Network Profile Croxteth & Norris Green November 2019 1 | Page READER INFORMATION Title Network Profile – Croxteth & Norris Green Team Liverpool CCG Business Intelligence Team; Liverpool City Council Intelligence & Data Analytics Team Author(s) Sophie Kelly, AnnMarie Daley, Danielle Wilson, Karen Jones Contributor(s) Liverpool City Council Social Services Analysis Team; Liverpool Community Health Analysis Team Reviewer(s) Network Clinical Leads; Locality Clinical Leads; Liverpol CCG Primary Care Team; Liverpool CCG Business Intelligence Team: Liverpool City Council Public Health Team; Mersey Care Community Health Intelligence and Public Health Teams Circulated to Network Clinical and Managerial Leads; Liverpool GP Bulletin; Liverpool CCG employees including Primary Care Team and Programme Managers; Adult Social Services (LCC); Public Health (LCC); Mersey Care, Provider Alliance Version 1.0 Status Final Date of release November 2019 Review date Annual update Purpose The packs are intended for Primary Care Networks to use to understand the needs of the populations they serve. They will support networks 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 contains Population Segmentation intelligence about each of the 14 Primary Care Network Units in Liverpool. The information benchmarks each network against its peers so they can understand 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 2 | Page Contents 1. Introduction .............................................................................................................................................................. 4 1.1 Network Profiles ..................................................................................................................................................... 4 1.2 Population Segmentation ................................................................................................................................. 4 1.3 Care setting usage rates by population segments (Total registered population) ............................................ 5 1.4 Population segment profile (Total registered population) ............................................................................... 6 1.5 Headline Opportunities ..................................................................................................................................... 7 1.6 GP Practice ........................................................................................................................................................ 8 1.7 Registered Population ....................................................................................................................................... 8 1.8 Registered Patient Ward Alignment ................................................................................................................. 8 1.9 Service Provision ............................................................................................................................................. 10 1.10 Service Assets for Health and Wellbeing ........................................................................................................ 10 2. Network Maps ......................................................................................................................................................... 13 3. Population Map ....................................................................................................................................................... 14 4.Demographics and Wider Determinants of Health ..................................................................................................... 16 4.1 Demographics ................................................................................................................................................. 16 4.2 Wider Detainments of Health ............................................................................................................................... 16 5. Potential Areas of Focus ......................................................................................................................................... 16 5.1 Healthy Adults and Children (Segment 1) ....................................................................................................... 16 5.2 Long term conditions (Segment 2) .................................................................................................................. 16 5.3 Complex Lives (Segment 4) ................................................................................................................................... 17 5.4 Frailty, Dementia and End of Life (Segment 5&6) ................................................................................................ 17 5.5 Settings of Care ..................................................................................................................................................... 17 6. Network Spine Chart ............................................................................................................................................... 18 See separate Metadata document for indicator definitions, sources and timeframes 3 | Page 1. Introduction 1.1 Network Profiles The Network profiles are intended for Primary Care Networks to use to understand the needs of the populations they serve. They will support networks in understanding health inequalities that may exist for their population and subsequently how they may want to configure services around patients. This series of reports contains Population Segmentation intelligence about each of the 14 Primary Care Network Units (PCN) in Liverpool. The information benchmarks each network against its peers to help understand population need, management and service utilisation across PCNs. The pack contains information on individual network demographics, wider determinants, population segments and care setting utilisation. 1.2 Population Segmentation For the purposes of this profile the population has been segmented into the following groupings according to similar health need. The below are the emerging Population Segments for Liverpool. Technical definitions for each segment are in development. Intelligence to date is based on working definitions. This is an All Age model. Therefore, definitions for each segment have been considered in respect of both adults, children and families. So, except for Frailty and Dementia, which is an elderly specific segment, the other segments include children. Intelligence for each segment covers adults and children where available. This model can evolve as the thinking of the system evolves. That means definitions, outcomes, profiles etc will be adapted based on feedback. 4 | Page 1.3 Care setting usage rates by population segments (Total registered population) Below is a summary of contacts to secondary and community care settings by population segmentation for Liverpool CCG registered patients. Rate of Use Of Different Care Settings By Population Segment SecondaryCare Contacts Face -to-FaceCommunityContacts EOL Frailty & Dementia Complex Lives Cancer LTC Pre-Conditions Learning Disability Physical Disability Healthy People Date Range is 1st October 2018 to 30th September 2019, apart from Community Contacts, where data range is 1st April 2018 to 31st March 2019 Rates are number of contacts in 12 months per 100 people in the segment Elective admissions include overnight and day case admissions and regular day/night attendances (e.g. dialysis) 5 | Page 1.4 Population segment profile (Total registered population) Data below is based on all registered patients for whom data is extracted in the monthly primary care dataflow, so anyone who dissents from the data sharing is not included below. Segments are mutually exclusive, e.g. if a person's dominant segment is 'End of Life' then they will not be counted in any other segment. Cancer segment represents people coded with Cancer in the last 2 years, rather than anyone who has ever had cancer. 6 | Page 1.5 Headline Opportunities Using the latest data available for measures included within the network spine chart (Section 6), the following opportunities have been calculated for measures where statistically this network reports a significantly worse rate than the Liverpool average. The opportunity has been calculated based on the Network rate moving in line with the Liverpool average rate. Below is a high-level summary, further analysis is provided in section 5 of this report; If Croxteth and Norris Green Network moved in line with the Liverpool average rate potentially there could be; 1. 77 less domestic violence cases 2. 61 less people with a risk strat score >=50 3. 436 fewer smokers 4. 920 less adults