Dudley Strategy for Tackling Health Inequalities 2010-15

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Standardised Rate per 100,000 PopulationStandardised Rate per 100,000 Population1983-19851984-19861985-19871986-19881987-19891988-19901989-19911990-19921991-19931992-19941993-19951994-19961995-19971996-19981997-19991998-20001999-20012000-20022001-20032002-20042003-20052004-20062005-20072006-20082007-20092008-2010Figure 380Directly Standardised Mortality Rates from Stroke by Year3-Year Rates, Dudley, Males & Females Aged Under 75, 1983-1985 to 2008-2010Target: Reduce mortality from Stroke by 20% by 2009 from 1996706050403020100Figure 4Directly Standardised Mortality Rates from Stroke by IMD 2007 National Quintile5-Year Rates, Dudley MBC, Both Sexes Aged Under 75, 2004-20083530252015105063
Secondary Prevention of CVDOptimum management of the vascular long term conditions within primary care is akey strategy in the reduction of CVD health inequalities. The numbers of peopleliving with a chronic disease are set to rise substantially because our population isgrowing, ageing and lifestyle risk factors such as obesity are becoming morecommon.Health inequalities may result due to deprivation, ethnicity, age, sex and occupation.This section focuses on deprivation as the information is available and deprivationhas been found to be linked with occupation and ethnicity.Health inequalities in relation to the secondary prevention of CVD can occur atdifferent points:- Are people coming forward in the first place? The gap in expected to actualprevalence for the key disease registers gives an indication- Once identified are people accessing treatment?o Are exclusions from the register justifiable? Exception reporting for thedisease registers gives an indicationo Are patients reviewed regularly and their risk factors measured andrecorded? QOF clinical indicators on recording gives an indicationo Are drugs prescribed where indicated? QOF clinical indicators onprescribing gives an indicationo Is there access to supportive services? Referrals to Lifestyle RiskManagement Services (LRMS) gives an indication- Are outcomes from treatment equitable?o Are risk factors controlled to target levels? QOF clinical indicators oncontrol gives an indicationo Are prescribed drugs titrated to optimum levels? Bespoke medicinemanagement audits can give an indicationo Are LRMS outcomes equitable? Outcomes monitoring data from LRMSgives an indicationPrevalence recording of vascular diseases and precursor conditionsThe quality and outcomes framework (QOF) of GP contracts requires GPs to reportthe number of people on the various special disease registers. The actual diseaseprevalence reported from QOF can be compared to expected disease prevalenceestimated from national disease prevalence models. Expected and actualprevalence for the key vascular diseases/conditions for Dudley as a whole is shownin Table 1.Table 1: Expected and Actual Prevalence. Dudley Average.Disease/condition Expected Prevalence Actual PrevalenceCHD 5% 4%Stroke 2% 2%Hypertension 25% 16%Diabetes 6% 5%Source: Doncaster PHIU April 2009 QOF Benchmarking tool64
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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
Page 13 and 14: ENSURE A HEALTHY STANDARD OF LIVING
Page 15 and 16: with, or at high risk of vascular d
Page 17 and 18: Tackling underage/illegal alcohol c
Page 19 and 20: 2. VISION STATEMENTThe mission stat
Page 21 and 22: tackle health inequalities in the t
Page 23 and 24: These recommendations are addressed
Page 25 and 26: injustice and deprivation impact ne
Page 27 and 28: - Giving priority to pre and post-n
Page 29 and 30: Percentage of live and still births
Page 31 and 32: EYFS Median Scores by National Depr
Page 33 and 34: data which shows us locally what ac
Page 35 and 36: instability. Factors such as job se
Page 37 and 38: Proportion of population claiming J
Page 39 and 40: Data is available for those ALMPs f
Page 41 and 42: Labour market outcomes to date are
Page 43 and 44: achieved through transfer payments,
Page 45 and 46: % share of equivalised incomeA comp
Page 47 and 48: Figure 7 shows the income distribut
Page 49 and 50: Figure 9Proportion of the populatio
Page 51 and 52: Although temperature variations dur
Page 53 and 54: 5. LEADERSHIP AND PARTNERSHIPDudley
Page 55 and 56: A Community Renewal team which coor
Page 57 and 58: 6. COMMUNITY ENGAGEMENTCommunity En
Page 59 and 60: o DMBC sharing their community enga
Page 61 and 62: Transferring power to communitiesNI
Page 63: Standardised Rate per 100,000 Popul
Page 67 and 68: Ratio of obsevred vs. expected prev
Page 69 and 70: Performance variation cannot be exp
Page 71 and 72: Table 4: Range of performance gapDi
Page 73 and 74: Conclusions:The general conclusions
Page 75 and 76: 7.2 ACUTE CARDIO-VASCULAR DISEASE (
Page 77 and 78: Standardised Rate per 100,000 Popul
Page 79: Timely ResponseApproximately 30% of
Page 82 and 83: IMD ScoreRevascularisation Ward Rat
Page 84 and 85: That an increase in access to diagn
Page 86 and 87: Establishing the level of health eq
Page 90 and 91: Timely ResponseTimely access to tre
Page 92 and 93: Continue implementation of current
Page 94 and 95: “reduce smoking during pregnancy
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 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
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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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and less radical treatment than you
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As more people than ever are surviv
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• Benchmarking of surgery aspirin
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There is a weak correlation between
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7.7 SEASONAL EXCESS DEATHSREDUCING
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Excess Winter Mortality Index (%)Me
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Brockmoor & PensnettSt JamesKingswi
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Percentage uptake of seasonal flu v
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Percentage uptake of seasonal flu v
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The group will establish terms of r
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Standardised Rate per 100,000 popul
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PercentagePercentageFigure 7aMechan
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PercentageFigure 8bMechanism of inj
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Key findings from analysis of morta
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Standardised rate per 100,000 popul
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PercentageFigure 17bMechanism of in
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Key findings from analysis of emerg
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Action plan updated in 2008 to rein
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the minimum standards set out by th
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Further analysis shows that for hyp
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8.2 SOCIAL CAREAdult Social CareSoc
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8.3 TRANSFORMING COMMUNITY SERVICES
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DCS has some key performance target
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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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