NHS RightCare Frailty Preview

Frimley Health

April 2018

Frimley Health Introduction

NHS RightCare is developing a focus pack for frailty and is currently going through an engagement process to agree the structure and indicator list to be used. The indicator list is expected to include both existing indicators (used in other NHS RightCare packs) and new indicators.

This Frailty Preview presents charts for a selection of relevant indicators . Interpreting the charts

Indicator Name STP / Region National Range Opportunity

National Average CCG National Position

Confidence Interval

% Difference to lowest/best As this confidence interval crosses the CCG Opportunity in £s or similar 5 CCGs horizontal axes, the amber opportunity does not patients to best/lowest 5 count towards the STP opportunity similar CCGs Percentage of GP registered population aged 75+ - April 2017

16 CCGs Frimley Health England 14

12

10

8

6

4

2

10G 10G

11C 11C 99M 10C 10T 10T

- % difference compared to lowest 5 similar CCGs and quantified potential improvement opportunity 20.0%

15.0%

10.0%

5.0%

0.0%

-5.0%

-10.0%

-15.0%

-20.0% Bracknell and Ascot Windsor, Ascot and Maidenhead North East and Farnham Heath 10T 10G 11C 99M 10C

STP Opportunity calculated by summing the CCGs with statistically significant opportunities Source: NHS Digital Frimley Health Percentage of GP registered population aged 65+ - April 2017

35 CCGs Frimley Health England 30

25

20

15

10

5

10G 10G

10T 10T 11C 99M 10C

- % difference compared to lowest 5 similar CCGs and quantified potential improvement opportunity 15.0%

10.0%

5.0%

0.0%

-5.0%

-10.0%

-15.0%

-20.0% Slough Bracknell and Ascot Windsor, Ascot and Maidenhead North and Farnham 10T 10G 11C 99M 10C

STP Opportunity calculated by summing the CCGs with statistically significant opportunities Source: NHS Digital Frimley Health Proportion of older people (aged 60+) living in income deprived households - 2015

60 CCGs Frimley Health England 50

40

30

20

10

10G 10G

10C 10C 11C 99M 10T

- % difference compared to lowest 5 similar CCGs and quantified potential improvement opportunity 50.0%

40.0%

30.0%

20.0%

10.0%

0.0%

-10.0% Surrey Heath Windsor, Ascot and Maidenhead North East Hampshire and Farnham Bracknell and Ascot Slough 10C 11C 99M 10G 10T

STP Opportunity calculated by summing the CCGs with statistically significant opportunities Source: English indices of deprivation 2015 Frimley Health Proportion of the adult population (aged 16+) meeting the recommended '5-a-day’ on a 'usual day' - 2015/16

80 CCGs Frimley Health England 70

60

50

40

30

20

10

10G 10G

10C 10C 99M 11C 10T 10T

- % difference compared to lowest 5 similar CCGs and quantified potential improvement opportunity 20.0%

15.0%

10.0%

5.0%

0.0%

-5.0%

-10.0%

-15.0% Slough Bracknell and Ascot Surrey Heath North East Hampshire and Farnham Windsor, Ascot and Maidenhead 10T 10G 10C 99M 11C

STP Opportunity calculated by summing the CCGs with statistically significant opportunities Source: Public Health England (PHE), Fingertips, Sport England, Active Lives Survey Frimley Health Percentage of adults (aged 19+) that are physically inactive (<30 moderate intensity equivalent minutes per week) - 2015/16

40 CCGs Frimley Health England 35

30

25

20

15

10

5

10G 10G

11C 11C 10C 99M 10T

- % difference compared to lowest 5 similar CCGs and quantified potential improvement opportunity 40.0%

30.0%

20.0%

10.0%

0.0%

-10.0%

-20.0% Bracknell and Ascot Windsor, Ascot and Maidenhead Surrey Heath North East Hampshire and Farnham Slough 10G 11C 10C 99M 10T

STP Opportunity calculated by summing the CCGs with statistically significant opportunities Source: Public Health England (PHE), Fingertips, Sport England, Active Lives Survey Frimley Health Percentage of adults (aged 18+) classified as overweight or obese - 2015/16

90 CCGs Frimley Health England 80

70

60

50

40

30

20

10

10G 10G

11C 11C 10C 99M 10T

- % difference compared to lowest 5 similar CCGs and quantified potential improvement opportunity 30.0%

25.0%

20.0%

15.0% 10.0% 5.0%

0.0%

-5.0%

-10.0%

-15.0%

-20.0% Windsor, Ascot and Maidenhead Bracknell and Ascot Surrey Heath North East Hampshire and Farnham Slough 11C 10G 10C 99M 10T

STP Opportunity calculated by summing the CCGs with statistically significant opportunities Source: Public Health England (PHE), Fingertips, Sport England, Active Lives Survey Frimley Health Percentage of people registered in a GP practice aged 18+ on clinical register for obesity - 2016/17

18 CCGs Frimley Health England 16

14

12

10

8

6

4

2

10G 10G

10C 10C 11C 99M 10T

- % difference compared to lowest 5 similar CCGs and quantified potential improvement opportunity 35.0%

30.0%

25.0%

20.0%

15.0%

10.0%

5.0%

0.0%

-5.0% Surrey Heath Windsor, Ascot and Maidenhead Bracknell and Ascot North East Hampshire and Farnham Slough 10C 11C 10G 99M 10T

STP Opportunity calculated by summing the CCGs with statistically significant opportunities Source: NHS Digital, Quality and Outcomes Framework (QOF) Frimley Health Percentage of people aged 18+ who are self-reported occasional or regular smokers - Jan-March 2017

30 CCGs Frimley Health England 25

20

15

10

5

10G 10G

10C 10C 11C 99M 99M 10T

- % difference compared to lowest 5 similar CCGs and quantified potential improvement opportunity 50.0%

40.0%

30.0%

20.0%

10.0%

0.0%

-10.0%

-20.0%

-30.0%

-40.0% Surrey Heath Bracknell and Ascot North East Hampshire and Farnham Windsor, Ascot and Maidenhead Slough 10C 10G 99M 11C 10T

STP Opportunity calculated by summing the CCGs with statistically significant opportunities Source: General Practice Patient Survey (GPPS) Frimley Health Rate of successful quitters at 4-weeks per 100,000 smokers aged 16+ - 2016/17 600 Ppl.

7,000 CCGs Frimley Health England 6,000

5,000

4,000

3,000

2,000

1,000

10G 10G

11C 11C 10C 99M 10T

- % difference compared to highest 5 similar CCGs and quantified potential improvement opportunity 20.0%

10.0%

0.0% 31 -10.0% 166 -20.0%

-30.0% 164 271 -40.0%

-50.0%

-60.0%

-70.0%

-80.0% Windsor, Ascot and Maidenhead Surrey Heath North East Hampshire and Farnham Bracknell and Ascot Slough 11C 10C 99M 10G 10T

STP Opportunity calculated by summing the CCGs with statistically significant opportunities Source: Risk Factors Intelligence Team, Public Health England (PHE), NHS Digital, Annual Population Survey, Office for National Statistics (ONS) Frimley Health Dementia: Estimated prevalence (%) for 65+ - February 2018

12 CCGs Frimley Health England 10

8

6

4

2

10G 10G

10T 10T 11C 10C 99M 99M

- % difference compared to lowest 5 similar CCGs and quantified potential improvement opportunity 20.0%

15.0%

10.0%

5.0%

0.0%

-5.0%

-10.0% North East Hampshire and Farnham Slough Bracknell and Ascot Windsor, Ascot and Maidenhead Surrey Heath 99M 10T 10G 11C 10C

STP Opportunity calculated by summing the CCGs with statistically significant opportunities Source: NHS Digital, Recorded Dementia Diagnoses Frimley Health Dementia: Diagnosis rate (%) for 65+ - February 2018 115 Ppl.

120 CCGs Frimley Health England 100

80

60

40

20

10G 10G

10T 10T 99M 11C 10C 10C

- % difference compared to highest 5 similar CCGs and quantified potential improvement opportunity 30.0%

20.0%

10.0%

0.0% 22 128 38

-10.0% 115

-20.0%

-30.0%

-40.0% Slough North East Hampshire and Farnham Bracknell and Ascot Surrey Heath Windsor, Ascot and Maidenhead 10T 99M 10G 10C 11C

STP Opportunity calculated by summing the CCGs with statistically significant opportunities Source: NHS Digital, Recorded Dementia Diagnoses Frimley Health Percentage of seasonal influenza vaccine uptake amongst GP patients aged 65+ - 1 Sep 2016 - 31 Jan 2017 2,542 Pats.

90 CCGs Frimley Health England 80

70

60

50

40

30

20

10

10G 10G

10T 10T 11C 99M 10C 10C

- % difference compared to highest 5 similar CCGs and quantified potential improvement opportunity 3.0%

2.0%

1.0%

0.0%

-1.0% 341 -2.0% 584 546 -3.0% 1,072

-4.0%

-5.0%

-6.0%

-7.0%

-8.0% Slough Windsor, Ascot and Maidenhead Bracknell and Ascot Surrey Heath North East Hampshire and Farnham 10T 11C 10G 10C 99M

STP Opportunity calculated by summing the CCGs with statistically significant opportunities Source: Public Health England (PHE), Influenza Immunisation Vaccine Uptake Monitoring Programme Frimley Health Rate of injuries due to falls in people aged 65+ per 100,000 age-sex weighted population - 2016/17 769 Adms.

3,500 CCGs Frimley Health England 3,000

2,500

2,000

1,500

1,000

500

10G 10G

10T 10T 99M 11C 10C

- % difference compared to lowest 5 similar CCGs and quantified potential improvement opportunity 80.0%

70.0%

60.0%

50.0%

40.0%

30.0% 185 291 20.0% 154 99 10.0% 41

0.0% Slough Bracknell and Ascot North East Hampshire and Farnham Windsor, Ascot and Maidenhead Surrey Heath 10T 10G 99M 11C 10C

STP Opportunity calculated by summing the CCGs with statistically significant opportunities Source: National Commissioning Data Repository - Secondary Uses Service (SUS Plus) Frimley Health Tendency to fall, not elsewhere classified (R296): Spend on non-elective admissions per 1,000 age-sex weighted £137k population - 2016/17

12,000 CCGs Frimley Health England 10,000

8,000

6,000

4,000

2,000

10G 10G

99M 99M 11C 10C 10C 10T

- % difference compared to lowest 5 similar CCGs and quantified potential improvement opportunity 80.0%

60.0%

40.0%

20.0% £73k £64k £24k 0.0% £17k

-20.0%

-40.0%

-60.0% North East Hampshire and Farnham Surrey Heath Windsor, Ascot and Maidenhead Slough Bracknell and Ascot 99M 10C 11C 10T 10G

STP Opportunity calculated by summing the CCGs with statistically significant opportunities Source: National Commissioning Data Repository - Secondary Uses Service (SUS Plus) Frimley Health Disorientation, unspecified (R410): Spend on non-elective admissions per 1,000 age-sex weighted population - £500k 2016/17

3,000 CCGs Frimley Health England 2,500

2,000

1,500

1,000

500

10G

11C 11C 99M 10C 10T

- % difference compared to lowest 5 similar CCGs and quantified potential improvement opportunity 250.0%

200.0%

150.0%

100.0%

£83k £79k £106k £156k 50.0% £75k

0.0% Bracknell and Ascot Windsor, Ascot and Maidenhead North East Hampshire and Farnham Surrey Heath Slough 10G 11C 99M 10C 10T

STP Opportunity calculated by summing the CCGs with statistically significant opportunities Source: National Commissioning Data Repository - Secondary Uses Service (SUS Plus) Frimley Health Syncope and collapse (R55X): Spend on non-elective admissions for people aged 75+ per 1,000 age-sex weighted £179k population - 2016/17

20,000 CCGs Frimley Health England 18,000 16,000 14,000 12,000 10,000 8,000 6,000

4,000

2,000

10G 10G

10C 10C 99M 11C 10T 10T

- % difference compared to lowest 5 similar CCGs and quantified potential improvement opportunity 180.0%

160.0%

140.0%

120.0%

100.0%

80.0%

60.0% £52k £60k 40.0%

20.0% £15k £13k £38k 0.0% Bracknell and Ascot Surrey Heath North East Hampshire and Farnham Windsor, Ascot and Maidenhead Slough 10G 10C 99M 11C 10T

STP Opportunity calculated by summing the CCGs with statistically significant opportunities Source: National Commissioning Data Repository - Secondary Uses Service (SUS Plus) Frimley Health Influenza: Spend on non-elective admissions per 1,000 age-sex weighted population - 2016/17 £45k

1,800 CCGs Frimley Health England 1,600

1,400

1,200

1,000

800

600

400

200

10G 10G

10C 10C 99M 11C 10T

- % difference compared to lowest 5 similar CCGs and quantified potential improvement opportunity 400.0%

350.0%

300.0%

250.0%

200.0%

150.0%

100.0% £17k 50.0% £13k £15k

0.0%

-50.0%

-100.0% Surrey Heath North East Hampshire and Farnham Windsor, Ascot and Maidenhead Bracknell and Ascot Slough 10C 99M 11C 10G 10T

STP Opportunity calculated by summing the CCGs with statistically significant opportunities Source: National Commissioning Data Repository - Secondary Uses Service (SUS Plus) Frimley Health Aspiration pneumonia: Spend on non-elective admissions per 1,000 age-sex weighted population - 2016/17 £316k

4,500 CCGs Frimley Health England 4,000

3,500

3,000

2,500

2,000

1,500

1,000

500

10G 10G

11C 11C 99M 10T 10C 10C

- % difference compared to lowest 5 similar CCGs and quantified potential improvement opportunity 120.0%

100.0%

80.0%

60.0%

40.0%

£88k £63k 20.0% £111k £54k £14k 0.0%

-20.0%

-40.0% Bracknell and Ascot Windsor, Ascot and Maidenhead North East Hampshire and Farnham Surrey Heath Slough 10G 11C 99M 10C 10T

STP Opportunity calculated by summing the CCGs with statistically significant opportunities Source: National Commissioning Data Repository - Secondary Uses Service (SUS Plus) Frimley Health Proportion of older people (aged 65+) offered rehabilitation following discharge from acute or community hospital - 190 Pats. 2016/17

12 CCGs Frimley Health England 10

8

6

4

2

10G 10G

10C 10C 99M 11C 10T

- % difference compared to highest 5 similar CCGs and quantified potential improvement opportunity 40.0%

20.0%

0.0%

47 -20.0% 47 97

-40.0%

-60.0%

-80.0% Surrey Heath North East Hampshire and Farnham Windsor, Ascot and Maidenhead Slough Bracknell and Ascot 10C 99M 11C 10T 10G

STP Opportunity calculated by summing the CCGs with statistically significant opportunities Source: NHS Digital Frimley Health Proportion of older people (aged 65+) who were still at home 91 days after discharge from hospital into reablement 24 Pats. / rehabilitation services - 2016/17

120 CCGs Frimley Health England 100

80

60

40

20

10G 10G

11C 11C 10C 10C 99M 10T

- % difference compared to highest 5 similar CCGs and quantified potential improvement opportunity 15.0%

10.0%

5.0%

0.0% 4 8 -5.0% 9 7 -10.0%

-15.0%

-20.0%

-25.0%

-30.0%

-35.0% Surrey Heath Windsor, Ascot and Maidenhead North East Hampshire and Farnham Slough Bracknell and Ascot 10C 11C 99M 10T 10G

STP Opportunity calculated by summing the CCGs with statistically significant opportunities Source: NHS Digital Frimley Health Permanent admissions to residential and nursing care homes, per 100,000 population aged 65+ - 2013/14

1,400 CCGs Frimley Health England 1,200

1,000

800

600

400

200

10G

11C 11C 10C 99M 10T 10T

- % difference compared to lowest 5 similar CCGs and quantified potential improvement opportunity 140.0%

120.0%

100.0%

80.0%

60.0%

40.0%

20.0%

0.0%

-20.0%

-40.0% Windsor, Ascot and Maidenhead Slough Surrey Heath North East Hampshire and Farnham Bracknell and Ascot 11C 10T 10C 99M 10G

STP Opportunity calculated by summing the CCGs with statistically significant opportunities Source: Public Health England (PHE), Fingertips, Adult Social Care Profile Frimley Health