Report to: City Area Partnership Item 5 15 August 2013 15th August 2013 Report by: City Community Health Partnership North West Sector

1. Introduction

At a number of Area Partnership meetings there has been discussion regarding NHS resources in different Area Partnership areas. This paper seeks to explain how resources are used across the sector.

2. Glasgow City CHP Glasgow City CHP is responsible for the provision of primary care and community services to the people of Glasgow, and for improving health and well being. The CHP covers the geographical area of , a population of 588,470, and includes 154 GP practices, 136 dental practices, 186 pharmacies and 85 optometry practices. (It should be noted that GPs, dentist, pharmacists and optometrists are not employed directly by the CHP. They are NHS contractors.)

The CHP has 3,140 whole time equivalent (wte) staff, and a combined budget of approximately £520m. Services within the CHP are delivered in three geographical sectors: x North East Glasgow with a population of 177,649; x North West Glasgow with a population of 190,332; and, x South Glasgow with a population of 220,489.

3. North West Sector The North West Sector has approximately 1250 wte staff, and is responsible for a budget of £179m per year.

The Sector delivers the following NHS Services and functions within North West Glasgow: x community nursing, health visiting and school nursing; x community rehabilitation services for older people and adults with a physical disability. x allied health professional services (including occupational therapy, physiotherapy, podiatry, dietetics and speech & language) x learning disability services; x adult mental health services; x older people’s mental health services x health improvement services x addictions services (as part of a formal partnership arrangement with the City Council) x initiatives with primary care contractors (GPs, dentists, community pharmacists and optometrists) x Sandyford Sexual Health Services (hosted within NW sector on behalf of NHSGGC) 4. North West Geography North West Glasgow spans the following 7 Glasgow City ward boundaries, (which each contain further distinct communities and neighbourhoods):- / / (including ) West Anderston/City /Kelvin (including and )

A small proportion of is within North West Sector, but predominately this is within North East Sector. Approximately one-third of Anderston / City also falls within North East Sector.

5. Budget North West sector budget is £179m

The budget is allocated among the different services as follows:

Care Group Budget (£000s) Accommodation and Admin 2,618.5 Addictions ( includes citywide services) 26,793.0 Clinical Director - Services 525.4 Executive 863.8 Family health services ( payment to GP 60,408.0 practices, dentists, pharmacies) Health Improvement 3,184.4 Planning 346.7 Hosted Services 10,630.9 Mental Health Adult In-patients 16,959.4 Primary Care and Community Services 18,959.4 Mental Health Community Services 3,772.1 Prescribing 34,558.0

6. Access to NHS services The majority of people access NHS services through their GP. While GP practices serve their local area, many of their patients (approximately 30%) are likely to live in a different part of the city (or even out with Glasgow). The decision to register with a particular GP is one that is personal to the patient – and many people will, for example, choose to remain with their family’s GP even if they now live some miles away. This provides a challenge in managing community health services on a geographical basis.

2 7. Localities The Public Bodies (Joint Working) () Bill sets out an aspiration for locality planning. The shape and size of localities would be decided jointly by NHSGG&C and Glasgow City Council as part of their plan for the integration of health and social care services. The Bill states that GPs and other health professionals as well representatives from the Council, Health Board, voluntary sector, patients and carers should be part of these localities.

Experience to date suggests that localities will need to be sufficiently large to allow meaningful local decision-making. North West sector has organised some services around 3 localities which were largely co-terminus with the previous 3 LCPP boards – Maryhill, Kelvin and Canal, West and Central and West. (Woodside Health Centre sits within the former LCCP area of Central and West, but was included in the Maryhill, Kelvin and Canal locality as that is where the majority of their patients live)

It has been difficult to keep local GPs engaged in the process – as they are more concerned with issues that cut across the whole sector or CHP ( e.g. diabetes services) , rather than on local, geographical concerns. There is always a tension regarding the potential for a ‘postcode lottery’ in relation to access to different NHS services.

8. CHP facilities in the existing locality areas It should be noted that while services will be based in a particular building, they will be providing a service in several local areas. E.g. Staff based at Callander Street will provide services in partnership with a large number of GPs across the sector – not just in the Maryhill, Kelvin and Canal locality. Sandyford provides some services for the whole of NHSGG&C area (and for some patients from other health board areas for specialist services) at their main base in Sauchiehall Street.

GP practices vary in size – in both number of doctors who are part of the practice and the number of patients they serve.

Medical services, provided across the three localities that make up the NW Sector are summarised below.

Maryhill, Kelvin and Canal – approx GP registered population of 81,562 x 17 GP practices (49 GPs) x Possilpark Health Centre x Addictions base at Closeburn Street x Addictions base at Callander Street x Maryhill Health Centre ( base for district nurses, health visitors, rehabilitation team) x Youth Health Service at Maryhill x Youth health service at Closeburn Street, Possilpark x Shawpark Centre, Maryhill (Community Mental Health) x Springpark Centre, Possilpark (Community Mental Health) x Woodside Health Centre

3 Central and West - approx GP registered population of 86,841 x 20 GP practices (56 GPs) x William Street – district nursing, addictions, physio and challenging behaviour unit, Specialist Children’s autism clinic) x NW Sector HQ , Gartnavel Royal Hospital x Mental Health In-patients (both adult and older people) , Gartnavel Royal Hospital x Centre for Community Health, Partick (base for health visitors, district nurses, rehabilitation team, Community Mental Health Team (including Crisis Team), physio and podiatry. x Sandy Road Clinic (base for Primary Care Mental Health team) x Sandyford Central x Yarrowview Clinic (citywide adult autism service)

West – approx GP registered population of 61,263 x 18 GP practices (43 GPs) x Drumchapel Health Centre (including a part-time Sandyford sexual health service) x Arndale Centre (Community Mental Health Team) x West Specialist Child Health Centre x Glenkirk base for older people’s team, Learning Disability and Community Respiratory Team. x Plean Street (base for health visiting, district nursing and Sandyford management office base, General Dental Practice, Podiatry, Dietetics- Weight Management)

9. NHS capital investment in North West Sector There is a significant programme of capital investment in North West Sector (in the region of £33m).

A new health centre is currently being built at Possilpark (due for completion in December 2013). Plans are also taking shape for 2 new health centres in Maryhill and Woodside. Building work should begin next spring /summer and completion is due during 2015.

Each of these new developments has a community benefit clause – providing employment and work placement opportunities for local people.

The CHP has an ongoing programme of property refurbishment and replacement. Sandyford Central and Drumchapel Health Centre have been put forward for inclusion within a list of priorities for future investment in Glasgow City CHP (although no funding is currently available).

4 10. CENTRAL AND WEST LOCALITY HEALTH PROFILES This section of the report covers information in the North West Sector covering Centre & West Locality. For the purposes of Anderston/City Area Partnership please note the information on the following areas within the report:

Anderston City Centre West & Kelvinhaugh Woodlands (N.B. Woodlands straddles Hillhead and Anderston APs)

10.1 Life expectancy Centre and West locality records amongst the best male and female life expectancy in NHSGG&C (with some neighbourhoods recording amongst the best in Scotland).

There is a significant disparity between average male and female life expectancy in Woodlands. The area records male life expectancy worse than the Scottish average (although 2 years better than the North West sector average). Female life expectancy in Woodlands is much better than the Scottish average and is amongst the best in North West sector.

Male Life expectancy Female Life expectancy

1. Finnieston 67.1 1 Finnieston and Kelvinhaugh 75.8 2. City Centre West 68.6 2 Partick 76.7 3 69.8 North West average 77.2 4 & 70.2 3 City Centre West 77.8 Partick S North West average 71 4 Glasgow Harbour & Partick 78.0 S 5 Partick 71.3 5 Anderston 78.9 6 Hillhead 72.3 5 and 78.9 7 Woodlands 73.0 7 Hillhead 79.0 8 Broomhill 74.1 Scottish average 79.5 Scottish average 74.5 8 Whiteinch 80.5 9 Anderston 75.4 9 Broomhill 80.7 10 Kelvingrove and 76.0 10 80.9 University 11 Dowanhill 77.9 11 Woodlands 81.3 12 79.2 12 Kelvingrove and University 81.9 13 Partickhill and Hyndland 79.3 13 and 82.3 14 Kelvinside and Jordanhill 80.1 14 Victoria Park 84.5

5 10.2 Alcohol and Drugs Most areas in the locality record rates for alcohol and drugs-related hospital admission rates that are below both the North West and Scottish average.

The worst 5 areas for both measures are Whiteinch, City Centre West, Hillhead, Partick and Anderston.

Kelvingrove and University and Broomhill have a much worse performance in relation to drugs-related admissions than alcohol-related admissions.

Hospitalisation Alcohol Hospitalisation Drugs 1. Whiteinch 1355 1 Whiteinch 162.5 2. City Centre West 1259 2 City Centre West 144.7 3 Hillhead 1221 North West average 88.9 4 Partick 1164 Scottish average 85.1 North West average 1127 3 Hillhead 73.4 5 Anderston 1034 4 Anderston 68.2 Scottish average 1088 5 Partick 60.0 6 Glasgow Harbour & 935 6 Kelvingrove and University 54.2 Partick S 7 Finnieston and 924 7 Finnieston and Kelvinhaugh 51.9 Kelvinhaugh 8 Woodlands 763 8 Broomhill 35.7 9 Victoria Park 624 9 Glasgow Harbour & Partick 28.4 S 10 Kelvingrove and 602 10 Woodlands 24.1 University 11 Kelvinside and Jordanhill 528 11 Victoria Park 23.0 12 Dowanhill 504 12 Partickhill and Hyndland 5.0 13 Broomhill 503 13 Kelvinside and Jordanhill 4.1 14 Partickhill and Hyndland 490 14 Dowanhill 0

6 10.3 Long Term conditions - COPD and CHD (rate per 100,000 population) The Locality generally performs better than both the North West and the Scottish average in relation to the rate of hospital admissions caused by COPD or CHD.

City Centre West and Partick record rates poorer than the North West average.

Hillhead records relatively high rates of CHD related admissions (above North West average) but is below the sector average for COPD admissions.

Hospitalisation COPD Hospitalisation CHD 1. City Centre West 273.6 1 Glasgow Harbour & Partick 408.5 S 2. Partick 273.0 2 Partick 408.3 North West average 263.4 3 Hillhead 395.3 3 Glasgow Harbour & 262.0 4 Whiteinch 377.6 Partick S 4 Woodlands 256.2 North West average 370.7 5 Whiteinch 240.8 5 Woodlands 360.9 6 Finnieston and 198.6 Scottish average 347.0 Kelvinhaugh 7 Kelvingrove and 184.6 6 City Centre West 338.4 University 8 Hillhead 180.5 7 Finnieston and Kelvinhaugh 312.8 Scottish average 158.6 8 Partickhill and Hyndland 278.1 9 Anderston 141.0 9 Anderston 271.4 10 Partickhill and 123.5 10 Dowanhill 270.0 Hyndland 11 Dowanhill 122.5 11 Kelvingrove and University 177.4 12 Kelvinside and 94.1 12 Broomhill 216.6 Jordanhill 13 Broomhill 66.7 13 Victoria Park 200.9 14 Victoria Park 56.7 14 Kelvinside and Jordanhill 190.8

10.4 Multiple admissions and emergency admissions

Patients 65+ with multiple Emergency admissions admissions 1. Hillhead 5177.9 1 Whiteinch 8638.6 2. Woodlands 4768.8 2 City Centre West 6939.9 3 Glasgow Harbour and 4725.9 North West average 6923.2 Partick South 4 Finnieston and 4587.6 3 Glasgow Harbour & 6828.8 Kelvinhaugh Partick S 5 Whiteinch 4384.9 4 Partick 6454.8 6 Partick 3801.0 Scottish average 6378.9 7 City Centre West 3604.7 5 Anderston 6378.1 8 Partickhill and Hyndland 3365.4 6 Hillhead 6189.9 North West average 3223.3 7 Woodlands 6028.3 9 Dowanhill 3223.3 8 Finnieston and 5722.1 Kelvinhaugh 10 Broomhill 3189.4 9 Broomhill 4995.1 7 Scottish average 3110.4 10 Kelvingrove and 4452.8 University 11 Anderston 2985.4 11 Kelvinside and 4307.3 Jordanhill 12 Kelvinside and Jordanhill 2908.4 12 Dowanhill 4302.6 13 Kelvingrove and 2519.2 13 Partickhill and 4239.1 University Hyndland 14 Victoria Park 2407.8 14 Victoria Park 4127.2

8 10.5 Mental Health Victoria Park and Broomhill generally record results better than the Scottish average in most measures. However these areas record relatively high rates of patients prescribed drugs for anxiety/depression (above the Scottish average), although both areas are significantly better than the Scottish average for psychiatric hospitals admissions.

Five areas record a suicide rate above the Scottish average

Patients prescribed drugs for Psychiatric hospitalisation rate anxiety/depression 1. Whiteinch 12.1% 1 Partick 625.0 2. Glasgow Harbour & 11.9% 2 Whiteinch 616.8 Partick S North West average 11.5% 3 Finnieston and 537.9 Kelvinhaugh 3 Partick 11.2% 4 Glasgow Harbour and 474.7 Partick South 4 Victoria Park 10.6% 5 City Centre West 454.0 5 Broomhill 9.9% North West average 396.4 Scottish average 9.7% 6 Anderston 379.1 6 Anderston 9.6% 7 Hillhead 332.5 6 City Centre West 9.6% 8 Kelvingrove and 325.1 University 8 Hillhead 9.2% Scottish average 303.0 9 Kelvinside and Jordanhill 9.0% 9 Dowanhill 292.5 10 Partickhill and Hyndland 8.2% 10 Woodlands 248.9 11 Woodlands 7.8% 11 Partickhill and 220.7 Hyndland 12 Finnieston and 7.6% 12 Broomhill 205.6 Kelvinhaugh 13 Dowanhill 7.3% 13 Kelvinside and 127.6 Jordanhill 14 Kelvingrove and 6.8% 14 Victoria Park 69.9 University

Deaths from suicide rate > 15% 1 Partick 56.4 2 Whiteinch 41.6 3 Glasgow Harbour & Partick S 29.1 4 Anderston 22.6 North West average 21.6 5 Hillhead 15.3 Scottish average 15.1

9 10.6 Child health The locality records particularly good results in relation to smoking in pregnancy and breastfeeding. Thirteen out of fourteen neighbourhoods record better than average results. Only Whiteinch records poorer than both the Scottish and the North West average for these 2 measures.

The Locality makes significant contribution to NHSGG&C performance in relation to the breastfeeding target.

Smoking in pregnancy Breastfeeding at 6-8 weeks 1. Whiteinch 33.9% 1 Whiteinch 23.1% North West average 29.4% Scottish average 26.4% 2. Partick 27.9% North West average 29.4% 3. Hillhead 26.9% 2 Glasgow Harbour & 31.1% Partick S Scottish average 22.6% 3 Anderston 38.6% 4 Glasgow Harbour & 20.9% 4 Partick 39.1% Partick S 5 Anderston 17.3% 5 City Centre West 41.5% 6 Broomhill 15.5% 6 Woodlands 45.8% 7 Kelvingrove and University 14.4% 7 Broomhill 49.1% 8 Finnieston and 13.5% 8 Hillhead 50.0% Kelvinhaugh 9 Dowanhill 11.7% 9 Kelvinside and Jordanhill 51.0% 10 Partickhill and Hyndland 11.6% 10 Finnieston & 53.7% Kelvinhaugh 10 Woodlands 11.6% 11 Dowanhill 56.3% 12 Kelvinside and Jordanhill 8.2% 12 Kelvingrove 57.1% - City Centre West * - 13 Victoria Park 61.3% - Victoria Park * - 14 Partickhill & Hyndland 66.3% No figure available *

10 The Locality records relatively poor results for immunisation, with the majority of neighbourhoods recording poorer results than both the Scottish and the North West sector average for children at 24 months (MMR and immunisation excluding MMR).

Immunisation excluding MMR MMR 1. Anderston 89.5% 1 Glasgow Harbour & 81.3% Partick S 2. Finnieston and 91.0% 2 Finnieston and 83.8% Kelvinhaugh Kelvinhaugh 3. City Centre West 91.4% 3 Kelvingrove and 86.0% University 4 Hillhead 91.5% 4 Dowanhill 87.0% 5 Woodlands 92.6% 5 Kelvinside and 87.6% Jordanhill 6 Glasgow Harbour & 93.8% 6 Woodlands 88% Partick S 7 Kelvingrove and 94.2% 7 City Centre West 88.6% University 8 Dowanhill 94.2% 8 Anderston 89.5% North West average 95.7% 9 Partickhill and 89.7% Hyndland 9 Kelvinside and Jordanhill 96.4% 10 Broomhill 90.0% 10 Partickhill and Hyndland 96.6% North West average 90.1% 11 Whiteinch 94.6% 11 Hillhead 90.2% 12 Partick 96.9% 12 Whiteinch 91.9% Scottish average 97.5% Scottish average 92.1% 13 Broomhill 97.8% 13 Partick 93.6% 14 Victoria Park 100% 14 Victoria Park 95.2%

11 Victoria Park, which generally records results better than North West and Scottish average has a relatively poor result for proportion of children under 15 years hospitalised through unintentional injury at home ( i.e. below Scottish average) . This is significantly worse than Kelvinside and Jordanhill and Dowanhill, which often have comparable results to Victoria Park on a range of measures.

The Locality records very good results in relation to the number of children aged 5 who have no decayed teeth. Depending on the timing and location of school dental inspections, there are no figures for some neighbourhoods.

Children<15 hospitalised by Dental health - No decayed teeth at 5 years unintentional injury at home 1. Anderston 944.5 1 Anderston 43.5% 2. Whiteinch 863.4 North West average 49.8% 3 City Centre West 727.3 2 Partick 60.0% 4 Kelvingrove and University 619.0 Scottish average 61.8% North West average 493.5 3 Kelvingrove and 72.2% University 5 Victoria Park 417.7 4 Finnieston and 73.3% Kelvinhaugh 6 Hillhead 386.1 5. Partickhill and 75% Hyndland Scottish average 377.5 6 Broomhill 78.9% 7 Partickhill and Hyndland 320.1 7 Kelvinside and 83.3% Jordanhill 8 Woodlands 298.4 8 Dowanhill 100.0% 9 Broomhill 287.1 - City Centre West No figure 10 Glasgow Harbour 276.0 - Hillhead No figure 11 Kelvinside and Jordanhill 273.0 - Woodlands No figure 12 Finnieston and 259.0 - Glasgow Harbour & No figure Kelvinhaugh Partick S 13 Dowanhill 252.5 - Whiteinch No figure 14 Partick 102.1 - Victoria Park No figure

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