The PHO View

John Wilkinson

APHO

Mental Health Observatory

Core FundingHealth ProfilesOccasional PapersWebsite

Drug &

alcohol monitoring

Maternal &

Infant Health

HES & Commissioning

National Library for Public Health

EU Commission

PHINECancer Registry

Competency 5 – Manage knowledge and assess needs – some examples• Joint Strategic Needs Assessment • Health Profiles• SHAPE • Mental Health Observatory• Drugs and Alcohol• Cancer data• National Library for Public Health • Regional Maternity Survey Office:• HES Service• Europe

Big Picture

• PHO delivers a number of non core functions

• Core functions now accounts for 25% of annual income

• More capacity and greater skill set in NEPHO

• PHINE

National Library for Public Health

• Single source for evidence for public health workforce

• Evidence-based resources from around the world, UK policy and guidance, news & events, etc. www.library.nhs.uk/publichealth

Drugs and alcohol

• Monthly (about 6 weeks after month end), quarterly and annual outputs to commissioners

• Used by DATs to commission, decommission and performance manage agencies

• Used by NTA and Healthcare Commission to manage whole system

• Alcohol data from April 2008 for PCTs

Training and Development

NEPHO run workshops, teaching training and advice in

areas such as:

• The development of profiles, indicators performance measures and targets

• Health Needs Assessment• Health Equity Audit• Health Impact Assessment• Ethnic (and diversity) monitoring

Example analysesNEPHO Life Expectancy reports

Trend in life expectancy at birth for males in South Tyneside

72

73

74

75

76

77

78

79

80

81

82

1995-1997 1996-1998 1997-1999 1998-2000 1999-2001 2000-2002 2001-2003 2002-2004 2003-2005

Life

exp

ecta

ncy

at b

irth

(yea

rs)

South Tyneside North East England Spearhead LAs

Example analysesNEPHO Life Expectancy reports

L.E. at birth for males in South Tyneside, projected against target

69

70

71

72

73

74

75

76

77

78

79

80

1995

-199

7

1996

-199

8

1997

-199

9

1998

-200

0

1999

-200

1

2000

-200

2

2001

-200

3

2002

-200

4

2003

-200

5

2004

-200

6

2005

-200

7

2006

-200

8

2007

-200

9

2008

-201

0

2009

-201

1

Life

Exp

ecta

ncy

at B

irth

(Yea

rs)

South Tyneside ENGLAND Target trajectory Linear (South Tyneside) Linear (ENGLAND)

Example analysesNEPHO Life Expectancy reports

Scenario modelling, males in South Tyneside

73

74

75

76

77

78

79

80

81

82

83

84

40%

redu

ction

incir

culat

ory d

eath

sat

ages

<75

20%

redu

ction

inca

ncer

mor

tality

atag

es <

75

20%

redu

ction

inac

ciden

t mor

tality

at al

l age

s

20%

redu

ction

insu

icide

at al

l age

s

All fo

ur ta

rget

s

Life

Exp

ecta

ncy

at B

irth

(Yea

rs)

PSA target for England (2009/2011) = 78.6 years

South Tyneside target (2009/2011) = 77.0 years

South Tyneside 2003/2005 = 74.8 years

Mental Health - Discharge to first contact

•Key indicator of post-discharge follow up

•Important for suicide prevention

•Collected through the Mental Health Minimum Dataset

•Data shown are for 2005/6

•Available in the NEPHO Mental Health Workbook

Interval between discharge and first clinical contact(Patients of all ages - 2005/6)

England

0%

10%

20%

30%

40%

50%

60%

70%

80%

Mental Health Local Implementation Areas

Prop

ortio

n of

pat

ient

s co

ntac

ted

By 27th day

By 20th day

By 13th dayBy 6th day

North East

0%

10%

20%

30%

40%

50%

60%

70%

80%

Darlin

gton

Co. Dur

ham

Hartle

pool

Gatesh

ead

Redca

r and

Cleve

land

Stock

ton

Middles

brou

gh

South

Tynes

ide

Newca

stle

North

Tynesid

e

Northu

mberla

nd

Sunde

rland

RMSO data

J un-05Mar-03Dec-00Sep-98J un-96Mar-94Dec-91Sep-89Jun-87Mar-85

0.0012

0.0010

0.0008

0.0006

0.0004

0.0002

0.0000

Quarter

Rate

11

Rate of gastroschisis by quarter of LMP

Europe

• “We want our region to perform best of all the regions in Europe” (SE Coast - Darzi Report)

Percentage of obese persons

0

5

10

15

20

25

Régions

% o

f obe

se p

erso

ns

Germany United-Kingdom Austria Belgium Spain France Luxembourg Netherlands

Sweden Estonia Hungary Latvia Malta 1st quartile 3rd quartile Median

Source: ISARE Data Set

SHAPE

Local ProvisionAdmissions to Trusts for PCT A (2004/05)

60.9%

11.8%

11.5%

7.5%

4.6%

1.2%

0.3% 0.3%

0.8%

0.2%0.1%

0.1%

0.7% Trust 1 Trust 2

Trust 3 Trust 4

Trust 5 Trust 6

Trust 7 Trust 8

Trust 9 Trust 10

Trust 11 Trust 12

OTHER

High Volume Emergency HRGs and ALOS

  HRG35 HRG LabelNat

ALOS Trust1 Trust2 Trust3 Trust4 Trust51 E36 Chest Pain <70 w/o cc 1.62 1.13 1.40 1.11 0.69 3.672 F47 General Abdominal Disorders <70 w/o cc 2.36 1.90 2.87 2.41 2.94 0.833 P03 Upper Respiratory Tract Disorders 0.88 0.63 1.31 0.80 1.69 0.174 M09 Threatened or Spontaneous Abortion 0.57 0.46 0.82 0.62 0.00  5 S16 Poisoning, Toxic, Environmental and Unspecified 1.96 1.43 1.07 1.26 0.73 0.006 P13 Other Gastrointestinal or Metabolic Disorders 1.49 1.10 1.62 1.14 3.03  7 D40 COPD or Bronchitis w/o cc 7.39 6.76 5.37 6.55   0.008 E35 Chest Pain >69 or w cc 3.49 2.44 3.76 2.21 1.00 0.759 P06 Minor Infections (including Immune Disorders) 1.44 0.84 1.00 1.23 2.44 1.67

10 P26 Infectious and Non-Infectious Gastroenteritis 1.07 0.76 1.50 0.88 2.79 1.0011 E12 Acute Myocardial Infarction w/o cc 7.53 6.56 7.97 6.31 4.00 7.7512 D99 Complex Elderly with a Respiratory System P.D 16.63 16.18 15.75 11.88   2.0013 F46 General Abdominal Disorders >69 or w cc 6.13 4.64 5.15 3.85 7.59 1.5014 D41 Unspecified Acute Lower Respiratory Infection 9.6 9.49 6.12 7.83 5.75 9.0015 E31 Syncope or Collapse >69 or w cc 7.65 6.66 6.70 5.90 8.67 3.0016 E22 Ischaemic Heart Disease without intervention 6.32 3.66 4.78 3.23 3.50 13.0017 P01 Asthma or Wheezing 1.24 0.81 1.21 1.25 2.00  18 E29 Arrhythmia or Conduction Disorders >69 or w cc 7.32 5.49 5.96 5.64 3.67 10.0019 L09 Kidney or Urinary Tract Infections >69 or w cc 13.97 13.23 10.80 8.24 7.50 5.0020 E23 IHD without intervention <70 w/o cc 3.67 2.77 3.09 2.41 1.00 2.50

Future?

• PHINE• PCT chief executives development group• What support is needed?• What could we do better?• What could we do less of?