Isleworth & Brentford Area Committee Isleworth & Brentford Area Committee Isleworth & Brentford Area Committee Brentford Area Development Health Impact Assessment Update 30 August 2007 Sharon Daye, Acting Director of Public Health Maggie McNab, Assistant Director of Public Health
Format of Presentation • Introduction and Summary of the original process • Outline of health priorities • Explanation of how health priorities are addressed • NHS primary care services, including GPs and patient numbers • Primary Care premises, capacity and costs • The HUDU model • Future plans e.g. Wallis House, Brentford Football Club and Hospital services in the context of our 5 year Commissioning Strategy Plan • Further detail about the outcomes of the original recommendations affecting health services
Health Priorities
Female life expectancy at birth, by ward, Hounslow, 2000-2004 Source: Office for National Statistics and Greater London Authority; analysis by London Health Observatory
Causes of premature death, Hounslow, 2005 Percentage of deaths aged Cause of Death under 75 attributable to cause Men Women Coronary Heart Disease 20.0 12.8 Cerebrovascular disease (stroke) 6.0 6.5 Other Circulatory Diseases 8.9 9.8 Cancers (malignant neoplasms) 29.1 35.6 Respiratory Disease 10.5 10.1 Digestive Disease 5.2 5.6 Accidents and Suicide 8.3 4.7 Other causes 12.0 14.9 Source: Office for National Statistics, Vital Statistics 2005, Table VS3
Deaths from cancer (SMRs), under the age of 75, by electoral ward, Hounslow 2000-2004 Source: ONS Death registrations; 2000-2004 ward level GLA population projections, scenario 8.07 (2001 populations were used for 2000 and 2001) analysis by London Health Observatory
Uptake of Breast Screening, by Area Committee, Round 5 Year 1 (2002/03) 68% 66% 64% 62% 60% 58% 56% 54% 52% Central Chiswick Area Heston & Isleworth & West Area Hounslow PCT Hounslow Area Cranford Area Brentford Area
Deaths from coronary heart diseases (CHD) (SMRs), under the age of 75, by electoral ward, Hounslow, 2000-2004 Source: ONS Death registrations; 2000-2004 ward level GLA population projections, scenario 8.07 (2001 populations were used for 2000 and 2001); analysis by London Health Observatory
Deaths from Circulatory Disease (SMRs) under the age of 75, by electoral ward, London Borough of Hounslow, 1999-2003 Source: ONS mortality data; GLA 2003 Round-based Ward Projections
Deaths from stroke (SMRs) under the age of 75, by electoral ward, Lodon Borough of Hounslow, 1999-2003 Source: ONS mortality data; GLA 2003 Round-based Ward Projections
Deaths from Respiratory Disease (SMRs) under the age of 75, by electoral ward, London Borough of Hounslow, 1999-2003
Teenage Conception rate by ward, 2001-03
Expected prevalence of Obesity, by PCT in North West London, compared with England, 2000-2002 PCT Expected prevalence of obesity Brent 19.65% Ealing 19.01% Harrow 19.52% H&F 15.78% Hillingdon 21.16% Hounslow 20.09% K&C 14.55% Westminster 14.91% England 22.10% Source: Department of Health, Health Survey for England data
Prevalence of obesity in reception and year 6 children, by school and Index of Multiple Deprivation, Hounslow, 2005/06
Estimated of expected prevalence of obesity in adults, by ward, Hounslow 2000-2002
Some of the key health outcomes which the PCT has facilitated include: � Reducing mortality from Cancer - During 2003- 05 the cancer mortality rate was 113.7 which is ahead of our LDP target of 119.3; � Reducing mortality from Cardiovascular Disease - The CVD mortality rate during 2003-05 was 113.9 ahead of the LDP target of 114.2; � Reducing inequalities in health outcomes - the initiation of breastfeeding has improved with a level of 83.7%, which is ahead of the LDP target of 76.1%.
People aged 18 to 64 (resident in households)* with limiting long- term illness or disability, by electoral ward, London Borough of Hounslow, 2001 Source: 2001 Census, Office for National Statistics
How are health priorities being addressed A range of activities eg: � Brentford School for Girls ‘Health Drop-in’ � Primary Angioplasty for patients with heart attacks � PCT NHS Stop Smoking Service Clinics (Group work at West Middlesex University Hospital Trust, and 1-1 support via Brentford GP Practices and Community Pharmacy) � Health Forecasting for COPD Patients (supported by the recent Council initiative for individual information on air pollution, ‘Air Text’) � See PCT’s most recent Annual Public Health Reports 2005 and 2006: www.hounslowpct.nhs.uk
Primary Care Structure & Capacity
Brentford Health Centre (PCT Freehold) 4 General Practices Practice GPs Other staff Dr Crowe List size 6225 5 10 Dr Lane List size 7124 5 5 Dr Yasin List size 2504 1 7 Rai &Stevens List size 1970 2 5 No known major issues re access to GPs. No issues about formal assignments (allocations) due to patients being unable to register in normal manner
Bordering Practices serving Brentford Chiswick • Dr Williams (2 GPs), Dr Burbidge (3 GPs), Dr Hirst (7 GPs), Dr Thakrar (2 GPs) Isleworth • Dr Heffernan (3 GPs), Dr Kooner (2 GPs), Luthra (3), Badget (6), Edwards (2), Ho (2) Ealing - (across the border) • Dr Keen (1), Weber (1), Bhatt/Szyszko (2), Yin (1), Dr Farley (4), James (4)
Hounslow PCT Patient Registrations Average LOCALITY LIST SIZE NUMBER OF GPS population (as 1.7.07) (on basis of full- per GP time GPs) Chiswick 35,870 27.5 1304 Isleworth 34,494 17 2029 Brentford 17,823 13 1371 Hounslow 87,024 43.5 2000 Central Feltham 57,262 24 2386 TOTAL 232,473 125 1860
Other Primary Health Care Pharmacy: 3 community pharmacies are currently operating in the area - no known access issues Dental Care: 3 local General Dental Services (commissioned NHS) and Community Dental Services currently operating at the Heart of Hounslow for specialised treatments. The Albany practice reopened after a fire so current NHS capacity is good with no known issues about access to care, and extended emergency evening sessions
Brentford Future Plans • Wallis House £200k Section 106 to expand and invest in better services, increasing capacity and access within Brentford Health Centre • Brentford Football Club Health Campus proposals welcomed, open to principle of joint working and support • West Middlesex Front End Early stages of negotiations for a joint Intermediate Care Facility
HUDU Guide to Healthy Communities 1. Healthy Lifestyles 2. Housing Quality 3. Access to Work 4. Accessibility 5. Food Access 6. Crime Reduction and Community Safety 7. Air Quality and Neighbourhood Amenity 8. Social Cohesion and Social Capital 9. Public Services 10. Resource Minimisation 11. Climate Change
Future of NHS Services ‘A Framework for Action’ (Healthcare for London) a plan from Sir Ara Darzi outlines 6 proposed models of provision for health care in the future: 1. home, 2. polyclinic, 3. local hospital, 4. elective centre (booked operations), 5. major acute hospital, 6. specialist hospital.
PCT 5 year Commissioning Strategy - Key Initiatives • Unscheduled (emergency) care – Increasing alternatives to local A&E • Planned care – Hub & spoke primary care service – Less hospital outpatient visits, more community clinics. • Maternity – Increasing capacity across NW London • Sustainable financial balance
Collaborative Commissioning Initiatives • Unscheduled care • Planned care • Long term conditions • Paediatrics • Obstetrics • Cancer • Stroke • Standard primary care procedures & pathways
Update on HIA Recommendations particularly affecting Health Services
Recommendations affecting Health Services 2. Co-ordination Joint Health and LBH Executive Directorates Quarterly meetings now in place 6. Funding Health and Planning Quarterly meetings and specific inclusion in the sustainability policy
Update on Recommendations cont’d 13. Community services & health facilities Health and Children’s Services • Funding and Section 106 - Included in ( 6 ) above • Statutory sector support for community and voluntary organisations engaged in informal maternal and child-care - Nursery Nurse support for local playgroups now provided • Explore possibility of a local Children’s Centre in supporting the co-ordination monitoring and evaluation of services – A Children’s Centre is being developed on Green Dragon Primary School site, completion due March 08. A Parent and Toddler Group and Baby Group already established
Update on Recommendations cont’d 13. Community services & health facilities Health and Children’s Services, continued……… • Review of existing services to support larger local population – PCT Children’s Services (0-19s) now re-organised into clusters of skill mix teams that will enhance professional leadership and enable flexible provision • Discussions with TVU re services for future student needs - To be included as a core element in CSP
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