broomfield, St Ann's and Seasalter wards. The wards with the lowest rates are Davington Priory, Westgate, Harbledown, Teynham and Lynsted and Little Stour and Ashstone.
The practices with the highest rates are Dr Garrod P J & Partners, Dr Johnson L F & Partner, Dr Simmonds R & Partner, Dr Q M Mangi & Partner and Dr Molony J P & Partners, those with the lowest rates are Canterbury Medical Practice, The Butchery Surgery, Dr Smith A & Partners, Boughton Medical Centre and University Medical Centre.
Page | 120
Ward Rates GP Practice Rates
Ward Code Ward Name 85+ GP Code Practice Name 85+ 29UCGX Sturry North 873.2 G82029 Dr Garrod P J & Partners 725.2 29UCHA West Bay 634.5 G82061 Dr Johnson L F & Partner 680.0 29UCGM Herne and Broomfield 613.5 G82802 Dr Simmonds R & Partner 619.7 29UMGU St Ann's 611.1 G82204 Dr Q M Mangi & Partner 583.9 29UCGW Seasalter 581.5 G82082 Dr Molony J P & Partners 562.5 29UCGN Heron 567.8 G82119 Dr Sigurdsson R G & Partners 535.6 29UMGC Abbey 552.6 G82039 Newton Place Surgery 512.3 29UCHC Wincheap 544.6 G82090 St Annes Group Practice 503.2 29UCGY Sturry South 542.9 G82060 Dr Grice D J P & Partners 500.0 29UCGS Northgate 517.5 G82115 Dr Jones G L & Partners 481.9 29UCGT Reculver 506.9 G82071 Dr Ribchester J M & Partners 475.2 29UCGJ Greenhill and Eddington 495.9 G82726 Dr Shar M B & Partner 475.0 29UCGD Barton 483.5 G82790 Dr Kinnersley D S & Partner 411.8 29UMHB Watling 475.6 G82012 Cossington House Surgery 406.5 29UCGR North Nailbourne 471.3 G82004 The Faversham Health Centre 401.4 29UCGH Gorrell 470.6 G82027 Dr Logan L C & Partners 387.8 29UCGQ Marshside 462.5 G82063 Market Place Surgery 348.4 29UEGN Eastry 458.3 G82228 Canterbury Medical Practice 318.2 29UCGZ Tankerton 449.1 G82148 The Butchery Surgery 273.5 29UMGE Boughton and Courtenay 446.6 G82138 Dr Smith A & Partners 232.4 29UCGG Chestfield and Swalecliffe 424.7 G82179 Boughton Medical Centre 229.2 29UCGU St Stephens 422.9 G82140 University Medical Centre 105.3 29UCGE Blean Forest 419.8 29UCGL Harbour 417.9 29UCGP Little Stour 414.4 29UCGF Chartham and Stone Street 402.1 29UMGH East Downs 345.5 29UCGC Barham Downs 338.0 29UEHB Sandwich 329.7 29UMGG Davington Priory 314.8 29UCHB Westgate 307.7 29UCGK Harbledown 292.7 29UMHA Teynham and Lynsted 261.7 29UEGQ Little Stour and Ashstone 202.1
Page | 121
Figure 132- Emergency admission rate for all ages
The wards with the highest rates for all ages are Reculver, West Bay, Sturry North, Heron and Abbey wards. Those with the lowest rates are Teynham and Lynsted, Harbledown, Chartham and Stone Street, St Stephens and Blean Forest.
The highest rates amongst practices are in St Annes Group Practice, Dr Garrod P J & Partners, Dr Shar M B & Partner, Dr Q M Mangi & Partner and Dr Grice D J P & Partners. The lowest rates are at Market Place Surgery, The Butchery Surgery, Dr Kinnersley D S & Partner, Boughton Medical Centre and University Medical Centre.
Page | 122
Ward Rates GP Practice Rates
Ward Code Ward Name All Ages GP Code Practice Name All Ages 29UCGT Reculver 112.8 G82090 St Annes Group Practice 99.5 29UCHA West Bay 111.5 G82029 Dr Garrod P J & Partners 97.7 29UCGX Sturry North 110.4 G82726 Dr Shar M B & Partner 95.0 29UCGN Heron 110.0 G82204 Dr Q M Mangi & Partner 91.6 29UMGC Abbey 101.6 G82060 Dr Grice D J P & Partners 87.5 29UCGW Seasalter 94.0 G82119 Dr Sigurdsson R G & Partners 81.8 29UCGG Chestfield and Swalecliffe 86.6 G82071 Dr Ribchester J M & Partners 77.4 29UCGZ Tankerton 84.8 G82115 Dr Jones G L & Partners 76.4 29UMGG Davington Priory 84.0 G82027 Dr Logan L C & Partners 75.0 29UCGR North Nailbourne 83.7 G82012 Cossington House Surgery 73.6 29UCGY Sturry South 83.2 G82061 Dr Johnson L F & Partner 70.5 29UCGH Gorrell 78.2 G82138 Dr Smith A & Partners 70.5 29UCGQ Marshside 77.8 G82039 Newton Place Surgery 69.9 29UCGS Northgate 77.5 G82802 Dr Simmonds R & Partner 67.4 29UCHC Wincheap 74.3 G82082 Dr Molony J P & Partners 62.8 29UCGJ Greenhill and Eddington 73.1 G82228 Canterbury Medical Practice 59.7 29UCGP Little Stour 71.8 G82004 The Faversham Health Centre 59.6 29UCGD Barton 71.4 G82063 Market Place Surgery 59.1 29UCGC Barham Downs 71.2 G82148 The Butchery Surgery 57.3 29UCGM Herne and Broomfield 68.0 G82790 Dr Kinnersley D S & Partner 50.2 29UMGU St Ann's 67.9 G82179 Boughton Medical Centre 35.5 29UMHB Watling 67.6 G82140 University Medical Centre 14.0 29UEGQ Little Stour and Ashstone 61.9 29UCGL Harbour 61.6 29UEHB Sandwich 59.2 29UCHB Westgate 58.9 29UMGE Boughton and Courtenay 57.9 29UMGH East Downs 57.0 29UEGN Eastry 56.7 29UMHA Teynham and Lynsted 51.4 29UCGK Harbledown 51.4 29UCGF Chartham and Stone Street 50.1 29UCGU St Stephens 42.4 29UCGE Blean Forest 35.7
Page | 123
Elective admission rates in Canterbury & Coastal CCG for older people, 2012/13 Figure 133- Elective admission rates for people aged 65-84 years
For Elective admission rates for people aged 65-84 the highest are found in North Nailbourne, Herne and Broomfield, Little Stour and Ashstone, Blean Forest and Barton wards, the lowest rates are in East Downs, Seasalter, Eastry, Tankerton and Little Stour. The GP practices with the highest rates are Dr Smith A & Partners, Dr Grice D J P & Partners, Dr Kinnersley D S & Partner, Dr Simmonds R & Partner and Dr Logan L C & Partners, the lowest rates are in The Faversham Health Centre, Dr Johnson L F & Partner, Boughton Medical Centre, University Medical Centre and Dr Shar M B & Partner.
Page | 124
Ward Rates GP Practice Rates
Ward Code Ward Name 65-84 GP Code Practice Name 65-84 29UCGR North Nailbourne 336.5 G82138 Dr Smith A & Partners 308.9 29UCGM Herne and Broomfield 325.4 G82060 Dr Grice D J P & Partners 302.1 29UEGQ Little Stour and Ashstone 324.7 G82790 Dr Kinnersley D S & Partner 285.5 29UCGE Blean Forest 323.3 G82802 Dr Simmonds R & Partner 273.8 29UCGD Barton 322.4 G82027 Dr Logan L C & Partners 273.3 29UCGT Reculver 314.5 G82090 St Annes Group Practice 271.7 29UCHA West Bay 304.9 G82039 Newton Place Surgery 269.8 29UMGU St Ann's 301.2 G82119 Dr Sigurdsson R G & Partners 268.6 29UCGU St Stephens 299.9 G82012 Cossington House Surgery 265.6 29UMGC Abbey 299.8 G82148 The Butchery Surgery 261.0 29UCGQ Marshside 297.3 G82029 Dr Garrod P J & Partners 258.9 29UCGY Sturry South 292.6 G82204 Dr Q M Mangi & Partner 252.4 29UEHB Sandwich 291.0 G82115 Dr Jones G L & Partners 250.7 29UCGJ Greenhill and Eddington 289.1 G82228 Canterbury Medical Practice 239.9 29UMHB Watling 285.4 G82082 Dr Molony J P & Partners 238.3 29UCGC Barham Downs 280.8 G82063 Market Place Surgery 236.7 29UCGX Sturry North 280.3 G82071 Dr Ribchester J M & Partners 229.4 29UCGS Northgate 279.8 G82004 The Faversham Health Centre 224.4 29UMGE Boughton and Courtenay 278.1 G82061 Dr Johnson L F & Partner 211.1 29UCHB Westgate 278.0 G82179 Boughton Medical Centre 208.2 29UMGG Davington Priory 274.6 G82140 University Medical Centre 190.3 29UCHC Wincheap 269.0 G82726 Dr Shar M B & Partner 173.5 29UCGG Chestfield and Swalecliffe 265.1 29UMHA Teynham and Lynsted 261.1 29UCGF Chartham and Stone Street 246.7 29UCGK Harbledown 245.6 29UCGL Harbour 245.5 29UCGN Heron 244.4 29UCGH Gorrell 232.7 29UMGH East Downs 225.3 29UCGW Seasalter 220.9 29UEGN Eastry 208.3 29UCGZ Tankerton 199.5 29UCGP Little Stour 192.8
Page | 125
Figure 134- Elective admission rates for people aged 85+ years
The wards with the highest rates for Elective admissions in the 85+ are Sturry South, East Downs, Marshside, Herne and Broomfield and Boughton and Courtenay wards, the lowest are found in Harbour, Sturry North, Teynham and Lynsted, Little Stour and Greenhill and Eddington. The highest GP practice rates are found in Dr Smith A & Partners, Dr Grice D J P & Partners, Dr Kinnersley D S & Partner, Dr Simmonds R & Partner and Dr Logan L C & Partners, the lowest rates are found in The Faversham Health Centre, Dr Johnson L F & Partner, Boughton Medical Centre, University Medical Centre and Dr Shar M B & Partner.
Page | 126
Ward Rates GP Practice Rates
Ward Code Ward Name 85+ GP Code Practice Name 85+ 29UCGY Sturry South 685.7 G82726 Dr Shar M B & Partner 750.0 29UMGH East Downs 418.2 G82790 Dr Kinnersley D S & Partner 512.6 29UCGQ Marshside 387.5 G82802 Dr Simmonds R & Partner 450.7 29UCGM Herne and Broomfield 374.2 G82082 Dr Molony J P & Partners 355.5 29UMGE Boughton and Courtenay 368.9 G82029 Dr Garrod P J & Partners 351.4 29UCGG Chestfield and Swalecliffe 361.6 G82148 The Butchery Surgery 350.4 29UCGW Seasalter 351.4 G82179 Boughton Medical Centre 312.5 29UCGS Northgate 342.1 G82204 Dr Q M Mangi & Partner 295.3 29UCGF Chartham and Stone Street 340.2 G82039 Newton Place Surgery 285.3 29UMGC Abbey 333.3 G82061 Dr Johnson L F & Partner 280.0 29UCHC Wincheap 330.4 G82063 Market Place Surgery 278.7 29UCGH Gorrell 317.6 G82071 Dr Ribchester J M & Partners 276.0 29UCGE Blean Forest 296.3 G82138 Dr Smith A & Partners 274.6 29UEHB Sandwich 289.9 G82027 Dr Logan L C & Partners 265.3 29UCGN Heron 279.7 G82140 University Medical Centre 263.2 29UEGN Eastry 277.8 G82119 Dr Sigurdsson R G & Partners 260.7 29UCHA West Bay 277.3 G82012 Cossington House Surgery 252.3 29UCGT Reculver 269.6 G82115 Dr Jones G L & Partners 250.0 29UCHB Westgate 253.2 G82090 St Annes Group Practice 245.2 29UCGZ Tankerton 249.1 G82004 The Faversham Health Centre 232.4 29UCGR North Nailbourne 242.0 G82060 Dr Grice D J P & Partners 224.7 29UCGC Barham Downs 239.4 G82228 Canterbury Medical Practice 220.3 29UMHB Watling 231.7 29UCGD Barton 227.3 29UCGU St Stephens 217.1 29UMGU St Ann's 211.1 29UCGK Harbledown 207.3 29UMGG Davington Priory 203.7 29UEGQ Little Stour and Ashstone 202.1 29UCGL Harbour 201.5 29UCGX Sturry North 183.1 29UMHA Teynham and Lynsted 177.6 29UCGP Little Stour 144.1 29UCGJ Greenhill and Eddington 89.4
Page | 127
Outpatient attendance rates in Canterbury & Coastal CCG for older people, 2012/13 Figure 135- First outpatient attendance rates for people aged 65-84 years
Outpatient attendance rates for people aged 65-84 are highest in Abbey, Herne and Broomfield, Barton, Sturry South and West Bay wards, the lowest rates are found in Chartham and Stone Street, East Downs, Tankerton, Eastry and Harbledown wards.
The highest practice rates are found at Dr Simmonds R & Partner, Dr Grice D J P & Partners, Cossington House Surgery, Dr Sigurdsson R G & Partners and Dr Smith A & Partners, the lowest rates are found in Canterbury Medical Practice, Market Place Surgery, Dr Shar M B & Partner, University Medical Centre and Boughton Medical Centre.
Page | 128
Ward Rates GP Practice Rates
Ward Code Ward Name 65-84 GP Code Practice Name 65-84 29UMGC Abbey 783.2 G82802 Dr Simmonds R & Partner 733.3 29UCGM Herne and Broomfield 776.1 G82060 Dr Grice D J P & Partners 682.2 29UCGD Barton 766.2 G82012 Cossington House Surgery 671.1 29UCGY Sturry South 719.1 G82119 Dr Sigurdsson R G & Partners 668.9 29UCHA West Bay 715.0 G82138 Dr Smith A & Partners 668.8 29UCGT Reculver 712.2 G82029 Dr Garrod P J & Partners 655.8 29UCGJ Greenhill and Eddington 698.4 G82090 St Annes Group Practice 646.0 29UCHC Wincheap 693.6 G82027 Dr Logan L C & Partners 643.8 29UMHB Watling 692.3 G82039 Newton Place Surgery 629.2 29UCGX Sturry North 683.8 G82082 Dr Molony J P & Partners 601.3 29UCGQ Marshside 683.0 G82061 Dr Johnson L F & Partner 593.0 29UCGN Heron 681.3 G82204 Dr Q M Mangi & Partner 591.8 29UCGR North Nailbourne 672.9 G82790 Dr Kinnersley D S & Partner 590.0 29UEGQ Little Stour and Ashstone 659.6 G82115 Dr Jones G L & Partners 588.0 29UCGE Blean Forest 653.0 G82071 Dr Ribchester J M & Partners 574.5 29UMGU St Ann's 653.0 G82148 The Butchery Surgery 565.8 29UMGG Davington Priory 641.5 G82004 The Faversham Health Centre 550.3 29UCGS Northgate 640.8 G82228 Canterbury Medical Practice 534.0 29UCGW Seasalter 629.8 G82063 Market Place Surgery 525.0 29UCGC Barham Downs 622.4 G82726 Dr Shar M B & Partner 522.1 29UEHB Sandwich 613.8 G82140 University Medical Centre 464.6 29UCGG Chestfield and Swalecliffe 613.1 G82179 Boughton Medical Centre 430.0 29UMHA Teynham and Lynsted 612.8 29UCGL Harbour 611.0 29UMGE Boughton and Courtenay 605.7 29UCGH Gorrell 590.1 29UCGU St Stephens 586.3 29UCGP Little Stour 574.3 29UCHB Westgate 552.8 29UCGF Chartham and Stone Street 545.3 29UMGH East Downs 537.5 29UCGZ Tankerton 527.6 29UEGN Eastry 503.2 29UCGK Harbledown 492.9
Page | 129
Figure 136- Outpatient first attendance rates for people aged 85+ years
Canterbury & Coastal CCG has 11 wards with rates higher than 1,000 per 1,000 85+ year olds for Outpatient appointments, these are Sturry South, Sturry North, Herne and Broomfield, Abbey, Seasalter, St Ann's, West Bay, Wincheap, Watling, Marshside and Heron wards. The wards with the lowest rates are Davington Priory, Teynham and Lynsted, Little Stour and Ashstone, Little Stour and Westgate. The highest GP practice rates are found in Dr Shar M B & Partner, Dr Simmonds R & Partner, Dr Garrod P J & Partners, Dr Molony J P & Partners and Dr Q M Mangi & Partner, the lowest rates are found in The Butchery Surgery, Dr Smith A & Partners, Boughton Medical Centre, Canterbury Medical Practice and University Medical Centre.
Page | 130
Ward Rates GP Practice Rates
Ward Code Ward Name 85+ GP Code Practice Name 85+ 29UCGY Sturry South 1442.9 G82726 Dr Shar M B & Partner 1437.5 29UCGX Sturry North 1295.8 G82802 Dr Simmonds R & Partner 1323.9 29UCGM Herne and Broomfield 1220.9 G82029 Dr Garrod P J & Partners 1247.7 29UMGC Abbey 1157.9 G82082 Dr Molony J P & Partners 1144.5 29UCGW Seasalter 1156.5 G82204 Dr Q M Mangi & Partner 1120.8 29UMGU St Ann's 1144.4 G82039 Newton Place Surgery 1095.1 29UCHA West Bay 1117.6 G82790 Dr Kinnersley D S & Partner 1058.8 29UCHC Wincheap 1098.2 G82061 Dr Johnson L F & Partner 1040.0 29UMHB Watling 1054.9 G82119 Dr Sigurdsson R G & Partners 1020.4 29UCGQ Marshside 1037.5 G82115 Dr Jones G L & Partners 974.6 29UCGN Heron 1035.5 G82071 Dr Ribchester J M & Partners 952.1 29UMGH East Downs 981.8 G82090 St Annes Group Practice 950.0 29UCGT Reculver 977.0 G82060 Dr Grice D J P & Partners 933.2 29UCGH Gorrell 964.7 G82004 The Faversham Health Centre 894.4 29UCGG Chestfield and Swalecliffe 961.6 G82027 Dr Logan L C & Partners 869.4 29UCGS Northgate 947.4 G82012 Cossington House Surgery 869.2 29UMGE Boughton and Courtenay 941.7 G82063 Market Place Surgery 822.3 29UEGN Eastry 923.6 G82148 The Butchery Surgery 820.5 29UCGF Chartham and Stone Street 917.5 G82138 Dr Smith A & Partners 753.5 29UCGZ Tankerton 917.0 G82179 Boughton Medical Centre 708.3 29UCGJ Greenhill and Eddington 910.6 G82228 Canterbury Medical Practice 695.8 29UCGL Harbour 910.4 G82140 University Medical Centre 631.6 29UCGR North Nailbourne 898.1 29UCGD Barton 896.7 29UCGC Barham Downs 873.2 29UCGK Harbledown 804.9 29UEHB Sandwich 797.1 29UCGU St Stephens 788.6 29UCGE Blean Forest 740.7 29UMGG Davington Priory 740.7 29UMHA Teynham and Lynsted 738.3 29UEGQ Little Stour and Ashstone 707.4 29UCGP Little Stour 693.7 29UCHB Westgate 673.1
Page | 131