Dudley Strategy for Tackling Health Inequalities 2010-15

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Further analysis shows that for hypertension, asthma and dementia, the „missing‟patients are spread out across most GP practices. This suggests that Dudley-wideinitiatives will be needed in order to improve the detection of these diseases. Incontrast, for diabetes, CHD and strokes, there are „missing‟ patients in only a smallnumber of practices. This suggests that action needs to be targeted in thesepractices in order to improve detection.There is also variation across practices in respect of MMR, childhood immunisationand flu vaccinations.Prevalence and vaccination Indicators have been agreed as part of the revisedperformance management arrangements described above to ensure that all practicesachieve the PCT‟s minimum standards in these areas.4. Managing Long Term ConditionsThe Quality and Outcomes Framework (QOF) provides a useful way of assessinghow well primary care manages people with a long-term condition. In Dudley, GPpractices as a whole are in line with the national and regional averages for mostaspects of chronic disease management. Again, this masks some very high levels ofperformance as well as some practices where performance is below average.Although the QOF was originally set up to incentivise best clinical practice, and is nota contractual requirement, the clinical standards do support high quality chronicdisease management.Through improved performance management arrangements, GP practices who arenot achieving targets will be supported to improve their existing performance andwhere they consistently fail measures will be put in place to addressunderperformance (see section 1). Good practice will be identified and shared toimprove outcomes for patients in poorer performing practices.Table 2 gives examples of the numbers of people in Dudley with long-term conditionsthat are missing out on specific treatments or interventions, which are known toimprove health. For these patients, health outcomes are likely to be poorer than forpatients receiving the treatments. Treating these patients to QOF standards wouldmake a significant contribution to reducing health inequalities in Dudley.The number of people with hypertension, whose blood pressure is not managed tothe standard, is of particular note, since poor blood pressure control for this group isa risk factor for a number of other serious long-term conditions.181
Table 2 – Numbers of patients with long-term conditions who are not receivingclinical treatments, which improve health based on 2008/9 QOF DataDudleyachievementin 2007/08No. eligiblepatientsClinical indicators (fromQOF)Blood pressuremanagement of patientswith coronary heartdisease (150/90 or less).CHD6 89.46% 12,172 1,283Patients with coronaryheart disease who havebeen prescribed a betablocker in the last 6months CHD10 75.20% 9,886 2,452Cholesterol managementof patients with TIA orstroke (5mmol/l or less).STR8 78.5% 5,153 1,090Blood pressuremanagement of patientswith hypertension (150/90or less). BP5 77.82% 49,873 11,061Patients with diabeteswhose blood sugar levelis under control (HbA1c is7.5 or less (or equivalenttest). DM20 69.52% 12,626 3,848Blood pressuremanagement of patientswith diabetes (145/85 orless). DM12 76.8% 12,881 2,988Patients with asthma whohave had a review in thelast 15 months. AST6 79.99% 17,995 3,600No. of patients nottreated to the QoFstandard (excludesexception reports)182
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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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Continue implementation of current
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“reduce smoking during pregnancy
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Percentage who currently smokePerce
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1. Stop Smoking Service ProvisionDu
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Proportion of clients that have qui
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3. Communication and EducationDSSS
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The PCT, Acute Trust, Local Authori
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admissions. The following year Dudl
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Standardised Rate per 100,00 popula
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Netherton &WoodsideHalesowen NorthC
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women the Mosaic groups with signif
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numbers of alcohol related sexual o
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These include:Securing additional i
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The deprivation gap in invasive can
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Age standardised incidence rate rat
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One of the priorities of the Cancer
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Colorectal cancerProstate cancerThe
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Page 142 and 143: There is a weak correlation between
Page 144 and 145: 7.7 SEASONAL EXCESS DEATHSREDUCING
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Page 148 and 149: Brockmoor & PensnettSt JamesKingswi
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Page 152 and 153: Percentage uptake of seasonal flu v
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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
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Page 176 and 177: Key findings from analysis of emerg
Page 178 and 179: Action plan updated in 2008 to rein
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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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Page 194 and 195: CHC‟s are trained and supported t
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Page 202 and 203: 9.1 DUDLEY HEALTH INEQUALITIES HIGH
Page 204 and 205: RECOMMENDATION ACTIVITY OUTCOMES LE
Page 210 and 211: Dudley Community Partnership (2005)
Page 212 and 213: Great Britain. Department of Health
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Page 216 and 217: APPENDIX 1 - PERFORMANCE INDICATORS
Page 218 and 219: Indicator Dudley England Least Most
Page 220 and 221: APPENDIX 2 - DELIVERY PLANS FOR PRI
Page 222 and 223: PRIORITY AREA: TOBACCO CONTROLRECOM
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Page 226 and 227: Empower community members toraise a
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Page 230 and 231: Offender ManagementRECOMMENDATION A
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RECOMMENDATION ACTIVITY OUTCOMES LE
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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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