Neighbourhood Profiles Anfield & Everton 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, 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 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 Assets ........................................................................................................................................................... 8 3. Neighbourhood Map .......................................................................................................................................... 11 4. Population Map .................................................................................................................................................. 12 5. Co – Morbidities ................................................................................................................................................. 14 6. Population Structure, Demographics, Risk Factors and Determinants of Health ............................................. 15 7. Neighbourhood Health Profile ........................................................................................................................... 15 See separate Metadata document for indicator definitions, sources and timeframes 3 | Page 1. Potential Areas of Focus Health • Older People Income deprivation affecting older people is significantly higher with 40%, compared to 34.4% for Liverpool. One in every 8 people aged over 65+ live alone (12.8%), although the proportion of people aged 65+ is significantly lower. Dementia prevalence is comparable to Liverpool. However, the proportion of patients aged 75+, with a fragility fracture treated with a bone sparing agent, is significantly lower than the total Liverpool position (36.1% compared to 58.2% for Liverpool). The proportion of patients on who are on 10 or more prescribed items is 7.5%, compared to 6.2% for Liverpool as a whole. The rate of emergency hospital admissions at end of life is significantly higher, at 28.9 per 1,000 compared to 21.7 for Liverpool – this neighbourhood has the highest rate in the city. • Risk of Hospital Admission Risk stratification allows GP practices to identify patients at risk of a hospital admission based on risk score. 1.6% of the Anfield and Everton neighbourhood population fall into risk score bracket >50% <90% (significantly above the Liverpool average of 1.3%) although a reduction from last year (2.2%). Active case management of these identified patients and targeted proactive care in the community will 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. Recorded Hypertension prevalence in this neighbourhood is significantly higher than the city average (17,897 per 100,000 compared to the Liverpool average of 16,840). This is also true for management of BP below 140/90 with 71.9% patients, compared to 70.6% for Liverpool. The proportion of patients aged 40-74 years offered a health check is significantly lower (57% compared to 73% for Liverpool), and the proportion of those who have completed their health check is 33.5%, ranked 4th lowest in the city. • Children Over a fifth of the neighbourhood population is aged 0-18 (22%), significantly higher than the city average. The birth rate is significantly higher with a rate per 1,000 of 68.2 compared to 55. The percentage of women smoking at the time of delivery is also significantly higher (19%). Breastfeeding rates are significantly lower at birth and 6 weeks post check-up. The neighbourhood has among the highest rates of children with a special education needs (SEN) support plan. There are a higher proportion of troubled families (8% compared to 5.4% for Liverpool). Educational attainment at GCSE grades A*-C is ranked the 2nd lowest when compared to all neighbourhoods, and pupil absenteeism is significantly higher than the city wide average with (14.3% in primary school and 21.4% in secondary school). Seasonal flu vaccine uptake for children at 2 & 3 years old and for pregnant women is significantly lower than the city-wide average. The number of accident and emergency attendances for LRTI, mental health and accidents are all significantly higher that the city average. Hospital admissions in 15-24 year olds for substance misuse is ranked 3rd highest when compared to all neighbourhood. • Cancer Early detection of cancer is essential to ensure prompt appropriate treatment, thus reducing premature deaths. Cancer prevalence rates are significantly lower compared to Liverpool, although the overall cancer mortality rate is the highest in the city, at 426.2 per 100,000 population, compared to the Liverpool average of 320.5 per 100,000. Lung cancer mortality is ranked the highest, with a rate of 143.3 per 100,000, compared to 93.2 per 100,000 when compared to all neighbourhoods. Uptake rates for all three cancer screening programmes are significantly lower, suggesting late diagnosis of cancers detected. • Respiratory Management Recorded COPD prevalence is significantly higher than the city average (5,345 compared to 3,853). Asthma prevalence is the highest, when compared to all neighbourhoods, with a rate of 7,639 per 100,000 population. Emergency admissions for COPD are ranked 2nd highest, when compared to all neighbourhoods, and disease management is also poor, with 52% of patients having a record of FEV1 in the previous 12 months, and reviews at 74%. Referrals to pulmonary rehab are comparable with Liverpool. Recording of asthma symptoms, day and night, is significantly lower with 58.9% compared to 65.4% for