Neighbourhood Profiles City Centre Summer 2018 1 | Page READER INFORMATION Title Neighbourhood Profiles Team Liverpool CCG Business Intelligence Team; Liverpool City Council Public Health Epidemiology Team Author(s) Andrea Hutchinson, Sophie Kelly, 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 to support Health and Social Care partners to understand the neighbourhoods they serve. They will support neighbourhoods in understanding 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 reconfigured 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 2. Introduction .................................................................................................................................... 5 2.1 GP Practices ............................................................................................................................ 6 2.2 Population Size ........................................................................................................................ 6 2.3 Registered Patient Ward Alignment ....................................................................................... 6 2.4 Service Provision ..................................................................................................................... 7 2.5 Service Assets for Health and Wellbeing ................................................................................ 9 3. Neighbourhood Map ..................................................................................................................... 13 4. Population Map ............................................................................................................................. 14 5. Comorbidities for People with Long Term Conditions .................................................................. 16 6. Population Structure, Demographics, Risk Factors and Determinants of Health ......................... 17 See separate Metadata document for indicator definitions, sources and timeframes. 3 | Page 1. Potential areas of focus • Alcohol. The annual cost of alcohol-related harm to the NHS in England is £3.5 billion, of which 45% is for inpatient care. Alcohol is the third biggest risk factor for ill health and premature death, behind smoking and blood pressure and a risk factor for many conditions including heart disease, high blood pressure, stroke and diabetes. City Centre neighbourhood has the highest rate of alcohol related admissions in Liverpool while referrals to Liverpool Community Alcohol Service (2016) were the second lowest among the neighbourhoods. Around 3,545 adults in City Centre report drinking above indicated levels. • Prevention A high take up of NHS Health Checks is important to identify early signs of poor health leading to opportunities for early interventions. The role of the NHS Health Check is to assess the patient’s level of risk of heart disease, stroke, kidney disease and diabetes, give feedback about that level of risk and provide information about how the patient can reduce their risk. Encouragingly City Centre has the second highest completion rate (5 years cumulative) for health checks in the city, however referrals for lifestyles interventions including smoking cessation, weight management and health trainers are all significantly below the city average, High blood pressure is the second biggest risk factor for premature death and disability yet is often preventable. One in ten people aged 45+ in City Centre have not had their blood pressure recorded in the last 5 years, significantly below the city level. Compared to the Liverpool average child vaccination and immunisation take-up rates are significantly lower and amongst the lowest in the city. • Mental Health Prevalence of common mental health problems (CMHP) and serious mental illness (SMI) including schizophrenia, bipolar and other psychosis are significantly above the Liverpool average. Smoking prevalence among people with SMI, recording of blood pressure and alcohol consumption are all significantly below the Liverpool average. Smoking prevalence among people with CMHP is significantly above the Liverpool rate while referrals to IAPT are the lowest in the city. City Centre has the highest rates of emergency admissions for self-harm, violence and for mental and behavioural conditions due to alcohol in Liverpool while those for mental and behavioural conditions due to other psychoactive substances are the second highest. The rate of violent crime is the highest in the city. • Children There are significant inequalities in health and social outcomes compared with all children and these contribute to poor health and social exclusion in later life. City Centre has the highest levels of looked after children, children in need of children's social care services, children who are the subject of a child protection plan, Early Help Family Assessments and children on the voluntary disability register in Liverpool. City Centre has the lowest level of pupils achieving the expected standard in reading, writing and mathematics at Key Stage 2. Around 1,029 children and young people under 25 years have common mental health problems including depression, stress and anxiety, the second highest level among the neighbourhoods. The rate of Accident and Emergency (A&E) attendances for mental health conditions among children is the highest in Liverpool. Injuries are a leading cause of hospitalisation and represent a major cause of premature mortality for children and young people; they are also a source of long-term health issues, including mental health related to experience(s). City Centre’s rate of A&E attendances due to accidents among children is significantly above the Liverpool average. Children in City Centre are more likely to stay in hospital for less than one day compared to other neighbourhoods. • Long Term Conditions People with long term conditions can often be intensive users of health and social care services, including community services, urgent and emergency care and acute services and account for half of all GP appointments. Prevalence of long term conditions including Coronary Heart Disease (CHD), Chronic Obstructive Pulmonary Disease (COPD), Atrial Fibrillation, Heart Failure, Stroke/Transient Ischaemic Attack (TIA), Peripheral Arterial Disease (PAD), SMI and CMHP in City Centre are all significantly above the Liverpool average and some of the highest in the city. Prevalence of visual and hearing impairment are also significantly higher than Liverpool. One in every 100 people aged 40+ years have at least a 70% risk or more of being admitted to hospital in an emergency in the next 12 months, the highest in Liverpool. There are around 956 people diagnosed with Diabetes which represents less than half of those 4 | Page expected to have the condition (45.2%). Of those people diagnosed with diabetes less than two in every five (37.5%) have achieved treatment targets for cholesterol, blood pressure and HbA1c, the lowest among the neighbourhoods. City Centre also has the lowest referral rate to pulmonary rehab in Liverpool,