Early Years Profile -

November 2016

Produced by

Samantha Bennett: Public Health Consultant (samantha.bennett2@.gov.uk) Del Herridge: Public Health Product & Data Manager ([email protected]) Zara Cuccu: Public Health Analyst ([email protected]) Lauren Liddell-Young: Information Officer ([email protected]) Correspondence to: Del Herridge Version: 1b Last Updated: November 2016

| Contents

1. Executive Summary ...... 2

1.1 Priorities for Sevenoaks ...... 2

1.2 Key Findings ...... 3

1.3 Call to Action ...... 5

2. Introduction & Objectives...... 6

3. Health Outcome Indicators ...... 10

3.1 Under 18 conceptions ...... 10

3.2 Infant mortality ...... 12

3.3 Low birth weight ...... 14

3.4 Smoking status at time of delivery ...... 16

3.5 Breastfeeding (initiation) ...... 17

3.6 Breastfeeding (prevalence at 6-8 weeks) ...... 18

3.7 Vaccination coverage ...... 19

3.8 Child development & school readiness ...... 21

3.9 Healthy weight (excess weight at 4-5 years) ...... 23

3.10 Tooth decay in children age five ...... 25

3.11 Hospital admissions due to an injury ...... 26

Appendix A: Ward key...... 28

Appendix B: Technical Information ...... 29

A.1.1 Confidence intervals ...... 29 A.1.1 Statistical significance ...... 29 A.1.1 Trend analysis ...... 29

Appendix C: Practice level immunisation data ...... 32

1 Early Years Profile – Sevenoaks, November 2016

| 1. Executive Summary

1.1 Priorities for Sevenoaks

• Decrease the percentage of 4-5yr olds with excess weight

o More 20% of reception year children are overweight • Increase the prevalence & coverage of breastfeeding at 6-8 weeks

o Coverage of breastfeeding status is less than required 95%, whilst prevalence is only 44% • Increase MMR vaccination coverage

o Level of MMR dose 2 coverage is less than the recommended 90%

2 Early Years Profile – Sevenoaks, November 2016

1.2 Key Findings

Population Deprivation

11.4% 7.5% of children of Sevenoaks’ population were living in income are aged 0 to 5 deprived household

Swanley St Mary’s was highlighted as high.

Under 18 conceptions Infant mortality

15.1 per 1,000 2.4 per 1,000 15- 17 year olds live births between 2012 and 2014

Lower than Kent. Decreasing across Kent since 1998-2001. Decreasing since 1998-2000. Low birth weight (less than 2500g) Smoking at time of delivery

Of 1,198 maternities in 2015/16, 212 or 5.6% 122 were smoking at

of live births time of delivery between 2013 and 2014

10.1%

Similar to Kent. Similar to previous years, but lower than Decreasing since 1998-2000. Kent.

3 Early Years Profile – Sevenoaks, November 2016

Breastfeeding prevalence at 6-8 weeks MMR vaccination coverage The prevalence of 85.7% breastfeeding at 6-8 of children at age 5 years weeks check had received two doses of MMR

44.5% Similar to Kent and just short of 90% 20.9% had unknown breastfeeding status vaccination coverage targets.

Child development Excess weight 77.6% Of children aged 4-5 years, measured as part of the of pupils achieved a good level of development National Child Measurement Programme

during 2014/15 20.6% were overweight or obese Higher than Kent. Similar to previous years and Kent. Tooth decay

Of children aged five surveyed,

experienced 13.4% decayed, missing or filled teeth

Similar to Kent.

4 Early Years Profile – Sevenoaks, November 2016

1.3 Call to Action

Overall, Sevenoaks performs similar to or better than Kent for the early years profile health outcome indicators.

Effective interventions should focus on the wards identified within the Mind the Gap analysis; St Mary’s. From analysis these wards or practices serving these were often identified within the highest 10% of early years health outcome indicators across Sevenoaks.

5 Early Years Profile – Sevenoaks, November 2016

| 2. Introduction & Objectives

The report has been produced to mirror the NHS and Public Health England, Child & Maternal Intelligence Network early years profiles for children aged 0 to 5 years.1 The early years have been well identified as the critical point to improve health and wellbeing over the life course.2

The health outcome indicators used include;

• under 18 conceptions, • infant mortality, • low birth weight, • smoking status at time of delivery, • breastfeeding prevalence at 6-8 weeks, • vaccination coverage, • child development, • excess weight, • tooth decay.

Comparisons have been made to Kent and England. Where possible, our analysis has been completed at a lower geographical level, by ward; therefore, we have pooled several years data to improve the reliability of our findings.

1 Public Health England (2015) National child & maternal health intelligence network: early years profiles. http://atlas.chimat.org.uk/IAS/dataviews/earlyyearsprofile 2 NHS England and Public Health England (2014) Guide to the early years profiles. https://www.england.nhs.uk/wp-content/uploads/2014/03/hv-ey-hlth-prof.pdf

6 Early Years Profile – Sevenoaks, November 2016

Sevenoaks is a district located within the west of the county. The main town is Sevenoaks, with good transport links from the M20 and M25. The rest of the district is rural with a number of villages. A ward map has been included, the key for ward names within Appendix A.

7 Early Years Profile – Sevenoaks, November 2016

The Health & Social Care Maps detail the headline demographic information for Sevenoaks. For the purpose of this report, we explored ward level population estimates for children aged 0 to 5, as a percentage of the all age resident population. For Sevenoaks 7.5% of its population were aged 0 to 5. The highest 20% and 10% of Sevenoaks;

Table 1: Resident population estimates, 2014: by ward.

Ward name Ages 0-5 All ages Percentage (n) (n) aged 0-5 (%) Sevenoaks Eastern 441 4230 10.4% Sevenoaks Northern 457 4558 10.0% Edenbridge South and West 440 4558 9.7% Sevenoaks Town and St John's 613 6786 9.0% and Riverhead 449 5145 8.7% Swanley St Mary's 372 4430 8.4% Source: ONS, produced by KPHO (ZC) October 2016.

8 Early Years Profile – Sevenoaks, November 2016

The Mind the Gap: Health Inequalities Action Plan for Kent sought to characterise the most deprived decile for Kent using segmentation. Within the Dartford, Gravesham & Swanley CCG area (not coterminous with district boundary) this highlighted LSOAs within ; Swanley St Mary’s.

See the Dartford, Gravesham & Swanley CCG summary for detailed locality maps. The GP practices that serve the most deprived decile, include: the Cedars Surgery and the Oaks Partnership.

The Income Deprivation Affecting Children Index has been mapped as part of the Health & Social Care Maps. This is an indicator that describes the proportion of children living within income deprived families.3

For Sevenoaks 11.4% of children were living in income deprived households. The highest 20% and 10% of Sevenoaks wards have been highlighted;

Table 2: Income deprivation affecting children, 2015.

Ward name Percentage of children living in income deprived households (%) Swanley St Mary's 31.2% Swanley White Oak 29.2% and Well Hill 17.6% Edenbridge South and West 17.3% Swanley Christchurch & 15.0% Ash 13.7%

Source: IMD, produced by KPHO (ZC) October 2016.

3 Families that either receive Income Support or income-based Jobseekers Allowance or Employment and Support Allowance or Pension Credit (Guarantee) or families in receipt of Working Tax Credit or Child Tax Credit with an equivalised income (excluding housing benefit) below 60 per cent of the national median before housing costs.

9 Early Years Profile – Sevenoaks, November 2016

| 3. Health Outcome Indicators

3.1 Under 18 conceptions The indicator definition4 is the rate of conceptions under the age of 18 per 1,000 female population aged 15-17 years. See report produced for Kent.

A key measure of inequality3 from the known relationship and poorer outcomes for mum and child in terms of:

• mum’s education, qualifications, risk of postnatal depression and mental health risk, • child’s likelihood of low birth weight, being breastfed and experiencing accidents and behavioural problems.

But, a limitation of this indicator is that it does not acknowledge miscarriage or abortion.

The rate of under 18 conceptions across Sevenoaks in 2012-2014 was:

• 15.1 per 1,000 female population aged 15-17 years,

• this was lower in comparison to 23.7 for Kent,

• and was lower in comparison to 25.0 for England.

4 NHS England and Public Health England (2014) Guide to the early years profiles. https://www.england.nhs.uk/wp-content/uploads/2014/03/hv-ey-hlth-prof.pdf

10 Early Years Profile – Sevenoaks, November 2016

The rate of under 18 conceptions across Sevenoaks between 1998-2000 and 2012-

2014 has been:

• decreasing by 0.5 under 18 conceptions per 1,000 female population with each passing time period, • this was similar in comparison to decreases of 1.0 Kent and 1.3 in England.

Ward level under 18 conceptions have been mapped for Sevenoaks within the Health & Social Care Maps this includes the following wards5 within the highest 20% and highlights those in the upper 10%. Whereby the rate was greater than 18.0 per 1,000 female population aged 15-17 years.

Table 3: Under 18 conceptions: by ward in 2012-2014.

Local percentile rank Swanley White Oak Edenbridge South & West Within the highest 10% Source: ONS, prepared by KPHO (ZC) October 2016.

5 Note: the remaining wards were suppressed due to conception counts less than 5.

11 Early Years Profile – Sevenoaks, November 2016

3.2 Infant mortality The indicator definition6 is the rate of infant deaths (persons aged less than 1 year) per 1,000 live births.

A key measure of inequality5 and an indicator of population health. There is a known relationship between infant mortality and:

• deprivation, maternal age under 20 years and non-white ethnicity of infant

This indicator is known to have a high level of validity.

The rate of infant mortality across Sevenoaks in 2013-20156 was:

• 2.4 per 1,000 live births, • this was in comparison to 3.0 for Kent. For Sevenoaks there were 9 infant deaths for the total period, which was an average of 3 infant deaths per year.

6 NHS England and Public Health England (2014) Guide to the early years profiles. https://www.england.nhs.uk/wp-content/uploads/2014/03/hv-ey-hlth-prof.pdf 6 Note: this is a locally produced figure, therefore, England data not available for the latest period.

12 Early Years Profile – Sevenoaks, November 2016

The rate of infant mortality across Sevenoaks has been presented between 1999- 2001 and 2012-2014:

• there were 18 infant deaths during 1999-2001,

• this was in comparison to 11 infant deaths during 2012-2014.

Across Kent, there has been a decrease in infant mortality over the period studied.

13 Early Years Profile – Sevenoaks, November 2016

3.3 Low birth weight The indicator definition7 is the percentage of live births with a low birth weight (less than 2500g).

A key public health indicator5 and a known relationship between low birth weight and:

• deprivation, lifestyle factors and access to maternity services. • And outcomes for; morbidity, mortality in infancy and childhood, as well as, long term health outcomes in adulthood

This indicator is known to have limitations as an indicator within some ethnic groups.

The percentage of low birth weight across Sevenoaks in 2013-20157 was:

• 5.6% of live births, • this was in comparison to 5.8% for Kent.

7 NHS England and Public Health England (2014) Guide to the early years profiles. https://www.england.nhs.uk/wp-content/uploads/2014/03/hv-ey-hlth-prof.pdf 7 Note: this is a locally produced figure, therefore, England data not available for the latest period.

14 Early Years Profile – Sevenoaks, November 2016

Low birth weight across Sevenoaks has been presented between 2006-2008 and

2013-2015:

• there were 222 low birth weight live births during 2006-2008,

• this was in comparison to 212 during 2013-2015.

Kent shows a decrease in low birth weight over the period studied.

Ward level low birth weight has been mapped for Sevenoaks within the Health & Social Care Maps this includes the following wards within the highest 20% and highlights those in the upper 10%;

Table 4: Low birth weight: by ward in 2013-2015. Local percentile and Hever Hartley and Hodsoll Street Within the highest 10% Sevenoaks Town and St John's Sevenoaks Kippington Hextable Seal and Weald Within the highest 20% , Chevening and Sundridge Source: ONS, prepared by KPHO (ZC) October 2016.

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3.4 Smoking status at time of delivery The indicator definition8 is the percentage of maternities whereby the woman was smoking at time of delivery.

A key public health indicator5 and a known relationship with:

• growth and development of baby, • complications during pregnancy, • as well as, preventable morbidity and mortality

This indicator is produced for CCGs and has been modelled to district level based on the number of births for district residents within CCGs. We are able to present data for the latest 3 contract years. All of the Kent districts met the quality indicator for less than 5% of records with an unknown smoking status.

The percentage smoking at time of delivery across Sevenoaks in 2015/16 was:

• 10.1% of maternities, similar to previous years,

• lower than 13.0% for Kent, but similar to 10.6% for England in 2015/16.

8 NHS England and Public Health England (2014) Guide to the early years profiles. https://www.england.nhs.uk/wp-content/uploads/2014/03/hv-ey-hlth-prof.pdf

16 Early Years Profile – Sevenoaks, November 2016

3.5 Breastfeeding (initiation) The indicator definition9 is the percentage of all mothers who breastfeed their babies in the first 48hrs after delivery.

A key public health indicator5 with known benefits from:

• reduced illness and hospital admissions, • and lifetime risk of obesity and diabetes The prevalence of breastfeeding initiation across the county in 2014/15 was 71.3%, which compares to an England rate of 74.3%. Several areas recorded no prevalence due to data quality issues. Data for 2015/16 is yet to be published.

The percentage of mothers who initiated breastfeeding in Sevenoaks in 2014/15:

• Data not published due to date quality issues

9 Taken from Public Health Profiles http://www.phoutcomes.info/search/Initiation#page/6/gid/1/pat/6/par/E12000008/ati/101/are/E07000110

17 Early Years Profile – Sevenoaks, November 2016

3.6 Breastfeeding (prevalence at 6-8 weeks) The indicator definition10 is the percentage of infants who were totally or partially breastfed at the 6-8 week check.

A key public health indicator5 with known benefits from:

• reduced illness and hospital admissions, • and lifetime risk of obesity and diabetes

None of the Kent districts met the quality indicator for more than 95% of maternities to have a known breastfeeding status. Therefore, there are great limitations for interpretation of this indicator, affecting accurate interpretation and comparison.

The percentage of infants totally or partially breastfed in Sevenoaks in 2015/16:

• 44.8% due a 6-8 week check,

• it should be recognised that 18.5% of maternities had a unknown status

10 NHS England and Public Health England (2014) Guide to the early years profiles. https://www.england.nhs.uk/wp-content/uploads/2014/03/hv-ey-hlth-prof.pdf

18 Early Years Profile – Sevenoaks, November 2016

3.7 Vaccination coverage The indicator definition11 is the percentage of children at age 5 years who have received two doses of MMR vaccine.

A key public health indicator5 for levels of other immunisation rates and the: • level of protection against vaccine preventable communicable diseases, • as well as, the overall levels of disease in the population. This indicator is produced at a general practice level and has been modelled to CCG level based on practice location. This was then apportioned to district level based on the numbers of children aged 5 years resident within the district as a proportion of the CCG total.

MMR vaccination coverage across Sevenoaks in 2015/167 was:

• 85.7% of children aged 5 years,

• this was similar in comparison to 85.9% for Kent.

Note 90% vaccination coverage targets are set for local authority districts.

11 NHS England and Public Health England (2014) Guide to the early years profiles. https://www.england.nhs.uk/wp-content/uploads/2014/03/hv-ey-hlth-prof.pdf

19 Early Years Profile – Sevenoaks, November 2016

MMR vaccination coverage has been presented for Kent and England between

2010/11 and 2015/16. For Kent:

• coverage was higher than England during 2010/11 and 2012/13,

• lower than England during 2014/15,

• but remains similar to England in the latest year.

MMR vaccination coverage for two doses (5 year olds); highlighted the following practices within the lowest 20% and the lowest 10%. Whereby coverage was lower than 80%.

Table 5: MMR vaccination coverage for two doses (5 year olds): by practice in 2015/16. Local percentile Town Medical Centre Within the lowest 10% Hextable Surgery Red Practice, Medical Centre Within the lowest 20% Source: CHIS, prepared by KPHO (ZC) October 2016.

A wider range of general practice vaccination coverage data for Sevenoaks has been included within Appendix B.

20 Early Years Profile – Sevenoaks, November 2016

3.8 Child development & school readiness The indicator definition12 is the percentage of children achieving a good level of development at the end of Early Years Foundation Stage (the end of the academic year in which the child turns 5). This is defined as achieving the expected level in areas of learning13 and in specific areas of literacy and mathematics.

A key public health indicator and priority: 10

• essential of children’s healthy development, • fundamental to later outcomes and life chances.

This is an indication for those in receipt of government funded education at the end of Early Years Foundation Stage. Therefore, does not represent those not in receipt of government funded education. Note there has been some change to this indicator over time.

Good level of development in Sevenoaks in 2014/15 was:

• achieved by 77.6% of pupils, • this was higher in comparison to 73.6% for Kent and similar to 66.3% for England.

12 Department for Education (2016) Early years foundation stage profile https://www.gov.uk/government/collections/statistics-early-years-foundation-stage-profile 13 personal, social and emotional development; physical development; and communication and language

21 Early Years Profile – Sevenoaks, November 2016

Achieving good level of development has been presented for Kent and England between 2013/14 and 2016/17. For Kent:

• higher than England consistently across the period,

• and has increased over time.

Achieving good level of development; highlighted the following wards within the lowest 20% and the lowest 10%. Whereby achievement was lower than 75%.

Table 6: Good level of development: by ward in 2014/15. Local percentile Halstead and Within the lowest 10% Swanley St Marys Edenbridge North and East Swanley White Oak Within the lowest 20% Edenbridge South and West Source: MIU, prepared by KPHO (ZC) October 2016.

22 Early Years Profile – Sevenoaks, November 2016

3.9 Healthy weight (excess weight at 4-5 years) The indicator definition14 is the percentage of children aged 4-5 years who were classified as overweight or obese of those who had valid height and weight measurements.

A key public health indicator and priority5 and known relationship with:

• risk of obesity in adulthood, • and increased morbidity and mortality.

Low participation would affect interpretation of prevalence estimates. Kent had high participation and met the quality indicator for greater than 90% participation by pupils in reception year.

The percentage of excess weight in Sevenoaks in 2014/15 was:

• 20.6% of those measured, • this was similar in comparison to 22.5% for Kent and 21.9% for England.

See further analysis here.

14 NHS England and Public Health England (2014) Guide to the early years profiles. https://www.england.nhs.uk/wp-content/uploads/2014/03/hv-ey-hlth-prof.pdf

23 Early Years Profile – Sevenoaks, November 2016

Overweight, obesity and excess weight across Sevenoaks and Kent has been presented between 2010/11 and 2014/15:

• the prevalence of overweight, obesity and excess weight has remained similar in Sevenoaks and in Kent between 2010/11 and 2014/15

Ward level reception year excess weight has been mapped for Sevenoaks within the Health & Social Care Maps this includes the following wards within the highest prevalence of excess weight within the highest 20% and highlights those in the upper 10%;

Table 7: Excess weight in reception year: by ward in 2013/14-2014/15. Local percentile Swanley St Mary's Swanley Christchurch & Swanley Village Within the highest 10% Hextable Edenbridge North & East Dunton Green & Riverhead Within the highest 20% Halstead, Knockholt & Badgers Mount Source: NCMP, prepared by KPHO (ZC) October 2016.

24 Early Years Profile – Sevenoaks, November 2016

3.10 Tooth decay in children age five The indicator definition15 is the percentage of children at age five years, within the survey sample, who had experienced decayed, missing or filled teeth.

A key public health indicator5 known to impact:

• quality of life, appearance and confidence, • as well as, missed school and education.

Each survey covers a cohort or children and there have been methodological changes between previous surveys, limiting analysis of trend. Survey non-response has been identified to be higher within more deprived areas, known to have higher tooth decay.13

Tooth decay (decayed, missing or filled) in children age five across Sevenoaks,

2015:7

• 13.4% of children aged five years, • similar in comparison to 16.2% for Kent and lower than 24.7% England.

Among Maidstone children, the average number of decayed teeth was 0.24 (a child this age normally has 20 primary teeth).

15 NHS England and Public Health England (2014) Guide to the early years profiles. https://www.england.nhs.uk/wp-content/uploads/2014/03/hv-ey-hlth-prof.pdf

25 Early Years Profile – Sevenoaks, November 2016

3.11 Hospital admissions due to an injury The indicator definition is the number of children aged 0-4 years who were admitted to hospital as a result of a deliberate or unintentional injury in per 10,000 resident 0-4 year olds.

The admission rate in Sevenoaks in 2015/16 was:

• 92.9 per 10,000 population

• this was similar in comparison to 118.6 for Kent.

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Ward level deliberate and unintentional injury admissions have been mapped for Sevenoaks within the Health & Social Care Maps. This includes the following wards with admissions rates within the highest 20% across Kent.

Deliberate and unintentional injury admissions: by ward in 2015/16.

The following wards had admission rates which were in the highest Kent quintile

• Crockenhill and Well Hill • , and • Kemsing • Leigh and Causeway • Cowden and Hever

Source: SUS, ONS prepared by KPHO (LLY) November 2016.

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| Appendix A: Ward key

Table 8: Sevenoaks: by ward

Key Name 43 Cowden & Hever 44 , & Chiddingstone 45 Dunton Green & Riverhead 46 Edenbridge South & West 47 & 48 Brasted, Chevening & Sundridge 49 Leigh & 50 Seal & Weald 51 Sevenoaks Town & St John's 52 Halstead, Knockholt & Badgers Mount 53 Crockenhill & Well Hill 54 Kemsing 55 & Shoreham 56 57 Farningham, Horton Kirby & South Darenth 58 & West Kingsdown 59 Ash 60 Hartley & Hodsoll Street 61 Edenbridge North & East 62 Sevenoaks Kippington 63 Sevenoaks Northern 64 Swanley St Mary's 65 Swanley White Oak 66 Swanley Christchurch & Swanley Village 67 Hextable 68 Sevenoaks Eastern Source: ONS, produced by KPHO (ZC) October 2016

28 Early Years Profile – Sevenoaks, November 2016

| Appendix B: Technical Information

A.1.1 Confidence intervals Confidence intervals have been presented throughout this report. For percentages the Wilson & Newcombe method was used, whereas, for rates the Byar’s method was used.

A.1.1 Statistical significance Statistical significance has been referred to throughout this report. The Altman method was used to explore statistical significance for percentages, as overlapping confidence intervals do not necessarily indicate no significant difference.

A.1.1 Trend analysis Trend analysis has been referred to throughout this report. Simple linear regression was used to calculate slope, to explore rate of change of indicators over time. Visual inspection of the data determined whether the trend was stable and this method appropriate.

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Indicator Data definition

Rate of conceptions per 1,000 females aged Numerator: Total conceptions to all women aged under 18 15-17 Denominator: Total female population aged 15-17

Crude rate of infant deaths (persons aged Numerator: The number of infant deaths (aged under 1 year) in calendar year. less than 1 year) per 1,000 live births, Denominator: The number of live births in calendar years pooled data for three year periods.

Percentage of all live births at term with Numerator: Number of live births with low birth weight (<2500g) low birth weight. Denominator: Number of live births

Proportion of women smoking at time of Numerator: Number of women who smoke at time of delivery delivery Denominator: Number of maternities

Breastfeeding prevalence at 6-8 weeks Numerator: Number of infants who are totally or partially breastfed at 6-8 week check after birth Denominator: Total number of infants due a 6-8 week check

MMR vaccination coverage for two doses (5 Numerator: Number of children at age 5 years who have received two doses of MMR vaccine year olds) Denominator: Number of children at age 5 years resident within each reporting area

Children achieving good level of Numerator: Number of foundation stage pupils with a good level of development. development at the end of reception Denominator: Number of foundation stage pupils.

30 Early Years Profile – Sevenoaks, November 2016

Indicator Data definition

Percentage of children aged 4-5 classified Numerator: The number of primary school age children in Reception with valid height and as overweight or obese weight recorded who are classified as overweight or obese. Denominator: The total number of primary school age children in Reception with valid height and weight recorded in a particular school year.

Rate of tooth decay in children aged 5 years Numerator: Total number of decayed, missing or filled teeth in the survey sample of 5-year-old children Denominator: Number of 5-year-old children in the survey sample.

31 Early Years Profile – Sevenoaks, November 2016

| Appendix C: Practice level immunisation data

MMR vaccination coverage is a good indicator of vaccination coverage as a whole, due to public concerns regarding safety.

The table below shows vaccination coverage for general practices within Sevenoaks, district:

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Table 9: Vaccination coverage: by practice in 2015/16.

Up to 1st Birthday Up to 2nd Birthday Up to 2nd Up to 5th Birthday primaries Up to 5th birthday boosters DTaP MenC PCV DTaP MMR MenC Hib PCV DT Pol Pertussi Hib MenC MMR PCV DtaP Hib MMR PCV IPV Hib IPV Hib Infant MenC Booster s Infant Infant 1st Infant IPV MenC Code Practice Name Booster dose

% % % % % % % % % % % % % % % % % % G82013 Amherst Medical Practice 86.4 89.1 88.4 83.9 92.7 89.5 93.5 32.3 91.4 91.4 91.4 91.4 92.0 92.0 93.3 91.4 92.0 85.9 G82019 Edenbridge Medical Centre 96.6 97.3 96.6 93.5 95.5 94.8 94.8 65.8 96.0 96.0 96.0 95.4 93.1 93.7 93.7 92.6 93.1 85.1 G82028 The Cedars Surgery 88.8 91.6 91.6 98.0 89.0 99.0 88.0 51.0 92.2 92.2 92.2 91.5 92.2 91.5 84.5 89.9 84.5 85.3 G82092 Winterton Surgery 98.7 98.7 98.7 89.2 89.2 96.4 89.2 21.7 96.4 96.4 96.4 95.5 95.5 97.3 94.6 91.1 95.5 83.0 G82110 Town Medical Centre 96.9 100.0 95.4 75.9 93.7 89.9 91.1 88.6 88.9 88.9 88.9 85.6 90.0 86.7 65.6 87.8 67.8 88.9 G82124 West Kingsdown Medical Practice 97.1 100.0 97.1 96.7 90.0 96.7 90.0 23.3 90.9 93.9 93.9 93.9 97.0 93.9 75.8 93.9 78.8 78.8 G82125 The Otford Medical Centre 90.4 91.3 92.2 91.5 84.0 94.3 86.8 65.1 98.6 98.6 98.6 95.8 95.1 97.9 87.4 95.1 86.0 93.0 G82205 St John's Medical Practice 93.9 97.0 92.7 92.4 91.9 93.6 93.6 62.8 93.5 94.0 94.0 91.5 88.9 93.5 85.9 90.5 83.9 88.9 G82218 Braeside Surgery 88.6 90.9 84.1 86.0 88.0 86.0 88.0 44.0 98.4 98.4 98.4 100.0 93.8 100.0 93.8 100.0 89.1 90.6 G82225 The Oaks Partnership 90.5 95.6 89.8 95.0 92.1 95.0 90.6 62.6 97.3 97.3 97.3 95.9 94.6 96.6 89.2 93.9 89.9 89.2 G82722 Hextable Surgery 86.1 88.9 86.1 93.9 75.8 93.9 75.8 42.4 95.0 95.0 95.0 95.0 90.0 90.0 72.5 92.5 75.0 85.0 G82888 South Park Medical Practice 97.1 97.1 97.1 97.9 100.0 97.9 100.0 77.1 97.0 97.0 97.0 97.0 95.5 97.0 89.6 95.5 92.5 91.0 Source: CHIS, prepared by KPHO (ZC) October 2016.

Key less than 80 80-90 90-95 95 or more

33 Early Years Profile – Sevenoaks, November 2016