Chapters
Locality Profile Map of the locality
AMERSHAM & CHESHAM LOCALITY PROFILE
CSCSU 9/9/2016 [Edition 1, Volume 1] Demographics and Public Health Data
Changes over the last 5 years
Local Plan Patient Services used
Community assets,
Pharmacies Dentists Opticians Learning Disability Centres Children Centres Social Care Voluntary sector services Rectory Meadow Surgery Amersham Health Centre Prisons, Universities, The New Surgery colleges, Private hospitals, John Hampden Surgery Schools etc. Water Meadow Surgery Hughenden Valley Surgery Gladstone Surgery
Prospect House
Little Chalfont Surgery
Key Contact : CCG Clinical Lead Dr Stephen Burr
Key Practice Name Locality 1 K82001: Rectory Meadow Surgery Amersham and Chesham 2 K82004: Amersham Health Centre Amersham and Chesham 3 K82024: The New Surgery Amersham and Chesham 4 K82035: John Hampden Surgery Amersham and Chesham 5 K82037: Water Meadow Surgery Amersham and Chesham 6 K82049: Hughenden Valley Surgery Amersham and Chesham 7 K82058: Gladstone Surgery Amersham and Chesham 8 K82618: Prospect House Amersham and Chesham 9 K82621: Little Chalfont Surgery Amersham and Chesham
Demographics and Public Health Data Specific issue’s to consider in the Amersham and Chesham (A&C) Locality in Chiltern CCG. The A&C Locality’s population size in 2014 is 73,983 people around 14% of the total Bucks population. 20% of the population is aged 65+ higher than CCCG average of 18% and Bucks average of 17%. 24% of the population is aged <19 similar to CCCG and Bucks average. The locality on average is less deprived and less ethnically diverse compared to the AVCCG and Buckinghamshire as a whole. Life expectancy is better than the national average but there is a difference of up to 4 years in life expectancy between males and females in Chiltern District Council, compared to a difference of 3.5 years in Bucks.
The population of Amersham and Chesham locality experiences similar or better health compared to the Buckinghamshire population. Emergency admission rates to hospital are statistically lower than the Bucks and CCG average. Elective admission rates are also statistically lower than the Bucks and CCG average. Early death rates are similar to Bucks which itself has some of the lowest death rates in the country.
Modelled estimates suggest that a number of people may have undiagnosed high blood pressure, diabetes or dementia. Primary care data (QOF) shows variation in the outcomes achieved by locality practices in the management of people with diabetes, coronary heart disease, hypertension, stroke and chronic kidney disease, with higher exception rates for some outcomes. Cancer screening uptake in the locality is similar or better than the CCG average. Patient satisfaction with GP practices in the locality range from 80% to 95%.
Specific issues for this locality to consider (in addition to the Director of Public Health’s Annual Report key recommendations) are:
The needs of older people across the locality (including dementia, depression and social isolation).
Management of people with long term conditions: cardiovascular conditions in particular, but also those with multiple conditions and co-existing mental health problems. Map 1 Map 2
Map 3 Map 4
Map of Chiltern CCG practices
DETAILED REPORT
Demography – Population
Locality size (2016): There are 9 GP practices in the Amersham and Chesham locality with a total registered population of 75,666, which is 22% of the total Chiltern CCG registered population.
GP Practices (2016): Rectory Meadow Surgery, Amersham Health Centre, The New Surgery, John Hampden Surgery, Water Meadow Surgery, Hughenden Valley Surgery, Gladstone Surgery, Prospect House, Little Chalfont Surgery
Age profile: Similar to Buckinghamshire population profile overall. Main differences are noted in the 25-34 age group, which is lower compared to the Chiltern CCG average for both males and females. Higher proportion of males and females aged 65-74 compared to Chiltern CCG average. Around 24% population in the Amersham and Chesham locality are aged <19 years and 20% over 65 years of age.
Population changes: There has been a small increase in all the older population groups since 2014 with a rise of 3.3% in those aged 65 and over; 3.6% aged 65-74; 2.4% aged 75-84 and 4.8% in those aged 85 and over. There has however been a large increase (19.5%) of those aged 95 and over although this involves smaller actual numbers (30).
Population Projection 2016-2026: The population for Chiltern District is predicted to increase by 4% (4,200 people). The district population is forecast to fall by 9% (975 people) in those aged 20-34 (compared to a fall of an average of 1% in Buckinghamshire) and 16% increase (3,270 people) in those aged 65 and over (compared to an average of 24% increase in Buckinghamshire). This includes a 42% increase (1,250 people) in those aged 85 and over (compared to an average increase of 47% in Buckinghamshire).
Ethnicity (2011): People from a black and minority ethnic group account for 9% of the total population compared to Chiltern CCG average of 15.9%, Buckinghamshire average of 13.6% and England average of 14.7% [Census 2011].
Deprivation (2015): The Index of Multiple Deprivation (2015) based on LSOAs shows an average deprivation score of 7.3 in Amersham and Chesham locality compared to 9.1 in Chiltern CCG (Range 6.4-13.4). (Higher the score, more the deprivation).
Chiltern DC registered population July 2016 with 2026 projection
85+ 80-84 75-79 70-74 65-69 60-64 55-59 50-54 45-49 40-44
35-39 main X axis 30-34 25-29 20-24 15-19 10-14 05-09 00-04
10 8 6 4 2 0 2 4 6 8 10 % of gender total population Female Male Female Chiltern 2016 Chiltern 2016 Chiltern 2026 Male Female Bucks 2026 Male Bucks 2026 Chiltern 2026
Housing in Poor Condition: This indicator from the Census 2011 indicates when a household has at least one bedroom too few for the number and composition of people living in the household and is considered overcrowded by the bedroom standard. In Amersham and Chesham locality, 2.8% of the population is living in households which are considered as overcrowded by this indicator which is below the average for Chiltern CCG of 3.7%.
Occupancy rating (bedrooms) of -1 or less AVCCG CCCG Bucks
8%
1 or 1 less -
6%
4%
2% % Ocupancy rating of (bedrooms) rating % Ocupancy
0% Central North South Amersham & Southern Wooburn Wycombe Chesham Green GP Locality Census 2011
Births, low birth weight and infant mortality
Births: There were 724 live births in the Amersham and Chesham locality, compared to 6,089 in all Buckinghamshire localities in 2015 (11.9% of all births in Buckinghamshire CCGs). The birth rate in the Amersham and Chesham locality was statistically significantly lower at 9.7, compared to the combined Buckinghamshire CCG rate of 11.8 in 2015, and the England rate of 12.2 (live births per 1,000 population, in 2014). The general fertility rate (per 1,000 female population aged 15-44) in the locality was 59.5 (which is not statistically different) compared to 64.8 in all Buckinghamshire localities, and 62.2 in England (2014).
Low birth weight (LBW): 2013-15 records (from ONS) show that 7.9% of babies born to mothers in the Amersham and Chesham locality had a low birth weight (<2,500g), compared to 7.4% of babies in all Buckinghamshire localities (and 7.4% of babies in England in 2014, latest data). This is not statistically different to the combined Buckinghamshire localities data.
Infant deaths: The infant mortality (deaths at ages under 1 year) rate for Amersham and Chesham locality in 2013-15 was 5.0, which is higher (but not statistically different) than the combined Buckinghamshire localities rate of 3.8 (England rate, in 2014, was 4.0 per 1,000 live births).
Children
Early Years Foundation Stage Profile (EYFSP): In Amersham and Chesham, 73.6% of pupils attending Buckinghamshire maintained schools and academies, achieved a Good Level of Development in 2016. This is higher than the average of 70.5% for all pupils attending Buckinghamshire schools/settings.
Looked After Children: The rate of Looked After Children in Amersham and Chesham locality is 2.8 per 1,000 which is lower (but not statistically different) than the combined Buckinghamshire localities rate of 3.3 (as at 31st March 2016).
Life Expectancy and Mortality
Life expectancy: The male life expectancy in the Amersham and Chesham population in 2013-15 was 83.5 years, which is statistically significantly higher the Buckinghamshire average of 82.3 years (England average = 79.5 in 2012-14). Female life expectancy was 87.6 in Amersham and Chesham compared to 85.1 in Buckinghamshire, which is statistically significantly higher (England average = 83.2 in 2012-14).
Mortality in under 75s: The chart below shows the contribution of each condition to the ‘gap’ in mortality between the locality and the Buckinghamshire mortality rate.
The mortality profile in the under 75 population in Amersham and Chesham locality shows a statistically significantly lower overall premature death rate than the combined Buckinghamshire localities (204.1 vs 240.6 per 100,000), with the major causes of premature deaths being Cancer, Circulatory disease and Respiratory disease.
Under 75s, cause specific mortality profile (2013-15 combined) Amersham & Chesham Locality
300
250 11.3 15.9 Other causes 10.6 200 9.8 Infectious & parasitic diseases 13.4 13.6 External causes 7.4 18.8 Genitourinary system diseases 10.8 Nervous system diseases 150 16.1 Mental and behavioral disorders Digestive diseases Respiratory diseases
standardised rates per 100,000 population 100,000 per rates standardised 112.4 - 100 Cancers 97.9 Circulatory diseases
Directly age Directly 50
50.2 41.0
0 Amersham & Chesham Locality Bucks CCGs Other causes 9.8 11.3 Infectious & parasitic diseases 2.0 2.4 External causes 13.6 15.9 Genitourinary system diseases 1.4 1.4 Nervous system diseases 7.4 10.6 Mental and behavioral disorders 2.1 4.3 Digestive diseases 10.8 13.4 Respiratory diseases 16.1 18.8 Cancers 97.9 112.4 Circulatory diseases 41.0 50.2
Mortality in over 75s: The mortality profile in the over 75 population in Amersham and Chesham locality also shows a statistically significantly lower overall death rate than the combined Buckinghamshire localities (5,491 vs 6,577 per 100,000), with the major causes of deaths in older ages being Circulatory disease, Cancer and Respiratory disease.
All ages, cause specific mortality profile (2013-15 combined) Amersham & Chesham Locality
8,000
7,000 307.6 171.6 6,000 419.7 Other causes 337.4 Infectious & parasitic diseases 861.9 5,000 147.0 External causes 244.6 272.9 Genitourinary system diseases 551.9 Nervous system diseases 4,000 250.5 1080.2 Mental and behavioral disorders
859.3 Digestive diseases
3,000 Respiratory diseases standardised rates per 100,000 population 100,000 per rates standardised - 1481.4 Cancers 1,342.9 Circulatory diseases
2,000 Directly age Directly
1,000 1884.5 1,617.5
0 Amersham & Chesham Locality Bucks CCGs Other causes 337.4 307.6 Infectious & parasitic diseases 41.9 72.9 External causes 147.0 171.6 Genitourinary system diseases 129.4 159.6 Nervous system diseases 244.6 419.7 Mental and behavioral disorders 551.9 861.9 Digestive diseases 250.5 272.9 Respiratory diseases 859.3 1080.2 Cancers 1,342.9 1481.4 Circulatory diseases 1,617.5 1884.5
Lifestyle
Smoking: Based on the Annual Population Survey (APS), 11.0% of adults are estimated to be smokers in Buckinghamshire compared to 16.9% in England (2015). This equates to around 6,533 current smokers in Amersham and Chesham locality.
Physical Activity: Based on the Active People Survey (APS) from Sport England, 22.0% of adults in Buckinghamshire are estimated to be physically inactive (less than 30 minutes activity a week), which is better than the England figure of 28.7%. This equates to around 13,437 adults in Amersham and Chesham locality.
Excess weight in Adults (Obese and overweight): Based on the Active People Survey (APS) from Sport England, 63% of adults in Buckinghamshire are estimated to be obese or overweight, which is similar to the England figure of 65%. This equates to around 38,173 adults in Amersham and Chesham locality.
Alcohol consumption: Based on the 2011 Topography of Drinking Behaviours in England, 7.6% of drinkers in Buckinghamshire are estimated to be higher risk (harmful) drinkers (men who regularly drink over 8 units per day or over 50 units per week and women who regularly drink over 6 units per day and over 35 units per week), compared to 7.1% in England. This equates to around 4,614 in Amersham and Chesham locality.
Obesity (Children) o Aged 4-5 years: According to the National Child Measurement Programme (NCMP), in 2014-15, 22.4% of children aged 4-5 years (Reception Year) are estimated to be overweight or obese in the Amersham and Chesham locality, compared to 18.6% in Buckinghamshire localities (which is statistically significantly higher), and 21.9% in England. o Aged 10-11 years: According to the National Child Measurement Programme (NCMP), in 2014-15, 27.5% of children aged 10-11 years (Year 6) are estimated to be overweight or obese in the Amersham and Chesham locality, compared to 26.6% in Buckinghamshire localities (which is not statistically significantly different), and 33.2% in England.
In treatment for substance misuse o The rate of adult clients in significant contact with Buckinghamshire’s substance misuse treatment system (structured and non-structured) during 2013/14 to 2015/16 was 218.7 (per 100,000) in Amersham and Chesham, which is statistically significantly lower than in Buckinghamshire localities (combined rate of 274.2). o The rate of adult clients in significant contact with Buckinghamshire’s substance misuse treatment system for alcohol only use (structured and non-structured) during 2013/14 to 2015/16 was 100.6 (per 100,000) in Amersham and Chesham, which is lower, but not statistically different than in Buckinghamshire localities (combined rate of 109.6). o The rate of adult clients in significant contact with Buckinghamshire’s substance misuse treatment system for drug use (structured and non-structured) during 2013/14 to 2015/16 was 118.1 (per 100,000) in Amersham and Chesham, which is statistically significantly lower than in Buckinghamshire localities (combined rate of 164.6).
Screening, immunization and NHS Health Checks
Cancer screening: o Cervical Cancer: 77.6% of eligible women were screened for cervical cancer in Amersham and Chesham locality compared to 75.1% in Chiltern CCG (NHS Cancer Screening Programme 2014/15). o Breast Cancer: 75.7% of eligible women were screened for breast cancer within 6 months of invitation in Amersham and Chesham locality compared to 76.2% in Chiltern CCG (NHS Cancer Screening Programme 2014/15). o Bowel Cancer: 62.6% of eligible people were screened for bowel cancer within 6 months of invitation in Amersham and Chesham locality compared to 58% in Chiltern CCG (NHS Cancer Screening Programme 2014/15).
Flu vaccination: In 2015/16, 74% of population aged 65 and over in Amersham and Chesham locality received the influenza vaccination compared to the Buckinghamshire average of 71%; slightly lower than the recommended level of uptake at 75%. Uptake among the pregnant group was 47% in Amersham and Chesham locality, higher than the Buckinghamshire average of 43%. Uptake among children aged 2, 3 and 4 was 43%, higher than the Buckinghamshire average of 39% and among children aged 5 and 6 was 56%, higher than the Buckinghamshire average of 44%.
NHS Health Checks: In 2015/16, local data shows 8.1% of the eligible population in Amersham and Chesham locality received an NHS Health Check compared to the Chiltern CCG average of 7.6% and Buckinghamshire average of 7.2%
% Offered and Given Health Check, by CCG locality in 2015/16 25%
Equivalent to annual 20% target of 20%
15%
10% Equivalent to 50% of eligible population given a health check
5%
% Offered Health Check % Given Health Check
0%
South
North
Central
Southern
Wycombe
Chiltern CCG Chiltern
Wooburn Green Wooburn
Aylesbury Vale CCG Vale Aylesbury Combined Bucks CCGs Bucks Combined Chesham & Amersham
Long term conditions – Detection and management
The General Practice disease registers provide a count of individuals on registers such as Coronary Heart Disease (CHD), Hypertension, and Chronic Obstructive Pulmonary Disease (COPD) register. These are detected prevalence rates and may not be true prevalence rates. Nationally, Public Health England have also developed models to estimate the prevalence of long term conditions in the local population using models that help estimate prevalence of conditions such as diabetes, hypertension, COPD, Dementia and CHD. These estimates help local healthcare organisations understand the undetected prevalence and actual disease burden. Modelled prevalence estimates draw on national surveys and local relevant data such as age, sex and deprivation. These modelled estimates are then compared against GP recorded data to identify the proportion of cases that may as yet be undiagnosed. It is important to note that these estimates have limitations but can be used to understand the ratio of detected to estimated prevalence of conditions like diabetes or hypertension. Confidence intervals are usually too wide to statistically compare the estimates locally and have not been published.
Expected prevalence: o Hypertension: Hypertension prevalence model estimates that the prevalence of hypertension in Amersham and Chesham locality is around 25% compared to the detected prevalence of 13.7% which means there could be around 8,400 individuals with undiagnosed hypertension in the locality and 36,600 undiagnosed in Chiltern CCG. o Diabetes: The diabetes prevalence model developed by Public Health England estimates the prevalence of diabetes in Chiltern CCG as 8% compared to the detected prevalence of 5.9%; which means there could be around 6,000 individuals with undetected diabetes in Chiltern CCG with around 1,600 undiagnosed in the Amersham and Chesham locality. (Note, these are modelled estimates and further analysis using practice population can be done to get approximate number of undetected cases in the practice population).
The NHS Health Checks programme in Buckinghamshire is expected to identify undiagnosed cases of hypertension and diabetes among those aged 40-75.
o Dementia: The Dementia modelled prevalence (Primary Care Web Tool, March 2015 data) shows a dementia diagnosis gap in Amersham and Chesham locality, with an estimated prevalence of 1.37% compared to a detected prevalence of 0.59%, which means there could be around 63 undiagnosed dementia cases in the locality. This compares to an estimated prevalence rate of 1.30% vs. 0.65% detected in Chiltern CCG (2,152 people), and 1.24% vs. 0.68% in Buckinghamshire’s CCGs combined (3,195) people.
Detected prevalence: (Source: 2015/16 CQRS provisional figures. Since these figures are not published by HSCIC, regional and national comparator values are not yet available.) o Hypertension: 13.7% in Amersham and Chesham locality with 10,322 individuals on hypertension register, compared to 13.4% in Buckinghamshire CCGs (combined). o Diabetes: 5.5% in Amersham and Chesham locality with 3,286 individuals on the diabetes register, compared to 5.9% in Buckinghamshire CCGs (combined). o Coronary heart disease (CHD): 2.8% in Amersham and Chesham locality with 2,080 individuals on the CHD register similar to Buckinghamshire CCGs (combined) average of 2.9%. o Heart failure (HF): 0.54% in Amersham and Chesham locality with 404 individuals on the HF register, compared to 0.60% in Buckinghamshire CCGs (combined). o Stroke and Transient Ischaemic Attack (STIA): 1.69% in Amersham and Chesham locality with 1,272 individuals on the STIA register, compared to 1.62% in Buckinghamshire CCGs (combined). o Atrial Fibrillation (AF): 2.1% in Amersham and Chesham locality with 1,550 individuals on the AF register, compared to 1.9% in Buckinghamshire CCGs (combined). o Chronic Kidney Disease (CKD): 3.5% in Amersham and Chesham locality with 2,051 individuals on the CKD register, compared to 3.3% in Buckinghamshire CCGs (combined). o COPD: 1.21% in Amersham and Chesham locality with 913 individuals on the COPD register, compared to Buckinghamshire CCGs (combined) average of 1.36%. o Asthma: 6.3% in Amersham and Chesham locality with 4,725 individuals on the Asthma register, compared to 6.0% in Buckinghamshire CCGs (combined). o Depression: 7.0% in Amersham and Chesham locality with 4,104 individuals on the Depression register, compared to 7.9% in Buckinghamshire CCGs (combined). o Dementia: 0.71% in Amersham and Chesham locality with 532 individuals on the Dementia register, compared to 0.73% in Buckinghamshire CCGs (combined). o Severe mental illness (SMI): 0.68% in Amersham and Chesham locality with 511 individuals on the SMI register, compared to 0.72% in Buckinghamshire CCGs (combined). o Cancer: 3.1% in Amersham and Chesham locality with 2,297 individuals on the Cancer register, compared to 2.7% in Buckinghamshire CCGs (combined).
Adult Social Care
Trend summary for clients receiving Adult Social Care services 2013/14 to 2015/16 Age-standardised per 100,000 populations)
For definitions of these terms please see the glossary on page 22
Healthcare use (hospitals) – Secondary Uses Services
Emergency admission rates (Directly standardised rate per 100,000 populations, 2015/16. Note: actual admission rates available in summary table) o All causes: The rate is significantly lower than the combined Buckinghamshire localities average.
Between 2008/09 and 2015/16 the rate of admissions in Amersham and Chesham locality have increased by 12%
All Emergency Admissions (excluding admissions to MH Trusts), All Ages, FY 08/09 to FY 15/16, by locality within Chiltern CCG
12,000
10,000
8,000
6,000
4,000 DASR per 100,000 population 100,000 per DASR
2,000
0 08/09 09/10 10/11 11/12 12/13 13/14 14/15 15/16 Year Amersham & Chesham Southern Wooburn Green Wycombe o Bucks CCGs (Combined) Aylesbury Vale CCG Chiltern CCG
o All causes, 65+: The rate is significantly lower than the combined Buckinghamshire localities average. o All causes, 75+: The rate is significantly lower than the combined Buckinghamshire localities average. . Between 2008/09 and 2015/16 the rate of admissions in Amersham and Chesham locality have increased by 14%
All Emergency Admissions (excluding admissions to MH Trusts), Ages 75+, FY 08/09 to FY 15/16, by locality within Chiltern CCG
40,000
35,000
30,000
25,000
20,000
15,000
DASR per 100,000 population 100,000 per DASR 10,000
5,000
0 08/09 09/10 10/11 11/12 12/13 13/14 14/15 15/16 Year Amersham & Chesham Southern Wooburn Green Wycombe Bucks CCGs (Combined) Aylesbury Vale CCG Chiltern CCG
o All circulatory: The rate is significantly lower than the combined Buckinghamshire localities average. o Coronary Heart Disease (CHD): The rate is lower than the combined Buckinghamshire localities but with no significant difference. o Stroke: The rate is lower than the combined Buckinghamshire localities but with no significant difference. o HF: The rate is significantly lower than the combined Buckinghamshire localities average. o Diabetes: The rate is lower than the combined Buckinghamshire localities but with no significant difference. o All respiratory: The rate is significantly lower than the combined Buckinghamshire localities average. o COPD: The rate is significantly lower than the combined Buckinghamshire localities average. o All cancers: The rate is significantly lower than the combined Buckinghamshire localities average. o Falls (65+): The rate is lower than the combined Buckinghamshire localities but with no significant difference.
Admission rates for Mental Health (specialties or diagnosis): The rate is significantly lower than the combined Buckinghamshire localities average.
Emergency admissions as a % of patients on the respective disease register (2015/16) o Heart failure: 14% in Amersham and Chesham locality compared to 19% in Buckinghamshire CCGs (from SCWCSU Urgent Care Dashboard). o COPD: 8% in Amersham and Chesham locality compared to 11% in Buckinghamshire CCGs (from SCWCSU Urgent Care Dashboard).
Top causes of admissions (all) in people aged 65 and over, 2013/14-2015/16 (combined) Amersham & Chesham 5,626 1 Cataract 1,142 20.3% 2 Cancer 1,096 19.5% 3 Pneumonia 491 8.7% 4 Blood in urine 473 8.4% 5 Osteoartritis lower limb 467 8.3% 6 Urinary tract infection 367 6.5% 7 Coronary heart disease 279 5.0% 8 Gastrointestinal bleed 232 4.1% 9 Sepsis 205 3.6% 10 Atrial fibrillation and flutter 203 3.6% 11 Gastroenteritis 189 3.4% 12 Falls 171 3.0% 13 Indigestion 166 3.0% 14 Inguinal hernia 145 2.6%
Bed days, 2015/16 o Emergency admission: In 2015/16 the registered population of Amersham and Chesham had a total of 16,198 bed days for emergency admissions. 70.6%, or 11,438 bed days, were in the 65+ population and 56.5%, or 9,146 bed days, were in the 75+ population.
o All admissions: In 2015/16 the registered population of Amersham and Chesham had a total of 29,114 bed days for all admissions. 52.5%, or 15,290 bed days, were in the 65+ population and 39.4%, or 11,479 bed days, were in the 75+ population.
o Emergency admissions 65+: 55.6% of in-year bed days, for the registered population of Amersham and Chesham, are for emergency admissions, with 74.8% of in-year bed days for the population aged 65+ being for emergency admissions.
Repeat admissions, 2015/16 o All ages: In the Amersham and Chesham locality, there were 5,670 emergency admissions to 4,228 people; 3,197 people had a single admission, 670 people had two admissions, 220 people had three admissions and 141 people had four or more emergency admissions in the year. In Amersham and Chesham locality the maximum number of repeat admissions was 13 within the year. Across the Buckinghamshire localities, of the 33,267 people admitted as an emergency in 2015/16, 2,743 were previously admitted as an emergency in 2014/15 and 1,657 of them were also previously admitted as an emergency in 2013/14.
o Ages 65+: In the Amersham and Chesham locality, there were 2,591 emergency admissions to 1,823 people; 1,265 people had a single admission, 353 people had two admissions, 124 people had three admissions and 81 people had four or more emergency admissions in the year. In Amersham and Chesham locality the maximum number of repeat admissions was 13 within the year. Across the Buckinghamshire localities, of the 12,891 people age 65 and over admitted as an emergency in 2015/16, 1,492 were previously admitted as an emergency in 2014/15 and 925 of them were also previously admitted as an emergency in 2013/14.
o Ages 75+: In the Amersham and Chesham locality, there were 1,870 emergency admissions to 1,320 people; 899 people had a single admission, 268 people had two admissions, 97 people had three admissions and 56 people had four or more emergency admissions in the year. In Amersham and Chesham locality the maximum number of repeat admissions was eight within the year. Across the Buckinghamshire localities, of the 9,045 people age 75 and over admitted as an emergency in 2015/16, 1,128 were previously admitted as an emergency in 2014/15 and 652 of them were also previously admitted as an emergency in 2013/14.
Diabetes repeat admissions o Person admissions: The 25 emergency admissions for diabetes in 2015/16 were to 21 different people o Repeat admissions: In the Amersham and Chesham locality, 19 people had one admission and two people each had three emergency admissions for diabetes. Across the Buckinghamshire localities, of the 222 people admitted as an emergency in 2015/16, 11 were previously admitted as an emergency in 2014/15 and nine of them were also previously admitted as an emergency in 2013/14 for diabetes.
Cancer admissions o All admissions: In 2015/16 in Amersham and Chesham locality, there were almost 1,900 admissions for cancer (primary diagnosis). The rate is significantly lower than the combined Buckinghamshire localities average. o Emergency: Of these, 25.1% (476 admissions) were an emergency. This is lower than the Buckinghamshire average of 26.2%.
Children’s admissions (Directly standardised rate per 100000 population, 2015/16) o All emergency admissions, under 5s: The rate is lower than the combined Buckinghamshire localities, but with no significant difference. . Between 2008/09 and 2015/16 the rate of admissions in Amersham and Chesham locality has remained almost the same All Emergency Admissions, Under 5s FY 08/09 to FY 15/16, by locality within Chiltern CCG
30,000
25,000
20,000
15,000
10,000 DASR per 100,000 population 100,000 per DASR
5,000
0 08/09 09/10 10/11 11/12 12/13 13/14 14/15 15/16 Year Amersham & Chesham Southern Wooburn Green Wycombe Bucks CCGs (Combined) Aylesbury Vale CCG Chiltern CCG
o All emergency admissions, under 15s: The rate is lower than the combined Buckinghamshire localities, but with no significant difference. o All emergency admissions, under 20s: The rate is significantly lower than the combined Buckinghamshire localities average. o Respiratory admissions (Lower Respiratory Tract Infections), under 20s: The rate is very similar to that of the combined Buckinghamshire localities and with no significant difference. o Accidental and deliberate injuries, under 15s: The rate is lower than the combined Buckinghamshire localities, but with no significant difference. o Accidental and deliberate injuries, 15-24s: The rate is lower than the combined Buckinghamshire localities, but with no significant difference. . Between 2008/09 and 2015/16 the rate of admissions in Amersham and Chesham locality has remained almost the same Emergency Admissions for unintentional and deliberate injuries, ages 15-24 FY 08/09 to FY 15/16, by locality within Chiltern CCG
1,800
1,600
1,400
1,200
1,000
800
600 DASR per 100,000 population 100,000 per DASR 400
200
0 08/09 09/10 10/11 11/12 12/13 13/14 14/15 15/16 Year Amersham & Chesham Southern Wooburn Green Wycombe Bucks CCGs (Combined) Aylesbury Vale CCG Chiltern CCG
Notes/caveats Indicators where data is not complete for Buckinghamshire localities (this will affect the South locality, Aylesbury Vale CCG total and Buckinghamshire CCGs combined total), i.e. data is only available for Buckinghamshire County only, but matched to localities for analysis purposes; o Deprivation maps (drawn for Buckinghamshire County, with locality boundaries) o Births o Early Years Foundation Stage Profile o Looked After Children o National Childhood Monitoring Programme (NCMP) o Substance Misuse o Adult Social Care
Glossary
Adult Social Care terms Daycare: Care and activities that take place outside of the home, usually at a day care centre. These activities tend to include arts, craft and gentle exercise along with a range of other activities. Direct Payment: Direct Payments are a sum of money available to people who have been assessed as eligible for Social Care services. This money provides clients with the choice and control to purchase their own care services. Equipment: Equipment is provided by Buckinghamshire County Council to help with daily living and personal care. This may include small items such as a raised toilet seat and minor home adaptations including stair or bath rails. Home Care: Home care is care provided in the client’s home by trained carers. This service helps with daily activities including getting dressed, supporting basic healthcare needs, meal preparation and toileting. Laundry: The Laundry service includes the collection, transportation, cleaning and delivery of clothes and bed linen. Supported Living: Our Supported Living services enable people with learning disabilities or long-term mental health needs to live in the community, in small and staffed homes. Support is provided to help with budgeting and household expenses. Telecare: Telecare includes assistive technology offering remote care to potentially vulnerable or physically less able people. This service provides care and reassurance to enable people to live independently in their own homes. Other terms Detected prevalence: The numbers of patients on each disease register, as a percentage of the number of patients on practices' lists. Directly Age-Standardised Rate (DASR) rate: DASR for an area is the number of events, usually expressed per 100,000, that would occur in that area if it had the same age structure as the standard population (e.g. European population) and the local age-specific rates of the area applied. This is useful for comparing populations with different age structures. Good level of development (GLD): Children are defined as having reached a GLD at the end of the EYFS if they achieve at least the expected level in: The Early Learning Goals in the prime areas of learning (Communication and Language, Physical Development, Personal, Social and Emotional Development) and; The Early Learning Goals in the specific areas of Mathematics and Literacy. Statistical Significance: Statistical significance (also mentioned as ‘significant’) means that a difference that is observed is unlikely to be due to chance alone. Comparison measured against Bucks localities (combined) average
Statistically worse Higher Not compared Similar Similar Statistically better Lower
Aylesbury Vale CCG Chiltern CCG Amersham Wooburn Indicator Year England Bucks AVCCG CCCG Central North South Southern Wycombe & Chesham Green Total population 2016 549,458 209,871 339,587 103,189 58,328 48,354 75,666 84,033 89,602 90,286 under 5 population 2016 32,338 12,652 19,686 7,522 2,795 2,335 4,135 4,443 5,069 6,039 under 5 % of total 2016 5.8% 5.9% 6.0% 5.8% 7.3% 4.8% 4.8% 5.5% 5.3% 5.7% 6.7% 65+ population 2016 98,445 36,589 61,856 14,928 10,897 10,764 15,131 16,492 17,937 12,296 65+ % of total 2016 17.3% 17.9% 17.4% 18.2% 14.5% 18.7% 22.3% 20.0% 19.6% 20.0% 13.6% 75+ population 2016 44,899 15,945 28,954 6,813 4,398 4,734 7,035 7,944 8,219 5,756 75+ % of total 2016 7.8% 8.2% 7.6% 8.5% 6.6% 7.5% 9.8% 9.3% 9.5% 9.2% 6.4% 85+ population 2016 13,373 4,698 8,675 2,060 1,233 1,405 2,089 2,539 2,478 1,569 85+ % of total 2016 2.3% 2.4% 2.2% 2.6% 2.0% 2.1% 2.9% 2.8% 3.0% 2.8% 1.7% Black and minority ethnic communities 2011 14.7% 13.6% 9.8% 15.9% 16.1% 4.8% 3.6% 9.0% 14.6% 6.9% 31.0%
Deprivation (average IMD score) 2015 21.8 9.7 10.8 9.1 13.5 8.9 8.0 7.3 8.5 6.4 13.4 Demography - Population - Demography Housing in poor condition: No central heating 2011 2.7% 1.4% 1.6% 1.4% 1.6% 1.7% 1.4% 1.2% 1.1% 1.2% 1.9% Overcrowding (bedrooms) 2011 4.6% 3.6% 3.5% 3.7% 5.3% 2.0% 1.7% 2.8% 2.4% 2.0% 7.3% Live births* 2015 6,089 2,404 3,685 1,487 592 325 724 784 801 1,376 Crude birth rate (per 1,000)* 2015 (P) 11.8 12.4 11.5 15.4 10.1 8.3 9.7 10.2 10.1 15.1 General fertility rate (per 1,000)* 2015 (P) 64.8 66.9 63.5 75.1 57.8 55.4 59.5 61.7 61.4 68.3 Low birth weight births, % <2,500g * 2013-15 7.4% 7.6% 7.2% 8.0% 7.0% 6.7% 7.9% 6.8% 6.0% 7.8%
Deaths at ages under 1 year 2013-15 68 30 38 Births,, LBWB & LBWB Births,, Infant Mortality Infant Infant mortality rate (per 1,000) 2013-15 3.8 4.4 3.5 5.5 1.7 4.1 5.0 2.2 1.2 4.7 # EYFSP pupils within the area* 2016 6,582 1,410 692 449 841 710 918 1,266 % achieving a Good Level of Development 2016 70.5 71.0 77.9 77.5 73.6 71.1 72.1 60.5
Children Looked After Children (LAC) rate (per 1,000) 2015/16 3.3 4.2 2.8 5.6 2.8 2.4 2.8 1.4 2.3 4.2 Life expectancy at birth - PERSONS 2013-15 83.8 82.9 84.3 81.4 84.1 84.7 85.6 83.2 85.3 83.2 Life expectancy at birth - MALES 2013-15 82.3 81.7 82.6 80.2 82.5 83.7 83.5 81.6 83.8 81.7 Life expectancy at birth - FEMALES 2013-15 85.1 84.1 85.9 82.4 85.7 85.6 87.6 84.7 86.6 84.6
All cause premature mortality rate 2013-15 241 254 233 293 236 212 204 266 211 255 & Mortality &
Life Expectancy Life Expectancy All cause 75+ mortality rate 2013-15 6,577 7,323 6,167 8,559 6,502 6,280 5,491 6,850 5,586 6,877
* Data item for which areas in South Oxfordshire cannot be obtained (P) Provisional data - awaiting updated populations
Comparison measured against Bucks localities (combined) average
Statistically worse Higher Not compared Similar Similar Statistically better Lower
Aylesbury Vale CCG Chiltern CCG Amersham Wooburn Indicator Year England Bucks AVCCG CCCG Central North South Southern Wycombe & Chesham Green Excess weight in children, 4-5 years (YrR)* 2014-15 18.6% 19.4% 18.0% 20.2% 18.5% 18.1% 22.4% 16.5% 17.3% 16.2% Excess weight in children, 10-11 years (Yr6)* 2014-15 26.6% 27.7% 25.9% 30.4% 22.6% 28.6% 27.5% 25.1% 20.1% 29.9% Adults in substance 2013/14 - 274 296 261 441 180 154 219 159 196 441 misuse treatment rate (per 100,000)* 2015/16 2013/14 -
Lifestyle Adults in alcohol treatment rate (per 100,000)* 109.6 126.3 99.1 171.3 88.3 84.5 100.6 62.3 90.0 137.9 2015/16 2013/14 - Adults in drug treatment rate (per 100,000)* 164.6 169.7 161.4 269.8 91.3 69.5 118.1 96.8 105.7 303.4 2015/16 Cervical Cancer Screening 2014/15 73.5 77.3 75.1 74.2 81.0 79.8 77.6 75.9 78.1 69.2 Breast Cancer Screening (within 6mths invite) 2014/15 72.8 74.8 76.2 72.9 71.5 79.8 75.7 74.9 79.6 75.0 Bowel Cancer Screening (within 6mths invite) 2014/15 57.6 59.0 58.0 55.1 60.9 62.6 62.6 56.2 60.3 52.2 Flu vaccination - 65+ population 2015/16 71.0% 70.6% 71.3% 71.2% 69.8% 70.6% 73.9% 69.1% 72.3% 69.3% Flu vaccination - pregnant women 2015/16 43.0% 44.5% 42.0% 41.9% 49.8% 48.1% 46.7% 43.4% 40.2% 39.4% Flu vaccination - children aged 2, 3 or 4 2015/16 38.9% 36.5% 40.3% 30.1% 38.4% 53.1% 43.1% 38.5% 49.1% 31.7% Flu vaccination - children aged 5 or 6 2015/16 44.2% 40.2% 46.7% 32.6% 52.6% 46.5% 55.5% 43.5% 63.8% 26.5%
NHS Health Checks - % Offered 2015/15 16.5% 15.5% 17.2% 14.3% 16.6% 15.6% 18.0% 14.4% 19.4% 17.0% and NHS Health Checks Health NHS and Screening, immunisation immunisation Screening, NHS Health Checks - % Uptake 2015/16 7.2% 6.6% 7.6% 5.6% 7.1% 6.9% 8.1% 6.7% 9.5% 6.1% Hypertension 2015/16 13.4% 13.5% 13.3% 11.9% 14.3% 15.9% 13.7% 13.7% 14.0% 11.9% Diabetes 2015/16 5.9% 6.0% 5.9% 6.4% 5.5% 5.8% 5.5% 5.7% 5.1% 7.2% Coronary Heart Disease (CHD) 2015/16 2.9% 3.1% 2.8% 3.0% 3.0% 3.4% 2.8% 3.0% 2.8% 2.6% Heart Failure 2015/16 0.60% 0.67% 0.56% 0.59% 0.66% 0.87% 0.54% 0.59% 0.59% 0.52% Stroke & Transient Ischaemic Attack (TIA) 2015/16 1.62% 1.52% 1.68% 1.42% 1.44% 1.82% 1.69% 1.84% 1.88% 1.31% Atrial Fibrillation 2015/16 1.9% 1.9% 1.9% 1.6% 2.0% 2.4% 2.1% 2.1% 2.1% 1.3% Chronic Kidney Disease 2015/16 3.3% 3.1% 3.4% 2.5% 3.1% 4.4% 3.5% 2.9% 3.2% 3.9% Chronic Obstructive Pulmonary Disease (COPD) 2015/16 1.36% 1.53% 1.25% 1.57% 1.40% 1.59% 1.21% 1.30% 1.34% 1.15% Asthma 2015/16 6.0% 6.3% 5.9% 6.4% 6.1% 6.2% 6.3% 5.5% 5.8% 6.0% Depression 2015/16 7.9% 8.7% 7.5% 9.6% 8.4% 7.2% 7.0% 7.7% 7.5% 7.6% Dementia 2015/16 0.73% 0.77% 0.71% 0.76% 0.72% 0.85% 0.71% 0.86% 0.72% 0.56% Severe Mental Illness 2015/16 0.72% 0.73% 0.71% 0.95% 0.53% 0.54% 0.68% 0.61% 0.63% 0.90% Prevalence Condition Term Long Cancer 2015/16 2.7% 2.6% 2.7% 2.2% 2.8% 3.2% 3.1% 2.9% 3.0% 1.8%
* Data item for which areas in South Oxfordshire cannot be obtained (P) Provisional data - awaiting updated populations Comparison measured against Bucks localities (combined) average
Statistically worse Higher Not compared Similar Similar Statistically better Lower
Aylesbury Vale CCG Chiltern CCG Amersham Wooburn Indicator Year England Bucks AVCCG CCCG Central North South Southern Wycombe & Chesham Green Daycare rate (per 100,000)* 2015/16 131.8 196.0 154.2 78.1 119.3 66.3 105.1 214.0 Direct Payment rate (per 100,000)* 2015/16 333.0 482.4 256.9 247.0 359.2 244.2 261.8 451.1 Equipment rate (per 100,000)* 2015/16 162.7 203.5 163.3 82.1 136.5 154.5 139.4 267.5 Home Care rate (per 100,000)* 2015/16 479.9 644.8 480.1 355.1 486.3 389.0 375.5 640.4
Services Laundry rate (per 100,000)* 2015/16 44.6 52.3 37.7 39.5 51.4 21.8 36.6 79.3
Supported Living rate (per 100,000)* 2015/16 88.6 153.7 59.8 104.1 72.8 38.6 27.3 156.1 Adult Social Care Care Social Adult Telecare rate (per 100,000)* 2015/16 1079.4 1587.3 1008.0 870.0 1117.6 896.0 922.9 1157.3 All age emergency admission rate 2015/16 8,762.3 9,113.4 8,551.2 10,079.0 8,215.0 8,295.7 7,637.0 8,649.1 8,065.3 9,741.4 65+ emergency admission rate 2015/16 20,079 20,357 19,902 21,298 19,497 20,009 17,889 22,492 18,481 20,945 75+ emergency admission rate 2015/16 30,760 30,906 30,671 31,052 30,529 31,047 27,673 33,755 29,108 32,355 Emergency circulatory admission rate 2015/16 702.3 712.2 696.0 758.2 707.2 647.7 611.0 789.5 620.9 769.4 Emergency CHD admission rate 2015/16 152.4 172.2 140.9 195.6 166.2 147.4 142.1 136.1 107.8 188.2 Emergency Stroke admission rate 2015/16 118.4 120.9 117.3 146.3 100.0 106.0 96.9 109.8 127.9 134.5 Emergency Heart Failure admission rate 2015/16 99.1 86.1 106.4 86.5 97.6 74.5 66.4 154.4 92.3 110.0 Emergency Diabetes admission rate 2015/16 51.0 60.2 45.8 81.9 41.7 39.9 35.1 50.9 30.5 67.4 Emergency respiratory admission rate 2015/16 1,123 1,166 1,099 1,292 1,170 935 912 1,142 972 1,368 Emergency COPD admission rate 2015/16 147.5 175.0 131.9 222.6 163.9 124.2 95.1 146.3 106.1 190.2 Emergency cancer admission rate 2015/16 702.3 712.2 696.0 758.2 707.2 647.7 611.0 789.5 620.9 769.4 65+ emergency Falls admission rate 2015/16 2,608 2,502 2,668 2,581 2,409 2,497 2,261 3,034 2,650 2,697 Mental Health admission rate 2015/16 309.1 338.8 292.5 460.5 243.1 201.7 222.0 226.4 308.0 393.2
Healthcare use Healthcare Cancer admission rate 2015/16 2,688 2,548 2,771 2,807 2,410 2,294 2,505 3,463 2,498 2,560 Under 5 emergency admission rate 2015/16 17,660 16,885 18,100 18,394 15,876 13,934 16,367 12,670 18,616 23,440 Under 15 emergency admission rate 2015/16 8,238 7,924 8,416 8,584 7,469 6,773 7,683 6,357 8,555 10,599 Under 20 emergency admission rate 2015/16 7,345 7,227 7,407 7,984 6,689 6,144 6,742 5,810 7,538 9,157 Under 20 emergency respiratory admission rate 2015/16 420.0 460.0 397.3 542.0 434.6 271.6 417.2 267.9 374.6 515.5 Under 15 emergency unintentional and 2015/16 945 1,019 902 1,125 774 1,042 831 816 1,041 903
(hospital admissions, rates per 100,000per rates population) admissions, (hospital deliberate injuries admission rate 15-24 emergency unintentional and deliberate 2015/16 1,419 1,632 1,291 1,862 1,149 1,881 1,250 993 1,357 1,501 injuries admission rate
* Data item for which areas in South Oxfordshire cannot be obtained (P) Provisional data - awaiting updated populations
Local Plan
Broad Findings from the earlier Chiltern District Local Plan and separate South Bucks District Local Plan Regulation 18 consultations: Plan Vision and Objectives Chiltern: The Core Strategy and Delivery DPD Employment and Shopping objectives were suggested as a starting point and it would appear that these are generally supported. Requested additional measures were for the protection of the Green Belt and AONB, improved design, enhancement of local character, better environmental measures, and HS2 (impact and opposition). Green Belt protection will need to be considered in the context of development needs and the Green Belt Assessment while HS2 is not a local plan matter and all other suggestions mentioned are supported. In addition the consultation highlighted support for a restructuring of Chesham employment base through identifying new employment space on the edge of the town in the Green Belt to encourage new investment, meet the needs of existing local businesses and support new local business start-ups and release of some outdated, poorly located employment space for housing/other uses.
The Consultation sought views on the following Spatial Strategy options: a) making more efficient use of land within built-up areas b) extensions to main settlements (Chesham, Amersham, Little Chalfont and Chalfont St Peter) c) extensions to a wider range of settlements (also Great Missenden, Prestwood and Chalfont St Giles) Classification: OFFICIAL 11 Classification: OFFICIAL d) village extensions e) potential expansion of nearby settlements outside the District through the Duty to Co-operate f) a new settlement in or near to the District. All of the above options were supported to some extent, albeit option a) being the most widely supported - 50% of all respondents rising to 56% for local residents. 22% of all respondents supported option b) and 19% supported option c). These options were mainly supported by landowners and developers, 50% supporting b) and 64% supporting c). Generally residents do not wish to see Green Belt releases in their area but may support urban extensions to other settlements but with significant numbers apparently accepting that some Green Belt loss may be required. There was limited support for option d) (only 7% of all respondents), mainly where developers were promoting specific sites for development. For option f), 3 respondents (including Aylesbury Vale District Council) suggested that a new settlement (either within or outside of Chiltern) could be considered as an alternative option. 12% of residents supported a combination of options a) to d). For option e), 8% of respondents stated that the Council should look to neighbouring authorities to take on Chiltern’s development needs as part of the Duty to Co-operate while 7% of respondents suggested that the Council should not allow any further development in the District, (this option cannot be considered).
Key Communities
Patient Services Used
Community assets: Pharmacies POS TRADING NAME ADDRESS TOWN TCO TEL FAX DE Boots the Chemist 18 Sycamore Road Amersham HP6 01494 01494 DR 724900 721689 Boots the Chemist 58 The Broadway Chesham HP5 01494 01494 1EG 782966 778747 Boots the Chemist 9 Park Parade, Western Dene Hazlemere HP15 01494 01494 7AA 711713 711713 Chess Pharmacy 260 – 290 Berkhampstead Road Chesham HP5 01494 01494 3EZ 782968 782968 Collins & Jervie Amersham Health Centre, Chiltern Amersham HP6 01494 01494 Avenue 5AY 432143 432153 FMY Chemists 36 High Street Chesham HP5 tba tba 1EP Fox Pharmacy 9 Turners Place Holmer Green HP15 01494 01494 6RN 713360 713360 31A Red Lion Street HP5 01494 01494 Garlicks Chemist Chesham 1ET 784664 784664 Hughenden Valley Valley Road HP14 01494 01494 Hughenden Valley Pharmacy 4LG 565458 565458 School Lane c/o Rectory Meadow HP7 01494 01494 Lloyds Pharmacy Amersham Surgery 0HG 725460 725460 145 High Street HP16 01494 01494 Prestwood Pharmacy Prestwood 9HF 862303 890133
252 Berkhampstead Road HP5 01494 01494 Rowlands Pharmacy Chesham 3ET 782929 782929 2 Market Parade HP15 01494 01494 Rowlands Pharmacy Hazlemere 7LQ 711557 712178 19 London Road HP7 01494 01494 809 Tesco Pharmacy Amersham 0HA 809847 849 Opticians Trade Name Premises Address Tel. no CCG of premises address Boots Opticians Boots Opticians 01494 812755 Chiltern CCG 21 Sycamore Road Amersham Buckinghamshire HP6 5EQ Boots Opticians Boots Opticians 01494 793498 Chiltern CCG 18 High Street Chesham Buckinhgamshire HP5 1EP Brian Suttie (Chalfont) Brian Suttie (Chalfont) Limited 01494 762338 Chiltern CCG Limited 14 Nightingales Corner Little Chalfont Amersham Buckinghamshire HP7 9PZ Crosseyes CrossEyes 01494 258586 Chiltern CCG 53 Hill Avenue Amersham HP6 5BY W J Kepetzis Optometrists W J Kepetzis Optometrists 01494 716708 Chiltern CCG 26 Eastern Dene Hazlemere High Wycombe Buckinghamshire HP15 7BS
One Vision Professional One Vision Professional Eyecare Ltd 01494 721421 Chiltern CCG Eyecare Ltd 37 High Street Amersham Buckinghamshire HP7 0DP
Orthodontists
Practice name Telephone number Oasis Dental 01494 727638 1a Lexham Gardens Amersham Buckinghamshire HP6 5JP
Dentists
Chess House Dental Practice 105 High Street Chesham 01494 771856 Chiltern NHS Chiltern CCG Full NHS Buckinghamshire HP5 1DE
Aspire Dental Care Little Chalfont Surgery 200 White Lion Road 01494 762601 Chiltern NHS Chiltern CCG Full NHS Amersham HP7 9NU
Amersham Dental Care 146 Station Road Amersham 01494 725111 Chiltern NHS Chiltern CCG Full NHS Buckinghamshire HP6 5DW
Practice Makes Perfect 1b Nightingale Corner Little Chalfont 01494 766568 Chiltern NHS Chiltern CCG Full NHS Buckinghamshire HP7 9PY
Dental Practice 9a Hill Avenue Amersham 01494 727013 Chiltern NHS Chiltern CCG Full NHS Buckinghamshire HP6 5BD
Tooth Booth Chess Medical Centre 260-290 Berkhampstead Road Chesham 01494 776550 Chiltern NHS Chiltern CCG Full NHS Buckinghamshire HP6 3EZ
Prestwood Centre Dental Surgery 99 High Street Prestwood 01494 865997 Chiltern NHS Chiltern CCG Full NHS Buckinghamshire HP16 9EU
Dental Practice 9a Hill Avenue Amersham 01494 727013 Chiltern NHS Chiltern CCG Full NHS Buckinghamshire HP6 5BD
Oasis Dental Care 1a Lexham Gardens Amersham 01494 727638 Chiltern NHS Chiltern CCG Child only Buckinghamshire HP6 5JP
Hazlemere Dental Practice 1Holmer Green 01494 711940 Wycombe NHS Chiltern CCG Child / exempts only Hazlemere Buckinghamshire HP15 7BB York House Dental Practice 249 Berkhamstead Road Chesham 01494 783874 Chiltern NHS Chiltern CCG Child / exempts only Buckinghamshire HP5 3AS Chesham Dental Care 14 Red Lion Street Chesham 01494 782940 Chiltern NHS Chiltern CCG Child / exempts only Buckinghamshire HP5 1HB AM Dentalcare, The Prestwood Centre 99 High Street 01494 868620 Chiltern NHS Chiltern CCG Child / exempts only Prestwood Buckinghamshire HP16 9EU
Market Square Dental Practice 16 Red Lion Street Chesham 01494 792810 Chiltern NHS Chiltern CCG Child / exempts only Buckinghamshire HP5 1EZ The Brocklehurst Dental Practice 202 White Lion Road 01494 763353 Chiltern NHS Chiltern CCG Child / exempts only Little Chalfont Amersham HP7 9NU
Voluntary sector services (Zita Culken – Prevention Matters)
Amersham and Chesham Priorities Dementia Friendly Communities Activities for Men Physical Health and Wellbeing
Background data
Physical Area The borders of the locality extend as far south as Hughenden Valley and Little Chalfont. A number of small villages on the outskirts make up the whole of the locality together with larger urban settlements, making this the third smallest of the seven Bucks GP localities (72,877 people). The total area is 205.5 Square Kilometres, although this includes the parishes of Penn and Little Missenden, which are shared between two other localities. The population in this locality is generally older than the Bucks average with a higher proportion of over 65’s (18.2%) and the number of older people over 65 is projected to increase.
Ethnic Diversity Chesham local area has the highest percentage of people from BME groups and issues have been identified around the integration of young Asian mums into the community. This is mainly due to the fact that English is not widely spoken and this has an effect on the children who also lack to integrate at school from an early age. Some work is being carried out in Newtown school where an Outreach Family Worker is currently involved with a number of Asian families requiring support.
Health and Deprivation The health of people in Chiltern is generally better than the England average and deprivation is lower than average, however about 1500 children still live in poverty. As a whole the locality is less deprived than the Bucks average, although the area in and around Chesham is the most deprived fifth of the population for Bucks. Life expectancy is 8.8 years lower for men and 6.00 years lower for women in the most deprived areas of Chiltern than in the least deprived areas.
A Public and Patient Engagement workshop identified that the main health issues in this locality were: Cardiovascular disease Falls in older people Mental Health Issues for Older People (including Depression and Dementia)
There was also an emphasis on the need for lifestyle changes (physical activity, alcohol, smoking and healthy eating). There were also issues identified around early years (parenting), the varied needs of different communities, education, access to services (GPs, referrals and travel to access services), joint working between health and social care, community care for vulnerable older people and social isolation. Chesham local area has the highest percentage of people from BME groups and issues have been identified around the integration of young Asian mums into the community. This is mainly due to the fact that English is not widely spoken and this has an effect on the children who also lack to integrate at school from an early age. Some work is being carried out in Newtown school where an Outreach Family Worker is currently involved with a number of Asian families requiring support.
Local Areas Amersham Amersham is a large urban area and has a very proactive community. The Library hosts a number of activities and the manager is keen to link with local groups to ensure that the needs of the local residents are met. The District Council offices are the base for the Chiltern Clinical Commissioning Group and Bucks Floating Support. The biggest need highlighted by the referrals to the CPWs seems to be Social Isolation. However, the number of social activities in the area is reasonably high and this need is generally met also by additional coffee mornings and lunch clubs offered by the numerous churches in this town. There is a community centre which is well used and hosts a number of social activities during the week. Amersham has 2 day centres for older people. The Camaraderie group meets in a Paradigm Scheme and is well attended. Clients generally use Dial-a-Ride to access the service and the organiser has done some work with the local library to bring a variety of activities to the clients. The group meets once per week and is offered to the clients at a cost of £10.00 including a meal. Transport remains an issue for people to attend as Dial-a-Ride can be quite expensive. The Sycamore Club is hosted by the Free Church in Amersham and offers a day centre once per week for people who suffer from dementia at a very low cost of £6.00 including transport and a meal. Transport here is also an issue for people who wish to come from further afield like Prestwood or Great Missenden. The group is not working at its full capacity although referrals have increased since the start of Prevention Matters.
A stroke support group meet at St John’s Methodist Church once per week. Transport has again been highlighted as the main issue and the group could benefit from a higher attendance. Age Concern also provide a reasonable support in the town with their lunch club which meets in the Community Centre which is very well attended and a Good Neighbourhood Scheme which provides befriending and support with shopping and transport. More volunteers are needed for this scheme. In essence, Amersham seems to be very well served when it comes to social activities. The existence of an active Older People Action Group ensures that local issues are raised and brought to the attention of the relevant people. However, access to a lot of activities is made difficult by the lack of affordable transport and the complete absence of any known voluntary car schemes.
Old Amersham has a very well established Older People Action Group (OASIS) with a total of 25 members who meet regularly. Amersham has a community centre which provides a central hub for communication. The Chiltern District Council Offices also have a number of leaflets on display. The various churches advertise their groups on their individual websites and the free magazine Your Amersham is delivered to approximately 9000 homes and is also available online.
Chesham Chesham has a population of just over 21000 people. Despite the fact that Chesham seems to have an extremely pro-active community, there are a number of serious pockets of deprivation which have an impact on the whole community. Chesham is relatively well serviced with regards to social activities. The Salvation Army run a number of lunch clubs and drop ins for socially isolated elderly people. However, the groups are slightly under attended and this is probably due to not enough publicity. Transport is sometimes an issue although Dial-A-Ride provide quite a range of choice for journeys but this can be quite costly to the client. There is an emergency car scheme for support in extreme weather (CHAV) and Chesham Voluntary Car Service provides transport specifically for doctors or hospital appointments from patients from Chesham surgeries. There is also an Age Concern group which offers befriending and support with shopping and medical trips. A number of organisations like Bucks Mind, Alzheimer’s Society and Mind The Gap offer social activities for older people and people with mental health issues. An overall problem appears to be the recruitment of volunteers. The Chesham Wellbeing project, which aims to raise the wellbeing of Chesham to an acceptable level, involves a number of on-going activities, some of which are linked to Prevention Matters outcomes. Some work is being undertaken by local health partners and other professionals to increase the integration of young Asian Families into the community and ensure that young families have the necessary support in terms of language and parenting skills. The Town Hall in Chesham provides a hub for a number of activities and it hosts a memory café run by the Alzheimer’s Society and an Art Group delivered by Bucks Mind. Both the groups are every popular and well attended. There is also an MS physio session which meets weekly in the Town Hall. The White Hill centre is also a hub for a number of regular activities. There are a number of churches that offer lunch clubs and coffee mornings. The Emmanuel Church hosts a regular Bucks Vision day centre. The group is relatively well attended but there are some problems associated with the overall structure of the organisation. Another good asset in Chesham town is the number of Paradigm Sheltered Housing schemes. These offer a number of activities to their residents such as coffee mornings, silver surfer sessions etc. And a meeting with the Schemes Manager highlighted their intention to offer these activities to the wider community and to use some of their venues to host day centres. Paradigm Housing has a number of Outreach workers who have a case load of residents whom they support with queries regarding their tenancy or any other issue that they may have. The idea was that during their “downtime” they could facilitate activities within the schemes.
The library also provides a central hub for the community and it offers a number of activities on a regular basis. There is a privately run day centre Douglas McMinn who offers support to elderly clients. The centre is opened 5 days per week and is staffed by 8 paid members of staff all qualified to NVQ Level 2. The cost for the day is quite high at £42 including transport. This is due to the fact that the staffs are highly qualified and the centre used to cater for people with high needs as they used to receive funding from BCC. Due to the fact that the group has mostly clients who suffer from relatively severe dementia, it would not be appropriate for clients with mild and moderate needs to join the group as this would not provide the necessary stimulation. The possibility of reserving one day of the week to more independent clients was discussed but this would encounter a number of problems regarding possible staff cuts as there would not be a need for qualified staff on that day. The group has 2 volunteers.
Chesham has a well-established Older People Action Group (COPAG) with a total of 65 individual members. There is a magazine which is produced twice per year (May and November) and is available to the wider community. The town Hall has a comprehensive display of leaflets and posters of local events and an easy accessible website. The library also provides a good hub for communication. There is also a monthly magazine called Your Chesham which is distributed to 12000 homes in Chesham and surrounding villages. This also includes any forthcoming events and groups and activities and it is also available online. In addition, the LAF has put available some funds to produce a paper Directory of Activities and Services for Older People in Chesham.
Prestwood and Great Missenden There are a number of social activities in Prestwood and Great Missenden run by the local churches. Aa day centre in Prestwood run by Bucks Mind provides support for elderly clients. The residents of Prestwood have recently formed their own Prestwood Village Association and this has a well-managed website with a directory of all local activities. The group aims to provide a source of information for the whole community. There is a free local community magazine called The Source which is published 5 times per year and is distributed by volunteers to homes in the village. The magazine is also available online. Prestwood has a number of very pro-active residents who are very involved in the development of their community. There are 2 doctors’ surgeries in Prestwood and CAB provides outreach service for people visiting the surgeries. The minister at King’s Church in Prestwood is actively involved in a number of projects. He coordinates PACT (Prestwood Area Community Transport) which is a local volunteer driver scheme which provides transport for people within a 5 miles radius of Prestwood during adverse weather. He is the main driver of the local magazine The Source and coordinates a number of volunteers who provide weekly visit to a local Nursing Home, providing entertainment and companionship for the residents. The church also runs a Prestwood Open Door club which is a monthly event for the elderly. CPW’s have reported that access to activities via public transport is a bit problematic as the buses are not very frequent and they do not coincide with other buses that go into the main town centres. Therefore elderly people find themselves isolated unless they choose to use Dial-a-Ride or other means of transport. There is also Prestwood and Great Kingshill Age Concern Luncheon Club held in the village hall in Prestwood on Tuesdays at 1 pm. A minibus service is available if people are not able to get there. The cost for this activity is £4.00.
Great Missenden has a weekly Age Concern lunch club held in the Baptist Church in the High Street. This is very well attended and transport is provided by the Age Concern minibus with the help of a volunteer driver. There are a number of volunteers who help out during the activity and the group has recently had a talk from a representative for Assistive Technology. The library in Great Missenden represents a community hub and is jointly run by volunteers and paid members of staff. A group of Great Missenden residents have formed the Link Missenden Group and their aim is to build community links. They are also working on the production of a paper directory for vulnerable people living in the HP16 area. As reported by the CPW’s, the main issue in this area is again social isolation. The villages are not very well serviced by public transport and the few buses that are available do not allow residents to then catch the bus to larger towns like Aylesbury or Chesham.
Surrounding Villages The locality has a number of villages and hamlets with very active communities and revitalisation groups whose work is essential in supporting the development of local communities. Hughenden Valley – There are a number of churches in this area all linked and that provide regular activities for residents. There is a village shop which was established 4 years ago after the old village shop closed down. The shop is run by volunteers and has one paid member of staff (Louise). It is managed by a committee and is owned by shareholders. It is
open7 days a week. One of the many benefits of the shop is that they home deliver to older people. Next door to the shop there is a village hall which runs a number of activities including Pilates, arts group, martial arts and a garden association. They also run an annual senior citizens event. There is a bi-annual fete held in the village. There is a residents’ association, a primary school, a GP surgery, a pharmacy and a pub also in the village. Spring Valley Centre (Fleet Street) is a day centre for those with learning difficulties. There is a play area in the village which is maintained by the Parish Council. The village has 750 households and 2,500 residents. Naphill and Walters Ash: This very small village has a Methodist Church which holds regular activities for residents such as coffee mornings. There is a village coffee shop which can be considered a hub. Naphill and Walter’s Ash have a community website which lists a number of clubs and activities which go on in the villages. The website hosts an online gazette which is also produced and printed by approximately 40 volunteers. Communication strategy: The village shop provides a hub for the community and events can be advertised there. The residents association also has a very comprehensive website. The Hilltop Villages Good Neighbours Scheme is a community group formed approximately a couple of years ago in response to the cutbacks in public services. The group covers residents living in the villages of Buckland Common, Cholesbury, Hawridge, and St Leonards. The project includes a Pub Lunch Club, and Extreme Weather 4 x 4 car Scheme and a Community Services Directory.
GP Practices There are 9 GP surgeries covering the Amersham & Chesham locality and two Prevention Matters Community Practice Workers who cover them.
Amersham Health Centre Chiltern Avenue Amersham HP6 5AY Tel: 01494 434344 http://www.amershamhealthcentre.co.uk
Gladstone Surgery Chess Medical Centre 260-290 Berkhampstead Road Chesham HP5 3EZ Tel: 01494 782884 http://www.gladstonesurgery.co.uk
Hughenden Valley Surgery Valley Road Hughenden High Wycombe HP14 4LG Tel: 01494 562189 or 01494 563275 http://www.ourpractice.co.uk
John Hampden Surgery 97 High Street Prestwood HP16 9EU Tel: 01494 890900 http://www.johnhampden.co.uk
Little Chalfont Surgery 200 White Lion Rd Little Chalfont HP7 9NU Tel: 01494 762323 http://www.littlechalfontsurgery.co.uk
Prospect House Surgery High Street Great Missenden HP16 0BG Tel: 01494 862325 http://www.thepracticeprospecthouse.nhs.uk
Rectory Meadow Surgery School Lane Old Amersham HP7 0HG Tel: 01494 727711 http://www.rectorymeadowsurgery.co.uk
The New Surgery Chess Medical Centre 260-290 Berkhampstead Road Chesham HP5 3EZ Tel: 01494 782262 http://www.newsurgerychesham.nhs.uk
Water Meadow Surgery Water Meadow Surgery 31a Red Lion Street Chesham HP5 1ET Tel: 01494 782241 http://www.watermeadowsurgery.co.uk
Prisons, Universities, colleges and Private hospitals etc. Amersham and Chesham College Amersham & Wycombe College is a further education college situated in Buckinghamshire, England. The college has three campuses; the primary site being located in Amersham, with two additional campuses located in neighboring towns of High Wycombe. Wikipedia Address: Stanley Hill, Amersham HP7 9HN Phone: 0800 614016 Total enrollment: 5,437 (2010) Local authority: Buckinghamshire
BMI Hospital
BMI The Chiltern Hospital Great Missenden Buckinghamshire BMI The Chiltern Hospital has 66 bedrooms, three theatres, as well as a high dependency unit. We also treat NHS funded patients, and patients who wish to pay for their own treatment. You can see which treatments are available for NHS funded patients by looking at the NHS Patients page. Here is a list of some of the treatments available at BMI the Chiltern Hospital:
Private Physiotherapy in Buckinghamshire Acupuncture physiotherapy Gaitscan Hydrotherapy Pain management physiotherapy Pelvic floor physiotherapy Sports Injuries
Diagnostics & Imaging Treatments in Buckinghamshire CT Scanning MRI Scan Ultrasound X-ray Private Oncology Treatment in Buckinghamshire Bowel cancer Chemotherapy Hormone therapy
Women's Health Services in Buckinghamshire Fertility Gynaecology Health screening Ovarian screening
Cosmetic Surgery Treatment in Buckinghamshire Cosmetic Surgery Vascular Surgery