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Long-term Conditions JSNA

Long-term conditions in with CCG

This local summary report forms part of the joint strategic needs assessment (JSNA) for long-term conditions in 2013. Below is a list of indicators with comparator values for Lancashire and . The areas are ordered left to right with the area on the left having the worst or equal worst value of the three and the area on the right having the best or equal best. All values for this local area are shaded light blue so you can find them easily. If a comparator area has a value that is significantlyi worse or better than this area then its cell is shaded red for worse or green for better.

Page two of this summary provides an explanation of the key points and the impact these may have on the population and healthcare services. The intention is for these summary reports to be used to aid commissioning decisions in local areas in conjunction with the recommendations of the long-term conditions JSNA for Lancashire.

Values Indicator Worse Better % people reporting long-term illness (daily activities Lan14: 20.6% BwD: 20.2% Eng: 17.6% limited by a LTC)ii % people reporting bad or very bad healthii BwD: 7.3% Lan14: 6.7% Eng: 5.5% % unpaid carer hours per weekii Lan14: 11.3% BwD 10.7% Eng: 10.2% Ratio of recorded/expected prevalence of CHDiii Eng: 0.74 Lan14: 0.81 BwD: 0.82 Ratio of recorded/expected prevalence of COPDiii Eng: 0.56 Lan14: 0.70 BwD: 0.80 Ratio of recorded/expected prevalence of BwD: 0.53 Lan14: 0.54 Eng: 0.55 hypertensioniii Ratio of recorded/expected prevalence of strokeiii Eng: 0.85 BwD: 0.86 Lan14: 0.87 Confidence in managing own healthiv BwD: 90.2% Lan14: 92.2% Eng: 92.7% Unemployment rate for people with LLTI 2011v BwD: 13.4% Eng: 10.8% Lan12: 9.1% Ratio of unemployment rates for those with compared BwD district: Eng: 1.8 Lan14: 1.8 to those without LLTI 2011v 1.7 Potential years of life lost (PYLL) from causes BwD: 3,355 Lan14: 3,029 Eng: 2,325 considered amenable to healthcare - malesvi Potential years of life lost (PYLL) from causes BwD: 2,317 Lan14: 2,227 Eng: 1,844 considered amenable to healthcare - femalesvi Unplanned hospitalisation for chronic ambulatory care BwD: 1,217 Lan14: 1,043 Eng: 801 sensitive conditionsvii Unplanned hospitalisation for asthma, diabetes and BwD: 608 Lan14: 487 Eng: 321 epilepsy in under-19sviii Emergency readmissions within 30 days of discharge BwD: 13.7 Lan14: 12.5 Eng: 11.8 from hospitalix Total admissions for long-term neurological conditions Lan14: 6.7 BwD: 6.2 Eng: 5.7 per 1,000 populationx Mean length of stay for inpatients with long-term Lan14: 11.3 Eng: 10.6 BwD: 9.5 neurological conditionsxi Emergency bed days for long-term conditions per Lan14: 514 Eng: 473 BwD: 457 1,000 populationxii In the last 6 months patients consider they have had enough support from local services or organisations to Eng: 64.0% Lan14: 66.3% BwD: 67.9% help manage their long-term health condition(s)iv Recorded prevalence of CHDxiii Lan14: 4.2% BwD: 3.9% Eng: 3.4% Recorded prevalence of COPDxiii Lan14: 2.2% BwD: 2.1% Eng: 1.7% Recorded prevalence of hypertensionxiii Lan14: 14.1% Eng: 13.6% BwD: 12.2% Recorded prevalence of strokexiii Lan14: 2.0% BwD: 1.7% Eng: 1.7%

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Long-term Conditions JSNA

So what does it all mean? Key facts Compared to Lancashire and the rest of the country, CCG performs 20.2% of the CCG population report their daily activities reasonably well on 12 out of 23 indicators; for 14 are limited by a long-term illness – significantly higher than England; ranking fourth highest within the eight indicators it is worse than England. For seven Lancashire CCGs indicators the CCG is worse than both England and Lancashire. These include: The percentage of unpaid carer hours is higher than for  the proportion of people reporting 'bad or very England, but lower than Lancashire-14; ranking the bad' health; lowest out of the Lancashire CCGs  in males, the potential years of life lost from The proportion of people reporting ‘bad or very bad causes considered amenable to healthcare; health’ is higher than England and Lancashire-14; the  unplanned hospitalisation for chronic second highest ranking amongst the Lancashire CCGs ambulatory care sensitive conditions;  unplanned hospitalisation for asthma, diabetes The ratio of reported to estimated CHD, COPD and and epilepsy in under-19s; and stroke prevalence is higher than for England, indicating  emergency readmissions within 30 days of a higher proportion of the estimated total population being diagnosed. However, recorded prevalence of discharge from hospital. hypertension is lower than England and Lancashire-14

Utilising a wide range of available resources - The CCG has approximately 44% and 26% more years from community services, the third sector, of life lost for males and females, respectively, when primary care and other health systems - can play compared with England a key role in self-care and shared decision making, which may reduce unplanned urgent care requirements for long-term conditions and impact positively on hospitalisations and emergency readmissions.

Positives Compared with England, there are higher rates of estimated cases of coronary heart disease (CHD) and chronic obstructive pulmonary disease (COPD). This indicates estimated cases are being diagnosed correctly and can be treated and managed appropriately for the benefit of the affected population

The mean length of stay for inpatients with long-term neurological conditions is better than for England and Lancashire-14xiv, whilst the number of emergency bed days for long-term conditions per 1,000 of the population is lower than for England and Lancashire. This may be indicative of effective care pathways and appropriate signposting, advice and support for people with long-term conditions.

Compared to England, a higher proportion of patients state that in the last six months they have had enough support from local services or organisations to help manage their long-term health condition(s).

For more information please see the Lancashire long-term conditions JSNA web pages. There are long-term conditions reports for each the six clinical commissioning groups, and summary reports for local authority areas in Lancashire-12 in the health and wellbeing sections of each area profile. The Blackburn with Darwen and reports are in their respective area profiles. Please direct all queries to [email protected].

Notes: iAPHO, Technical briefing 3: Commonly used public health statistics and their confidence intervals, Mar 2008. ii2011 Census. iii2011 recorded vs expected. ivGP Patient Survey 2012/13. vONS, 2011. DC6302EW - economic activity by hours worked by sex by long- term health problem or disability. LLTI = limiting long-term illness. viDirectly standardised potential years of life lost (PYLL) rate (DSR) per 100,000 European population, 2011. Health and Social Care Information Centre (HSCIC). viiDSR for all ages per 100,000 population, 95% confidence intervals (CIs), 2011/12. Hospital Episode Statistics (HES), ONS mid-year population estimates and GP population counts from NHAIS (Exeter). viiiIndirectly standardised rate (ISR) per 100,000 population, 95% CIs, 2011/12. Hospital Episode Statistics (HES), ONS mid-year population estimates and GP population counts from NHAIS (Exeter). ixPercentage of emergency admissions (ISR), (excludes cancer and obstetrics), 2010/11. xTotal admissions per 1,000 population, 2011/12.HSCIC, NHS comparators. xiMean length of stay Apr 2010-Mar 2011. HSCIC. xiiEmergency bed days per 1,000 population, Apr 2010-Mar 2011, HSCIC, NHS comparators. xiiiQuality and Outcomes Framework (QOF) for Apr 2011-Mar 2012, HSCIC. xivLancashire-12 refers to the 12 districts within Lancashire County Council; Lancashire-14 incorporates the unitary authorities of Blackpool and Blackburn with Darwen. • 2 •

Long-term Conditions JSNA

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