Transcript Indications of Public Health in the English Regions
Effective public health intelligence for London
Justine Fitzpatrick, Allan Baker London Health Observatory
Learning objectives
• Understand the networks and partnerships working to provide public health intelligence for London • Understand the LHO and its role in supporting public health and commissioning in London
What will be covered?
• What is the London Health Observatory?
• Overview of health intelligence partners in London • Overview of current work at London Health Observatory • An example: the health inequalities indicator in the World Class Commissioning Framework • A discussion: What are the current priorities for public health intelligence in London?
APHO: The Observatory Network and Lead Areas LHO lead areas:
•Health inequalities •Ethnicity •Smoking •NICE
• • • • • •
The functions of PHOs in England
To work in partnership with researchers, regional and local health policy makers and practitioners to: Monitor trends in health and its determinants, highlighting areas for action Highlight future health problems Assess the health impact of potential and past policies Draw together information from different sources and to identify gaps in information Provide standard sets of community health information at local government and regional level To support the development of skills in public health practitioners and NHS staff, for example in equity audits and health impact assessments, and build capacity in public health intelligence.
Adapted from “Saving Lives - Our Healthier Nation” a “Choosing Health – Making Healthier Choices Easier”
What sort of work does LHO do?
Enquiry service Signposting data and information Tools and methods for data analysis interpretation of health data Public health performance monitoring Support health practitioner and intelligence networks Communication and advocacy for better public health information.
Widening access to data RESPONSIVE PRO-ACTIVE
Role of PHOs in health intelligence
Collecting Data/ Information Using Health Intelligence To Improve Health & Care Turning Data into Health Intelligence Other Agencies Public Health Observatory role Collating/ Processing Data
National Organisations Universities Regional Organisations Health Protection Agency Thames Cancer Registry Local Organisations Acute Trusts Department of Health Regional Office of DH and NHS London
LHO (CSL)
Primary Care Trusts Office for National Statistics Government Office for London Greater London Authority Local Authorities
Commissioning Support for London
LHO Governance
LHO Core Work Chief Medical Officer for England National Steering Group for PHOs Regional Director of Public Health LHO PCT Intelligence Work London’s Primary Care Trusts Chief Executive of CSL Medical Director of CSL APHO Executive London Health Observatory LHO Advisory Board
Examples of current LHO Work
• CSL (PCT Intelligence ) • Health needs assessment toolkit • Health performance dashboard • National Programme • Local smoking profiles • The Health Inequalities Intervention Tool • The Local Basket of Inequalities Indicators • Physical activity social marketing tool • London Programme • London boost of the Health Survey for England (mental health and social capital) • Child health profiles • Local authority health profiles 2009 • Enquiry service (HES and general enquiries) • Small area indicators for PCTs • Practice profiles refresh • Public health performance reports
Who uses our services?
LHO Enquiry Service - summary of sources of enquiries, January to September 2009 (454 enquiries)
14% 5% 3% 9% 3% 2% 3% 3% 4% 6% 6% 42% London PCTs Outside London PCTs London NHS bodies (e.g.NHS for London, Healthcare for London) GLA and Government Office for London London local authorities London NHS trusts Other NHS Government depts Academics Consultants / private companies Public Other (Media, Charities, Other PHOs etc.)
How is LHO work commissioned?
• LHO enquiry service • Individual PCTs • CSL business partners • London’s DsPH • Other London partners (NHS London, RPHG, GOL, GLA etc) • APHO Executive • Department of Health • Information Centre
Useful links
• Recommended to explore website!
• Enquiry service: [email protected]
• LHO website www.lho.org.uk
• APHO website www.apho.org.uk
• CSL website www.csl.nhs.uk
World Class Commissioning Assurance Framework Health Inequalities Indicator
Allan Baker London Health Observatory
WCC Assurance Framework
• 54 Indicators • PCTs select 8 to reflect strategic priorities • 2008 – 2 compulsory indicators: Life expectancy Index of Multiple Deprivation • DH requested advice for replacing IMD
Selection of a new indicator
•
30 th July
– APHO meet with DH • London Health Observatory – leads on health inequalities • East Midlands PHO – recently researched methods for measuring health inequalities within a PCT
Criteria
• Mortality indicator to show extent of inequalities within PCTs • Easy to understand and interpret • Robust • Relate to other health inequality resources • Consistent over time • Available quickly
Options
• Which measure of mortality • All ages, all causes - or subsets • Sex-specific – or all persons • Time period • Geography
Options – type of indicator
• Range indicator • Lorenz curve based indicator • Slope indices
Recommendation for a new indicator
•
7 August
– recommendation to DH • Life expectancy at birth – 5 years data • Deprivation deciles within PCTs • Deciles based on LSOAs • Sex-specific • Slope index of inequality
Slope Index of Inequality
L ife E x pec tanc y by D epriv ation D ec iles , s howing the S lope Index of Inequality C amden P C T , Males , 2003-07 S lope Index of Inequality = 11.2 y ears (95% C onfidenc e Interv al: 9.3 to 13.0)
95 90 85 80 75 70 65 60 0% 10% 20% 30% 40% 50% 60% 70% 80%
P erc entag e of population, ranked from hig h to low IMD s c ore
90% 100% Inequality S lope L ife E xpectancy with 95% confidence limits
Timetable for delivery
•
18th August
– DH agree to proposal •
7 th Sept
– APHO provide data •
15 th Sept
– APHO provide metadata •
16 th Sept
– WCC Datapacks launched
WCC Datapack – SII results for London
SII Results by IMD scores
50 45 40 35 30 25 20 15 10 5 0 0.0
2.0
4.0
6.0
8.0
10.0
Slope Index of Inequality 12.0
14.0
16.0
SII results by Life Expectancy
16 14 12 10 8 6 4 2 0 G re en Is w lin ic gt h on Te To ac w hi er ng H am C le ts La ity a m be nd th H ac kn ey N ew ha m H W ar al in th ge am y F or es Le w t is ha m B ar ki ng a nd D ag en ha S m ou th w ar k C am H de H am n ou m ns W er lo an sm w ds ith w a or th nd F ul ha m E al H in ill g in gd on E nf ie ld C ro yd on B re nt H av er R in g ed br S id ut ge to B n ex an le d y M er to K n in gs to n B R ro ic m hm le y on B d ar ne an d t H ar Tw K ro ic en w ke si nh W ng am es to tm n in an st d er C he ls ea London PCTs
Distribution of deprivation – percentage of population in national deprivation quintiles
• Barking and Dagenham – 92% in Q4 & Q5 • Richmond – 82% in Q1 & Q2 • Westminster – spread between Q2 – Q5 • Tower Hamlets – 90% in Q4 & Q5
Next steps
• Analysis of results • Trend data – 2001-05 and 2002-06 • Latest data – 2004-2008 • Guidance on trajectory setting
APHO website
www.apho.org.uk/resource/view.aspx?RID=75050 APHO recommendation Slope Index of Inequality dataset Guide to interpretation Life expectancy results for deprivation deciles Summary charts for each PCT LSOA to deprivation decile look-up