Dudley Strategy for Tackling Health Inequalities 2010-15

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That an increase in access to diagnostics and revascularisation for acute MIresulting from the opening of the tertiary PPCI service and general capacityimprovements within secondary care has improved the equity of access andnarrowed inequalities over the last five years. Some factors besides actual needare still an influence.That there are significant differences in referral to cardiac rehabilitation by age,diagnostic group, ethnicity, gender and employment status that needs to beinvestigatedRecommendations for Acute CHDThe NST identifies a number of priority areas for action and this section draws onthose in conjunction with the main findings from this health needs assessment:Introduce public awareness campaigns with a targeted approach to groups withhigher needs; over 65s, BME, women and deprived areas. Health careprofessionals should take every opportunity to advise all patients with, or at highrisk of, vascular disease to call 999 should they experience unexplained chestpain.Continue to embed delivery of expanded services for acute MI diagnostics andrevascularisation and review the equity of provision in a further 5 years time.Investigate reasons for „no procedures‟ being undertaken with the PPCI serviceRepeat the cardiac rehabilitation equity audit with larger numbers to establish afuller picture and implement recommendations made from this. This shouldinclude a review of DNAs and DNRs for cardiac rehabilitation and theestablishment of routine procedure to follow-up these groups.Transient Ischemic Attack (TIA) and StrokeUntil fairly recently society has been fatalistic about stroke seeing it as an inevitabilityof aging. However medical and technological advances have transformed ourunderstanding of the brain and the treatments available for restoring blood flow andimproving brain function when areas of the brain get damaged. It is now recognizedthat time is critical – the faster someone reaches expert help, the greater theirchances of making a full recovery.The National Stroke Strategy (Great Britain. Department of Health, 2007a) waspublished with a view to introduce a comprehensive revolution of stroke services withthe implementation of rapid response systems that get people to centres of expertisequickly, directly to the scan they need and onwards to appropriate treatment andcare. Key priorities within the stroke strategy include:the need to speed up access to diagnostic scanning/imaging for TIAthe need to ensure stroke is treated as a medical emergency (hyper acutestroke) with access to diagnostics and thrombolysis within an appropriatetimeframe. „Time means brain‟.improving rehabilitation and long term careThe stroke strategy was followed by the Accelerating Progress in Stroke CareImprovement Programme in March 2010 which set a number of national indicatorsfor stroke and TIA care with targets for achievement by April 2011 (Figure 11) to83
speed up delivery of the National Stroke Strategy within the worsening financialclimate. NICE have also produced a set of quality standards that dovetail into thenational indicators. Best practice tariffs have also been introduced from April 2010incentivising hospitals to achieve targets and quality standards in relation to careprovided on an acute stroke unit and timely delivery of initial brain imaging.Figure 1184
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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
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 82 and 83: IMD ScoreRevascularisation Ward Rat
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
Page 132 and 133: 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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