joint strategic needs assessment foundation profile - JSNA

Interative Hull Atlas: www.hullpublichealth.org/Pages/hull_atlas.htm More information: www.jsnaonline.org and www.hullpublichealth.org
should be particularly the case for practices with high list sizes and/or
practices with a single GP.
16. Reducing excess hospital admissions and mortality in the most deprived
groups will require a multi-faceted approach involving improving patient selfcare,
reducing risk factors such as smoking, lack of exercise, poor diet, etc,
raising health aspirations, improving on-going care at primary care level in
practices with a high proportion of patients living in deprived areas, etc.
Extension of the telephone helpline coverage may also help as this could
reduce hospital admissions if out-of-hours advice is available.
17. To reduce hospital admissions and length of stay, improve awareness of
diabetes through staff training and increase the number of inpatient diabetes
specialist nurses posts to improve hospital care.
18. To improve footcare, provide accreditation of the podiatry team with a post
created to co-ordinate all accreditation, and review footcare within primary
care.
19. Put plans in place to reduce the DNA (“did not attend”) rate for retinal
screening.
20. Give consideration to nerve damage and nerve pain within primary care, and
assess the estimated Glomerular Filtration Rate (eGFR) and chronic kidney
disease primary care QOF indicators in more detail.
10.3.7 Diagnosed Prevalence in Relation to Deprivation
It is possible to assign a deprivation score to each general practice using the Index of
Multiple Deprivation 2007 score assigned to each patient (based on their postcode) and
calculate the mean IMD 2007 score for each practice (i.e. weighted by patient
population). Table 279 shows the prevalence of diagnosed diabetes on the practice
disease registers for 2009/10 grouping the practices into five groups. Figure 221 shows
the practice IMD 2007 scores and the prevalence of diagnosed diabetes for each
practice. It can be seen from both the figure that there appears to be a slight
association between the diagnosed prevalence of diabetes and deprivation measured at
practice level, but the association is quite not statistically significant (p=0.085). One
would expect diabetes to be more prevalent in the more deprived groups. Mortality
rates are higher for the more deprived areas including premature mortality, so it is
possible that more people are dying from diseases such as cardiovascular disease, so
fewer people in the most deprived quintile are included on the disease registers (and/or
for a shorter period of time). The underlying data for the figure is given in the
APPENDIX on page 924.
This information is for 2009/10 and comes from the Quality Management and Analysis
System (QMAS) from which an extract is taken at the end of March and should be
equivalent to the extract taken nationally which forms the QOF.
The latest list size refers to the registered population as at 1 st January 2010, but the
number and prevalence on the disease register is as at 31 st March 2010 (the same
definitions used in QOF), and this means that the prevalence can be biased if large
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