Neighbourhood Profiles Aintree Summer 2018 1 | Page READER INFORMATION Title Neighbourhood Profiles Team Liverpool CCG Business Intelligence Team; Liverpool City Council Public Health Epidemiology Team Author(s) Sophie Kelly, Andrea Hutchinson, and Kate Hodgkiss Contributor(s) Liverpool City Council Social Services Analysis Team; Liverpool Community Health Analysis Team Reviewer(s) Neighbourhood Clinical Leads; Locality Clinical Leads; Liverpol CCG Primary Care Team; Liverpool CCG Business Intelligence Team: Liverpool City Council Public Health Team; Liverpool Community Health Intelligence and Public Health Teams Circulated to Neighbourhood Clinical and Managerial Leads; Liverpool GP Bulletin; Liverpool CCG employees including Primary Care Team and Programme Managers; Adult Social Services (LCC); Public Health (LCC); Liverpool Community Health Version 1.0 Status Final Date of release July 2018 Review date To be confirmed Purpose The packs are intended for General Practice neighbourhoods to use to understand the needs of the populations they serve. They will support neighbourhoods in understaning health inequalities that may exist for their population and subsequently how they may want to configure services around patients. Description This series of reports contain intelligence about each of the 12 General Practice Neighbourhoods in Liverpool. The information benchmarks each neighbourhood against its peers so they can understand the the relative need, management and service utilisation of people in their area. The pack contains information on wider determinants of health, health, social care and community services. Reference JSNA Documents The Joint Strategic Needs Assessment (JSNA) identifies the key issues affecting the health and wellbeing of local people, both now and in the future. The JSNA looks at the strategic needs of Liverpool, as well as issues such as inequalities between different populations who live in the city. It is the main source of information on health and wellbeing, and acts as a reference for commissioners and policy makers across the Health & Care system. All the JSNA material is available via: www.liverpool.gov.uk/jsna PCQF The Primary Care Quality Framework (PCQF) is a suite of indicators which are monitored on a monthly basis across all practices, neighbourhoods and localities in the city. It brings together indicators taken from various sources including QOF and GP spec. Many of the indicators are monitored using data extracted directly from practice systems, whilst others use hospital datasets or nationally published data. The aim of the framework is to improve quality and reduce variation in primary care. When practices identify that there may be scope for improvement against a particular indicator, they can choose to include it in their practice development plan. You can access the PCQF via Aristotle 2 | Page Contents 1. Potential Areas of Focus ........................................................................................................................................... 4 Health ................................................................................................................................................................................ 4 Social Care ......................................................................................................................................................................... 5 2. Introduction .................................................................................................................................................................. 6 2.1 GP Practice ........................................................................................................................................................ 6 2.2 Registered Population ....................................................................................................................................... 6 2.3 Registered Patient Ward Alignment ................................................................................................................. 6 2.4 Service Provision ............................................................................................................................................... 7 2.5 Service Assets for Health and Wellbeing .......................................................................................................... 7 3. Neighbourhood Map ............................................................................................................................................... 10 4. Population Map ....................................................................................................................................................... 11 5. Co – Morbidities ...................................................................................................................................................... 13 6. Population Structure, Demographics, Risk Factors and Determinants of Health ................................................... 14 7. Neighbourhood Profile ................................................................................................................................................ 14 See separate Metadata document for indicator definitions, sources and timeframes 3 | Page 1. Potential Areas of Focus Health • Older People This neighbourhood has significantly higher proportions of older people aged 65+ (16.1 % compared to 14.4%) and the proportion of one person households is significantly higher (12.7% compared to 11.9%). The rate of people who are recorded on the end of life register is significantly higher and this cohort of patients will require access to high quality care in general practice and the community. Mortality rates across most disease areas have improved since last year. Hearing impairment prevalence is one of the highest rates in the city (7,935.1 compared to 6,797.5 per 100,000 population). Patients aged over 40 years with a risk score above 40% is significantly higher. Dementia prevalence is comparable to the Liverpool average 898.1 per 100,000 population however the observed to expected ratio is significantly lower suggesting there are patients living in Aintree neighbourhood undiagnosed. Patients with a fragility fracture treated with bone sparing agents is significantly lower than the city average with 42.9% compared to 58.2% city wide. End of life prevalence is significantly higher with 826 per 100,000 population compared to 655 per 100,000 for Liverpool, although emergency admission for end of life patents remains the lowest in the city. However admissions due to falls in 65+ is ranked the highest in Liverpool with 38.45 per 1000 population • Risk of Hospital Admission Risk stratification allows GP practices to identify patients at risk of a hospital admission based on risk score, 1.7% of the Aintree neighbourhood population fall into risk score bracket >50%<90% (significantly above the Liverpool average with 1.3%). Proactive case management using an MDT approach via the community care teams will help to prevent unnecessary visits to hospital. • Hypertension Management 90% of risk factors for hypertension are modifiable. High blood pressure accounts for 80% of all cases of CHD and contributes to 9% of the burden of disease in the UK, second only to tobacco. Overall recorded hypertension prevalence in this neighbourhood is comparable to the city average, however those with CHD is significantly lower than the city average with 85.8% compared to 88.3% for Liverpool. Patients that are on some form of treatment i.e. aspirin, anti-platelet therapy, or anticoagulant is also significantly lower. The completion of health checks in patients aged 40-74 years is significantly lower with 47.1% compared to 48.7% for Liverpool. • Diabetes prevalence is higher than the Liverpool average 62.73.4 per 100,000 however disease management in patients is significantly lower for example 61.3% of patients have maintained their HbA1C level to 7.5 or less compared to 65% for Liverpool. Only 60% of patients have had all of their 8 care processes in the previous 12 months and emergency admissions for diabetic complications is significantly higher than the city average with 0.52 per 1,000 population compared to 0.40 • Children 16.1% of the population in Aintree neighbourhood are children aged 5-18 years, which is a significantly higher than the city average. Flu vaccination uptake in children aged 2 & 3 year olds is comparable to the city average. Breast feeding initiation rates at birth and 6 weeks are significantly lower 27.8% and 18% respectively. Asthma prevalence in amongst young people aged 18-25 years is significantly higher than the Liverpool average (6.6% compared to 4%) and is ranked highest out of all neighbourhoods. The Child AED attendance rate for accidents is significantly higher than the city average (356.2 compared to 116.6 per 1,000 population) this is also the same for AED attendances for LRTI with a rate of 209 compared to 59.3 per 1,000. GSCE attainment rates are significantly below the city average with 42.3% achieving grade A*-C compared to 53.4% for Liverpool, this is also a reduction on last year’s performance. • Cancer Early detection of cancers is essential to ensure prompt appropriate treatment thus reducing premature deaths. Cancer prevalence rates are the highest in the city with a rate of 4177.1 per 100,000 population. 4 | Page However, uptake rates for all three cancer screening programmes are either comparable or significantly