Report to: Anderston City Area Partnership Item 5 15 August 2013 15th August 2013 Report by: Glasgow City Community Health Partnership North West Sector 1. Introduction At a number of Area Partnership meetings there has been discussion regarding NHS resources in different Area Partnership areas. This paper seeks to explain how resources are used across the sector. 2. Glasgow City CHP Glasgow City CHP is responsible for the provision of primary care and community services to the people of Glasgow, and for improving health and well being. The CHP covers the geographical area of Glasgow City Council, a population of 588,470, and includes 154 GP practices, 136 dental practices, 186 pharmacies and 85 optometry practices. (It should be noted that GPs, dentist, pharmacists and optometrists are not employed directly by the CHP. They are NHS contractors.) The CHP has 3,140 whole time equivalent (wte) staff, and a combined budget of approximately £520m. Services within the CHP are delivered in three geographical sectors: x North East Glasgow with a population of 177,649; x North West Glasgow with a population of 190,332; and, x South Glasgow with a population of 220,489. 3. North West Sector The North West Sector has approximately 1250 wte staff, and is responsible for a budget of £179m per year. The Sector delivers the following NHS Services and functions within North West Glasgow: x community nursing, health visiting and school nursing; x community rehabilitation services for older people and adults with a physical disability. x allied health professional services (including occupational therapy, physiotherapy, podiatry, dietetics and speech & language) x learning disability services; x adult mental health services; x older people’s mental health services x health improvement services x addictions services (as part of a formal partnership arrangement with the City Council) x initiatives with primary care contractors (GPs, dentists, community pharmacists and optometrists) x Sandyford Sexual Health Services (hosted within NW sector on behalf of NHSGGC) 4. North West Geography North West Glasgow spans the following 7 Glasgow City ward boundaries, (which each contain further distinct communities and neighbourhoods):- Drumchapel/ Anniesland Garscadden/Scotstounhill (including Yoker) Partick West Anderston/City Hillhead Maryhill/Kelvin Canal (including Ruchill and Possilpark) A small proportion of Springburn is within North West Sector, but predominately this is within North East Sector. Approximately one-third of Anderston / City also falls within North East Sector. 5. Budget North West sector budget is £179m The budget is allocated among the different services as follows: Care Group Budget (£000s) Accommodation and Admin 2,618.5 Addictions ( includes citywide services) 26,793.0 Clinical Director - Services 525.4 Executive 863.8 Family health services ( payment to GP 60,408.0 practices, dentists, pharmacies) Health Improvement 3,184.4 Planning 346.7 Hosted Services 10,630.9 Mental Health Adult In-patients 16,959.4 Primary Care and Community Services 18,959.4 Mental Health Community Services 3,772.1 Prescribing 34,558.0 6. Access to NHS services The majority of people access NHS services through their GP. While GP practices serve their local area, many of their patients (approximately 30%) are likely to live in a different part of the city (or even out with Glasgow). The decision to register with a particular GP is one that is personal to the patient – and many people will, for example, choose to remain with their family’s GP even if they now live some miles away. This provides a challenge in managing community health services on a geographical basis. 2 7. Localities The Public Bodies (Joint Working) (Scotland) Bill sets out an aspiration for locality planning. The shape and size of localities would be decided jointly by NHSGG&C and Glasgow City Council as part of their plan for the integration of health and social care services. The Bill states that GPs and other health professionals as well representatives from the Council, Health Board, voluntary sector, patients and carers should be part of these localities. Experience to date suggests that localities will need to be sufficiently large to allow meaningful local decision-making. North West sector has organised some services around 3 localities which were largely co-terminus with the previous 3 LCPP boards – Maryhill, Kelvin and Canal, West and Central and West. (Woodside Health Centre sits within the former LCCP area of Central and West, but was included in the Maryhill, Kelvin and Canal locality as that is where the majority of their patients live) It has been difficult to keep local GPs engaged in the process – as they are more concerned with issues that cut across the whole sector or CHP ( e.g. diabetes services) , rather than on local, geographical concerns. There is always a tension regarding the potential for a ‘postcode lottery’ in relation to access to different NHS services. 8. CHP facilities in the existing locality areas It should be noted that while services will be based in a particular building, they will be providing a service in several local areas. E.g. Staff based at Callander Street will provide services in partnership with a large number of GPs across the sector – not just in the Maryhill, Kelvin and Canal locality. Sandyford provides some services for the whole of NHSGG&C area (and for some patients from other health board areas for specialist services) at their main base in Sauchiehall Street. GP practices vary in size – in both number of doctors who are part of the practice and the number of patients they serve. Medical services, provided across the three localities that make up the NW Sector are summarised below. Maryhill, Kelvin and Canal – approx GP registered population of 81,562 x 17 GP practices (49 GPs) x Possilpark Health Centre x Addictions base at Closeburn Street x Addictions base at Callander Street x Maryhill Health Centre ( base for district nurses, health visitors, rehabilitation team) x Youth Health Service at Maryhill x Youth health service at Closeburn Street, Possilpark x Shawpark Centre, Maryhill (Community Mental Health) x Springpark Centre, Possilpark (Community Mental Health) x Woodside Health Centre 3 Central and West - approx GP registered population of 86,841 x 20 GP practices (56 GPs) x William Street – district nursing, addictions, physio and challenging behaviour unit, Specialist Children’s autism clinic) x NW Sector HQ , Gartnavel Royal Hospital x Mental Health In-patients (both adult and older people) , Gartnavel Royal Hospital x Centre for Community Health, Partick (base for health visitors, district nurses, rehabilitation team, Community Mental Health Team (including Crisis Team), physio and podiatry. x Sandy Road Clinic (base for Primary Care Mental Health team) x Sandyford Central x Yarrowview Clinic (citywide adult autism service) West – approx GP registered population of 61,263 x 18 GP practices (43 GPs) x Drumchapel Health Centre (including a part-time Sandyford sexual health service) x Arndale Centre (Community Mental Health Team) x West Specialist Child Health Centre x Glenkirk base for older people’s team, Learning Disability and Community Respiratory Team. x Plean Street (base for health visiting, district nursing and Sandyford management office base, General Dental Practice, Podiatry, Dietetics- Weight Management) 9. NHS capital investment in North West Sector There is a significant programme of capital investment in North West Sector (in the region of £33m). A new health centre is currently being built at Possilpark (due for completion in December 2013). Plans are also taking shape for 2 new health centres in Maryhill and Woodside. Building work should begin next spring /summer and completion is due during 2015. Each of these new developments has a community benefit clause – providing employment and work placement opportunities for local people. The CHP has an ongoing programme of property refurbishment and replacement. Sandyford Central and Drumchapel Health Centre have been put forward for inclusion within a list of priorities for future investment in Glasgow City CHP (although no funding is currently available). 4 10. CENTRAL AND WEST LOCALITY HEALTH PROFILES This section of the report covers information in the North West Sector covering Centre & West Locality. For the purposes of Anderston/City Area Partnership please note the information on the following areas within the report: Anderston City Centre West Finnieston & Kelvinhaugh Woodlands (N.B. Woodlands straddles Hillhead and Anderston APs) 10.1 Life expectancy Centre and West locality records amongst the best male and female life expectancy in NHSGG&C (with some neighbourhoods recording amongst the best in Scotland). There is a significant disparity between average male and female life expectancy in Woodlands. The area records male life expectancy worse than the Scottish average (although 2 years better than the North West sector average). Female life expectancy in Woodlands is much better than the Scottish average and is amongst the best in North West sector. Male Life expectancy Female Life expectancy 1. Finnieston 67.1 1 Finnieston and Kelvinhaugh 75.8 2. City Centre West 68.6 2 Partick 76.7 3 Whiteinch 69.8 North West average 77.2 4 Glasgow Harbour & 70.2 3 City Centre West 77.8 Partick S North West average 71 4 Glasgow Harbour & Partick 78.0 S 5 Partick 71.3 5 Anderston 78.9 6 Hillhead 72.3 5 Partickhill and Hyndland 78.9 7 Woodlands 73.0 7 Hillhead 79.0 8 Broomhill 74.1 Scottish average 79.5 Scottish average 74.5 8 Whiteinch 80.5 9 Anderston 75.4 9 Broomhill 80.7 10 Kelvingrove and 76.0 10 Dowanhill 80.9 University 11 Dowanhill 77.9 11 Woodlands 81.3 12 Victoria Park 79.2 12 Kelvingrove and University 81.9 13 Partickhill and Hyndland 79.3 13 Kelvinside and Jordanhill 82.3 14 Kelvinside and Jordanhill 80.1 14 Victoria Park 84.5 5 10.2 Alcohol and Drugs Most areas in the locality record rates for alcohol and drugs-related hospital admission rates that are below both the North West and Scottish average.