Public Health Evidence and
Intelligence Bulletin September 2014
Welcome to the September edition of the Public Health Evidence and
Intelligence Bulletin. The Bulletin is a regular newsletter providing you
with links and information on current reports we have produced locally
and where you can access them.
It also contains information and links to key nationally produced reports
that contain Halton data.
In this Issue:
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Stoptober & Halton Smoking Stats
Flu Immunisation
GP Practice JSNAs
Pharmaceutical Needs Assessment Consultation
Hypertension
Health Checks
Spotlight on….Respiratory Health Profile
Mortality Bubble Charts
NICE Guidance
Estimates for smoking prevalence vary
depending on the survey used.
29.7% (Based on representative population
Stoptober – the 28-day national stop
smoking challenge – is set to return for
a third year at the start of October.
Stopping smoking for 28 days means
you’re four times more likely to stop for
good and last year over 160,000
people successfully quit in the nation’s
biggest mass participation stop
smoking challenge ever.
The Health Improvement Team in
Halton can give people more
information about how they can get
involved in the Stoptober challenge.
Full details can be accessed by calling
01928 593043 or by visiting their
website:
http://www.healthimprovementteam.co.
uk/our-services/smoking/stoptoberhalton/
sample via the Merseyside Lifestyles Survey,
2013)
23.1% (Data from Integrated Household
Survey, ONS, 2013)
Currently (2011), rates of male and
female lung cancer incidence in
Halton, were higher than both the
North West and England.
However, rates were much lower in
males during 2011 (76.8 incidences
per
100,000
population),
than
previously (1993 – 133.5 incidences
per 100,000 population).
The female rate of lung cancer
incidence has increased considerably
from 1993 to 2011; very much in-line
with regional and national trends.
(Data from HSCIC, 2013)
In Halton (2006-2010), the percentage
of people with lung cancer surviving
beyond a year after diagnosis, is
34.7%, with the percentage surviving
beyond five years (2002-2006) from
diagnosis at 10.9%.
These survival rates are higher than
that seen regionally and nationally.
(Data from NWCIS, 2014)
Smoking is by far the most important preventable
cause of cancer in the world. It accounts for one in
four UK cancer deaths, and nearly a fifth of all
cancer cases. That’s staggering.
Even more staggering is the fact that half of all
smokers eventually die from cancer, or other
smoking-related illnesses. And a quarter of
smokers die in middle age, between 35 and 69
Cancer Research UK, 2012
In 2012 mortality for lung cancer in
men was much lower than in previous
years in spite of an increase in female
lung cancer incidence.
(Data from HSCIC, 2014)
Seasonal
influenza is
usually a mild
disease, but
for some
people who
catch the
virus, it can
lead to
serious
complications
and even
death. About
8,000 people are estimated to die from
it in the UK each year. The groups who
are ‘at risk’ are the over 65s, people
with long term conditions such as
cardiac, renal, liver, respiratory,
neurological diseases, those who have
had a stroke, are immunosuppressed
or those that are pregnant. The NHS
offers a free seasonal influenza
vaccination to all those people in these
‘at risk’ groups.
Last year Halton practices recorded
the lowest flu vaccine uptake in
Merseyside. Merseyside as a whole
achieved good uptake in comparison
to England’s 25 teams, this indicates
that other Merseyside areas performed
much better than Halton. As a result of
the poor performance a multiagency,
multidisciplinary group has been set up
to improve flu vaccination uptake in the
2014/15 vaccination year.
Key stats for Halton and Merseyside
taken from Immform include the
following:
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Average uptake in the over 65s
age group in Halton was 73.5%,
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which is below the Merseyside
figure of 76.5%. Merseyside was
ranked joint first in England for this
age group.
Only 38.3% of pregnant women in
Halton received the influenza
vaccine compared to 42.9% for
Merseyside. However, this was
similar to the England average of
39.8%.
Uptake for those under 65 in
Halton was 51.9% compared to
55.3% for Merseyside.
Uptake in 2 and 3 year olds in
Halton was similar to England.
Uptake for Community and Primary
Care staff was 44.9% for
Bridgewater (Halton & St. Helens),
44.3% for 5 Boroughs and 56% for
Halton Primary Care.
The Team has recently been involved
in developing a series of Joint
Strategic Needs Assessments for the
17 GP practices across Halton. The
JSNAs which will be available via the
link below in the next few weeks,
contain a range of information
including; data on cancer screening
and detection, flu immunisation, Cardio
Vascular Disease, Chronic Obstructive
Pulmonary Disease, obesity, alcohol,
smoking and A&E admissions. The
profiles include data collected from the
practices themselves, local and
national averages, and targets to
highlight areas for improvement.
Comparisons can be made in figures
and graphs between the practices.
Link to profiles:
http://www4.halton.gov.uk/Pages/health/J
SNA.aspx
A PNA is a document which records
the assessment of the need for
pharmaceutical services within a
specific area. As such, it sets out a
statement of the pharmaceutical
services which are currently provided,
together with when and where these
are available to a given population.
The same regulations require NHS
England to use the PNA to consider
applications to open a new pharmacy,
move an existing pharmacy or to
commission additional services from
pharmacy.
The Health and Wellbeing Board has
established a PNA Task & Finish
Group to oversee the development of
the new PNA. This group includes
membership
from
our
partner
organisations, Healthwatch and the
Local Pharmaceutical Committee.
As part of the development process,
the Regulations require that the HWB
undertakes a formal consultation on a
draft of its PNA. The key outcomes for
this consultation are:
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To
encourage
constructive
feedback from a variety of
stakeholders
To ensure a wide range of primary
care health professionals provide
opinions and views on what is
contained within the PNA
Halton’s PNA consultation will take
place from 22 September to 24
November 2014. Further details can
be found by following the attached
link:www.halton.gov.uk/pna
Hypertension is a key cause of
premature mortality in Halton. There
are currently 19,093 adults in Halton
on primary care registers (QOF
Registers) with hypertension. This
represents 14.8% of the adult
population. However, estimates show
that 30.8% of people in the borough
have the condition, which means that
about 20,000 adults have the condition
but have not been diagnosed.
Hypertension is a risk factor for
cardiovascular disease which includes
heart attacks and strokes. In addition,
certain behaviour such as drinking
alcohol, high sugary and fatty food
intake, smoking and lack of physical
activity also increases the risk. There
are some risk factors that are
independent of behaviours such as
age, sex, ethnicity and deprivation.
Unfortunately across England 45% of
hypertension remains undiagnosed
until an acute event occurs.
Working alongside the Cheshire and
Merseyside
collaborative
service
(Champs),
Halton
intends
to
implement
plans
to
reduce
hypertension locally. A detailed report
outlining these plans was presented to
the Health and Wellbeing Board on
17th September.
A link to the full report is available
below:
http://moderngov.halton.gov.uk/docum
ents/s34679/HWB%20Board%2017th
%20September%202014%20Hyperten
sion.pdf
NHS
Health
Checks
is
the
government’s flagship programme for
the prevention of CVD, diabetes and
kidney disease. The programme now
also aims to reduce levels of alcohol
related harm and raise awareness of
the signs of dementia and where
people can go for help.
Research undertaken by Health
Inequalities Specialist Professor Chris
Bentley reveals that 40% of Halton
residents with long term conditions do
not visit GP practices, hence, the
importance of the programme in
identifying
these
residents
and
enabling early treatment.
An annual report on the performance
of Health Checks in Halton was
presented to the Health and Wellbeing
Board on 17th September. The report
can be accessed via the following link:
http://moderngov.halton.gov.uk/documents
/s34677/HWB%20Board%2017th%20Sept
ember%202014%20NHS%20Health%20C
hecks.pdf
The Evidence and Intelligence Team
have recently produced a Respiratory
Health Profile of Halton. Some of the
key facts include:
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It is estimated about 3,916 people
aged 16+ living in Halton had
Chronic Obstructive Pulmonary
Disease (COPD) in 2010. By 2020
this figure may be as much as
4,420.
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The prevalence of COPD and
asthma is higher in Halton than the
North of England and England
(according to QOF data, 2012/13).
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The management of patients with
COPD and asthma are similar to
the North of England and England
averages
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Emergency hospital admission
rates for COPD and pneumonia
show that the vast majority of
admissions are for people aged
65+. There is also a relationship
with temperature, with a greater
percentage of admissions seen in
the winter months.
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Death rates for COPD have been
falling but are above the North
West and England rates.
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Mortality rates from respiratory
causes in those aged under 75
years and pneumonia are also
higher than England but similar to
the North West.
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Overall, deaths from respiratory
diseases rise the most during the
winter months, so are therefore
Some of the key statistics from the
report include:
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Of the 35,169 registered patients
eligible (at quarter 4 2013/14),
5,217 were invited for a health
check
Of those invited 2,179 received a
Health Check, giving a take up rate
of 42%
There is a wide variation in the
proportion of the eligible population
invited and receiving a Health
Check in each practice. Newtown
Surgery and Castlefields Health
Centre
invited
the
highest
proportions
(63%
and
41%
respectively).
Similarly there is a wide variation in
take up rates across practices.
responsible for a high proportion of
excess winter deaths.
Total Disability Adjusted Life Years
Lost in Halton (all causes)
The full profile is available via the
attached link:
http://www3.halton.gov.uk/Pages/healt
h/HealthProfiling.aspx
The team has recently updated the
Halton Mortality Bubble Charts. The
full versions can be accessed via the
links underneath each of the smaller
versions below:
Main causes of death in Halton 2013
Link to full diagram:
http://www4.halton.gov.uk/Pages/councild
emocracy/pdfs/CensusandStatistics/DALY
2014%20(2012popfigures).pdf
Recent Public Health Related
Guidance
Managing overweight and obesity in
adults- lifestyle weight management
services (PH53)- May 2014
Link to full diagram:
http://www4.halton.gov.uk/Pages/councildemo
cracy/pdfs/CensusandStatistics/Haltondetailed
mortalitybubblechart.pdf
A number of new pieces of guidance
are currently in development. We will
keep you updated via these websites
when they are published.
http://www.nice.org.uk/
https://www.evidence.nhs.uk/
Sharon McAteer:
sharon.mcateer@halton.gov.uk
Team email:
health.intelligence@halton.gcsx.gov.uk
Team webpage:
http://www3.halton.gov.uk/Pages/health/h
ealthpolicy.aspx
Team members:
Ifeoma Onyia:
ifeoma.onyia@halton.gov.uk
Katherine Woodcock*:
katherine.woodcock@halton.gov.uk
Jennifer Oultram:
jennifer.oultram@halton.gov.uk
James Watson:
james.watson@halton.gov.uk
Diane Lloyd: diane.lloyd@halton.gov.uk
*currently on maternity leave