NHS RightCare Frailty Preview
Kent & Medway
April 2018
Kent & Medway Introduction
NHS RightCare is developing a focus pack for frailty and is currently going through an engagement process to agree the structure and indicator list to be used. The indicator list is expected to include both existing indicators (used in other NHS RightCare packs) and new indicators.
This Frailty Preview presents charts for a selection of relevant indicators . Interpreting the charts
Indicator Name STP / Region National Range Opportunity
National Average CCG National Position
Confidence Interval
% Difference to lowest/best As this confidence interval crosses the CCG Opportunity in £s or similar 5 CCGs horizontal axes, the amber opportunity does not patients to best/lowest 5 count towards the STP opportunity similar CCGs Percentage of GP registered population aged 75+ - April 2017
16 CCGs Kent & Medway England 14
12
10
8
6
4
2
09E 09E 10E 10E
99J 99J 10A 09J 09J
09W 09W 09C
10D 10D
-
30.0% % difference compared to lowest 5 similar CCGs and quantified potential improvement opportunity
25.0%
20.0%
15.0%
10.0%
5.0%
0.0%
-5.0%
-10.0% Medway Swale Dartford, Gravesham and Ashford West Kent Canterbury and Coastal Thanet South Kent Coast 09W 10D Swanley 09C 99J 09E 10E 10A 09J
STP Opportunity calculated by summing the CCGs with statistically significant opportunities Source: NHS Digital Kent & Medway Percentage of GP registered population aged 65+ - April 2017
35 CCGs Kent & Medway England 30
25
20
15
10
5
09E 09E 10E 10E
09J 09J 99J 10A
09W 09W 09C
10D 10D
-
30.0% % difference compared to lowest 5 similar CCGs and quantified potential improvement opportunity
25.0%
20.0%
15.0%
10.0%
5.0%
0.0%
-5.0%
-10.0% Medway Dartford, Gravesham and Swale Ashford West Kent Canterbury and Coastal Thanet South Kent Coast 09W Swanley 10D 09C 99J 09E 10E 10A 09J
STP Opportunity calculated by summing the CCGs with statistically significant opportunities Source: NHS Digital Kent & Medway Proportion of older people (aged 60+) living in income deprived households - 2015
60 CCGs Kent & Medway England 50
40
30
20
10
09E 09E 10E
99J 99J 09J 10A 10A
09C 09C 09W 09W
10D 10D
- % difference compared to lowest 5 similar CCGs and quantified potential improvement opportunity 40.0%
35.0%
30.0%
25.0%
20.0%
15.0%
10.0%
5.0%
0.0% West Kent Dartford, Gravesham and Swanley Ashford Canterbury and Coastal Medway South Kent Coast Swale Thanet 99J 09J 09C 09E 09W 10A 10D 10E
STP Opportunity calculated by summing the CCGs with statistically significant opportunities Source: English indices of deprivation 2015 Kent & Medway Proportion of the adult population (aged 16+) meeting the recommended '5-a-day’ on a 'usual day' - 2015/16
80 CCGs Kent & Medway England 70
60
50
40
30
20
10
09E 09E 10E
10A 10A 99J 09J 09J
09W 09W 09C
10D 10D
-
25.0% % difference compared to lowest 5 similar CCGs and quantified potential improvement opportunity
20.0%
15.0%
10.0%
5.0%
0.0%
-5.0%
-10.0% Medway Dartford, Gravesham and Thanet Canterbury and Coastal South Kent Coast Ashford Swale West Kent 09W Swanley 10E 09E 10A 09C 10D 99J 09J
STP Opportunity calculated by summing the CCGs with statistically significant opportunities Source: Public Health England (PHE), Fingertips, Sport England, Active Lives Survey Kent & Medway Percentage of adults (aged 19+) that are physically inactive (<30 moderate intensity equivalent minutes per week) - 2015/16
40 CCGs Kent & Medway England 35
30
25
20
15
10
5
09E 09E 10E
99J 99J 10A 09J 09J
09W 09W 09C
10D 10D
-
40.0% % difference compared to lowest 5 similar CCGs and quantified potential improvement opportunity
30.0%
20.0%
10.0%
0.0%
-10.0%
-20.0% Medway Dartford, Gravesham and Swale Ashford West Kent Thanet Canterbury and Coastal South Kent Coast 09W Swanley 10D 09C 99J 10E 09E 10A 09J
STP Opportunity calculated by summing the CCGs with statistically significant opportunities Source: Public Health England (PHE), Fingertips, Sport England, Active Lives Survey Kent & Medway Percentage of adults (aged 18+) classified as overweight or obese - 2015/16
90 CCGs Kent & Medway England 80
70
60
50
40
30
20
10
09E 09E 10E
99J 99J 09J 10A
09W 09W 09C 09C
10D 10D
-
25.0% % difference compared to lowest 5 similar CCGs and quantified potential improvement opportunity
20.0%
15.0%
10.0%
5.0%
0.0%
-5.0%
-10.0%
-15.0% Canterbury and Coastal Ashford West Kent Dartford, Gravesham and Swale Thanet South Kent Coast Medway 09E 09C 99J Swanley 10D 10E 10A 09W 09J
STP Opportunity calculated by summing the CCGs with statistically significant opportunities Source: Public Health England (PHE), Fingertips, Sport England, Active Lives Survey Kent & Medway Percentage of people registered in a GP practice aged 18+ on clinical register for obesity - 2016/17
18 CCGs Kent & Medway England 16
14
12
10
8
6
4
2
09E 09E 10E 10E
09J 09J 10A 99J 99J
09C 09C 09W 09W
10D 10D
-
40.0% % difference compared to lowest 5 similar CCGs and quantified potential improvement opportunity
30.0%
20.0%
10.0%
0.0%
-10.0%
-20.0% Canterbury and Coastal West Kent Dartford, Gravesham and Ashford Thanet Medway South Kent Coast Swale 09E 99J Swanley 09C 10E 09W 10A 10D 09J
STP Opportunity calculated by summing the CCGs with statistically significant opportunities Source: NHS Digital, Quality and Outcomes Framework (QOF) Kent & Medway Percentage of people aged 18+ who are self-reported occasional or regular smokers - Jan-March 2017
30 CCGs Kent & Medway England 25
20
15
10
5
09E 09E 10E
99J 99J 09J 10A
09C 09C 09W
10D 10D
-
60.0% % difference compared to lowest 5 similar CCGs and quantified potential improvement opportunity
50.0%
40.0%
30.0%
20.0%
10.0%
0.0%
-10.0% West Kent Canterbury and Coastal Dartford, Gravesham and Ashford Medway Thanet Swale South Kent Coast 99J 09E Swanley 09C 09W 10E 10D 10A 09J
STP Opportunity calculated by summing the CCGs with statistically significant opportunities Source: General Practice Patient Survey (GPPS) Kent & Medway Rate of successful quitters at 4-weeks per 100,000 smokers aged 16+ - 2016/17 1,929 Ppl.
7,000 CCGs Kent & Medway England 6,000
5,000
4,000
3,000
2,000
1,000
09E 09E 10E
10A 10A 99J 09J 09J
09C 09C 09W
10D 10D
-
0.0% % difference compared to highest 5 similar CCGs and quantified potential improvement opportunity 93
-10.0% 172 207 229 163 579 -20.0% 210 277
-30.0%
-40.0%
-50.0%
-60.0% Dartford, Gravesham and Swale Thanet Canterbury and Coastal South Kent Coast Ashford West Kent Medway Swanley 10D 10E 09E 10A 09C 99J 09W 09J
STP Opportunity calculated by summing the CCGs with statistically significant opportunities Source: Risk Factors Intelligence Team, Public Health England (PHE), NHS Digital, Annual Population Survey, Office for National Statistics (ONS) Kent & Medway Dementia: Estimated prevalence (%) for 65+ - February 2018
12 CCGs Kent & Medway England 10
8
6
4
2
09E 09E 10E
09J 09J 99J 10A 10A
09C 09C 09W
10D 10D
-
35.0% % difference compared to lowest 5 similar CCGs and quantified potential improvement opportunity
30.0%
25.0%
20.0%
15.0%
10.0% 5.0%
0.0%
-5.0%
-10.0%
-15.0% Swale Dartford, Gravesham and Ashford West Kent Medway Canterbury and Coastal Thanet South Kent Coast 10D Swanley 09C 99J 09W 09E 10E 10A 09J
STP Opportunity calculated by summing the CCGs with statistically significant opportunities Source: NHS Digital, Recorded Dementia Diagnoses Kent & Medway Dementia: Diagnosis rate (%) for 65+ - February 2018 2,224 Ppl.
120 CCGs Kent & Medway England 100
80
60
40
20
09E 09E 10E 10E
10A 10A 09J 09J 99J
09W 09W 09C
10D 10D
-
10.0% % difference compared to highest 5 similar CCGs and quantified potential improvement opportunity
5.0%
0.0% 30 -5.0% 420 205 297 143 314 -10.0% 321 524 -15.0%
-20.0%
-25.0%
-30.0%
-35.0%
-40.0% Medway Dartford, Gravesham and Ashford West Kent South Kent Coast Thanet Canterbury and Coastal Swale 09W Swanley 09C 99J 10A 10E 09E 10D 09J
STP Opportunity calculated by summing the CCGs with statistically significant opportunities Source: NHS Digital, Recorded Dementia Diagnoses Kent & Medway Percentage of seasonal influenza vaccine uptake amongst GP patients aged 65+ - 1 Sep 2016 - 31 Jan 2017 16,900 Pats.
90 CCGs Kent & Medway England 80
70
60
50
40
30
20
10
10E 10E 09E 09E
09J 09J 99J 10A 10A
09W 09W 09C
10D 10D
-
0.0% % difference compared to highest 5 similar CCGs and quantified potential improvement opportunity
-2.0% 708 3,117 773 2,060 2,191 2,419 -4.0% 3,059 2,574 -6.0%
-8.0%
-10.0%
-12.0%
-14.0% Thanet Dartford, Gravesham and Swale Medway Canterbury and Coastal West Kent South Kent Coast Ashford 10E Swanley 10D 09W 09E 99J 10A 09C 09J
STP Opportunity calculated by summing the CCGs with statistically significant opportunities Source: Public Health England (PHE), Influenza Immunisation Vaccine Uptake Monitoring Programme Kent & Medway Rate of injuries due to falls in people aged 65+ per 100,000 age-sex weighted population - 2016/17 1,410 Adms.
3,500 CCGs Kent & Medway England 3,000
2,500
2,000
1,500
1,000
500
09E 09E 10E 10E
10A 10A 09J 99J
09C 09C 09W 09W
10D 10D
-
80.0% % difference compared to lowest 5 similar CCGs and quantified potential improvement opportunity
60.0%
40.0% 409 737 20.0% 189 75
39 0.0%
-20.0%
-40.0% Canterbury and Coastal Ashford South Kent Coast Thanet Medway Swale Dartford, Gravesham and West Kent 09E 09C 10A 10E 09W 10D Swanley 99J 09J
STP Opportunity calculated by summing the CCGs with statistically significant opportunities Source: National Commissioning Data Repository - Secondary Uses Service (SUS Plus) Kent & Medway Tendency to fall, not elsewhere classified (R296): Spend on non-elective admissions per 1,000 age-sex weighted £1,128k population - 2016/17
12,000 CCGs Kent & Medway England 10,000
8,000
6,000
4,000
2,000
10E 10E 09E
10A 10A 99J 09J 09J
09W 09W 09C 09C
10D 10D
-
120.0% % difference compared to lowest 5 similar CCGs and quantified potential improvement opportunity
100.0%
80.0%
60.0%
40.0% £92k £372k £664k 20.0%
0.0% £54k
-20.0%
-40.0%
-60.0%
-80.0% Thanet Canterbury and Coastal South Kent Coast Ashford Swale Dartford, Gravesham and Medway West Kent 10E 09E 10A 09C 10D Swanley 09W 99J 09J
STP Opportunity calculated by summing the CCGs with statistically significant opportunities Source: National Commissioning Data Repository - Secondary Uses Service (SUS Plus) Kent & Medway Disorientation, unspecified (R410): Spend on non-elective admissions per 1,000 age-sex weighted population - £433k 2016/17
3,000 CCGs Kent & Medway England 2,500
2,000
1,500
1,000
500
10E 10E 09E 09E
09J 09J 10A 10A 99J
09C 09C 09W
10D 10D
-
200.0% % difference compared to lowest 5 similar CCGs and quantified potential improvement opportunity
150.0%
100.0%
£337k 50.0% £96k £12k £13k 0.0% £1k £12k
-50.0%
-100.0% South Kent Coast Canterbury and Coastal Thanet Ashford Medway Swale Dartford, Gravesham and West Kent 10A 09E 10E 09C 09W 10D Swanley 99J 09J
STP Opportunity calculated by summing the CCGs with statistically significant opportunities Source: National Commissioning Data Repository - Secondary Uses Service (SUS Plus) Kent & Medway Syncope and collapse (R55X): Spend on non-elective admissions for people aged 75+ per 1,000 age-sex weighted £134k population - 2016/17
20,000 CCGs Kent & Medway England 18,000 16,000 14,000 12,000 10,000 8,000 6,000
4,000
2,000
10E 10E 09E
10A 10A 09J 99J 99J
09C 09C 09W
10D 10D
-
80.0% % difference compared to lowest 5 similar CCGs and quantified potential improvement opportunity
60.0%
40.0%
20.0% £41k £93k
0.0% £1k
-20.0%
-40.0%
-60.0% South Kent Coast Thanet Ashford Swale Medway Canterbury and Coastal Dartford, Gravesham and West Kent 10A 10E 09C 10D 09W 09E Swanley 99J 09J
STP Opportunity calculated by summing the CCGs with statistically significant opportunities Source: National Commissioning Data Repository - Secondary Uses Service (SUS Plus) Kent & Medway Influenza: Spend on non-elective admissions per 1,000 age-sex weighted population - 2016/17 £k
1,800 CCGs Kent & Medway England 1,600
1,400
1,200
1,000
800
600
400
200
10E 10E 09E
09J 09J 10A 99J
09W 09W 09C
10D 10D
-
200.0% % difference compared to lowest 5 similar CCGs and quantified potential improvement opportunity
150.0%
100.0%
50.0% £22k 0.0%
-50.0%
-100.0%
-150.0% Dartford, Gravesham and Medway Swale Thanet Canterbury and Coastal South Kent Coast Ashford West Kent Swanley 09W 10D 10E 09E 10A 09C 99J 09J
STP Opportunity calculated by summing the CCGs with statistically significant opportunities Source: National Commissioning Data Repository - Secondary Uses Service (SUS Plus) Kent & Medway Aspiration pneumonia: Spend on non-elective admissions per 1,000 age-sex weighted population - 2016/17 £341k
4,500 CCGs Kent & Medway England 4,000
3,500
3,000
2,500
2,000
1,500
1,000
500
09E 09E 10E
10A 10A 99J 09J 09J
09C 09C 09W 09W
10D 10D
-
200.0% % difference compared to lowest 5 similar CCGs and quantified potential improvement opportunity
150.0%
100.0%
50.0% £149k
£192k £30k £71k 0.0% £33k
-50.0%
-100.0% Ashford South Kent Coast Canterbury and Coastal Thanet West Kent Dartford, Gravesham and Medway Swale 09C 10A 09E 10E 99J Swanley 09W 10D 09J
STP Opportunity calculated by summing the CCGs with statistically significant opportunities Source: National Commissioning Data Repository - Secondary Uses Service (SUS Plus) Kent & Medway Proportion of older people (aged 65+) offered rehabilitation following discharge from acute or community hospital - 211 Pats. 2016/17
12 CCGs Kent & Medway England 10
8
6
4
2
09E 09E 10E
99J 99J 09J 10A 10A
09C 09C 09W
10D 10D
-
140.0% % difference compared to highest 5 similar CCGs and quantified potential improvement opportunity
120.0%
100.0%
80.0%
60.0%
40.0%
20.0%
0.0% 58 6 18 59 -20.0% 94
-40.0%
-60.0% Swale South Kent Coast West Kent Dartford, Gravesham and Thanet Canterbury and Coastal Ashford Medway 10D 10A 99J Swanley 10E 09E 09C 09W 09J
STP Opportunity calculated by summing the CCGs with statistically significant opportunities Source: NHS Digital Kent & Medway Proportion of older people (aged 65+) who were still at home 91 days after discharge from hospital into reablement 59 Pats. / rehabilitation services - 2016/17
120 CCGs Kent & Medway England 100
80
60
40
20
09E 09E 10E
09J 09J 10A 99J 99J
09W 09W 09C
10D 10D
-
10.0% % difference compared to highest 5 similar CCGs and quantified potential improvement opportunity
5.0%
0.0% 2 7 4 11 11 -5.0% 27 8 13
-10.0%
-15.0%
-20.0% Medway Dartford, Gravesham and Swale Thanet Canterbury and Coastal South Kent Coast Ashford West Kent 09W Swanley 10D 10E 09E 10A 09C 99J 09J
STP Opportunity calculated by summing the CCGs with statistically significant opportunities Source: NHS Digital Kent & Medway Permanent admissions to residential and nursing care homes, per 100,000 population aged 65+ - 2013/14
1,400 CCGs Kent & Medway England 1,200
1,000
800
600
400
200
10E 10E 09E
09J 09J 99J 10A 10A
09W 09W 09C
10D 10D
-
40.0% % difference compared to lowest 5 similar CCGs and quantified potential improvement opportunity
35.0%
30.0%
25.0%
20.0%
15.0% 10.0% 5.0%
0.0%
-5.0%
-10.0%
-15.0% Medway Swale South Kent Coast Thanet Dartford, Gravesham and Canterbury and Coastal Ashford West Kent 09W 10D 10A 10E Swanley 09E 09C 99J 09J
STP Opportunity calculated by summing the CCGs with statistically significant opportunities Source: Public Health England (PHE), Fingertips, Adult Social Care Profile Kent & Medway