Dudley Strategy for Tackling Health Inequalities 2010-15

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Establishing the level of health equity involves investigating if differences exist inaccess and treatment/ treatment outcomes based on deprivation, ethnicity, age, sexand occupation. The extent to which this can be achieved easily depends on thelevel of data available especially within routine data sets and also thecoverage/reach of a service or programme. Developments within stroke/TIA arerelatively new - coverage of new service developments are low and data systems arein development or very recently implemented. As a result this section has gaps in itsanalysis and makes recommendations for future audits. Areas reviewed include:admissions for stroke and TIA,timely access to treatment for emergency stroke and TIA,access to timely diagnostics and treatment for urgent and non-urgent strokeand TIA.The pathways for stroke and TIA can be categorised into urgent and non urgent. Forurgent (hyper acute) patients should be admitted to a stroke ward, given theappropriate scans within 1 hour and thrombolysed within 3 hours. Dudley Group ofHospitals introduced a 24/7 thrombolysis service in 2007 to meet this requirement.For non urgent stroke, patients should be admitted to a stroke ward and scannedwithin 24 hours. TIA patients identified as urgent - at high risk of stroke, may or maynot be admitted, but should be scanned and treated within 24 hours. Those at lowrisk should be treated and managed within 7 days. In Dudley, a fast track referralsystem operates within the hospital and throughout primary care to ensure urgentand non urgent cases are treated at the TIA clinic within the necessary time frames.AdmissionsEmergency admissions have been relatively static over the last 5 years for both menand women, while elective admissions have risen, especially for men, although thisis not a statistically significant rise. Men have higher rates of admissions thanwomen overall, which reflects their higher risk of CVD. The admissions data forstroke and TIA shows that at the macro level, admissions generally reflected thehigher risk and needs of specific population groups including men, BME anddeprived groups but that factors other than actual need, strongly influenced accessto treatment once deprivation, sex and age were accounted for.85
Standardised Rate per 100,000 PopulationStandardised Rate per 100,000 Population2003/04-2005/062003/04-2005/062004/05-2006/072004/05-2006/072005/06-2007/082005/06-2007/082006/07-2008/092006/07-2008/09Figure 12160Directly Standardised Rates of Emergency admissions Stroke TIA by Year3-Year Rates, Dudley MBC, Males & Females All Ages, 2003/04-2005/06 to2006/07-2008/09140120100806040200Figure 1335Directly Standardised Rates of Elective admissions Stroke TIA by Year3-Year Rates, Dudley MBC, Males & Females All Ages, 2003/04-2005/06 to2006/07-2008/0930252015105086
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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
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 84 and 85: That an increase in access to diagn
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
Page 134 and 135: 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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