Dementia in the East of England

DEMENTIA IN THE EAST OF ENGLAND

Produced by Melissa Darwent Information Manager East of England Clinical Network [email protected]

Source: PHE Fingertips DEMENTIA INDICATORS OVERVIEW

The aim of this pack, which has been produced by the East of England Mental Health Clinical Network, is to give CCGs and STPs insight into indicators on the dementia pathway with comparisons drawn from both the East of England and England. The introductory pages show variation of rates across the East of England for population predictions of people over 90 years of age and mortality rates of people with a dementia diagnosis. The data is taken from the PHE (Public Health England) Fingertips tool (using 2015/16 data) which is produced by the Dementia Intelligence Network (DIN) and provides health intelligence with which to inform the provision of care for people in England who have dementia. The infographics sheets provides a snapshot of indicators arranged into six data domains based upon the dementia pathway; Prevalence,Preventing well, Diagnosing well, Living well, Supporting well and Dying well. These data domains are explained in more detail below. Data and metadata are available online and as a downloadable document. (https://fingertips.phe.org.uk/profile-group/mental- health/profile/dementia)

Prevalence Preventing Diagnosing Supporting Living Well Dying Well Well Well Well The face-to-face review Objective 12 of the National should focus on support Dementia Strategy (2009) Recorded dementia The following 7 This indicator Changes in the needs of the patient and calls for improved end of life prevalence is measured indicators are included: measures new surrounding carer. The review should environment can care for people with as a % of recorded on Smoking; Obesity; dementia diagnosis address four key issues: dementia and this includes increase the levels of practice diesease Hypertension; Stroke; with blood tests § an appropriate physical taking into account their registers. It is accepted CHD; Depression; and recorded between 12 anxiety and stress for and mental health choice of where to die. that the majority of Diabetes. months before and 6 an individual. People review for the patient A person with dementia people with dementia The rationale for this is months after being with dementia can be § if applicable, the carer’s should be supported to die needs for information are 65 or older. that they are known risk entered onto the more susceptible in a place of their choice commensurate with the Objective two of the register. to these changes, whenever possible. For factors for dementia. stage of the illness and National Dementia This indicator is a The NICE clinical which can cause many people this will be the patient’s health and somewhere familiar such as Strategy (2009) states measure of recorded guideline on dementia additional distress. social care needs their own home or the 'all people with prevalence and not states that a basic Admissions to hospital, § if applicable, the impact particularly ones of sheltered housing or care dementia to have actual prevalence and dementia screen is of caring on the care- home in which they live. short duration should access to treatment, therefore under-reports performed at the time giver Dying in the usual place of care and support as groups that are less of presentation, usually be avoided if at all § communication and residence is used as a needed following likely to be registered within primary care. possible for this co-ordination measure of the quality of diagnosis'. with a GP. This includes a variety population. arrangements with end of life care for people of blood tests. secondary care (if with dementia aged 65+. applicable). POPULATION PROJECTION FOR AGES 90+ IN 2035

The number of people with dementia in the UK is forecast to increase to over 1 million by 2025 and over 2 million by 2051. This is a worse case scenario, under an assumption that there are no public health interventions and changes are driven by an ageing population alone (Alzheimers UK, 2014). The map below shows the population projections for 2035 of people over 90 years of age in the East of England.

182.17% to 247.6%

164.85% to 182.16%

145.17% to 164.84%

123.11% to 145.16%

63.6% to 123.1%

Source: https://shapeatlas.net/place *registration required MORTALITY RATES

Source: PHE Fingertips Dementia Profile 2015

The graph above illustrates the rate of mortality of people with a mention of dementia. This could be classified either by an underlying cause of death or a contributory cause. The data is collected from the 2015 calendar year and is split by CCG with an England average of 873 shown on the graph.

As an example, the above table shows that in 2015 for Luton CCG, of 100,000 people over the age of 65, 925 of them died while having a diagnosis of dementia.

The data has been age standardised, which means that the data for each yearly age group has been weighted equally. This eliminates the issue of there being far more people in the younger catogories (e.g aged 65-70) which would skew the data towards showing only the rate of mortality for people in younger catogories.

This data comes from The Office for National Statistics Mortality File and is available through the National Dementia Intelligence Network. DEMENTIA INFOGRAPHICS

Order of dementia infographics

East of England Herts and West Essex STP East and North Hertfordshire CCG Mid and South Essex STP Herts Valley CCG Basildon and Brentwood CCG West Essex CCG Castlepoint and Rochford CCG Mid Essex CCG Norfolk and Waveney STP Southend CCG Great Yarmouth and Waveney CCG Thurrock CCG North Norfolk CCG Norwich CCG BLMK STP South Norfolk CCG Bedfordshire CCG West Norfolk CCG Luton CCG Milton Keynes CCG Suffolk and North East Essex STP Ipswich and East Suffolk CCG Cambridgeshire and Peterborough STP North East Essex CCG Cambridgeshire and Peterborough CCG West Suffolk CCG DEMENTIA IN THE EAST OF ENGLAND

Preventing Well Diagnosis Diagnosing Well Dying Well Place of Death: East of England 54.8% EoE England Recorded People diagnosed England: 9% 32% with dementia : All 56.5% Home Smoking: Care Home Ages recorded UnUrencreocrdoerdded Recorded 17.4% X18.x.1x% Hospital prevalence (aged 45.2% 15+) 49,649 59% Obesity: Recorded Definition: New dementia diagnosis with blood prevalence 18+) test recorded between 12 months before and 6 Place of Death: England 8.9% X9..x5x%% months after entering onto the register. PHE Fingertips 2015/16 9% 31% Hypertension: People diagnosed Home Recorded Care Home 14.2% X13.x.8x% with dementia: 65+ Supporting Well prevalence (all Hospital ages) years Rate of emergency admissions (aged 65+) EoE: 2,909 per 100,000 emergency admissions (aged 65+) 60% Stroke: Recorded England: 3,387 per 100,000 emergency admissions (aged 65+) prevalence (all 48,067 1.7% X1..x7x%% Rate short stay emergency admissions ages) Death in Usual Place of Residence: EoE: 22.61% EoE: 57.2% England: 28.3% CHD: Recorded England: 68.6% PHE Fingertips 2015/16 *Rates are directly standardised PHE Fingertips 2015/16 prevalence (all 3.1% X3..x2x%% PHE Fingertips 2015/16 ages) Dementia Care Review Depression: Living Well No care review in Recorded 7.9% X8..x3x%% The face-to-face review should address four key prevalence (aged the last 12 months 18+) issues: 22.8% Diabetes: 1. A physical and mental health review for the patient Recorded 6.2% X6..x5x%% 2. The Carers needs prevalence (aged Care review in the 3. If applicable, the impact of caring on the care-giver 17+) 77.2% last 12 months 4.Communication and co-ordination arrangements with

secondary care PHE Fingertips 2015/16 PHE Fingertips 2015/16 DEMENTIA IN MID AND SOUTH ESSEX STP

Source: PHE Fingertips DEMENTIA IN BASILDON AND BRENTWOOD CCG

Preventing Well Diagnosis Diagnosing Well Dying Well Basildon and Brentwood : Place of Death: Basildon and Brentwood DEM005: Blood Tests England 50.9% CCG Recorded 43% People diagnosed Recorded Home with dementia : All England: Care Smoking: 56.5% 7% Ages Unrecorded Home Recorded 17.4% 18.1% recorded Hospital prevalence (aged 49.1% 15+) 2,061 50% Definition: New dementia diagnosis with blood Obesity: Recorded test recorded between 12 months before and 6 prevalence 18+) 8.4% 9.5% months after entering onto the register. Place of Death: England PHE Fingertips 2015/16

Hypertension: People diagnosed 9% 31% Home Recorded 14.9% 13.8% with dementia: 65+ Supporting Well Care Home prevalence (all years Rate of emergency admissions (aged 65+) Hospital ages) Basildon and Brentwood: 3.289 per 100,000 emergency admissions (aged 65+) 60% Stroke: Recorded 1,989 England: 3,387 per 100,000 emergency admissions (aged 65+) prevalence (all 1.8% 1.7% ages) Rate short stay emergency admissions Death in Usual Place of Residence: Basildon and Brentwood: 12.8% CCG: 57.24% England: 28.3% CHD: Recorded England: 68.6% PHE Fingertips 2015/16 *Rates are directly standardised PHE Fingertips 2015/16 PHE Fingertips 2015/16 prevalence (all 3.0% 3.2% ages) Dementia Care Review Depression: Living Well Recorded 8.9% 8.3% prevalence (aged The face-to-face review should address four key issues: 50% 18+) No care review in the last 12 months Diabetes: 1. A physical and mental health review for the patient 2. The Carers needs Recorded 6.1% 6.5% Care review in the prevalence (aged 3. If applicable, the impact of caring on the care-giver last 12 months 17+) 4.Communication and co-ordination arrangements with secondary care 50% PHE Fingertips 2015/16 PHE Fingertips 2015/16 DEMENTIA IN CASTLEPOINT AND ROCHFORD CCG

Preventing Well Diagnosis Diagnosing Well Dying Well Castlepoint and Rochford : DEM005: Blood Place of Death: Castlepoint and Tests Recorded Rochford 44% CCG England People diagnosed England: Recorded 32% with dementia : All 56.5% 13% Home Ages Care Home Smoking: recorded Unrecorded Hospital Recorded 16.0% X18.x.1x% 56% prevalence (aged 1,546 15+) 55% Definition: New dementia diagnosis with blood Obesity: Recorded test recorded between 12 months before and 6 prevalence 18+) months after entering onto the register. Place of Death: England 7.9% X9..x5x%% PHE Fingertips 2015/16 People diagnosed 31% Hypertension: with dementia: 65+ 9% Home years Recorded 17.1% X13.x.8x% Supporting Well Care Home prevalence (all Hospital ages) 1,505 Rate of emergency admissions (aged 65+) CCG: 3,367 per 100,000 emergency admissions (aged 65+) 60% Stroke: Recorded England: 3,387 per 100,000 emergency admissions (aged 65+) prevalence (all 1.8% X1..x7x%% ages) Rate short stay emergency admissions Death in Usual Place of Residence: CCG: 34.35% CCG: 67.76% England: 28.3% England: 68.6% CHD: Recorded PHE Fingertips 2015/16 *Rates are directly standardised PHE Fingertips 2015/16 PHE Fingertips 2015/16 prevalence (all 3.6% X3..x2x%% ages) Living Well Dementia Care Review Depression: No care review Recorded 7.3% X8..x3x%% in the last 12 prevalence (aged The face-to-face review should address four key issues: months 18+) 30% 1. A physical and mental health review for the patient Diabetes: 2. The Carers needs Recorded 7.0% X6..x5x%% prevalence (aged 3. If applicable, the impact of caring on the care-giver Care review in the 17+) 4.Communication and co-ordination arrangements with 70% last 12 months secondary care PHE Fingertips 2015/16 PHE Fingertips 2015/16 DEMENTIA IN MID ESSEX CCG

Preventing Well Diagnosis Diagnosing Well Dying Well Mid Essex : DEM005: Blood Tests Recorded Place of Death: Mid Essex 49% CCG England People diagnosed England: Recorded 7% with dementia : All 56.5% 30% Home Care Ages recorded Smoking: Unrecorded Home Recorded 15.9% X18.x.1x% 51% Hospital prevalence (aged 2,896 63% 15+) Definition: New dementia diagnosis with blood Obesity: Recorded test recorded between 12 months before and 6 prevalence 18+) Place of Death: England 8.4% X9..x5x%% months after entering onto the register. PHE Fingertips 2015/16 People diagnosed 31% Hypertension: 9% Home with dementia: 65+ Supporting Well Recorded 14.1% X13.x.8x% Care Home prevalence (all years Rate of emergency admissions (aged 65+) Hospital ages) CCG: 2,828 per 100,000 emergency admissions (aged 65+) England: 3,387 per 100,000 emergency admissions (aged 65+) 60% Stroke: Recorded 2,785 prevalence (all 1.7% 616...272%% Rate short stay emergency admissions ages) CCG: 27.77% Death in Usual Place of Residence: England: 28.3% CCG: 68.19%

CHD: Recorded PHE Fingertips 2015/16 England: 68.6% PHE Fingertips 2015/16 *Rates are directly standardised PHE Fingertips 2015/16 prevalence (all 3.1% X3..x2x%% ages) Dementia Care Review Depression: Living Well No care review in the last Recorded 6.7% X8..x3x%% prevalence (aged The face-to-face review should daddress four key issues: 12 months 18+) 23% Diabetes: 1. A physical and mental health review for the patient 2. The Carers needs Recorded 6.2% 6.25% prevalence (aged 3. If applicable, the impact of caring on the care-giver Care review in the 17+) 4.Communication and co-ordination arrangements with 77% last 12 months secondary care PHE Fingertips 2015/16 PHE Fingertips 2015/16 DEMENTIA IN SOUTHEND CCG

Preventing Well Diagnosis Diagnosing Well Dying Well Southend : DEM005: Blood Tests Recorded Place of Death: Southend

CCG England England: 56% People diagnosed Recorded 10% 56.5% 25% with dementia : All Home Smoking: recorded Care Home Ages Unrecorded Hospital Recorded 20.2% X18.x.1x% prevalence (aged 44% 15+) 1,663 65% Definition: New dementia diagnosis with blood Obesity: Recorded test recorded between 12 months before and 6 prevalence 18+) Place of Death: England 9.4% X9..x5x%% months after entering onto the register. PHE Fingertips 2015/16 People diagnosed 9% 31% Home Hypertension: with dementia: 65+ Recorded 15.2% X13.x.8x% Supporting Well Care Home prevalence (all years Hospital ages) Rate of emergency admissions (aged 65+) CCG: 4,342 per 100,000 emergency admissions (aged 65+) 60% Stroke: Recorded 1,614 England: 3,387 per 100,000 emergency admissions (aged 65+) prevalence (all 1.7% X1..x7x%% ages) Rate short stay emergency admissions Death in Usual Place of Residence: CCG: 36.3% CCG: 76.1% England: 28.3% CHD: Recorded England: 68.6% PHE Fingertips 2015/16 *Rates are directly standardised PHE Fingertips 2015/16 PHE Fingertips 2015/16 prevalence (all 3.3% X3..x2x%% ages) Dementia Care Review : Living Well Depression No care Recorded 8.5% X8..x3x%% review in the prevalence (aged The face-to-face review should address four key issues: last 12 18+) 24% months 1. A physical and mental health review for the patient Diabetes: 2. The Carers needs Recorded 6.5% X6..x5x%% prevalence (aged 3. If applicable, the impact of caring on the care-giver Care review in the 17+) 4.Communication and co-ordination arrangements with 76% last 12 months secondary care

PHE Fingertips 2015/16 PHE Fingertips 2015/16 DEMENTIA IN THURROCK CCG

Preventing Well Diagnosis Diagnosing Well Dying Well Thurrock : DEM005: Blood Tests Recorded Place of Death: Thurrock

CCG England 50% People diagnosed 40% England: Recorded with dementia : All Home Smoking: 56.5% 13% Care Home Ages recorded Hospital Recorded 19.7% X18.x.1x% Unrecorded prevalence (aged 50% 15+) 957 47% Obesity: Recorded Definition: New dementia diagnosis with blood prevalence 18+) test recorded between 12 months before and 6 Place of Death: England 10.5% X9..x5x%% months after entering onto the register. PHE Fingertips 2015/16 People diagnosed Hypertension: 9% 31% Home with dementia: 65+ Recorded 14.0% X13.x.8x% Supporting Well Care Home prevalence (all years Hospital ages) Rate of emergency admissions (aged 65+) CCG: 2,964 per 100,000 emergency admissions (aged 65+) 60% Stroke: Recorded 929 England: 3,387 per 100,000 emergency admissions (aged 65+) prevalence (all 1.5% X1..x7x%% ages) Rate short stay emergency admissions Death in Usual Place of Residence: CCG: 11.1% England: 28.3% CCG: 75.5% CHD: Recorded PHE Fingertips 2015/16 *Rates are directly standardised PHE Fingertips 2015/16 England: 68.6% prevalence (all 2.6% X3..x2x%% PHE Fingertips 2015/16 ages) Dementia Care Review Depression: Living Well Recorded 8.6% X8..x3x%% No care prevalence (aged The face-to-face review should address four key issues: review in the 18+) last 12 25% months Diabetes: 1. A physical and mental health review for the patient Recorded 6.4% X6..x5x%% 2. The Carers needs prevalence (aged 3. If applicable, the impact of caring on the care-giver 17+) Care review in the 4.Communication and co-ordination arrangements with 75% last 12 months secondary care PHE Fingertips 2015/16 PHE Fingertips 2015/16 DEMENTIA IN BEDFORD, LUTON AND MILTON KEYNES STP

Source: PHE Fingertips DEMENTIA IN BEDFORDSHIRE CCG

Preventing Well Diagnosis Diagnosing Well Dying Well Bedfordshire : DEM005: Blood Tests Recorded Place of Death: Bedfordshire

CCG England 57.1% People diagnosed 33% England: Recorded 11% Home with dementia : All Care Smoking: 56.5% Ages Home recorded Recorded 16.9% X18.x.1x% Unrecorded Hospital prevalence (aged 42.9% 15+) 2,829 56% Obesity: Recorded Definition: New dementia diagnosis with blood prevalence 18+) test recorded between 12 months before and 6 Place of Death: England 10.2% X9..x5x%% months after entering onto the register. PHE Fingertips 2015/16 People diagnosed 9% 31% Hypertension: with dementia: 65+ Home Recorded Supporting Well 13.9% X13.x.8x% years Care Home prevalence (all Hospital ages) Rate of emergency admissions (aged 65+) CCG: 2,909 per 100,000 emergency admissions (aged 65+) 60% Stroke: Recorded 2,741 England: 3,387 per 100,000 emergency admissions (aged 65+) prevalence (all 1.5% X1..x7x%% ages) Rate short stay emergency admissions Death in Usual Place of Residence: CCG: 22.61% CCG: 66.6% England: 28.3% CHD: Recorded England: 68.6% PHE Fingertips 2015/16 *Rates are directly standardised PHE Fingertips 2015/16 PHE Fingertips 2015/16 prevalence (all 3.0% X3..x2x%% ages) Living Well Dementia Care Review Depression: Recorded 8.8% X8..x3x%% The face-to-face review should address four key prevalence (aged issues: 50% 18+) No care review in the last Diabetes: 1. A physical and mental health review for the patient 12 months Recorded 6.4% X6..x5x%% 2. The Carers needs prevalence (aged Care review in the last 12 months 17+) 3. If applicable, the impact of caring on the care-giver 4.Communication and co-ordination arrangements with 50% secondary care PHE Fingertips 2015/16 PHE Fingertips 2015/16 DEMENTIA IN LUTON CCG

Preventing Well Diagnosis Diagnosing Well Dying Well Luton : DEM005: Blood Tests Recorded Place of Death: Luton

CCG England 56% People diagnosed England: Recorded 8% 36% Home with dementia : All 56.5% Care Smoking: Ages recorded Home Recorded Unrecorded 19.4% X18.x.1x% Hospital prevalence (aged 44% 15+) 1,121 56%

Obesity: Recorded Definition: New dementia diagnosis with blood prevalence 18+) test recorded between 12 months before and 6 10.3% X9..x5x%% months after entering onto the register. Place of Death: England PHE Fingertips 2015/16 People diagnosed 31% Hypertension: 9% Home with dementia: 65+ Recorded Supporting Well Care Home 11.9% X13.x.8x% years prevalence (all Hospital ages) Rate of emergency admissions (aged 65+) CCG: 3,469 per 100,000 emergency admissions (aged 65+) 60% Stroke: Recorded 1,058 England: 3,387 per 100,000 emergency admissions (aged 65+) prevalence (all 1.2% X1..x7x%% ages) Rate short stay emergency admissions Death in Usual Place of Residence: CCG: 25.2% CCG: 64.29% England: 28.3% CHD: Recorded England: 68.6% prevalence (all 2.5% X3..x2x%% PHE Fingertips 2015/16 *Rates are directly standardised PHE Fingertips 2015/16 PHE Fingertips 2015/16 ages) Dementia Care Review Depression: Living Well No care review in the last Recorded 6.5% X8..x3x%% prevalence (aged The face-to-face review should address four key issues: 12 months 18+) 20% Diabetes: 1. A physical and mental health review for the patient Recorded 7.7% X6..x5x%% 2. The Carers needs prevalence (aged 3. If applicable, the impact of caring on the care-giver 17+) 80% 4.Communication and co-ordination arrangements with Care review in the secondary care last 12 months PHE Fingertips 2015/16 PHE Fingertips 2015/16 DEMENTIA IN MILTON KEYNES CCG

Preventing Well Diagnosis Diagnosing Well Dying Well Milton Keynes : DEM005: Blood Tests Recorded Place of Death: Milton Keynes CCG England 48% People diagnosed England: Recorded 40% with dementia : All 56.5% 7% Home Smoking: Ages recorded Unrecorded Care Home Recorded 18.2% X18.x.1x% Hospital prevalence (aged 52% 15+) 1,384 53% Definition: New dementia diagnosis with blood Obesity: Recorded test recorded between 12 months before and 6 prevalence 18+) 8.8% X9..x5x%% months after entering onto the register. Place of Death: England PHE Fingertips 2015/16 People diagnosed Hypertension: 9% 31% Home with dementia: 65+ Recorded 12.1% X13.x.8x% Supporting Well Care Home prevalence (all years Rate of emergency admissions (aged 65+) Hospital ages) CCG: 4,087 per 100,000 emergency admissions (aged 65+) 60% Stroke: Recorded 1,328 England: 3,387 per 100,000 emergency admissions (aged 65+) *Rates are directly standardised prevalence (all 1.1% X1..x7x%% ages) Rate short stay emergency admissions Death in Usual Place of Residence: CCG: 28.5% CCG: 61.01% England: 28.3% CHD: Recorded England: 68.6% *Rates are directly standardised PHE Fingertips 2015/16 PHE Fingertips 2015/16 prevalence (all 2.3% X3..x2x%% PHE Fingertips 2015/16 ages) Dementia Care Review Depression: Living Well No care review in Recorded 8.1% X8..x3x%% prevalence (aged The face-to-face review should address four key the last 12 months issues: 18+) 21.5% Diabetes: 1. A physical and mental health review for the patient Recorded 5.8% X6..x5x%% 2. The Carers needs prevalence (aged Care review in the 17+) 3. If applicable, the impact of caring on the care-giver 78.5% last 12 months 4.Communication and co-ordination arrangements with secondary care PHE Fingertips 2015/16 PHE Fingertips 2015/16 DEMENTIA IN CAMBRIDGESHIRE AND PETERBOROUGH STP

Source: PHE Fingertips DEMENTIA IN CAMBRIDGESHIRE AND PETERBOROUGH CCG

Preventing Well Diagnosis Diagnosing Well Dying Well Cambridgeshire and Peterborough : DEM005: Place of Death: Cambridgeshire Blood Tests Recorded and Peterborough CCG England People diagnosed 55% England: Recorded 11% with dementia : All 56.5% 25% Smoking: Home Ages recorded Care Home Recorded Unrecorded 17.8% X18.x.1x% Hospital prevalence (aged 45% 15+) 6,238 64% Obesity: Recorded Definition: New dementia diagnosis with blood prevalence 18+) test recorded between 12 months before and 6 8.4% X9..x5x%% months after entering onto the register. Place of Death: England PHE Fingertips 2015/16 People diagnosed Hypertension: 31% with dementia: 65+ 9% Home Recorded 12.6% X13.x.8x% Supporting Well Care Home prevalence (all years ages) Rate of emergency admissions (aged 65+) Hospital CCG: 3,406 per 100,000 emergency admissions (aged 65+) Stroke: Recorded 6,028 England: 3,387 per 100,000 emergency admissions (aged 65+) 60% prevalence (all X.xx% 1.4% 1.7% Rate short stay emergency admissions ages) Death in Usual Place of Residence: CCG: 28.6% England: 28.3% CCG: 74.3% CHD: Recorded England: 68.6% PHE Fingertips 2015/16 PHE Fingertips 2015/16 prevalence (all 2.8% X3..x2x%% *Rates are directly standardised PHE Fingertips 2015/16 ages) Dementia Care Review Depression: Living Well Recorded 7.7% X8..x3x%% prevalence (aged The face-to-face review should address four key issues: 18+) 50% No care review in the last Diabetes: 1. A physical and mental health review for the patient 12 months 2. The Carers needs Recorded 5.8% X6..x5x%% prevalence (aged 3. If applicable, the impact of caring on the care-giver Care review in the last 12 months 17+) 4.Communication and co-ordination arrangements with secondary care 50% PHE Fingertips 2015/16 PHE Fingertips 2015/16 DEMENTIA IN HERTS AND WEST ESSEX STP

Source: PHE Fingertips DEMENTIA IN EAST AND NORTH HERTS CCG

Preventing Well Diagnosis Diagnosing Well Dying Well East and North Herts : DEM005: Blood Tests Place of Death: East and North Herts Recorded CCG England 55% People diagnosed Recorded 33% with dementia : All England: 9% Home Smoking: 56.5% Care Home Ages Unrecorded Recorded 15.9% X18.x.1x% recorded Hospital prevalence (aged 45% 15+) 4,138 58% Definition: New dementia diagnosis with blood Obesity: Recorded test recorded between 12 months before and 6 prevalence 18+) 9.0% X9..x5x%% months after entering onto the register. Place of Death: England PHE Fingertips 2015/16 People diagnosed 9% 31% Hypertension: with dementia: 65+ Home Recorded Supporting Well Care Home 13.2% X13.x.8x% years prevalence (all Hospital ages) Rate of emergency admissions (aged 65+) CCG: 3,210 per 100,000 emergency admissions (aged 65+) 60% Stroke: Recorded 4,036 England: 3,387 per 100,000 emergency admissions (aged 65+) prevalence (all 1.6% X1..x7x%% ages) Rate short stay emergency admissions Death in Usual Place of Residence: CCG: 31.53% CCG: 66% CHD: Recorded England: 28.3% England: 68.6% PHE Fingertips 2015/16 *Rates are directly standardised PHE Fingertips 2015/16 prevalence (all 2.9% X3..x2x%% PHE Fingertips 2015/16 ages) Dementia Care Review Depression: Living Well No care review in Recorded 7.9% X8..x3x%% The face-to-face review should address four key prevalence (aged the last 12 months issues: 18+) 22% Diabetes: 1. A physical and mental health review for the patient Recorded 5.7% X6..x5x%% prevalence (aged 2. The Carers needs 17+) 3. If applicable, the impact of caring on the care-giver 78% 4.Communication and co-ordination arrangements with Care review in the secondary care last 12 months PHE Fingertips 2015/16 PHE Fingertips 2015/16 DEMENTIA IN HERTS VALLEY CCG

Preventing Well Diagnosis Diagnosing Well Dying Well Herts Valley : DEM005: Blood Tests Recorded Place of Death: Herts Valley

CCG England 60% 8% People diagnosed England: 31% with dementia : All 56.5% Recorded Home Smoking: Ages recorded Care Home Recorded 15.1% X18.x.1x% Unrecorded Hospital prevalence (aged 40% 15+) 4,217 61% Obesity: Recorded Definition: New dementia diagnosis with blood prevalence 18+) test recorded between 12 months before and 6 Place of Death: England 7.6% X9..x5x%% months after entering onto the register. PHE Fingertips 2015/16 People diagnosed 9% 31% Hypertension: with dementia: 65+ Home Recorded Care Home 12.4% X13.x.8x% years Supporting Well prevalence (all Hospital ages) Rate of emergency admissions (aged 65+) CCG: 2,890 per 100,000 emergency admissions (aged 65+) 60% : Recorded 4,086 Stroke England: 3,387 per 100,000 emergency admissions (aged 65+) prevalence (all 1.5% X1..x7x%% ages) Rate short stay emergency admissions Death in Usual Place of Residence: CCG: 29.8% CCG: 67.64% CHD: Recorded England: 28.3% England: 68.6% PHE Fingertips 2015/16 prevalence (all 2.5% X3..x2x%% *Rates are directly standardised PHE Fingertips 2015/16 PHE Fingertips 2015/16 ages) Dementia Care Review Depression: Living Well No care review in the last Recorded 7.8% X8..x3x%% prevalence (aged The face-to-face review should address four key issues: 12 months 18+) 20% Diabetes: 1. A physical and mental health review for the patient 2. The Carers needs Recorded 5.3% X6..x5x%% prevalence (aged 3. If applicable, the impact of caring on the care-giver Care review in the 17+) 4.Communication and co-ordination arrangements with 80% last 12 months secondary care PHE Fingertips 2015/16 PHE Fingertips 2015/16 DEMENTIA IN WEST ESSEX CCG

Preventing Well Diagnosis Diagnosing Well Dying Well West Essex : DEM005: Blood Tests Recorded Place of Death: West Essex

CCG England 55% 8% People diagnosed England: Recorded 32% with dementia : All 56.5% Home Smoking: Care Home Ages recorded Recorded 17.3% X18.x.1x% Unrecorded Hospital prevalence (aged 45% 15+) 2,447 60%

Obesity: Recorded Definition: New dementia diagnosis with blood prevalence 18+) 7.9% X9..x5x%% test recorded between 12 months before and 6 Place of Death: England months after entering onto the register. PHE Fingertips 2015/16 People diagnosed Hypertension: 9% 31% Home with dementia: 65+ Recorded 14.0% X13.x.8x% Supporting Well Care Home prevalence (all years Hospital ages) Rate of emergency admissions (aged 65+) CCG: 3,584 per 100,000 emergency admissions (aged 65+) 60% Stroke: Recorded 2,369 England: 3,387 per 100,000 emergency admissions (aged 65+) prevalence (all 1.6% X1..x7x%% ages) Rate short stay emergency admissions Death in Usual Place of Residence: CCG: 25.5% CCG: 75.3% CHD: Recorded England: 28.3% England: 68.6% PHE Fingertips 2015/16 *Rates are directly standardised PHE Fingertips 2015/16 prevalence (all 3.0% X3..x2x%% PHE Fingertips 2015/16 ages) Dementia Care Review Depression: Living Well No care Recorded 7.7% X8..x3x%% prevalence (aged The face-to-face review should address four key issues: review in the 18+) last 12 25% months Diabetes: 1. A physical and mental health review for the patient Recorded 2. The Carers needs 6.0% X6..x5x%% prevalence (aged 3. If applicable, the impact of caring on the care-giver Care review in the 17+) 4.Communication and co-ordination arrangements with 75% last 12 months secondary care PHE Fingertips 2015/16 PHE Fingertips 2015/16 DEMENTIA IN NORFOLK AND WAVENEY STP

Source: PHE Fingertips DEMENTIA IN GREAT YARMOUTH AND WAVENEY CCG

Preventing Well Diagnosis Diagnosing Well Dying Well Great Yarmouth and Waveney : DEM005: Place of Death: Great Yarmouth and Blood Tests Recorded Waveney CCG England 52% People diagnosed Recorded 11% with dementia : All England: 25% Smoking: 56.5% Home Care Home Recorded Ages recorded Unrecorded 21.3% X18.x.1x% Hospital prevalence (aged 48% 15+) 2,316 64% Obesity: Recorded Definition: New dementia diagnosis with blood prevalence 18+) test recorded between 12 months before and 6 11.4% X9..x5x%% months after entering onto the register. Place of Death: England PHE Fingertips 2015/16 People diagnosed 31% Hypertension: 9% Home Recorded with dementia: 65+ 16.9% X13.x.8x% Care Home prevalence (all years Supporting Well Rate of emergency admissions (aged 65+) ages) Hospital CCG: 2,909 per 100,000 emergency admissions (aged 65+) 60% Stroke: Recorded 2,231 England: 3,387 per 100,000 emergency admissions (aged 65+) prevalence (all 2.2% X1..x7x%% ages) Rate short stay emergency admissions Death in Usual Place of Residence: CCG: 22.61% CCG: 75.7% England: 28.3% CHD: Recorded England: 68.6% PHE Fingertips 2015/16 *Rates are directly standardised PHE Fingertips 2015/16 prevalence (all 4.0% X3..x2x%% PHE Fingertips 2015/16 ages) Dementia Care Review Depression: Living Well No care review Recorded 9.2% X8..x3x%% in the last 12 prevalence (aged The face-to-face review should address four key issues: months 18+) 26% Diabetes: 1. A physical and mental health review for the patient Recorded 2. The Carers needs 7.7% X6..x5x%% Care review in the prevalence (aged 3. If applicable, the impact of caring on the care-giver 17+) last 12 months 4.Communication and co-ordination arrangements with 74% secondary care PHE Fingertips 2015/16 PHE Fingertips 2015/16 DEMENTIA IN NORTH NORFOLK CCG

Preventing Well Diagnosis Diagnosing Well Dying Well North Norfolk : DEM005: Blood Tests Recorded Place of Death: North Norfolk

CCG England 6% People diagnosed 59% 27% with dementia : All Recorded Home Smoking: Ages Care Home Recorded England: Hospital 15.8% X18.x.1x% Unrecorded prevalence (aged 56.5% 41% 15+) 2,012 recorded 67%

Obesity: Recorded Definition: New dementia diagnosis with blood prevalence 18+) 10.2% X9..x5x%% test recorded between 12 months before and 6 Place of Death: England months after entering onto the register. PHE Fingertips 2015/16 People diagnosed 9% 31% Hypertension: Home with dementia: 65+ Recorded 17.8% X13.x.8x% Supporting Well Care Home prevalence (all years Hospital ages) Rate of emergency admissions (aged 65+) CCG: 2,303 per 100,000 emergency admissions (aged 65+) 60% Stroke: Recorded 1,968 England: 3,387 per 100,000 emergency admissions (aged 65+) prevalence (all 2.7% X1..x7x%% ages) Rate short stay emergency admissions Death in Usual Place of Residence: CCG: 27.53% CCG: 72.77% England: 28.3% CHD: Recorded England: 68.6% PHE Fingertips 2015/16 *Rates are directly standardised PHE Fingertips 2015/16 prevalence (all 4.5% X3..x2x%% PHE Fingertips 2015/16 ages) Living Well Dementia Care Review Depression: Recorded 7.2% X8..x3x%% The face-to-face review should address four key No care review prevalence (aged in the last 12 18+) issues: 26% months Diabetes: 1. A physical and mental health review for the patient Recorded 7.0% X6..x5x%% prevalence (aged 2. The Carers needs Care review in the 17+) 3. If applicable, the impact of caring on the care-giver 74% last 12 months 4.Communication and co-ordination arrangements with secondary care PHE Fingertips 2015/16 PHE Fingertips 2015/16 DEMENTIA IN NORWICH CCG

Preventing Well Diagnosis Diagnosing Well Dying Well Norwich : DEM005: Blood Tests Recorded Place of Death: Norwich CCG England 58% People diagnosed Recorded 34% with dementia : All England: 11% Home Smoking: 56.5% Care Ages Home Recorded 20.2% X18.x.1x% recorded Unrecorded prevalence (aged 42% Hospital 15+) 1,527 55%

Obesity: Recorded Definition: New dementia diagnosis with blood prevalence 18+) test recorded between 12 months before and 6 Place of Death: England 7.8% X9..x5x%% months after entering onto the register. PHE Fingertips 2015/16 People diagnosed 9% 31% Hypertension: Home with dementia: 65+ Recorded 11.8% X13.x.8x% Supporting Well Care Home prevalence (all years Hospital ages) Rate of emergency admissions (aged 65+) CCG: 2,459 per 100,000 emergency admissions (aged 65+) 60% Stroke: Recorded 1,488 England: 3,387 per 100,000 emergency admissions (aged 65+) prevalence (all 1.7% X1..x7x%% ages) Rate short stay emergency admissions Death in Usual Place of Residence: CCG: 27.77% CCG: 65% CHD: Recorded England: 28.3% England: 68.6% PHE Fingertips 2015/16 *Rates are directly standardised PHE Fingertips 2015/16 prevalence (all 2.9% X3..x2x%% PHE Fingertips 2015/16 ages) Living Well Dementia Care Review Depression: No care Recorded 8.3% X8..x3x%% The face-to-face review should address four key prevalence (aged review in the 18+) issues: last 12 19% months Diabetes: 1. A physical and mental health review for the patient Recorded 5.0% X6..x5x%% prevalence (aged 2. The Carers needs Care review in the 17+) 3. If applicable, the impact of caring on the care-giver 81% last 12 months 4.Communication and co-ordination arrangements with secondary care PHE Fingertips 2015/16 PHE Fingertips 2015/16 DEMENTIA IN SOUTH NORFOLK CCG

Preventing Well Diagnosis Diagnosing Well Dying Well South Norfolk : DEM005: Blood Tests Place of Death: South Norfolk Recorded CCG England People diagnosed 60% 10% Recorded 25% with dementia : All Home Smoking: England: Ages 56.5% Care Home Recorded 16.5% X18.x.1x% Unrecorded Hospital prevalence (aged recorded 40% 15+) 1,991 65%

Obesity: Recorded Definition: New dementia diagnosis with blood prevalence 18+) test recorded between 12 months before and 6 X.xx% Place of Death: England 10.8% 9.5% months after entering onto the register. PHE Fingertips 2015/16 People diagnosed 9% 31% Hypertension: Home with dementia: 65+ Recorded 15.5% X13.x.8x% Supporting Well Care Home prevalence (all years Rate of emergency admissions (aged 65+) Hospital ages) CCG: 2,294 per 100,000 emergency admissions (aged 65+) 60% Stroke: Recorded 1,956 England: 3,387per 100,000 emergency admissions (aged 65+) prevalence (all 2.0% X1..x7x%% ages) Rate short stay emergency admissions Death in Usual Place of Residence: CCG: 28.16% CCG: 75.47% England: 28.3% CHD: Recorded England: 68.6% PHE Fingertips 2015/16 *Rates are directly standardised PHE Fingertips 2015/16 prevalence (all 3.5% X3..x2x%% PHE Fingertips 2015/16 ages) Dementia Care Review Depression: Living Well Recorded 7.6% X8..x3x%% No care prevalence (aged The face-to-face review should address four key issues: review in the 18+) 22% last 12 Diabetes: 1. A physical and mental health review for the patient months Recorded 6.3% X6..x5x%% 2. The Carers needs prevalence (aged 3. If applicable, the impact of caring on the care-giver Care review in the 17+) 4.Communication and co-ordination arrangements with 78% last 12 months secondary care PHE Fingertips 2015/16 PHE Fingertips 2015/16 DEMENTIA IN WEST NORFOLK CCG

Preventing Well Diagnosis Diagnosing Well Dying Well West Norfolk : DEM005: Blood Tests Recorded Place of Death: West Norfolk CCG England People diagnosed 63% 9% England: Recorded with dementia : All 21% Home Smoking: 56.5% Ages Care Home Recorded 19.4% X18.x.1x% recorded Unrecorded Hospital prevalence (aged 37% 15+) 1,745 70%

Obesity: Recorded Definition: New dementia diagnosis with blood prevalence 18+) test recorded between 12 months before and 6 Place of Death: England 11.0% X9..x5x%% months after entering onto the register. PHE Fingertips 2015/16 People diagnosed 9% 31% Hypertension: Home with dementia: 65+ Recorded Supporting Well Care Home 18.4% X13.x.8x% years prevalence (all Rate of emergency admissions (aged 65+) Hospital ages) CCG: 3,073 per 100,000 emergency admissions (aged 65+) 60% Stroke: Recorded 1,699 England: 3,387 per 100,000 emergency admissions (aged 65+) prevalence (all 2.6% X1..x7x%% Rate short stay emergency admissions ages) Death in Usual Place of Residence: CCG: 35.86% England: 28.3% CCG: 75.1% CHD: Recorded England: 68.6% PHE Fingertips 2015/16 *Rates are directly standardised PHE Fingertips 2015/16 prevalence (all 4.6% X3..x2x%% PHE Fingertips 2015/16 ages) Living Well Dementia Care Review Depression: Recorded 8.2% X8..x3x%% No care review in prevalence (aged The face-to-face review should address four key issues: the last 12 months 18+) 25% Diabetes: 1. A physical and mental health review for the patient Recorded 2. The Carers needs 8.2% X6..x5x%% prevalence (aged 3. If applicable, the impact of caring on the care-giver Care review in the 17+) 4.Communication and co-ordination arrangements with 75% last 12 months secondary care PHE Fingertips 2015/16 PHE Fingertips 2015/16 DEMENTIA IN SUFFOLK AND NORTH EAST ESSEX STP

Source: PHE Fingertips DEMENTIA IN IPSWICH AND EAST SUFFOLK CCG

Preventing Well Diagnosis Diagnosing Well Dying Well Ipswich and East Suffolk : DEM005: Blood Place of Death: Ipswich and East Tests Recorded Suffolk CCG England 58% People diagnosed England: Recorded 11% with dementia : All 56.5% 27% Home Smoking: recorded Care Home Ages Unrecorded Recorded 17.0% X18.x.1x% Hospital prevalence (aged 42% 15+) 3,750 62% Definition: New dementia diagnosis with blood : Recorded Obesity test recorded between 12 months before and 6 prevalence 18+) Place of Death: England 10.2% X9..x5x%% months after entering onto the register. PHE Fingertips 2015/16 People diagnosed 9% 31% Home Hypertension: with dementia: 65+ Care Home Recorded 14.7% X13.x.8x% Supporting Well prevalence (all years Hospital ages) Rate of emergency admissions (aged 65+) CCG: 2,909 per 100,000 emergency admissions (aged 65+) 60% Stroke: Recorded 3,648 England: 3,387 per 100,000 emergency admissions (aged 65+) prevalence (all 2.0% X1..x7x%% ages) Rate short stay emergency admissions Death in Usual Place of Residence: CCG: 22.61% CCG: 73.48% CHD: Recorded England: 28.3% England: 68.6% PHE Fingertips 2015/16 PHE Fingertips 2015/16 prevalence (all 3.7% X3..x2x%% *Rates are directly standardised PHE Fingertips 2015/16 ages) Dementia Care Review Depression: Living Well No care review in Recorded 8.7% X8..x3x%% prevalence (aged The face-to-face review should address four key issues: the last 12 months 18+) 23% 1. A physical and mental health review for the patient Diabetes: 2. The Carers needs Recorded 5.9% X6..x5x%% prevalence (aged 3. If applicable, the impact of caring on the care-giver Care review in the 17+) 4.Communication and co-ordination arrangements with 77% last 12 months secondary care

PHE Fingertips 2015/16 PHE Fingertips 2015/16 DEMENTIA IN NORTH EAST ESSEX CCG

Preventing Well Diagnosis Diagnosing Well Dying Well North East Essex : DEM005: Blood Tests Recorded Place of Death: North East Essex CCG England People diagnosed 54% 10% 29% with dementia : All Recorded Home Smoking: Care Home Ages Hospital Recorded 18.8% X18.x.1x% England: Unrecorded prevalence (aged 56.5% 46% 61% 15+) 2,803 recorded Obesity: Recorded Definition: New dementia diagnosis with blood prevalence 18+) test recorded between 12 months before and 6 Place of Death: England 9.9% X9..x5x%% months after entering onto the register. PHE Fingertips 2015/16 People diagnosed 9% 31% Hypertension: with dementia: 65+ Home Recorded Supporting Well Care Home 16.0% X13.x.8x% years prevalence (all Rate of emergency admissions (aged 65+) Hospital ages) CCG: 2,930 per 100,000 emergency admissions (aged 65+) England: 3,387 per 100,000 emergency admissions (aged 65+) 60% Stroke: Recorded 2,641 prevalence (all 1.9% X1..x7x%% Rate short stay emergency admissions ages) CCG: 28.32% Death in Usual Place of Residence: England: 28.3% CCG: 70.71% CHD: Recorded *Rates are directly standardised PHE Fingertips 2015/16 England: 68.6% PHE Fingertips 2015/16 PHE Fingertips 2015/16 prevalence (all 3.6% X3..x2x%% ages) Dementia Care Review Depression: Living Well No care review Recorded 8.2% X8..x3x%% prevalence (aged The face-to-face review should address four key issues: in the last 12 18+) 23% months Diabetes: 1. A physical and mental health review for the patient Recorded 6.8% X6..x5x%% 2. The Carers needs prevalence (aged 3. If applicable, the impact of caring on the care-giver Care review in the 17+) 4.Communication and co-ordination arrangements with 77% last 12 months secondary care PHE Fingertips 2015/16 PHE Fingertips 2015/16 DEMENTIA IN WEST SUFFOLK CCG

Preventing Well Diagnosis Diagnosing Well Dying Well West Suffolk : DEM005: Blood Tests Recorded Place of Death: West Suffolk

CCG England People diagnosed 55% Recorded 11% 29% with dementia : All England: Home Smoking: Ages 56.5% Care Home Recorded 17.7% X18.x.1x% Unrecorded Hospital prevalence (aged recorded 15+) 2,008 45% 60%

Obesity: Recorded Definition: New dementia diagnosis with blood prevalence 18+) test recorded between 12 months before and 6 X.xx% Place of Death: England 9.1% 9.5% months after entering onto the register. PHE Fingertips 2015/16 People diagnosed Hypertension: 9% 31% Home with dementia: 65+ Recorded 15.1% X13.x.8x% Care Home prevalence (all Supporting Well years Hospital ages) Rate of emergency admissions (aged 65+) CCG: 3,117 per 100,000 emergency admissions (aged 65+) 60% Stroke: Recorded 1,968 England: 3,387 per 100,000 emergency admissions (aged 65+) prevalence (all 1.8% X1..x7x%% ages) Rate short stay emergency admissions Death in Usual Place of Residence: CCG: 31.7% CCG: 79.2% CHD: Recorded England: 28.3% England: 68.6% prevalence (all PHE Fingertips 2015/16 PHE Fingertips 2015/16 PHE Fingertips 2015/16 3.4% X3..x2x%% *Rates are directly standardised ages) Dementia Care Review Depression: Living Well No care review Recorded 8.7% X8..x3x%% prevalence (aged The face-to-face review should address four key issues: in the last 12 18+) months 20% Diabetes: 1. A physical and mental health review for the patient Recorded 6.5% X6..x5x%% 2. The Carers needs prevalence (aged 3. If applicable, the impact of caring on the care-giver Care review in the 17+) 4.Communication and co-ordination arrangements with 80% last 12 months secondary care PHE Fingertips 2015/16 PHE Fingertips 2015/16 INFORMATION

Version History Sources Used

Version Date Amendment History https://fingertips.phe.org.uk/profile-group/ Out of draft and to be piloted Melissa Darwent mental-health/profile/dementia 1 on 6 out of 20 CCGs in the ammendments EoE 20/10/2017 Feedback received from the 6 http://content.digital.nhs.uk/mhsds CCGs and ammendments Melissa Darwent 2 made including addition of ammendments demographics map and 14/11/2017 https://www.alzheimers.org.uk/info/20046/ estimated diagnosis data. help_with_dementia_care/80/ end_of_life_care

Key Contacts Regarding This Pack

Name Job Title Contact Details Melissa Darwent Information Manager [email protected] Graham Munn Quality Improvement Manager [email protected] Joanna Lyne Quality Improvement Officer [email protected]