Chapters Locality Profile Map of the locality AMERSHAM & CHESHAM LOCALITY PROFILE CSCSU 9/9/2016 [Edition 1, Volume 1] Demographics and Public Health Data Changes over the last 5 years Local Plan Patient Services used Community assets, Pharmacies Dentists Opticians Learning Disability Centres Children Centres Social Care Voluntary sector services Rectory Meadow Surgery Amersham Health Centre Prisons, Universities, The New Surgery colleges, Private hospitals, John Hampden Surgery Schools etc. Water Meadow Surgery Hughenden Valley Surgery Gladstone Surgery Prospect House Little Chalfont Surgery Key Contact : CCG Clinical Lead Dr Stephen Burr Key Practice Name Locality 1 K82001: Rectory Meadow Surgery Amersham and Chesham 2 K82004: Amersham Health Centre Amersham and Chesham 3 K82024: The New Surgery Amersham and Chesham 4 K82035: John Hampden Surgery Amersham and Chesham 5 K82037: Water Meadow Surgery Amersham and Chesham 6 K82049: Hughenden Valley Surgery Amersham and Chesham 7 K82058: Gladstone Surgery Amersham and Chesham 8 K82618: Prospect House Amersham and Chesham 9 K82621: Little Chalfont Surgery Amersham and Chesham Demographics and Public Health Data Specific issue’s to consider in the Amersham and Chesham (A&C) Locality in Chiltern CCG. The A&C Locality’s population size in 2014 is 73,983 people around 14% of the total Bucks population. 20% of the population is aged 65+ higher than CCCG average of 18% and Bucks average of 17%. 24% of the population is aged <19 similar to CCCG and Bucks average. The locality on average is less deprived and less ethnically diverse compared to the AVCCG and Buckinghamshire as a whole. Life expectancy is better than the national average but there is a difference of up to 4 years in life expectancy between males and females in Chiltern District Council, compared to a difference of 3.5 years in Bucks. The population of Amersham and Chesham locality experiences similar or better health compared to the Buckinghamshire population. Emergency admission rates to hospital are statistically lower than the Bucks and CCG average. Elective admission rates are also statistically lower than the Bucks and CCG average. Early death rates are similar to Bucks which itself has some of the lowest death rates in the country. Modelled estimates suggest that a number of people may have undiagnosed high blood pressure, diabetes or dementia. Primary care data (QOF) shows variation in the outcomes achieved by locality practices in the management of people with diabetes, coronary heart disease, hypertension, stroke and chronic kidney disease, with higher exception rates for some outcomes. Cancer screening uptake in the locality is similar or better than the CCG average. Patient satisfaction with GP practices in the locality range from 80% to 95%. Specific issues for this locality to consider (in addition to the Director of Public Health’s Annual Report key recommendations) are: The needs of older people across the locality (including dementia, depression and social isolation). Management of people with long term conditions: cardiovascular conditions in particular, but also those with multiple conditions and co-existing mental health problems. Map 1 Map 2 Map 3 Map 4 Map of Chiltern CCG practices DETAILED REPORT Demography – Population Locality size (2016): There are 9 GP practices in the Amersham and Chesham locality with a total registered population of 75,666, which is 22% of the total Chiltern CCG registered population. GP Practices (2016): Rectory Meadow Surgery, Amersham Health Centre, The New Surgery, John Hampden Surgery, Water Meadow Surgery, Hughenden Valley Surgery, Gladstone Surgery, Prospect House, Little Chalfont Surgery Age profile: Similar to Buckinghamshire population profile overall. Main differences are noted in the 25-34 age group, which is lower compared to the Chiltern CCG average for both males and females. Higher proportion of males and females aged 65-74 compared to Chiltern CCG average. Around 24% population in the Amersham and Chesham locality are aged <19 years and 20% over 65 years of age. Population changes: There has been a small increase in all the older population groups since 2014 with a rise of 3.3% in those aged 65 and over; 3.6% aged 65-74; 2.4% aged 75-84 and 4.8% in those aged 85 and over. There has however been a large increase (19.5%) of those aged 95 and over although this involves smaller actual numbers (30). Population Projection 2016-2026: The population for Chiltern District is predicted to increase by 4% (4,200 people). The district population is forecast to fall by 9% (975 people) in those aged 20-34 (compared to a fall of an average of 1% in Buckinghamshire) and 16% increase (3,270 people) in those aged 65 and over (compared to an average of 24% increase in Buckinghamshire). This includes a 42% increase (1,250 people) in those aged 85 and over (compared to an average increase of 47% in Buckinghamshire). Ethnicity (2011): People from a black and minority ethnic group account for 9% of the total population compared to Chiltern CCG average of 15.9%, Buckinghamshire average of 13.6% and England average of 14.7% [Census 2011]. Deprivation (2015): The Index of Multiple Deprivation (2015) based on LSOAs shows an average deprivation score of 7.3 in Amersham and Chesham locality compared to 9.1 in Chiltern CCG (Range 6.4-13.4). (Higher the score, more the deprivation). Chiltern DC registered population July 2016 with 2026 projection 85+ 80-84 75-79 70-74 65-69 60-64 55-59 50-54 45-49 40-44 35-39 main X axis 30-34 25-29 20-24 15-19 10-14 05-09 00-04 10 8 6 4 2 0 2 4 6 8 10 % of gender total population Female Male Female Chiltern 2016 Chiltern 2016 Chiltern 2026 Male Female Bucks 2026 Male Bucks 2026 Chiltern 2026 Housing in Poor Condition: This indicator from the Census 2011 indicates when a household has at least one bedroom too few for the number and composition of people living in the household and is considered overcrowded by the bedroom standard. In Amersham and Chesham locality, 2.8% of the population is living in households which are considered as overcrowded by this indicator which is below the average for Chiltern CCG of 3.7%. Occupancy rating (bedrooms) of -1 or less AVCCG CCCG Bucks 8% 1 or less - 6% 4% 2% % Ocupancy rating of(bedrooms) % rating Ocupancy 0% Central North South Amersham & Southern Wooburn Wycombe Chesham Green GP Locality Census 2011 Births, low birth weight and infant mortality Births: There were 724 live births in the Amersham and Chesham locality, compared to 6,089 in all Buckinghamshire localities in 2015 (11.9% of all births in Buckinghamshire CCGs). The birth rate in the Amersham and Chesham locality was statistically significantly lower at 9.7, compared to the combined Buckinghamshire CCG rate of 11.8 in 2015, and the England rate of 12.2 (live births per 1,000 population, in 2014). The general fertility rate (per 1,000 female population aged 15-44) in the locality was 59.5 (which is not statistically different) compared to 64.8 in all Buckinghamshire localities, and 62.2 in England (2014). Low birth weight (LBW): 2013-15 records (from ONS) show that 7.9% of babies born to mothers in the Amersham and Chesham locality had a low birth weight (<2,500g), compared to 7.4% of babies in all Buckinghamshire localities (and 7.4% of babies in England in 2014, latest data). This is not statistically different to the combined Buckinghamshire localities data. Infant deaths: The infant mortality (deaths at ages under 1 year) rate for Amersham and Chesham locality in 2013-15 was 5.0, which is higher (but not statistically different) than the combined Buckinghamshire localities rate of 3.8 (England rate, in 2014, was 4.0 per 1,000 live births). Children Early Years Foundation Stage Profile (EYFSP): In Amersham and Chesham, 73.6% of pupils attending Buckinghamshire maintained schools and academies, achieved a Good Level of Development in 2016. This is higher than the average of 70.5% for all pupils attending Buckinghamshire schools/settings. Looked After Children: The rate of Looked After Children in Amersham and Chesham locality is 2.8 per 1,000 which is lower (but not statistically different) than the combined Buckinghamshire localities rate of 3.3 (as at 31st March 2016). Life Expectancy and Mortality Life expectancy: The male life expectancy in the Amersham and Chesham population in 2013-15 was 83.5 years, which is statistically significantly higher the Buckinghamshire average of 82.3 years (England average = 79.5 in 2012-14). Female life expectancy was 87.6 in Amersham and Chesham compared to 85.1 in Buckinghamshire, which is statistically significantly higher (England average = 83.2 in 2012-14). Mortality in under 75s: The chart below shows the contribution of each condition to the ‘gap’ in mortality between the locality and the Buckinghamshire mortality rate. The mortality profile in the under 75 population in Amersham and Chesham locality shows a statistically significantly lower overall premature death rate than the combined Buckinghamshire localities (204.1 vs 240.6 per 100,000), with the major causes of premature deaths being Cancer, Circulatory disease and Respiratory disease. Under 75s, cause specific mortality profile (2013-15 combined) Amersham & Chesham Locality 300 250 11.3 15.9 Other causes 10.6 200 9.8 Infectious & parasitic diseases 13.4 13.6 External causes 7.4 18.8 Genitourinary system diseases 10.8 Nervous system diseases 150 16.1 Mental and behavioral disorders Digestive diseases Respiratory diseases