Epidemiology & Health Sciences Team (Public Health)

ADULT HEALTH & WELL-BEING PROFILE (2012) NORTH & WEST OPERATIONAL UNIT SUMMARY

September 2013

CONTENTS:

1–PAGE SUMMARY

APPENDIX 1 GEOGRAPHY AND ABBREVIATIONS

Caveat for 1-page summary – this summary and listing of ‘challenges’, ‘good practice’ and ‘areas for improvement’ are based on our own interpretation of the profiles. Any would-be user of these are encouraged to look at the profile themselves which provides the full range of measures at various levels of detail. Wider determinants Potential for Health Improvement Health Protection Need for Health & Social Care ADULT HEALTH & WELL-BEING PROFILES FOR THE NORTH & WEST OPERATIONAL UNIT Population = 25% of NHS H Life expectancy: lower in Wick N; Wick S, Cervical screening programme: Crude rates of LT conditions : Unit is highest for Asthma, Hypertension, Ft W N; Cat S; Skye NE. Higher for RCSW highest uptake Obesity, CHD & CKD as recorded on primary care registers and due solely to Aged 65y & over: Unit average is Breast cancer screening: highest higher rates in the North 21%; Sutherland is 26% uptake overall in NHS H, highest in Population 10 yr growth (2001-10): Hospitalisation (alcohol-related) : twice , lowest in <2%, most in Lochaber (5%) and the NHS H average rate in Wick S; lowest Disease management rates: proportions of those with dementia & with decrease in Caithness (2%) in RCSW & Suth S. Bowel Screening: higher than national average, high in Caithness, severe mental illness receiving reviews, high in Sutherland and SL &WR. Remote/Rural : 70% in remote rural; Hospitalisation (drug-misuse ): rate in lower in Lochaber Caithness significantly higher than NHS H 30% v.remote small towns Vacc. rates against flu in elderly : The Disease management rates: overall rate for screening for depression in average (almost 3x higher). Lower rates in Deprivation: the Units 15% most unit rate is lower than NHS H Cardiovascular disease or diabetes was the lowest in NHS H-exception in Sutherland & SL&WR, all significantly deprived data zones (based on the average but the rate in Caithness is Sutherland lower than NHS H average. national scale) are all in Caithness higher. Disease management rates: lowest rate of Flu vaccination of those at risk on (3% (2,374 people) of the N & W disease registers in Lochaber Units total population live in these Smoking prevalence (estimated) : lowest Vacc. rates against flu in young at Rates of hospitalisation: high for COPD in Lochalsh but low in Sutherland areas) in Thurso W & highest in Ft W S risk : higher than NHSH average, East. High for CHD in Cat NE and Wick N. Employment or Income particularly in Sutherland and in Incidence of cancers: higher in Wick S deprivation: Percentage of pop. Smoking cessation: Unit has the lowest SL&WR Prevalence of diabetes: higher in Wick S higher than NHS H average in the uptake (5%) but the highest quit rate Rates of emergency hospitalisation of older people: higher in all districts, North area mainly due to higher (54%) across NHS H. significantly in Caithness & Lochaber Caithness rates Rates of multiple hospitalisations of older people: significantly higher in 9 Access deprivation: within NHS H, intermediate geographies, particularly Cat S. overall the most, highest in SL&WR Profile of older people at risk of hospitalisation: more severe particularly in (53% of pop.) Caithness; Sutherland rates were lower Access to services particularly in Skye, Lochalsh & where over half the population is the most access deprived in NHS Unequal population trends, higher than the Health Board average in Lochaber, decrease in Caithness Challenges: Nearly one third of the population of the district of Sutherland are aged 65 years & over Those living in the 15% most deprived data zones (nationally) all live in the district of Caithness (<2,500). Crude rates of Asthma, Hypertension, Obesity, CHD & CKD were the highest in NHS Highland due to the high rates in the North area. High rates of uptake of screening programmes, particularly in the North Good practice: Flu vaccination rates high in the north area High rates of disease management of dementia and the severely mentally ill in the districts of Sutherland and SL&WR Hospitalisation rates for drug and alcohol related reasons are high in Caithness Possible reasons: (1) higher prevalence (2) access to addiction services Emergency hospitalisation rates of older people the highest in NHS Highland particularly for Caithness and Lochaber Possible reasons (1) poor anticipatory care (2) access to & quality of community health & social services including nursing homes (3) lack of carers Multiple hospitalisation rates of older people higher in many areas particularly in Caithness South Areas for improvement: Possible reasons: (1) access to rehabilitation services (2) Quality of hospital discharge planning Disease management including flu vaccination in those at risk , review of those with severe mental illness and Dementia were lower in Lochaber Possible reasons (1) Lack of proactive Primary care and Community health care services Prevalence of Diabetes and the incidence of cancers were high in Wick South Possible reasons (1) need to investigate further in terms of data trends and population risk factors e.g. Obesity

APPENDIX 1

Geography & Abbreviations These are as exact as possible geographies based on data at datazone level or GP Practice location

Operational Unit Areas Districts/Localities Abreviations Caithness Cat North Sutherland Suth North & West Lochaber Loc West Skye, Lochalsh & Wester Ross SL &WR & Strathspey, Nairn & Ardersier B&SNA South Inveness East Inv. East South and Mid West Inv. West East Ross E. Ross Mid Mid Ross Mid Ross Bute & B & C Helensburgh & Lomond H & L & Bute Argyll & Bute Mid Argyll, & MAKI Oban, Lorn & the Isles OLI

When data is only available at Intermediate (IZ) geography, the following mapping applies BUT the sums of IZs DO NOT define the Districts or areas

North Area (North & West Operational Unit) Intermediate Geographies (IZs) District Name Abbreviation Name Abbreviation Caithness North East Cat NE Caithness North West Cat NW Caithness South Cat S Thurso East Thurso E Caithness Cat Thurso West Thurso W Wick North Wick N Wick South Wick S Sutherland East Suth E Sutherland North & West Suth N&W Sutherland Suth Sutherland South Suth S

West Area (North & West Operational Unit) Intermediate Geographies (IZs) District Name Abbreviation Name Abbreviation Lochaber East & North Loc E&N Lochaber West Loc W Lochaber Loc Fort William North Ft W N Fort William South Ft W S Lochalsh Lochalsh Ross & Cromarty North West RCNW Ross & Cromarty South West RCSW Skye Lochalsh & Wester Ross SL&WR Skye North East Skye NE Skye North West Skye NW Skye S Skye South

Other abbreviations

ASN Additional Support Needs CHD Coronary Heart disease COPD Chronic Obstructive Pulmonary Disease CKD Chronic Kidney Disease H HSCP Highland Health & Social Care Partnership area (Highland Council area) HMRC Her Majesty Revenue & Customs LA Local Authority LT conditions Long term conditions NHS H NHS Highland

Summary by: Susan Vaughan (e-mail: [email protected] ) Sara Huc (e-mail: [email protected] ) Epidemiology & Health Sciences, Public Health, House, Inverness, IV2 3BW

September 2013