HIGH WEALD LEWES HAVENS CLINICAL COMMISSIONING GROUP 2015 NEEDS AND ASSETS PROFILE. East Sussex Public Health 2015

Transcription

1 HIGH WEALD LEWES HAVENS CLINICAL COMMISSIONING GROUP 2015 NEEDS AND ASSETS PROFILE East Sussex Public Health HWLH CCG Local Needs and Assets Profile 2015

2 Contents Introduction... 3 Key findings... 4 Demography Premature mortality - causes of death Causes of Inequalities in life expectancy Health profiles summary Public Health Outcomes Framework CCG Outcomes Indicator Set (CCGOIS) Appendix 1: JSNAA Scorecard locality profile key findings Appendix 2: JSNAA Scorecard locality profiles High Weald Locality Lewes Locality Havens Locality Indicator definitions Appendix 3: Acronyms and abbreviations Appendix 4: Information sources HWLH CCG Local Needs and Assets Profile 2015

3 Introduction This profile should be used to inform decisions and plans and to identify priorities to improve local people s health and reduce health inequalities in Hastings and Rother Clinical Commissioning Group (CCG). This profile identifies needs (which may also be referred to or seen as deficits) as well as assets (which may also be referred to or seen as strengths) from the routinely available data. When using routinely available data the needs are identified when indicators are significantly worse when compared to a comparator such as England or East Sussex and the assets when indicators are significantly better. Needs and assets are also identified through a process of triangulation where information from a range of sources has shown similar results or themes. These are presented in the Key Findings section of this profile. This profile forms part of the East Sussex Joint Strategic Needs and Assets Assessment (JSNAA) and draws together data and analysis from East Sussex Public Health Annual Reports and various Health Profiles produced by Public Health England. It brings together existing data and analysis, from a variety of sources, at CCG, district/borough council and East Sussex levels. Importantly it provides benchmarked data that show how the area compares to the national average. Indicator data is mostly available either at administrative geographies (district/borough/county councils) or CCGs. Benchmarked information for as many of the indicators as possible covered by the Public Health Outcomes Framework and CCG Outcomes Indicator Set have been included. Breakdowns of the causes of the gap in life expectancy at district/borough level are included. Also included are JSNAA scorecard profiles and key findings for localities, and these can be found in the appendices. 3 HWLH CCG Local Needs and Assets Profile 2015

4 Key Findings Key findings Within any population there are potentially a large number of needs (or deficits) and assets (or strengths) that can be identified which impact on the health of that population. When using routinely available data, needs or deficits are identified when indicators are significantly worse when compared to a comparator such as England or East Sussex and assets or strengths when indicators are significantly better. This profile has pulled together information from a variety of sources to identify health needs, health determinant factors and assets impacting on the health of the population of High Weald Lewes Havens CCG to inform decisions and plans to improve local people s health and reduce health inequalities. Whilst identifying a number of needs and assets, the profile also provides information to support identification of a limited number. These have been identified because they have a significant impact in terms of severity and size and through a process of triangulation where information from a range of sources has shown similar results or themes. They are presented in this section. Population The profile shows an older population structure compared to England with a significantly higher percentage of older people aged 65 years and over and 85 years and over. Population projections show that the proportion of older people will continue to increase. The CCG has a significantly lower percentage of pensioners living alone compared to England. Given the older age profile of the CCG, services that support the health, wellbeing and independence of older people are therefore a priority. The CCG has a significantly higher proportion of the population providing 1 hour or more unpaid care per week compared to England, but a significantly 4 HWLH CCG Local Needs and Assets Profile 2015

5 lower proportion of the population providing 50 hours or more per week compared to England. Wealden district has a significantly lower percentage of persons reporting bad or very bad health compared to England. Lewes district has a significantly higher percentage of people reporting a limiting long term illness or disability compared to England. Wider determinants of health in High Weald Havens Lewes CCG Across socioeconomic indicators and determinants of health such as child poverty, income, deprivation, housing, employment, violence and crime the CCG is significantly better compared to England. For children aged 5 years, East Sussex has significantly better child development scores than England, however for children aged 6 years, East Sussex has significantly fewer achieving expected levels in the phonics screening check. Lewes and Wealden districts have significantly higher life expectancies at birth and at 65 years compared to England. Healthy lifestyles Many deaths and illnesses can be avoided by building on existing community assets and enabling communities to have more control over their lifestyle choices, improving health and well-being. Smoking The percentage of children aged 15 who are smokers in East Sussex is significantly worse than England. The CCG has a significantly lower percentage than England for women smoking during pregnancy. The recording of smoking status by GPs for persons aged 15 years and over and for patients with certain conditions is significantly worse than England, as is the record of offer of support/treatment. Smoking-attributable hospital admissions and mortality are significantly better than for England. Alcohol the percentage of children using alcohol in East Sussex is significantly worse than England. Alcohol-related hospital admissions and 5 HWLH CCG Local Needs and Assets Profile 2015

6 deaths from alcohol are generally similar to or significantly better than for England in the Lewes and Wealden districts. Drugs the percentage of children using drugs in East Sussex is significantly worse than England but the rate of young people (15-24 years) admitted to hospital due to substance misuse is significantly lower than England. Estimated drug misuse (15-64 years) is significantly lower compared to England. East Sussex has a significantly higher percentage of non-opiate users successfully completing drug treatment when compared to England. Obesity Lewes and Wealden districts have significantly lower levels of childhood obesity compared to England. Wealden has significantly higher percentages of the population engaging in the recommended levels of physical activity. Excess weight in adults is significantly higher than England in the Lewes district. A significantly higher percentage of the population in East Sussex are estimated to use outdoor space for exercise/health compared to England. Sexual Health Wealden district has significantly lower rates of teenage conceptions compared to England. Wealden district has significantly lower percentages of young people (15-24 years) screened for Chlamydia compared to England and also a significantly lower rate of diagnosed Chlamydia in young people compared to England. Across the CCG area the uptake and coverage of HIV testing is generally significantly worse than England. HIV diagnosed prevalence is significantly higher in Lewes than for England. East Sussex has a significantly higher rate of GP prescribed LARC compared to England. Rates of STIs are generally significantly better or similar to the rates for England. Vaccination, Immunisation and NHS health checks the uptake of childhood immunisation is significantly worse in Lewes district compared to England. Within Wealden it is generally similar to England. The CCG is significantly worse than England for uptake of seasonal flu vaccination for the at-risk population, persons aged 65 years and over ad children aged 2 years. The 6 HWLH CCG Local Needs and Assets Profile 2015

7 CCG has a significantly lower percentage of eligible patients who were both offered and received a NHS Health Check. Breastfeeding the CCG has a significantly higher percentage of mothers initiating breastfeeding and breastfeeding at 6-8 weeks, compared to England. Health status and chronic diseases East Sussex has significantly higher preventable sight loss conditions than England. Premature mortality from all causes and mortality from causes considered preventable is significantly lower compared to England across the CCG area. Mortality from chronic liver disease, deaths from liver disease in under 75s and deaths from liver disease in under 75s considered preventable is similar to or significantly better compared to England. The prevalence of diabetes is significantly lower compared to England. In some aspects of the management of diabetic patients in primary care the CCG is significantly better than England (HbA1c levels) however in other aspects of care the CCG is worse compared to England (blood pressure, cholesterol, seasonal flu, retinal screening, dietary review and foot examination). The prevalence of COPD, admissions and deaths due to COPD are all significantly lower compared to England. Deaths from respiratory disease for all ages and for persons aged under 75 years are significantly better than for England. Respiratory deaths for persons aged under 75 years that are considered preventable are significantly lower than England in Wealden district. The CCG has a significantly higher prevalence of hypertension than England. The management of hypertension patients in primary care is worse than for England. The management of patients with CHD in primary care is either similar to England or significantly worse than for England. Emergency admissions due to CHD or for myocardial infarction are significantly lower compared to England. The CCG has a significantly higher prevalence of 7 HWLH CCG Local Needs and Assets Profile 2015

8 stroke compared to England and for some indicators around the management of stroke patients in primary care, is worse compared to England. Lewes district has significantly lower emergency stroke admissions compared to England. Mortality from circulatory disease for Wealden and Lewes districts is significantly better for persons aged under 75 years. Mortality from cardiovascular disease in persons aged under 75 years and where considered preventable is generally significantly better than for England across the CCG area. Across the CCG area there is a significantly lower incidence of TB compared to England. Cancer Cancer is one of the main contributors to the inequalities in life expectancy. The incidence of all cancers is significantly lower compared to England. However, the percentage of patients on GP lists with cancer is significantly higher compared to England (no adjustment for age). The CCG has significantly lower rates than England of deaths from all cancers for all ages and is significantly lower in Wealden for persons aged under 75 years. The rate of deaths in under 75s from cancers that are considered preventable are significantly lower than England in the Wealden district for all persons and for males. Across the CCG area the incidence of and mortality from lung cancer is significantly better than England for all ages and those under 75. Screening for cervical cancer is significantly better than England for Lewes and Wealden districts. The coverage of breast screening is significantly higher compared to England for Wealden district. The incidence of new cases of breast cancer in women is significantly worse compared to England across the CCG area, particularly in Wealden. The incidence of prostate cancer in males is significantly worse compared to England in Wealden district. 8 HWLH CCG Local Needs and Assets Profile 2015

9 The incidence of malignant melanoma (type of skin cancer) is significantly higher across the CCG area. The CCG has a significantly lower incidence of kidney cancer, stomach cancer, liver cancer and thyroid cancer compared to England. Mental health The incidence and prevalence of depression is significantly higher for the CCG compared to England. Indicators around the management in primary care of patients with severe mental illness are significantly worse than for England. Compared to England, the CCG has significantly higher rates of people on care programme approach and referrals to IAPT services but significantly lower rates of A&E attendances for a psychiatric disorder, people receiving assertive outreach, persons in contact with secondary mental health services with a crisis plan in place and persons subject to the Mental Health Act. Lewes district has significantly higher hospital admissions due to selfharm, whilst Wealden has significantly lower rates. The CCG is significantly lower than England for Care Programme Approach patients who have received a review after 12 months. Accidents and injuries Wealden district has a significantly higher rate than England of all road casualties. Wealden district also has significantly higher rates of hospital admissions and deaths due to road transport accidents/injuries but a significantly lower rate of pedestrian casualties when compared to England. Along with Wealden district, Lewes district also has a significantly higher rate of persons killed or seriously injured on the district s roads. Compared to England, Lewes district has a significantly higher rate of hospital admissions due to poisoning injuries. Falls and serious head injuries in Lewes district are significantly lower than for England and in Wealden district serious head injuries and poisoning injuries are significantly lower. 9 HWLH CCG Local Needs and Assets Profile 2015

10 Across the CCG area the rate of hospital admissions due to violence are significantly better compared to England. Place of death Most people approaching the end of life would prefer to be cared for at home, as long as high quality care can be assured and as long as they do not place too great a burden on their families and carers. The percentage of deaths in care homes and hospices are significantly higher than for England, with significantly lower percentages than England for deaths in hospital. 10 HWLH CCG Local Needs and Assets Profile 2015

11 Demography The map below shows High Weald Lewes Havens CCG in relation to the Local Authority District/Borough boundaries. The pie chart shows the percentage of High Weald Lewes Havens CCG patients resident in each of the district/boroughs and the bar chart shows the percentage of the resident population of the district/boroughs that are registered with High Weald Lewes Havens CCG. 11 HWLH CCG Local Needs and Assets Profile 2015

12 12 HWLH CCG Local Needs and Assets Profile 2015

13 The map below shows the specific geography of the CCG. The Index of Multiple Deprivation (IMD) by Lower Super Output Area (LSOA) for High Weald Lewes Havens CCG is shown for both IMD 2010 (see IMD 2010 Map for High Weald Lewes Havens CCG) and IMD 2015 (see IMD 2015 Map for High Weald Lewes Havens CCG). Both maps identify the LSOAs by national quintiles and show that in IMD 2010 there are no LSOAs amongst the most deprived 20% of areas in England and in IMD 2015 there is one. Note that IMD 2015 was published in September 2015 so has been included to provide the most up-to-date deprivation picture, however, the majority of the indicators that relate to derivation in this needs and assets profile will be IMD HWLH CCG Local Needs and Assets Profile 2015

14 IMD 2010 Map for High Weald Lewes Havens CCG IMD 2015 Map for High Weald Lewes Havens CCG 14 HWLH CCG Local Needs and Assets Profile 2015

15 The following three maps show the percentage of the resident population by LSOA within specific age groups. Data has been presented in an East Sussex context, where quintile 1 identifies the 20% of LSOAs in East Sussex with the highest percentages of the specific age group being mapped. 15 HWLH CCG Local Needs and Assets Profile 2015

16 16 HWLH CCG Local Needs and Assets Profile 2015

17 High Weald Lewes Havens has an older population structure compared to England and a lower percentage of 20 to 40 year olds (both males and females) than England. Source: Small Area Population Estimates, ONS Crown Copyright 2014 Premature mortality - causes of death There were 427 deaths of residents aged 0-74 years in the CCG in The figure overleaf shows the causes of death for those residents (the bigger the size of the circle the greater the number of deaths from that cause). Around half of premature deaths are caused by cancer (51%) and circulatory diseases are the cause of around 1 in 5 premature deaths (18%). 17 HWLH CCG Local Needs and Assets Profile 2015

18 18 HWLH CCG Local Needs and Assets Profile 2015

19 Causes of Inequalities in life expectancy Lewes In , the absolute gap in life expectancy between the most and least deprived quintiles in Lewes was 3.8 years for males (83.5 years in the least deprived quintile and 79.7 years in the most deprived quintile) and 2.2 years for females (86.4 years in the least deprived quintile and 84.2 years in the most deprived quintile). Cancer is the main contributor to the gap in life expectancy in both males (40%) and females (49%). Wealden In , the absolute gap in life expectancy between the most and least deprived quintiles in Wealden was 3.7 years for males (82.0 years in the least deprived quintile and 78.3 years in the most deprived quintile) and 3.2 years for females (85.4 years in the least deprived quintile and 82.2 years in the most deprived quintile). In males cancer (22%) and external causes (14%) were some of the main contributors to the gap in life expectancy and in 19 HWLH CCG Local Needs and Assets Profile 2015

20 females it was circulatory (23%) and digestive (18%) diseases. For both males (37%) and females (25%), other causes also contributed to the gap in life expectancy. 20 HWLH CCG Local Needs and Assets Profile 2015

21 Health profiles summary The indicators presented here have been taken from a variety of health profiles that have been published by Public Health England (see Appendix 4). Where possible, the local value has been benchmarked against the England value, with green representing significantly better than England, red significantly worse, and yellow no significant difference. Blue represents significantly different from the England value, where light blue is significantly less than England and dark blue is significantly higher than England, but without an indication of whether this is better or worse (e.g. a significantly higher percentage of older people would be coloured dark blue as it is not better or worse but just significantly higher). White indicates no significance testing for that indicator. The indicators have been grouped around five domains, in line with Health Profiles produced by the Department of Health: Our communities (e.g. socio-economic factors, demography) Children's and young people's health (e.g. breastfeeding, teenage pregnancy) Adults' health and lifestyle (e.g. smoking prevalence, alcohol consumption) Disease and poor health (e.g. hospital admissions, QOF disease indicators) Life expectancy and causes of death (e.g. mortality rates, place of death). 21 HWLH CCG Local Needs and Assets Profile 2015

22 Socioeconomic Demography England Eastbourne Hastings Lewes Rother Wealden East Sussex HWLH CCG EHS CCG H&R CCG OUR COMMUNITIES Total population, ,865, ,537 90,754 99,479 91, , , , , ,808 Number of live births, ,517 1,125 1, ,304 5,268 Fertility rate (live births per 1,000 females yrs), % aged 0-4 years, % aged 65 years and over - all persons, % aged 65 years and over - males, % aged 65 years and over - females, % aged 85 years and over - all persons, % aged 85 years and over - males, % aged 85 years and over - females, Dependency ratio (pension age pop (65 yrs male, yrs females) and over/working age pop), Non-White British population (%), Supported asylum seekers (per 10,000), 2013/14 Q Traveller children: % school children who are Gypsy/Roma, 2013/ Migrant GP registrations (per 1,000 residents), Population turnover (internal migration) (per 1,000 residents), English language skills: % of people who cannot speak English / speak it well, People living alone: % of all households occupied by a single person, Lone parents households: % of households that have lone parents with dependent children, Nursing home patients (% GP registered population), 2010/ Pensioners living alone (%), Relationship breakup: % of adults whose current marital status is separated or divorced, Socioeconomic deprivation: overall IMD score, Deprivation (% people living in 20% most deprived areas in England (IMD 2010)), Income Deprivation (%), IDACI (Income Deprivation Affecting Children Index) (%), Children in low income families aged 0-4 yrs, (%), Children in low income families aged yrs, (%), Children in poverty (under 16s), (%), Children in poverty (all dependent children under 20), (%), Free school meals: % uptake among all pupils, Older People in Deprivation (IDAOPI) (%), Fuel Poverty, (%), Households with dependent children & at least one person with long term health problem/disability (%), HWLH CCG Needs and Assets Profile 2015

23 Violence & crime Education & Employment Housing England Eastbourne Hastings Lewes Rother Wealden East Sussex HWLH CCG EHS CCG H&R CCG OUR COMMUNITIES Households with central heating, (%), Rented accommodation: % of all households living in rented accommodation, Overcrowding (%), Statutory homelessness (per 1,000 households), 2013/ Statutory homelessness - households in temporary accommodation (per 1,000 households), 2013/ Family homelessness (per 1,000 households), 2013/ Homeless households headed by a young person aged years (per 1,000 households), 2013/ Children achieving a good level of development at end of Year R (%), 2013/ Children with free school meal status achieving good level of development at end of Year R (%), 2013/ Year 1 pupils achieving expected level in the phonics screening check (%), 2013/ Year 1 pupils with free school meal status achieving expected level in phonics screening (%), 2013/ GCSE achieved (5A*-C inc. Eng & Maths) (%), 2013/ GCSE achieved 5A*-C including Eng & Maths with free school meal status (%), 2012/ Pupil absence, (%) 2013/ Secondary school pupil absence (% of half days missed), 2012/ Fixed period exclusions from primary schools (%), 2012/ Fixed period exclusions from secondary schools (%), 2012/ Fixed period exclusion due to drugs/alcohol use (%), 2012/ Fixed period exclusion due to persistent disruptive behaviour: % of school pupils, 2012/ Permanent exclusions - Secondary school, (%) 2013/ year olds not in education employment or training, (%) Adults that have no qualifications or level one qualifications (%), Working status - Paid work or full-time education (%), 2013/ Unemployment (% working age claiming out-of-work benefit), 2012/ Long term unemployment (per 1, years), Households with dependent children where no adult is in employment (%), Violent crime (per 1,000), 2013/ Domestic Abuse: incident rate per 1,000 population, 2013/ Sexual offences (per 1,000), 2013/ Re-offending levels: offenders who re-offend (%), Re-offending levels: average number of re-offences per offender, HWLH CCG Needs and Assets Profile 2015

24 Environment Carers Social & primary care services England Eastbourne Hastings Lewes Rother Wealden East Sussex HWLH CCG EHS CCG H&R CCG OUR COMMUNITIES GP patient survey: % reporting good overall experience of making appointment, 2013/ GP patient survey: % satisfied with opening hours, 2013/ GP patient survey: % satisfied with phone access, 2013/ GP patient survey: % who know how to contact an out-of-hours GP service, 2013/ GP patient survey: % who saw/spoke to nurse or GP same or next day, 2013/ GP patient survey: % who would recommend practice, 2013/ Social Care service users who said services have made them feel safe & secure (%), 2012/ Social Care service users extremely satisfied or very satisfied with their care & support (%), 2012/ Adult social care users who have as much social contact as they would like (%), 2013/ Provision of 1 hour or more unpaid care per week (%), Provision of 50 hours or more unpaid care per week (%), GP patient survey: % reporting caring responsibility, 2013/ children under 15 yrs who provide unpaid care (%), Children under 15 yrs who provide 20+ hrs of unpaid care per week (%), Young people yrs providing unpaid care (%), Young people yrs who provide 20 hrs + of unpaid care per week (%), Social Isolation: % of adult carers who have as much social contact as they would like, 2012/ Population exposed to road, rail & air transport noise of 65dB(A) or more during daytime (%), Population exposed to road, rail & air transport noise of 55 db(a) or more during night-time (%), Complaints about noise (per 1,000), 2013/ HWLH CCG Needs and Assets Profile 2015

25 Obesity Immunisation Pregnancy & infancy England Eastbourne Hastings Lewes Rother Wealden East Sussex HWLH CCG EHS CCG H&R CCG CHILDREN'S AND YOUNG PEOPLE'S HEALTH Ectopic pregnancy admissions (per 100,000 females yrs), 2013/ Antenatal assessments before 13 weeks (%), 2013/ Population vaccination coverage - Seasonal Flu (Pregant women) (%), 2014/ Caesarian Sections (%), 2012/ Deliveries to women aged 35 yrs or over (%), 2012/ Admission of babies aged under 14 days (per 1,000 deliveries), 2011/ Smoking at time of delivery (%), 2013/ Low birthweight of all babies (%), Low birth weight of term babies (37 or more weeks) (%), Breastfeeding initiation (%), 2013/ Breastfeeding prevalence at 6-8 weeks after birth (%), 2013/ Newborn hearing screening coverage (%), 2013/ DtaP / IPV / Hib (by age 1 year) (%), 2013/ PCV (by age 1 year) (%), 2013/ MenC (by age 1 year) (%), 2012/ DtaP / IPV / Hib (by age 2 years) (%), 2013/ Hib / MenC booster (by age 2 years) (%), 2013/ MMR for one dose (by age 2 years) (%), 2013/ PCV booster (by age 2 years) (%), 2013/ Population vaccination coverage - Seasonal Flu (2 year olds) (%), 2014/ Population vaccination coverage - Seasonal Flu (3 year olds) (%), 2014/ Population vaccination coverage - Seasonal Flu (4 year olds) (%), 2014/ Hib / Men C booster (by age 5 years) (%), 2013/ MMR for one dose (by age 5 years) (%), 2013/ MMR for two doses (by age 5 years) (%), 2013/ HPV (females years old) (%), 2013/ Participation in at least 3 hours of sport/pe (%), 2009/10 47 Reception: Prevalence of underweight (%), 2013/ Reception: Prevalence of healthy weight (%), 2013/ Reception: Prevalence of overweight (including obese) (%), 2013/ Reception: Prevalence of obesity (%), 2013/ Year 6: Prevalence of underweight (%), 2013/ Year 6: Prevalence of healthy weight (%), 2013/ Year 6: Prevalence of overweight (including obese) (%), 2013/ Year 6: Prevalence of obesity (%), 2013/ HWLH CCG Needs and Assets Profile 2015

26 Children's Services Learning disabilities England Eastbourne Hastings Lewes Rother Wealden East Sussex HWLH CCG EHS CCG H&R CCG CHILDREN'S AND YOUNG PEOPLE'S HEALTH Pupils with Learning Disability (%), Pupils with behavioural, emotional and social support needs (%), Children with Autism known to schools (per 1,000 pupils), 2013/ Children with Moderate Learning Difficulties known to schools (per 1,000 pupils), 2013/ Children with Severe Learning Difficulties known to schools (per 1,000 pupils), 2013/ Pupils with speech, language or communication needs (%), Pupils with special educational needs (SEN) (%), Pupils with a SEN statement (%), Pupils with SEN on School Action Plus (%), Pupils with SEN on School Action (%), Children in need referrals (per 10,000 aged under 18 yrs), 2013/ Children in need (per 10,000 aged under 18 yrs), 2013/ New cases of children in need (per 10,000 aged under 18 yrs), 2013/ Children in need due to abuse, neglect or family dysfunction (% of children in need), Children in need for more than 2 years (% of children in need), Looked after children aged 10 to 15 yrs (rate per 10,000), Looked after young people aged 16 and 17 yrs (rate per 10,000), Looked after children under 18 yrs (per 10,000), 2013/ Looked after children in foster placements (% of looked after children), Looked after children in secure units, children's homes & hostels (% of looked after children), Children in care who gained 5 GCSEs at A*-C incl. English and Maths (%), Development assessments up-to-date for looked after children under 5 yrs (%), Emotional & behavioural health assessment of looked after children (% assessed), Emotional & behavioural health outcome for looked after children where considered 'of concern' (%), 2012/ Emotional well-being of looked after children: average score, 2013/ Health assessments for looked after children: % who had an annual assessment, Children in care immunisations (%), GCSEs achieved (5A*-C inc. English and maths) for children in care (%), Children leaving care (per 10, yrs), 2013/ Children who were the subject of a child protection plan at year end (per 10, yrs), 2013/ Children who became the subject of a child protection plan during the year (per 10, yrs), 2013/ Children who became subject of a child protection plan for a second/subsequent time, 0-17 yrs (%), Children under child protection who were reviewed within the required timescales, 0-17 yrs (%), HWLH CCG Needs and Assets Profile 2015

27 Emotional Wellbeing Crime Sexual Health Addictive behaviours CHILDREN'S AND YOUNG PEOPLE'S HEALTH Oral Health England Eastbourne Hastings Lewes Rother Wealden East Sussex HWLH CCG EHS CCG H&R CCG Smoking prevalence at age 15 - current smokers (%) 2014/ Smoking prevalence at age 15 - regular smokers (%) 2014/ Smoking prevalence at age 15 - occasional smokers (%) 2014/ Occasional smoker (modelled prevalence, age 11-15) (%), Occasional smoker (modelled prevalence, age 16-17) (%), Regular smoker (modelled prevalence, age 11-15) (%), Regular smoker (modelled prevalence, age 16-17) (%), Children and young people using alcohol (%), Children and young people using drugs (%), Pupils who say they need more/ better information and advice on sex and relationships (%), Under 16 conceptions (per 1,000 females yrs), Under 18 conceptions (per 1,000 females yrs), Under 18s abortions (per 1,000 females yrs), Under 18s births (per 1,000 females yrs), Under 18s conceptions leading to abortion (%), Under 25s repeat abortions (%), Teenage mothers (% of deliveries), 2013/ Chlamydia proportion aged screened (%), Chlamydia detection rate (per 100, yrs), Chlamydia detection rate, males (per 100, yrs), Chlamydia detection rate, females ( per 1000, yrs), New sexually transmitted infections (incl Chlamydia) (per 100, yrs), Children aged yrs who have formally entered the youth justice system (per 1,000), 2012/ Children aged 15 yrs who have formally entered the youth justice system (per 1,000), 2012/ Children aged 16 yrs who have formally entered the youth justice system (per1,000), 2012/ Children in the youth justice system (per 1, yrs), 2013/ First time entrants to the youth justice system (per 100, yrs), Young people yrs who have formally entered the youth justice system (per 1,000), 2012/ Children aged 5 with one or more decayed, missing or filled teeth, 2011/ Tooth decay in children aged 5 (mean dmft per child), 2011/ Children who enjoy good relationships with family & friends (%), 2009/10 53 Pupils who say they have been bullied (%) School deals with bullying not very or not at all well (%), Young people s participation in positive activities (%), 2009/ HWLH CCG Needs and Assets Profile 2015

28 Sexual Health Physical activity and obesity Smoking England Eastbourne Hastings Lewes Rother Wealden East Sussex HWLH CCG EHS CCG H&R CCG ADULT'S HEALTH AND LIFESTYLES Smoking prevalence 18+ yrs (%), Smoking prevalence - routine & manual 18+ yrs (%), GP patient survey: ex-smoking prevalence (%), 2013/ GP patient survey: smoking prevalence (%), 2013/ Recorded smoking prevalence 15+ yrs (QOF) (%), 2013/ SMOK001: record of smoking status in last 24 mths (15+ yrs), 2013/ SMOK002: status recorded in last 12 mths (certain conditions) (%), 2013/ SMOK004: record of offer of support and treatment (15+ yrs, last 24 mnths) (%), 2013/ SMOK005: Smokers on GP registers (certain conditions) offered cessation support & treatment (% within year), 2013/ Exception rate for smoking indicators (%), 2013/ Successful quitters at 4 weeks (per 100,000 smokers 16+ yrs), 2013/ Binge drinking adults (%), Alcohol People drinking at increasing or higher risk levels (% 16+ yrs), Healthy eating adults (%), Excess weight in adults (%), Obese adults (%), Obesity: QOF prevalence (16+ yrs), 2013/ Physically active adults (%), Physically inactive adults (%), Use of outdoor space for exercise/health (estimated % 16+ yrs), Mar Feb GP prescribed LARC rate (per 1,000 females yrs), STI testing rate (excl Chlamydia aged < 25 yrs) (per 100, yrs), HIV testing coverage, men (%), HIV testing coverage, MSM (%), HIV testing coverage, total (%), HIV testing coverage, women (%), HIV testing uptake, men (%), HIV testing uptake, MSM (%), HIV testing uptake, total (%), HIV testing uptake, women (%), Abortions under 10 weeks (%), Total abortions rate (per 1,000 females yrs), HWLH CCG Needs and Assets Profile 2015

29 Children and young people England Eastbourne Hastings Lewes Rother Wealden East Sussex HWLH CCG EHS CCG H&R CCG DISEASE AND POOR HEALTH A&E attendances in under 5s (per 1,000), 2010/ / A&E attendances 5-17 yrs (per 1,000), 2010/ / A&E attendances 0-17 yrs (per 1,000), 2010/ / Emergency admissions in under 5s (per 1,000), 2010/ / Elective admissions for all causes 0-17 yrs (per 1,000), 2010/ / Emergency admissions for all causes 0-17 yrs (per 1,000), 2010/ / Outpatient first attendances 0-17 yrs (per 1,000), 2010/ / Ratio of first to follow-up outpatient attendances 0-17 yrs (per 1,000), 2010/ / DNA rate for outpatient appointments 0-17 yrs (per 1,000), 2010/ / Admissions for gastroenteritis in infants aged under one year (per 10,000), 2012/ Admissions for gastroenteritis in infants aged one year (per 10,000), 2012/ Admissions for gastroenteritis in children aged 2, 3 and 4 years (per 10,000), 2012/ Admissions for gastroenteritis in children aged under five years (per 10,000), 2012/ Emergency admissions for lower respiratory tract infections, 0-18 yrs (DSR per 100,000), 2013/ Emergency admissions for lower respiratory tract infections, males 0-18 yrs, (DSR per 100,000), 2013/ Emergency admissions for lower respiratory tract infections, females 0-18 yrs (DSR per 100,000), 2013/ Admissions for respiratory tract infections in infants aged under one year (per 10,000), 2012/ Admissions for respiratory tract infections in infants aged one year (per 10,000), 2012/ Admissions for respiratory tract infections in children aged 2, 3 and 4 years (per 10,000), 2012/ Admissions for respiratory tract infections in children aged under five years (per 10,000), 2012/ Admissions for asthma 0-18 yrs (per 10,000), 2013/ Emergency admissions for asthma, diabetes & epilepsy, 0-18 yrs (DSR per 100,000), 2013/ Emergency admissions for asthma, diabetes & epilepsy, males 0-18 yrs (DSR per 100,000), 2013/ Emergency admissions for asthma, diabetes & epilepsy, females 0-18 yrs (DSR per 100,000), 2013/ Emergency epilepsy admissions, yrs (per 100,000 population), 2012/ Emergency diabetes admissions, yrs (per 100,000 population), 2012/ Admissions caused by unintentional & deliberate injuries, 0-4 yrs (per 10,000), 2013/ Admissions caused by unintentional & deliberate injuries, 0-14 yrs (per 10,000), 2013/ Admissions caused by unintentional & deliberate injuries, yrs (per 10,000), 2013/ Children under 16 yrs injured on the road (per 100,000), Admissions for mental health conditions, 0-17 yrs (per 10,000), 2013/ Admissions due to substance misuse, yrs (DSR per 100,000), 2011/ / Admissions as a result of self-harm, yrs (DSR per 100,000), 2013/ Alcohol-specific hospital stays, 0-17 yrs (per 100,000), 2011/12-13/ HWLH CCG Needs and Assets Profile 2015

30 Alcohol England Eastbourne Hastings Lewes Rother Wealden East Sussex HWLH CCG EHS CCG H&R CCG DISEASE AND POOR HEALTH Smoking Smoking attributable hospital admissions, 35+ yrs (DSR per 100,00), 2012/ Alcohol-specific hospital admission (DSR per 100,000), 2013/ Alcohol-specific hospital admission, males (DSR per 100,000), 2013/ Alcohol-specific hospital admission, females (DSR per 100,000), 2013/ Alcohol-related hospital admission (Broad) (DSR per 100,000), 2013/ Alcohol-related hospital admission (Broad), males (DSR per 100,000), 2013/ Alcohol-related hospital admission (Broad), females (DSR per 100,000), 2013/ Alcohol-related hospital admission (Narrow) (DSR per 100,000), 2013/ Alcohol-related hospital admission (Narrow), males (DSR per 100,000), 2013/ Alcohol-related hospital admission (Narrow), females (DSR per 100,000), 2013/ Admission episodes for alcohol-related conditions (Broad) (DSR per 100,000), 2013/ Admission episodes for alcohol-related conditions (Broad), males (DSR per 100,000), 2013/ Admission episodes for alcohol-related conditions (Broad), females (DSR per 100,000), 2013/ Admission episodes for alcohol-related conditions (Narrow) (DSR per 100,000), 2013/ Admission episodes for alcohol-related conditions (Narrow), males (DSR per 100,000), 2013/ Admission episodes for alcohol-related conditions (Narrow), females (DSR per 100,000), 2013/ Admission episodes for alcohol-related malignant neoplasms (Broad) (DSR per 100,000), 2013/ Admission episodes for alcohol-related malignant neoplasms (Broad), males (DSR per 100,000), 2013/ Admission episodes for alcohol-related malignant neoplasms (Broad), females (DSR per 100,000), 2013/ Admission episodes for alcohol-related cardiovascular diseases (Broad) (DSR per 100,000), 2013/ Admission episodes for alcohol-related cardiovascular diseases (Broad), males (DSR per 100,000), 2013/ Admission episodes for alcohol-related cardiovascular diseases (Broad), females (DSR per 100,000), 2013/ Admission episodes for alcohol-related mental & behavioural disorders due to alcohol (Broad) (DSR per 100,000), 2013/ Admission episodes for alcohol-related mental & behavioural disorders due to alcohol (Broad), males (DSR per 100,000), 2013/ Admission episodes for alcohol-related mental & behavioural disorders due to alcohol (Broad), females (DSR per 100,000), 2013/ Admission episodes for alcohol-related alcoholic liver disease (Broad) (DSR per 100,000), 2013/ Admission episodes for alcohol-related alcoholic liver disease (Broad), males (DSR per 100,000), 2013/ Admission episodes for alcohol-related alcoholic liver disease (Broad), females (DSR per 100,000), 2013/ Admission episodes for alcohol-related malignant neoplasms (Narrow) (DSR per 100,000), 2013/ Admission episodes for alcohol-related malignant neoplasms (Narrow), males (DSR per 100,000), 2013/ Admission episodes for alcohol-related malignant neoplasms (Narrow), female (DSR per 100,000), 2013/ Admission episodes for alcohol-related unintentional injuries (Narrow) (DSR per 100,000), 2013/ Admission episodes for alcohol-related unintentional injuries (Narrow), males (DSR per 100,000), 2013/ Admission episodes for alcohol-related unintentional injuries (Narrow), females (DSR per 100,000), 2013/ Admission episodes for alcohol-related mental & behavioural disorders due to alcohol (Narrow) (DSR per 100,000), 2013/ Admission episodes for alcohol-related mental & behavioural disorders due to alcohol (Narrow), males (DSR per 100,000), 2013/ Admission episodes for alcohol-related mental & behavioural disorders due to alcohol (Narrow), females (DSR per 100,000), 2013/ Admission episodes for alcohol-related intentional self-poisoning by & exposure to alcohol (Narrow) (DSR per 100,000), 2013/ Admission episodes for alcohol-related intentional self-poisoning by & exposure to alcohol (Narrow), males (DSR per 100,000), 2013/ Admission episodes for alcohol-related intentional self-poisoning by & exposure to alcohol (Narrow), females (DSR per 100,000), 2013/ Adults in treatment at specialist alcohol misuse services (per 1, yrs), 2013/ Successful completion of treatment for alcohol: % who do not re-present within 6 months, Claimants of benefits due to alcoholism (per 100,000 working age pop), HWLH CCG Needs and Assets Profile 2015

31 Drugs Accidents and injuries (& violence) STIs Liver England Eastbourne Hastings Lewes Rother Wealden East Sussex HWLH CCG EHS CCG H&R CCG DISEASE AND POOR HEALTH Hospital admissions due to liver disease (DSR per 100,000), 2012/ Hospital admissions due to liver disease, males (DSR per 100,000), 2012/ Hospital admissions due to liver disease, females (DSR per 100,000), 2012/ Hospital admissions for non-alcoholic fatty liver disease (DSR per 100,000), 2012/ New STI diagnosis rate (per 100,000), All new STI diagnoses (excl Chlamydia aged <25 yrs) (per 100, yrs), STI testing positivity (excl Chlamydia aged <25 yrs) (%), Chlamydia diagnostic rate (per 100,000), Chlamydia diagnostic rate (per 100, yrs), Genital herpes diagnosis rate (per 100,000), Genital warts diagnosis rate (per 100,000), Gonorrhoea diagnosis rate (per 100,000), Syphilis diagnosis rate (per 100,000), HIV diagnosed prevalence yrs (per 1,000), People presenting with HIV at a late stage of infection (%), Pelvic inflammatory disease admissions (per 100,000 females yrs), 2013/ A&E attendances due to unintentional and deliberate injury (DSR per 100,000), 2010/ Admissions due to burn injuries (DSR per 100,000), 2008/ / Admissions due to drowning or submersion (per 100,000), 2006/ / Admissions due to exposure to smoke, fire & flames injuries (DSR per 100,000), 2008/ / Admissions due to fall injuries (DSR per 100,000), 2010/ Admissions due to land transport injury (DSR per 100,000), Admissions due to motor vehicle traffic injury (DSR per 100,000), 2010/ Admissions due to poisoning injuries (DSR per 100,000), 2010/ Admissions due to serious head injury (DSR per 100,000), 2008/09 to 2010/ Admissions due to unintentional injury cause (DSR per 100,000), 2010/ Admissions due to unintentional poisoning injuries (DSR per 100,000), 2010/ Serious' unintentional injuries likely to require hospital admission (DSR per 100,000), 2010/ Pedestrian casualties (per 100,000), All road casualties (per 100,000), Hospital admissions for violence (DSR per 100,000 population), 2011/ / Drug misuse (estimated opiate and/or crack cocaine rate per 1,000 pop years), 2011/ People who inject drugs (per 1, yrs), 2011/ Adults in treatment at specialist drug misuse services (per 1, yrs), 2013/ Parents in drug treatment (per 100, yrs), 2011/ People entering prison with substance dependence issues previously not known to community treatment (%), 2012/ Successful completion of drug treatment - opiate users (%), Successful completion of drug treatment - non-opiate users (%), Persons who inject drugs who have received a hepatitis C test (%), 2012/ HWLH CCG Needs and Assets Profile 2015