DEMENTIA IN THE EAST OF ENGLAND Produced by Melissa Darwent Information Manager East of England Clinical Network [email protected] Source: PHE Fingertips DEMENTIA INDICATORS OVERVIEW The aim of this pack, which has been produced by the East of England Mental Health Clinical Network, is to give CCGs and STPs insight into indicators on the dementia pathway with comparisons drawn from both the East of England and England. The introductory pages show variation of rates across the East of England for population predictions of people over 90 years of age and mortality rates of people with a dementia diagnosis. The data is taken from the PHE (Public Health England) Fingertips tool (using 2015/16 data) which is produced by the Dementia Intelligence Network (DIN) and provides health intelligence with which to inform the provision of care for people in England who have dementia. The infographics sheets provides a snapshot of indicators arranged into six data domains based upon the dementia pathway; Prevalence,Preventing well, Diagnosing well, Living well, Supporting well and Dying well. These data domains are explained in more detail below. Data and metadata are available online and as a downloadable document. (https://fingertips.phe.org.uk/profile-group/mental- health/profile/dementia) Prevalence Preventing Diagnosing Supporting Living Well Dying Well Well Well Well The face-to-face review Objective 12 of the National should focus on support Dementia Strategy (2009) Recorded dementia The following 7 This indicator Changes in the needs of the patient and calls for improved end of life prevalence is measured indicators are included: measures new surrounding carer. The review should environment can care for people with as a % of recorded on Smoking; Obesity; dementia diagnosis address four key issues: dementia and this includes increase the levels of practice diesease Hypertension; Stroke; with blood tests § an appropriate physical taking into account their registers. It is accepted CHD; Depression; and recorded between 12 anxiety and stress for and mental health choice of where to die. that the majority of Diabetes. months before and 6 an individual. People review for the patient A person with dementia people with dementia The rationale for this is months after being with dementia can be § if applicable, the carer’s should be supported to die needs for information are 65 or older. that they are known risk entered onto the more susceptible in a place of their choice commensurate with the Objective two of the register. to these changes, whenever possible. For factors for dementia. stage of the illness and National Dementia This indicator is a The NICE clinical which can cause many people this will be the patient’s health and somewhere familiar such as Strategy (2009) states measure of recorded guideline on dementia additional distress. social care needs their own home or the 'all people with prevalence and not states that a basic Admissions to hospital, § if applicable, the impact particularly ones of sheltered housing or care dementia to have actual prevalence and dementia screen is of caring on the care- home in which they live. short duration should access to treatment, therefore under-reports performed at the time giver Dying in the usual place of care and support as groups that are less of presentation, usually be avoided if at all § communication and residence is used as a needed following likely to be registered within primary care. possible for this co-ordination measure of the quality of diagnosis'. with a GP. This includes a variety population. arrangements with end of life care for people of blood tests. secondary care (if with dementia aged 65+. applicable). POPULATION PROJECTION FOR AGES 90+ IN 2035 The number of people with dementia in the UK is forecast to increase to over 1 million by 2025 and over 2 million by 2051. This is a worse case scenario, under an assumption that there are no public health interventions and changes are driven by an ageing population alone (Alzheimers UK, 2014). The map below shows the population projections for 2035 of people over 90 years of age in the East of England. 182.17% to 247.6% 164.85% to 182.16% 145.17% to 164.84% 123.11% to 145.16% 63.6% to 123.1% Source: https://shapeatlas.net/place *registration required MORTALITY RATES Source: PHE Fingertips Dementia Profile 2015 The graph above illustrates the rate of mortality of people with a mention of dementia. This could be classified either by an underlying cause of death or a contributory cause. The data is collected from the 2015 calendar year and is split by CCG with an England average of 873 shown on the graph. As an example, the above table shows that in 2015 for Luton CCG, of 100,000 people over the age of 65, 925 of them died while having a diagnosis of dementia. The data has been age standardised, which means that the data for each yearly age group has been weighted equally. This eliminates the issue of there being far more people in the younger catogories (e.g aged 65-70) which would skew the data towards showing only the rate of mortality for people in younger catogories. This data comes from The Office for National Statistics Mortality File and is available through the National Dementia Intelligence Network. DEMENTIA INFOGRAPHICS Order of dementia infographics East of England Herts and West Essex STP East and North Hertfordshire CCG Mid and South Essex STP Herts Valley CCG Basildon and Brentwood CCG West Essex CCG Castlepoint and Rochford CCG Mid Essex CCG Norfolk and Waveney STP Southend CCG Great Yarmouth and Waveney CCG Thurrock CCG North Norfolk CCG Norwich CCG BLMK STP South Norfolk CCG Bedfordshire CCG West Norfolk CCG Luton CCG Milton Keynes CCG Suffolk and North East Essex STP Ipswich and East Suffolk CCG Cambridgeshire and Peterborough STP North East Essex CCG Cambridgeshire and Peterborough CCG West Suffolk CCG DEMENTIA IN THE EAST OF ENGLAND Preventing Well Diagnosis Diagnosing Well Dying Well Place of Death: East of England 54.8% EoE England Recorded People diagnosed England: 9% 32% with dementia : All 56.5% Home Smoking: Care Home Ages recorded UnUrencreocrdoerdded Recorded 17.4% X18.x.1x% Hospital prevalence (aged 45.2% 15+) 49,649 59% Obesity: Recorded Definition: New dementia diagnosis with blood prevalence 18+) test recorded between 12 months before and 6 Place of Death: England 8.9% X9..x5x%% months after entering onto the register. PHE Fingertips 2015/16 9% 31% Hypertension: People diagnosed Home Recorded Care Home 14.2% X13.x.8x% with dementia: 65+ Supporting Well prevalence (all Hospital ages) years Rate of emergency admissions (aged 65+) EoE: 2,909 per 100,000 emergency admissions (aged 65+) 60% Stroke: Recorded England: 3,387 per 100,000 emergency admissions (aged 65+) prevalence (all 48,067 1.7% X1..x7x%% Rate short stay emergency admissions ages) Death in Usual Place of Residence: EoE: 22.61% England: 28.3% EoE: 57.2% CHD: Recorded England: 68.6% PHE Fingertips 2015/16 *Rates are directly standardised PHE Fingertips 2015/16 prevalence (all 3.1% X3..x2x%% PHE Fingertips 2015/16 ages) Dementia Care Review Depression: Living Well No care review in Recorded 7.9% X8..x3x%% The face-to-face review should address four key prevalence (aged the last 12 months 18+) issues: 22.8% Diabetes: 1. A physical and mental health review for the patient Recorded 6.2% X6..x5x%% 2. The Carers needs prevalence (aged Care review in the 3. If applicable, the impact of caring on the care-giver 17+) 77.2% last 12 months 4.Communication and co-ordination arrangements with secondary care PHE Fingertips 2015/16 PHE Fingertips 2015/16 DEMENTIA IN MID AND SOUTH ESSEX STP Source: PHE Fingertips DEMENTIA IN BASILDON AND BRENTWOOD CCG Preventing Well Diagnosis Diagnosing Well Dying Well Basildon and Brentwood : Place of Death: Basildon and Brentwood DEM005: Blood Tests England 50.9% CCG Recorded 43% People diagnosed Recorded Home with dementia : All England: Care Smoking: 56.5% 7% Ages Unrecorded Home Recorded 17.4% 18.1% recorded Hospital prevalence (aged 49.1% 15+) 2,061 50% Definition: New dementia diagnosis with blood Obesity: Recorded test recorded between 12 months before and 6 prevalence 18+) 8.4% 9.5% months after entering onto the register. Place of Death: England PHE Fingertips 2015/16 Hypertension: People diagnosed 9% 31% Home Recorded 14.9% 13.8% with dementia: 65+ Supporting Well Care Home prevalence (all years Rate of emergency admissions (aged 65+) Hospital ages) Basildon and Brentwood: 3.289 per 100,000 emergency admissions (aged 65+) 60% Stroke: Recorded 1,989 England: 3,387 per 100,000 emergency admissions (aged 65+) prevalence (all 1.8% 1.7% ages) Rate short stay emergency admissions Death in Usual Place of Residence: Basildon and Brentwood: 12.8% CCG: 57.24% England: 28.3% CHD: Recorded England: 68.6% PHE Fingertips 2015/16 *Rates are directly standardised PHE Fingertips 2015/16 PHE Fingertips 2015/16 prevalence (all 3.0% 3.2% ages) Dementia Care Review Depression: Living Well Recorded 8.9% 8.3% prevalence (aged The face-to-face review should address four key issues: 50% 18+) No care review in the last 12 months Diabetes: 1. A physical and mental health review for the patient 2. The Carers needs Recorded 6.1% 6.5% Care review in the prevalence (aged 3. If applicable, the impact of caring on the care-giver last 12 months 17+) 4.Communication and co-ordination arrangements with secondary care 50% PHE Fingertips 2015/16 PHE Fingertips 2015/16 DEMENTIA IN CASTLEPOINT AND ROCHFORD CCG Preventing Well Diagnosis Diagnosing Well Dying Well Castlepoint and Rochford : DEM005: Blood Place of Death: Castlepoint and Tests Recorded Rochford 44% CCG England People diagnosed England: Recorded 32% with dementia : All 56.5% 13% Home Ages Care Home Smoking: recorded Unrecorded Hospital Recorded 16.0% X18.x.1x% 56% prevalence (aged 1,546 15+) 55% Definition: New dementia diagnosis with blood Obesity: Recorded test recorded between 12 months before and 6 prevalence 18+) months after entering onto the register.