Dudley Strategy for Tackling Health Inequalities 2010-15

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Continue implementation of current stroke/TIA workstreams to increase speed ofaccess to diagnostics and treatment to meet the national targets set out in theaccelerating stroke improvement programme in all cases, specifically:If any metrics remain significantly below target, consider equity auditing tocompare demographics of patients receiving optimum versus non optimumcare.Audit GP TIA referrals data for consistencyReview GP practice performance for outlying practices in relation toadmissions data91
7.3 TOBACCO CONTROLIntroductionTobacco control is collective action taken to reduce smoking prevalence; as researchshows that no single approach to tackling smoking will be successful in isolation. TheGovernment has implemented a comprehensive range of measures over the lastdecade based on the World Health Bank recommendations known as the „six strand‟approach. The six strands are:1. Reducing exposure to secondhand smoke (SHS)2. Communication and education3. Reducing the availability and supply of cheap tobacco4. Support for stop smoking services5. Reducing tobacco promotion6. Tobacco regulationThis approach has been shown to be highly effective in England with some of themeasures being largely self sustaining, for example the health warnings on tobaccopacks and smokefree public places. Key areas that require continued funding andintervention at local level are the provision of stop smoking services, tackling illicittobacco and communications and education campaigns (APPG, 2010).Cigarette smoking is closely and pervasively linked to a wide range of markers ofsocioeconomic and personal disadvantage resulting in increased well known healthrisks. Smoking also directly exacerbates poverty, by taking up a substantialproportion of disposable income and pre-empting expenditure on basic necessitiessuch as food and clothing (RCP, 2000).Nationally, around 35% (22,000) of all deaths due to respiratory diseases and 29%(37,500) of all cancer deaths were attributable to smoking. In addition, 14% (20,600)of deaths due to circulatory diseases and 6% (1,300) of deaths due to diseases ofthe digestive system were attributable to smoking (ONS, 2010). In Dudley, it isestimated that between 2006-8, there were 1,497 deaths that were attributableto smoking (Dudley PCT, 2009a).Smoking in pregnancy can increase infant mortality by approximately 40% (GreatBritain. Department of Health, 2009b). Babies born into poorer households aresignificantly more heavily exposed to passive smoking throughout infancy andchildhood, and non-smokers living in more deprived circumstances remain moreheavily exposed to other people‟s smoke throughout life. Being born into anenvironment where smoking is modelled as the norm inevitably leads to higher ratesof smoking uptake in adolescents from poor backgrounds (RCP, 2000), thereforeperpetuating smoking and health inequalities.Smoking prevalence in pregnant women nationally was 14% in 2008 as measuredby women‟s self-reporting at the time of delivery (this is widely thought to be anunderestimate since there is evidence of significant underreporting. (Great Britain.Department of Health, 2009b) . The PSA (2010) target was to:92
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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
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 86 and 87: Establishing the level of health eq
Page 90 and 91: Timely ResponseTimely access to tre
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
Page 136 and 137: • 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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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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