Dudley Strategy for Tackling Health Inequalities 2010-15

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IMD ScoreRevascularisation Ward Rate (Crude Rate per 100,000)Figure 9: Revascularisation Access (r=0.34)400Relationship Between Revascularisation Rates and Coronary Heart DiseaseMortality Rates per 100,000 population for Dudley Wards 2008-093503002502001501005000 50 100 150 200 250 300 350CHD Mortality Rate (Crude Rate per 100,000)Source: Secondary Users Service (SUS) Hospital AdmissionsOffice of National Statistics (ONS) Annual Deaths ExtractOffice of National Statistics (ONS) Mid-Year Population EstimatesFigure10: Revascularisation Access (r=0.26)Mostdeprived5045403530Crude Revascularisations Rate per 100,000 Dudley Resident PopulationCompared With Index of Multiple Deprivation (IMD) 2007 Score For DudleyWards, 2008/092520151050Least0deprived50 100 150 200 250 300 350 400Revascularisations crude rate per 100.000 populationSource: Office of National Statistics (ONS) Mid-Year Population EstimatesDepartment of Communities & Local Government Indices of Deprivation 200781
Cardiac RehabilitationDudley has a gold star cardiac exercise rehabilitation service providing a 26 weekstructured exercise programme at phase 3 followed by a further 26 weeksmaintenance programme at phase 4. All patients are offered cardiac exerciserehabilitation post MI, and post MI revascularization, PCI, PPCI and CABG, and forstable and unstable angina. Table 2 shows uptakes across the conditions werevariable for 2008/9 in Dudley reflecting the national picture.Table 2CardiacRehabilitationUptake Rates(2008/9)TotalpatientsdischargedwithprimarydiagnosisEstimated No ofpatientseligible/referredfor cardiac rehab*Numberstartingcardiacrehab% of thoseeligiblestartingcardiacrehabAcute MI 362 304 131 43.1%CoronaryrevascularisationCABG/PCI388 326 156 47.8%ACS unstable 147 124 30 24.2%anginaStable Angina 145 122 42 34.4%PPCI 114 95 68 71.6%Other (HF, 144 121 52 42.9%arrhythmias)*This data was not routinely available for 08/09, hence this is an estimation based onthe Black Country Cardiac Network uptake of cardiac rehabilitation study whichidentified an 84% uptake rate for Action Heart. This data will be routinely availablefrom 09/10.An uptake study was conducted across the Black Country during 2008/9 whichidentified that 16% of patients were not referred for Cardiac Rehabilitation in Dudleyand showed significant differences in referral by age, diagnostic group, ethnicity,gender and employment status. The audit was repeated during 09/10 with largernumbers so that a more detailed analysis could be carried out at each healtheconomy level but this is not yet available.ConclusionsThe general conclusions from this acute CHD Health Needs Assessment are:The admissions data for CVD and AMI shows that at the macro level, admissionsgenerally reflect the higher risk and needs of specific population groups includingmen, BME and deprived groups but that other factors other than actual need,strongly influence access to treatment once deprivation, sex and age areaccounted for.Public knowledge and awareness of the symptoms and need to call 999 is low inthe general population and pre hospital delays are greater in older people,women and patients with pre-existing conditions. There are also health seekingbehaviour differences for ethnic and deprived groups82
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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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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 and 64: Standardised Rate per 100,000 Popul
Page 65 and 66: Secondary Prevention of CVDOptimum
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 79: Timely ResponseApproximately 30% of
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
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
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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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