Dudley Strategy for Tackling Health Inequalities 2010-15

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There is a weak correlation between deprivation and emergency admissions forCOPD, with GP practices with a higher percentage of their population in the mostdeprived quintile showing slightly more tendency to have higher rates of emergencyadmissions for COPD. (Figure 6)COPD SERVICES IN DUDLEYCOPD LESA COPD Local Enhanced Service (LES) is in place that provides proactivemanagement of patients with COPD to reduce hospital admissions byreducing and minimising duration of exacerbations.Each practice has developed a „high risk of admission‟ register so that thesepatients can be easily identified.The initiative has seen the introduction of a self management plan for everypatient as well as the provision of standby antibiotics/steroids for patients.Additionally a web based intranet site has been developed detailing guidelinesfor the treatment and management of COPD patients which is accessible toall health professionals across the borough.Current data is indicating that there are positive outcomes from this serviceand a reduction in admissions to hospital for COPD.The COPD LES is closely monitored and the numbers of reviews and patientadmissions to hospitals are brought to the attention of the practices anddiscussed.Other initiativesA lead Respiratory Nurse for community nursing linking in with the DudleyRespiratory Assessment Service. The role includes support to generic staffincluding primary care practitioners, community case managers and othercommunity staff.COPD personal management plans (part of LES)All the practices to have at least one member of staff to have undertakentraining and have the COPD Diploma.Pulmonary rehabilitation services are available at a range of communityvenuesOxygen therapy assessment service with full patient support provision.Smoking cessation servicesLocal clinical guidelines agreed between primary and secondary careThe National Strategy for COPD consultation document was issued this year andscrutinized via the Respiratory LIT. In Dudley COPD has had a concerted focusdriven by the LES. There are further areas that Dudley needs to take forward e.g.end of life care and identifying people with COPD not known to practices.The performance of COPD services and review of the pathway is reviewed by theRespiratory Local Implementation Team that meets quarterly and includes bothprimary and secondary care clinicians, pharmacists, public health, nurses andcommissioners,141
HINST and COPDAlthough the HINST did not hold a specific workshop on COPD when they visited,they have since produced a series of recommendations on delivering bettermanagement of COPD based on the experiences of the Spearhead PCTs. Theserecommendations have been reviewed and concur with the COPD pathway that isimplemented in Dudley.The local priorities for development are:-As part of the National COPD Strategy and to increase ascertainment numbersin Dudley a „Missing Millions‟ (previously undiagnosed COPD) pilot hascommenced: Audit of 800 patients via GP surgeries, community pharmacists,Dudley Stop Smoking ServiceImplement the new NICE guidelines for COPD Mild, Moderate, Severe and VerySevereThere is an application via SHA for End of Life workforce projects for an end oflife care lead/nurse for COPDThere is a concerted focus to improve under diagnosis and increaseascertainment of asthma in Dudley via an education and training programme.There will also be actions to reduce the numbers of recurrent admissions withasthma142
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2010FDudley Strategy forTackling He
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ENDORSEMENT OF THE 2010 - 2015HEALT
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CONTENTSFOREWORD………………
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Standardised Rate per 100,000 Popul
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There were three principles that un
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This work has been built on trustin
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ENSURE A HEALTHY STANDARD OF LIVING
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with, or at high risk of vascular d
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Tackling underage/illegal alcohol c
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2. VISION STATEMENTThe mission stat
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tackle health inequalities in the t
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These recommendations are addressed
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injustice and deprivation impact ne
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- Giving priority to pre and post-n
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Percentage of live and still births
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EYFS Median Scores by National Depr
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data which shows us locally what ac
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instability. Factors such as job se
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Proportion of population claiming J
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Data is available for those ALMPs f
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Labour market outcomes to date are
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achieved through transfer payments,
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% share of equivalised incomeA comp
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Figure 7 shows the income distribut
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Figure 9Proportion of the populatio
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Although temperature variations dur
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5. LEADERSHIP AND PARTNERSHIPDudley
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A Community Renewal team which coor
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6. COMMUNITY ENGAGEMENTCommunity En
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o DMBC sharing their community enga
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Transferring power to communitiesNI
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Secondary Prevention of CVDOptimum
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Ratio of obsevred vs. expected prev
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Performance variation cannot be exp
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Table 4: Range of performance gapDi
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Conclusions:The general conclusions
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7.2 ACUTE CARDIO-VASCULAR DISEASE (
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Timely ResponseApproximately 30% of
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IMD ScoreRevascularisation Ward Rat
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That an increase in access to diagn
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Establishing the level of health eq
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Timely ResponseTimely access to tre
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Page 96 and 97: Percentage who currently smokePerce
Page 98 and 99: 1. Stop Smoking Service ProvisionDu
Page 100 and 101: Proportion of clients that have qui
Page 102 and 103: 3. Communication and EducationDSSS
Page 104 and 105: The PCT, Acute Trust, Local Authori
Page 106 and 107: Standardised Rate per 100,000 Popul
Page 108 and 109: admissions. The following year Dudl
Page 110 and 111: Standardised Rate per 100,00 popula
Page 112 and 113: Netherton &WoodsideHalesowen NorthC
Page 114 and 115: women the Mosaic groups with signif
Page 116 and 117: numbers of alcohol related sexual o
Page 118 and 119: These include:Securing additional i
Page 122 and 123: The deprivation gap in invasive can
Page 124 and 125: Age standardised incidence rate rat
Page 128 and 129: One of the priorities of the Cancer
Page 130 and 131: Colorectal cancerProstate cancerThe
Page 132 and 133: and less radical treatment than you
Page 134 and 135: As more people than ever are surviv
Page 136 and 137: • Benchmarking of surgery aspirin
Page 144 and 145: 7.7 SEASONAL EXCESS DEATHSREDUCING
Page 146 and 147: Excess Winter Mortality Index (%)Me
Page 148 and 149: Brockmoor & PensnettSt JamesKingswi
Page 150 and 151: Percentage uptake of seasonal flu v
Page 152 and 153: Percentage uptake of seasonal flu v
Page 154 and 155: The group will establish terms of r
Page 158 and 159: Standardised Rate per 100,000 popul
Page 162 and 163: PercentagePercentageFigure 7aMechan
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Page 166 and 167: Key findings from analysis of morta
Page 168 and 169: Standardised rate per 100,000 popul
Page 174 and 175: PercentageFigure 17bMechanism of in
Page 176 and 177: Key findings from analysis of emerg
Page 178 and 179: Action plan updated in 2008 to rein
Page 180 and 181: the minimum standards set out by th
Page 182 and 183: Further analysis shows that for hyp
Page 184 and 185: 8.2 SOCIAL CAREAdult Social CareSoc
Page 186 and 187: 8.3 TRANSFORMING COMMUNITY SERVICES
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Page 190 and 191: 8.4 DEVELOPING THE ROLE OF THE VOLU
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at the heart of action to address c
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CHC‟s are trained and supported t
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capacity and confidence of individu
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which it has never done before. The
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centres‟ outreach workers and Hea
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9.1 DUDLEY HEALTH INEQUALITIES HIGH
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RECOMMENDATION ACTIVITY OUTCOMES LE
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Dudley Community Partnership (2005)
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Great Britain. Department of Health
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NHS Dudley and Dudley Metropolitan
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APPENDIX 1 - PERFORMANCE INDICATORS
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Indicator Dudley England Least Most
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APPENDIX 2 - DELIVERY PLANS FOR PRI
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PRIORITY AREA: TOBACCO CONTROLRECOM
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All of these initiatives will requi
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Empower community members toraise a
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Develop an integrated alcoholtreatm
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Offender ManagementRECOMMENDATION A
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PRIORITY AREA: SEASONAL EXCESS DEAT
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APPENDIX 3 - HEALTH INEQUALITIES CH
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PRIORITY ACTIONENGAGEMENT- WORKFORC
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Dudley Strategy for Tackling Health Inequalities 2010-15

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