Eglad Data - A New Generation Of Risk

Transcription

1 Alcohol ad drugs: JSNA support pack Key data to support plaig for effective alcohol prevetio, treatmet ad recovery ROTHERHAM ROTHERHAM

2 SUPPORTING INFORMATION The health harms associated with alcohol cosumptio i Eglad are widespread, with aroud 9 millio adults drikig at levels that pose some level of risk to their health. Because of the breadth of the problems, this pack provides a rage of alcohol related data i relatio to levels of harm ad the local alcohol treatmet system's respose. Usig a rage of key idicators, the pack aims to describe the extet of alcohol related problems at a local level usig data from the Alcohol Profiles for Eglad (LAPE). To fully uderstadig how your local alcohol system is respodig to these problems, locally ad atioally held data ca be used. Data relatig to local areas' targeted alcohol itervetios is ot collected atioally, but should be available at a local level ad a list of wider data sources is refereced below. Key performace iformatio about alcohol cliets i your local treatmet system are the preseted, alogside atioal data for compariso. The data is take from the Drug Treatmet Moitorig System (NDTMS) ad relates to cliets i Eglad who are i treatmet primarily for alcohol misuse. Detailed iformatio relatig to the methods used i calculatig all data items i this pack is available i the supportig documet 'Techical Defiitios for the Alcohol Data'. INVESTMENT AND VALUE FOR MONEY Fudig through the Public Health Grat allows local authorities to commissio Idetificatio ad Brief Advice (IBA) ad specialist treatmet for those with greater eeds. authorities ad Cliical Commissioig Groups ca work together to idetify potetial additioal fudig for hospital based services via Cliical Commissioig Groups. A 'Why Ivest' documet will be published alogside the JSNA packs to support the case for ivestmet i alcohol prevetio ad treatmet itervetios. LOCAL DATA TO REDUCE ALCOHOL RELATED HARM AND COMPARISON GROUPS The followig three sectios make data comparisos agaist a atioal bechmark ad usig a earest eighbour approach. The earest eighbour approach groups each local area with 15 other areas that are similar across a rage of demographic, socio-ecoomic ad geographic variables. Utilisig a earest eighbour approach allows for like-for-like comparisos of areas ad ca reveal patters i the data that would ot otherwise be see whe oly makig comparisos agaist a atioal bechmark. It is therefore importat to cosider both atioal ad earest eighbour comparisos whe iterpretig your data. All data has bee divided i to four equal groups (quartiles) i order to allocate levels of harm. Quartile oe, show i dark gree, is idicative of lower levels of alcohol related harm compared to the bechmark. Groups two ad three idicate icreasig levels of harm respectively, ad areas i quartile four (show i red) suggest areas have the highest levels of harm compared to the bechmark. 1 Least amout of harm Lower harm levels 3 Higher harm levels 4 Most amout of harm HOSPITAL ADMISSIONS DUE TO ALCOHOL The data reflects the geeral level of health harm from alcohol i the populatio. Hospital admissios ca be a result of casual regular alcohol use above lower-risk levels as well as chroic heavy drikig i the populatio ad is most likely to be foud i icreasig-risk drikers, higher-risk drikers, depedet drikers ad bige drikers. High levels of alcohol specific admissios clearly idicate levels of alcohol misuse. The rate of alcohol-related hospital admissios will be used as a idicator i the Public Health Outcome Framework. Some alcohol-related hospital admissios are specifically caused by alcohol while others are cotributed to by alcohol (attributable). 1 Least amout of harm Lower harm levels 3 Higher harm levels 4 Most amout of harm Measure Nearest Neighbour Group Measure Group Uder 18s hospital admissios (all geders, crude rate per 1 populatio) Admissio episodes (All geders, directly stadardised rate per 1) Alcohol attributable hospital admissios (All geders, crude rate per 1 populatio) /9 9/1 1/11 8/9 9/1 1/11 Alcohol specific hospital admissios (All geders, crude rate per 1 populatio) /9 9/1 1/11 8/9 9/1 1/11 PAGE OF 8

3 MORTALITY AND MONTHS OF LIFE LOST The data reflects the level of chroic heavy drikig i the populatio ad is most likely to be foud i higher-risk drikers ad depedet drikers. High rates of alcohol specific mortality ad mortality from chroic liver disease are likely to idicate a sigificat populatio who have bee drikig heavily ad persistetly over the past 1 3 years. Whilst alcohol misuse is the primary cause of liver disease, obesity is a growig sigificat causal factor. Broadly speakig alcohol attributable deaths make up aroud 3 of all deaths. Of these, about a third are alcohol specific deaths e.g. from alcohol poisoig, alcoholic liver disease, alcoholic pacreatitis. The remaiig alcohol-attributable deaths are from coditios partially attributed to alcohol, roughly two thirds of which are from chroic coditios e.g. Haemorrhagic stroke, Cardiac arrhythmias, Maligat eoplasm of oesophagus, with the remaider caused by acute cosequeces such as road traffic accidets or itetioal self-harm. 1 Least amout of harm Lower harm levels 3 Higher harm levels 4 Most amout of harm Moths of Life Lost Measure Nearest Neighbour Group Measure Group Moths of life lost (males) Females Males Moths of life lost (females) Measure Nearest Neighbour Group Measure Group Alcohol specific mortality (All geders, crude rate per 1 populatio) Liver mortality (All geders, crude rate per 1 populatio) Alcohol attributable mortality (All geders, crude rate per 1 populatio) PAGE 3 OF 8

4 ALCOHOL AND CRIME The data reflects the level of crime liked to drikig i the populatio ad is most likely to be foud i bige drikers, higher-risk drikers ad depedet drikers. Higher levels of alcohol-related recorded crimes ad violet crimes are likely to be sigificatly liked to bige drikers ad the ight-time ecoomy. It is ot possible to determie whether these drikers are icreasig risk, higher risk or depedet drikers however they are obviously drikig problematically. 1 Least amout of harm Lower harm levels 3 Higher harm levels 4 Most amout of harm Alcohol ad Crime 1 Measure Nearest Neighbour Group Measure Group Alcohol related recorded crime (Crude rate per 1 populatio) /1 1/11 11/1 Alcohol related violet crime (Crude rate per 1 populatio) /1 1/11 11/1 LOCAL DATA TO REDUCE WIDER ALCOHOL RELATED HARM Primary ad Secodary Care Data NHS Health check Directed Ehaced Service (DES) for Alcohol Hospital Episode Statistics (HES) Accidet ad Emergecy Data o violet icidets Public Health Outcomes Framework Wider Public Health Data Area Profiles for Eglad Smokig, Drikig ad Drug Use amog Youg People i Eglad, Drikig: Adults Behaviour ad Kowledge ad Statistics o Alcohol ealth/dh_4354 Health Profiles for Eglad ONS Alcohol-related deaths i the Uited Kigdom -9 Further Alcohol Treatmet Data Alcohol Treatmet Moitorig System Performace Reports PAGE 4 OF 8

5 WAITING TIMES This sectio provides iformatio relatig to the legth of time cliets waited to access alcohol treatmet for the first itervetio they received. People who eed alcohol treatmet eed prompt help if they are to recover from depedecy ad keepig waitig times low will play a vital role i supportig recovery from alcohol depedecy. ### Adults waitig uder three weeks to start treatmet is the proportio of adults waitig less tha 3 weeks to start treatmet i the ### year out of all cliets i treatmet durig the year Adults waitig over six weeks to start treatmet is the proportio of adults waitig more tha 6 weeks to start treatmet i the year out of all cliets i treatmet durig the year Uder 3 weeks Over 6 weeks DEMOGRAPHICS AND HEADLINE TREATMENT FIGURES The atioal average age of cliets i alcohol treatmet is 4 ad although there are more me tha wome i treatmet, the age distributio for both geders is very similar. This sectio shows the umber of people who were i alcohol treatmet i 1-13 ad whether they commeced treatmet i that year or were already i treatmet at the start of it. A supplemetary figure is provided which shows the umber of people i drug treatmet i 1-13 who stated that alcohol was a adjuctive problematic substace to other primary drug use. These people are ot icluded aywhere else i this report but will be receivig treatmet for alcohol depedecy as part of their drug treatmet. ### Number of adults i alcohol treatmet i # Number of adults startig ew alcohol treatmet i 1-13 * is the proportio of adults startig ew treatmet i the year out of all cliets i treatmet durig the year #### Number ad proportio of adults i drug treatmet i 1-13 who cite additioal problematic alcohol use Male Mea age ad geder of all adults i alcohol treatmet i 11-1 Female All Male Female All SAFEGUARDING Approximately oe i three of Eglad's alcohol treatmet populatio has a child livig with them at least some of the time. The 4 Alcohol Harm Reductio Strategy for Eglad (Cabiet Office) estimated that 1.3 millio childre uder 16 i Eglad are affected by parets whose drikig is classified as either harmful or depedet. A estimated.6 millio childre () i the UK are livig with parets who are drikig hazardously ad 75, (6) are livig with depedet drikers (Maig, V. et. al. (9) New estimates o the umber of childre livig with substace-misusig parets: Results from UK atioal household surveys. Joural of Public Health, 9 (1), pp ). Adults receivig alcohol treatmet who are i cotact with childre Livig with childre * Parets but ot livig with childre * Icomplete Data *ote: proportios here are calculated out of total cliets with completed data rather tha all cliets i treatmet ### ### Livig with childre Paret ot livig with childre Icomplete data PAGE 5 OF 8

6 EMPLOYMENT The data below shows the employmet status of people startig treatmet i your area i Beig i work or udertakig meaigful activity is strogly associated with improved recovery outcomes, as is accessig educatio ad traiig. However, the majority of people i drug ad alcohol treatmet will require sigificat support to address their educatio, traiig ad employmet eeds ad to get them job ready. The data below helps illustrate the scale of this challege i your area. PHE will supply more iformatio o this to support your eeds assessmet, i the form of treatmet data matched with the Labour Market System (LMS) beefits data held by DWP. Joit workig betwee your local treatmet ad educatio ad employmet support services (Jobcetre Plus ad Work Programme providers) is key to meetig this challege. Employmet status at the start of treatmet Proportio of Proportio of 5 eligible cliets eligible cliets 4 EMPST Regular employmet , Uemployed 4 1 5, Log term sick or ,5 disabled Employed Uemployed Sick / disabled DRINKING LEVELS AND ADDITIONAL SUBSTANCES USED This sectio shows the umber of people drikig at higher risk levels, the umber of uits cosumed i the 8 days prior to treatmet ad the umber of people usig additioal substaces to alcohol. Higher risk drikig is defied here as wome drikig more tha 14 uits per moth ad me drikig more tha uits per moth ad is i lie with the Govermet's defiitio of weekly higher risk cosumptio levels (5 uits per week for me ad 35 uits per week for wome). Drikig at higher risk levels icreases the risk of alcohol related disease. For example, the risk of liver disease is icreased by 13 times. Risk of coroary heart disease is icreased by 1.7 times for me ad 1.3 times for wome. Although the majority of cliets cite usig alcohol i the moth prior to treatmet, 9 atioally cite o alcohol use. There are several reasos why this could be the case: they may have bee referred to treatmet directly from the crimial justice system or they may be i treatmet to maitai abstiece ad relapse-prevetio. Additioal use of opiates ad crack are metioed here as they are ofte used by cliets with the most complex problems. Caabis is also show separately as it is the most commo adjuctive substace cited by alcohol cliets i treatmet. 591 Drikig at higher risk levels i the 8 days prior to eterig ### treatmet *ote: proportios here are calculated out of total cliets with completed data rather tha all cliets i treatmet Uits cosumed i the 8 days prior to eterig treatmet Over * * *ote: proportios here are calculated out of total cliets with completed data rather tha all cliets i treatmet Missig 9 3 Proportio of cliets by drikig levels prior to treatmet Missig Other substace use i additio to alcohol Additioally usig opiates or crack Additioally usig caabis Additioally usig other drugs (ot opiates, crack or caabis) *ote: cliets may cite more tha oe additioal substace ad are couted oce uder each relevat category. Therefore the sum of does ot ecessarily match the i the graph which couts cliets oce regardless of umber of additioal substaces cited Opiates/Crack Caabis Other drugs PAGE 6 OF 8

7 COMPOUNDING ISSUES IN THE TREATMENT POPULATION May adults i alcohol treatmet experiece complex ad wide-ragig problems. The 11 data items described below provide a overview of these. This is iteded to give a impressio of the additioal characteristics of the people treated locally ad idetify issues which may warrat further ivestigatio. Compoudig issues 1 Also usig opiates ad/or crack Usig aother drug (ot opiates/crack) Has had 3 or more courses of treatmet Has a housig issue at the start of treatmet ### Is receivig care from metal health services for reasos other tha substace misuse Is uemployed at start of treatmet Referred from the crimial justice system Lives with childre Is pregat ### Has also received/is receivig structured treatmet for drug use (other tha alcohol) * cells highlighted red idicate that completio rates for this complexity item are below 8 ad results should be iterpreted with cautio of idividuals meetig each complexity item 5 1 RESIDENTIAL REHAB The data below shows the umber of adult alcohol users i your area who have bee to residetial rehab durig their latest period of treatmet (as a proportio of your whole treatmet populatio ad agaist the atioal proportio). Structured alcohol treatmet mostly takes place i the commuity, ear to users families ad support etworks. However, i lie with NICE recommedatios, a stay i residetial rehab is appropriate for the most serious cases, ad local areas are ecouraged to provide this optio as part of a itegrated recoveryorietated system. Number of adults who atteded residetial rehab Proportio of treatmet populatio 9 4,38 Proportio of treatmet populatio LENGTH OF TIME IN TREATMENT A course of alcohol treatmet ca ivolve oe or more differet types of itervetio. The umber of cliets receivig each itervetio type durig their course of treatmet is show i this sectio. Cliets may receive more tha oe itervetio type durig their treatmet ad are couted oce for each type they receive. As a result percetages sum to greater tha 1. The most commo type of itervetios atioally are psychosocial itervetios ad other structured treatmet. Legth of time i treatmet Uder 3 moths Betwee 3 ad 6 moths Betwee 6 ad 1 moths Over 1 year Average (days) Over 1 year Over 1 year () () Betwee 6 ad 1 moths Betwee 3 ad 6 moths Uder 3 moths Betwee 6 ad 1 moths Betwee 3 ad 6 moths Uder 3 moths PAGE 7 OF 8

8 TREATMENT OUTCOMES The followig sectio relates to cliets completig their period i treatmet i 1-13, ad whether they completed successfully ad did ot retur withi 6 moths. The Govermet's alcohol strategy states that icreasig effective treatmet for depedet drikers will offer the most immediate opportuity to reduce alcohol-related admissios ad costs to the NHS. Although there is o sigle measure of effective treatmet for alcohol depedecy, the followig data demostrates how well the curret system is workig i treatig those who are receivig structured treatmet. The legth of a typical treatmet period was aroud 6 moths, although atioally 13 of cliets remaied i treatmet for more tha 1 year. Retaiig cliets for their full course of treatmet is importat i order to icrease the levels of successful treatmet completio ad reduce rates of early treatmet drop out. Coversely, havig a high proportio of cliets i treatmet for more tha a year may idicate that they are ot movig effectively through ad out of the treatmet system. The successful completios data provides a idicatio of the effectiveess of the treatmet system i your area. A high umber of successful completios ad a low umber of represetatios to treatmet idicate that your treatmet services are respodig well to the eeds of those i treatmet. 66 The umber of adults leavig alcohol treatmet i 1-13 * *ote: is the umber who left i the year out of all cliets i treatmet i the year ### Cliets completig treatmet successfully i of all exits of all i treatmet ### Cliets completig treatmet successfully (betwee 1st Jauary 1 ad 31st december 1) ad ot returig withi 6 moths *ote that i order to allow for a represetatio period, the treatmet populatio time period refers to the caledar year rather tha the fiacial year used i the rest of this report. Therefore the umber of completios will differ from that i the above item which refers to the fiacial year Please ote that the percetages give i this pack are rouded to the earest per cet. Totals may ot add up to 1 due to roudig. RESTRICTED STATISTICS You are remided that the alcohol data provided i this documet are official statistics to which you have privileged access i advace of release. Such access is carefully cotrolled ad is provided for maagemet, quality assurace, ad briefig purposes oly. Release ito the public domai or ay public commet o these statistics prior to official publicatio plaed for 16th October 13 would udermie the itegrity of official statistics. Ay accidetal or wrogful release should be reported immediately ad may lead to a iquiry. Wrogful release icludes idicatios of the cotet, icludig descriptios such as "favourable" or "ufavourable". If i doubt you should cosult Malcolm Roxburgh or Joatha Kight, via EvideceApplicatioTeam@phe.gov.uk, who ca advise. Please prevet iappropriate use by treatig this iformatio as restricted, refrai from passig iformatio o to others who have ot bee give prior access ad use it oly for the purposes for which it has bee provided. If you ited to publish figures from the JSNA after 16th October you must restrict figures less tha 5 ay ay associated figures to prevet deductive disclosure. The restricted status of this data will be lifted after the release of the Alcohol Aual Report o 16th October 13. PAGE 8 OF 8