Public Health Outcomes Framework – South Northamptonshire · lost due to sickness absence...

May

2017 Public Health Outcomes Framework – South Northamptonshire

Produced by Specialist Public Health (SPH) and

Business Intelligence & Project Mangement (BI&PM) 1

Contents

Introduction ............................................................................................................................................ 1

Overarching Indicators ........................................................................................................................... 8

Domain 1: Wider Determinants of Health ............................................................................................. 9

Domain 2: Health Improvement .......................................................................................................... 12

Domain 3: Health Protection ............................................................................................................... 17

Domain 4: Healthcare and premature mortality ................................................................................ 18

Appendix A ........................................................................................................................................... 23

Appendix B ............................................................................................................................................ 23

Introduction

The Public Health Outcomes Framework sets out the desired outcomes to help understand how well public

health is being improved and protected. The framework has overarching indicators and four domains

covering the spectrum of public health.

Data is published by Public Health England on a quarterly cycle and is available at www.phoutcomes.info.

This is the local quarterly report which represents the May 2017 update. It also provides a summary profile

with key specialist public health actions currently in place to address these outcomes. Local indicators have

been included as supporting information where possible and appropriate.

For the full list of indicators by the county and districts and their comparison with the England average please

see Appendix. For information on what has been updated for each indicator in November please see Error!

Reference source not found..

We welcome any feedback on these reports; please send any comments to

[email protected]

Key

Statistically significant drop in value compared to

previous data period where less is better

Statistically significant increase in value compared to

previous data period where more is better

Drop in value compared to previous data period but

not statistically significant

Increase in value compared to previous data period

but not statistically significant

Statistically significant drop in value compared to

previous data period where less is worse

Statistically significant increase in value compared to

previous data period where more is worse

May




Executive Summary

This summary shows the indicators grouped by three categories: in line or better than England, of concern,

and action required.

In line with or better than England – Indicators significantly better or in line with England and showing

improvement.

Domain South Northamptonshire

DOT

since last

period

DOT

since

baseline

Commentary

Overarching 0.1ii - Life expectancy at 65 - Female �� Significantly higher than England and

trend increasing

0.1ii - Life expectancy at birth - Female �� Significantly higher than England and

trend increasing

0.2iii - Slope index of inequality in life expectancy at

birth within English local authorities, based on local

deprivation deciles within each area - Male

�� Trend decreasing

0.2iv - Gap in life expectancy at birth between each

local authority and England as a whole - Female ��

Significantly higher than England and

trend increasing

Wider

determinants

1.08i - Gap in the employment rate between those

with a long-term health condition and the overall

employment rate

�� Trend decreasing

1.08iv - Percentage of people aged 16-64 in

employment - Female ��

Not significantly different to England

and trend increasing


employment - Persons ��


trend increasing

1.09i - Sickness absence - the percentage of employees

who had at least one day off in the previous week ��


and trend decreasing

1.09ii - Sickness absence - the percent of working days

lost due to sickness absence ��

Significantly lower than England and

trend decreasing

1.14i - The rate of complaints about noise �� Significantly lower than England and

trend decreasing

Health

improvement

2.06ii - Child excess weight in 4-5 and 10-11 year olds -

10-11 year olds ��


trend decreasing

2.07i - Hospital admissions caused by unintentional

and deliberate injuries in children (aged 0-14 years) ��




and deliberate injuries in children (aged 0-4 years) ��


trend decreasing

2.10ii - Emergency Hospital Admissions for Intentional

Self-Harm - Male ��



2.11i - Proportion of the population meeting the

recommended '5-a-day' on a 'usual day' (adults) ��


trend increasing

2.11ii - Average number of portions of fruit consumed

daily (adults) ��


trend increasing

2.18 - Admission episodes for alcohol-related

conditions - narrow definition - Female ��


trend decreasing

May





DOT

since last

period

DOT

since

baseline

Commentary


conditions - narrow definition - Male ��


trend decreasing


conditions - narrow definition - Persons ��


trend decreasing

2.19 - Cancer diagnosed at early stage (experimental

statistics) �� Trend increasing

2.20iii - Cancer screening coverage - bowel cancer �� Significantly higher than England and

trend significantly increasing

2.20iv - Abdominal Aortic Aneurysm Screening -

Coverage - Male ��


trend increasing

2.24iii - Emergency hospital admissions due to falls in

people aged 65 and over - aged 80+ - Female ��



Health

protection

3.01 - Fraction of mortality attributable to particulate

air pollution �� Trend decreasing

3.02 - Chlamydia detection rate (15-24 year olds) -

Female ��


Male ��

3.05ii - Incidence of TB �� Below target and trend decreasing

3.08 - Adjusted antibiotic prescribing in primary care

by the NHS ��

Below target and trend significantly

decreasing

Healthcare and

premature

mortality

4.03 - Mortality rate from causes considered

preventable - Female ��


trend decreasing


preventable - Male ��


trend decreasing


preventable - Persons ��


trend decreasing

4.04i - Under 75 mortality rate from all cardiovascular

diseases - Female ��


trend decreasing


diseases - Male ��


trend decreasing


diseases - Persons ��


trend decreasing

4.05i - Under 75 mortality rate from cancer - Female �� Significantly lower than England and

trend decreasing

4.05i - Under 75 mortality rate from cancer - Male �� Not significantly different to England


4.05i - Under 75 mortality rate from cancer - Persons �� Significantly lower than England and

trend decreasing

4.05ii - Under 75 mortality rate from cancer

considered preventable - Female ��



May





DOT

since last

period

DOT

since

baseline

Commentary


considered preventable - Male ��


trend decreasing


considered preventable - Persons ��


trend decreasing

4.06i - Under 75 mortality rate from liver disease -

Persons ��


trend decreasing

4.06ii - Under 75 mortality rate from liver disease

considered preventable - Persons ��

Significantly lower than England, no

trend data

4.07ii - Under 75 mortality rate from respiratory

disease considered preventable - Persons ��

Significantly lower than England, no

trend data

4.08 - Mortality rate from a range of specified

communicable diseases, including influenza - Persons ��



4.11 - Emergency readmissions within 30 days of

discharge from hospital - Female ��


trend decreasing

4.14i - Hip fractures in people aged 65 and over -

Female ��



4.14i - Hip fractures in people aged 65 and over - Male �� Not significantly different to England



Persons ��



4.14ii - Hip fractures in people aged 65 and over - aged

65-79 - Persons ��



4.14iii - Hip fractures in people aged 65 and over -

aged 80+ - Female ��




aged 80+ - Persons ��



4.15ii - Excess winter deaths index (single year, age

85+) - Female ��




85+) - Persons ��



Of Concern – Indicators significantly better or in line with England but not showing an improvement, and

those significantly worse but showing an improvement.


DOT

since last

period

DOT

since

baseline

Commentary

Overarching 0.1ii - Life expectancy at 65 - Male �� Significantly higher than England and

trend decreasing

0.1ii - Life expectancy at birth - Male �� Significantly higher than England and

trend decreasing

May





DOT

since last

period

DOT

since

baseline

Commentary



deprivation deciles within each area - Female

�� Trend increasing


local authority and England as a whole - Male ��


trend decreasing

Wider

determinants

1.01i - Children in low income families (all dependent

children under 20) ��



1.01ii - Children in low income families (under 16s) �� Significantly lower than England and


1.03 - Pupil absence �� Significantly lower than England and

trend increasing


employment - Male ��


trend decreasing

1.10 - Killed and seriously injured (KSI) casualties on

England's roads ��


trend decreasing

1.12i - Violent crime (including sexual violence) -

hospital admissions for violence - Male ��


trend increasing


hospital admissions for violence - Persons ��


trend increasing

1.12ii - Violent crime (including sexual violence) -

violence offences per 1,000 population �� Trend increasing

1.12iii- Violent crime (including sexual violence) - rate

of sexual offences per 1,000 population �� Trend increasing

1.13i - Re-offending levels - percentage of offenders

who re-offend �� Trend increasing

1.13ii - Re-offending levels - average number of re-

offences per offender �� Trend increasing

1.15ii - Statutory homelessness - households in

temporary accommodation ��


trend increasing

1.17 - Fuel poverty �� Significantly lower than England and


Health

improvement 2.01 - Low birth weight of term babies ��



2.04 - Under 18 conceptions �� Significantly lower than England and

trend increasing

2.06i - Child excess weight in 4-5 and 10-11 year olds -

4-5 year olds ��


trend increasing


Self-Harm - Female ��




Self-Harm - Persons ��



2.11iii - Average number of portions of vegetables

consumed daily (adults) ��



May





DOT

since last

period

DOT

since

baseline

Commentary

2.12 - Excess weight in Adults �� Not significantly different to England,

no trend data

2.13i - Percentage of physically active and inactive

adults - active adults ��



2.13ii - Percentage of physically active and inactive

adults - inactive adults ��


trend increasing

2.14 - Smoking Prevalence in adult in routine and

manual occupations - current smokers (APS) ��



2.14 - Smoking Prevalence in adults - current smokers

(APS) ��


trend increasing

2.17 - Recorded diabetes �� Significantly lower than England and

trend increasing

2.20i - Cancer screening coverage - breast cancer �� Significantly higher than England and

trend decreasing

2.20ii - Cancer screening coverage - cervical cancer �� Significantly higher than England and

trend decreasing

2.24i - Emergency hospital admissions due to falls in

people aged 65 and over - Male ��




people aged 65 and over - Persons ��



2.24ii - Emergency hospital admissions due to falls in

people aged 65 and over - aged 65-79 - Male ��




people aged 65 and over - aged 65-79 - Persons ��




people aged 65 and over - aged 80+ - Male ��




people aged 65 and over - aged 80+ - Persons ��



Healthcare and

premature

mortality

4.01 - Infant mortality �� Not significantly different to England


4.02 - Proportion of five year old children free from

dental decay ��



4.04ii - Under 75 mortality rate from cardiovascular

diseases considered preventable - Female ��

Not significantly different to England,

no trend data


diseases considered preventable - Male ��


trend increasing


diseases considered preventable - Persons ��


trend increasing

4.07i - Under 75 mortality rate from respiratory

disease - Female ��

Not significantly different to England,

no trend data


disease - Male ��



May





DOT

since last

period

DOT

since

baseline

Commentary


disease - Persons ��


trend increasing


discharge from hospital - Male ��




discharge from hospital - Persons ��


trend increasing

4.13 - Health related quality of life for older people �� Not significantly different to England


4.15i - Excess winter deaths index (single year, all ages)

- Female ��




- Male ��




- Persons ��




85+) - Male ��



4.15iii - Excess winter deaths index (3 years, all ages) -

Female ��




Male ��



4.15iv - Excess winter deaths index (3 years, age 85+) -

Female ��




Male ��




Persons ��



Action Required – Indicators significantly worse than England and not improving.


DOT

since last

period

DOT

since

baseline

Commentary

Health

improvement

2.07ii - Hospital admissions caused by unintentional

and deliberate injuries in young people (aged 15-24

years)

�� Significantly higher than England and

trend increasing


people aged 65 and over - Female ��


trend increasing


people aged 65 and over - aged 65-79 - Female ��


trend increasing

Health

protection


Persons �� Below target and trend decreasing

Healthcare and

premature

mortality


Persons ��


trend increasing

May




Overarching Indicators

The overarching indicators are important summary measures of mortality and morbidity and inequalities in

life expectancy.

Indicator

Unit of

measure-

ment

Tolerance:

lower or

higher is

better?

Latest

Period Values 95% CIs

DOT

since

last

period

DOT

since

base-

line

0.1ii - Life expectancy at 65 - Female Years Higher 2013 -

15 22.2 21.7 - 22.7 ��

0.1ii - Life expectancy at 65 - Male Years Higher 2013 -

15 19.6 19.1 - 20.1 ��

0.1ii - Life expectancy at birth - Female Years Higher 2013 -

15 84.9 84.2 - 85.6 ��

0.1ii - Life expectancy at birth - Male Years Higher 2013 -

15 80.9 80.1 - 81.7 ��



deprivation deciles within each area - Female

Years NA 2013 -

15 4.4 1.8 - 6.9 ��



deprivation deciles within each area - Male

Years NA 2013 -

15 1.4 -1.5 - 4.2 ��


local authority and England as a whole - Female Years Higher

2013 -

15 1.7 1.0 - 2.5 ��


local authority and England as a whole - Male Years Higher

2013 -

15 1.4 0.6 - 2.2 ��

Commentary

South Northamptonshire’s 2013-15 life expectancies at birth and at age 65 for both males and females were

significantly better than the national averages. There have not been any significant changes in life expectancy

compared to the 2009-11 baseline, but the male life expectancies have been on a decreasing trend and the

female life expectancies have been increasing.

The slope index of inequalities (SII) in life expectancy was a new indicator in PHOF from February 2016. It

has been added to provide a local measure of inequality in life expectancy at birth. The SII measures how

• The average number of years a person would expect to live if they experience the

age specific death rates for that area througout their life.

0.1ii Life Expectancy at birth

• The average number of years at age 65 a person would expect to live if they

experience the age specific death rates for that area throughout their life.

0.1iii Life expectancy at age 65

May




much life expectancy varies with deprivation. It takes account of health inequalities across the whole range

of deprivation within the local authority. The SII for females has increased from 1.6 in 2010-12 to 4.4 in 2013-

15; for males, the SII has decreased from 3.5 to 1.4 in the same period.

The gap in life expectancy at birth between South Northamptonshire and England is 1.5 years for females

and 2.5 years for males. These indicators have not changed significantly compared to 2009-11.

Of Concern:

• Life expectancy (male)

• Gap in life expectancy at birth between each local authority and England as a whole

Domain 1: Wider Determinants of Health

Indicator

Unit of

measure-

ment

Tolerance:

lower or

higher is

better?

Latest


DOT

since

last

period

DOT

since

base-

line

1.01i - Children in low income families (all

dependent children under 20) % Lower 2014 6.8 6.5 - 7.2 ��

1.01ii - Children in low income families (under 16s) % Lower 2014 7.0 6.6 - 7.4 ��

1.03 - Pupil absence % Lower 2014/

15 4.1 3.8 - 4.4 ��

1.08i - Gap in the employment rate between those

with a long-term health condition and the overall

employment rate

Percent-

age point Lower

2015/

16 -6.7 - ��


employment - Female % Higher

2015/

16 72.4 63.0 - 81.8 ��


employment - Male % Higher

2015/

16 90.3 83.8 - 96.8 ��


employment - Persons % Higher

2015/

16 81.2 75.3 - 87.1 ��

1.09i - Sickness absence - the percentage of

employees who had at least one day off in the

previous week

% Lower 2012 -

14 1.6 0.6 - 4.1 ��

1.09ii - Sickness absence - the percent of working

days lost due to sickness absence % Lower

2012 -

14 0.4 0.1 - 0.9 ��

1.10 - Killed and seriously injured (KSI) casualties on

England's roads

Crude rate

per

100,000

Lower 2013 -

15 70.3 60.6 - 81.2 ��


hospital admissions for violence - Female

DSR per

100,000 Lower

2013/

14 -

15/16

- - ��


hospital admissions for violence - Male

DSR per

100,000 Lower

2013/

14 -

15/16

34.9 24.7 - 47.9 ��

May




Indicator

Unit of

measure-

ment

Tolerance:

lower or

higher is

better?

Latest


DOT

since

last

period

DOT

since

base-

line


hospital admissions for violence - Persons

DSR per

100,000 Lower

2013/

14 -

15/16

19.1 13.9 - 25.6 ��

1.12ii - Violent crime (including sexual violence) -

violence offences per 1,000 population

Crude rate

per 1000 NA

2015/

16 12.0 11.5 - 12.5 ��

1.12iii- Violent crime (including sexual violence) -

rate of sexual offences per 1,000 population

Crude rate

per 1000 NA

2015/

16 1.3 1.2 - 1.5 ��

1.13i - Re-offending levels - percentage of offenders

who re-offend % NA 2014 15.1 11.5 - 19.5 ��

1.13ii - Re-offending levels - average number of re-

offences per offender

Crude rate

per

offender

NA 2014 0.5 0.4 - 0.6 ��

1.14i - The rate of complaints about noise Crude rate

per 1000 Lower

2014/

15 4.2 3.8 - 4.7 ��

1.15i - Statutory homelessness - Eligible homeless

people not in priority need

Crude rate

per 1000 Lower

2015/

16 - - ��

1.15ii - Statutory homelessness - households in

temporary accommodation

Crude rate

per 1000 Lower

2015/

16 0.5 0.3 - 0.8 ��

1.17 - Fuel poverty % Lower 2014 9.5 9.2 - 9.8 ��

Commentary

Children in low income families: The proportion of children in low income families in South

Northamptonshire has consistently been significantly lower than the national average since the 2010

baseline, both in all dependent children under 20, and in under 16s. In 2014, 6.8% of all dependent children

under 20 and 7.0% of under 16s were in low income families, compared to the national averages of 19.1%

and 20.1%, respectively. Both indicators increased compared to 2013, but the differences are not statistically

significant and the England averages also increased during this period.

Pupil absence: At 4.08%, the percentage of half days missed by pupils due to overall absence in South

Northamptonshire in 2014/15 was significantly lower than the national average of 4.62. There was a slight

increase between 2013/14 and 2014/15, but this was not statistically significant and overall there has been

a downwards trend since the baseline of 4.62% in 2010/11.

Employment in 16-64 year olds: Overall, the proportion of people in employment was significantly higher

than the national average and increased from 80.7% in 2014/15 to 81.2% in 2015/16, although this

difference is not statistically significant. There has been an increase in the proportion of adults in

employment compared to the baseline in 2011/12, but the difference is not statistically significant. The

proportion of males in employment was significantly higher than the national average, whereas the

proportion of females in employment was similar to the national average.

May




The gap in employment rate between people with a long-term health condition and the overall employment

rate was -6.7 percentage points in 2015/16, down from 7.7 percentage points in 2014/15 and below the

national average of 8.8. Confidence intervals are not provided for this indicator so it is not possible to

determine statistical significance.

Sickness absence: The percentage of employees who had at least one day off in the previous week was

similar to the national average at 1.6% compared to 2.4%, while the the percentage of working days lost due

to sickness absence was significantly lower than the national average at 0.4% compared to 1.5%. Both

indicators have decreased between 2009-11 and 2012-14, but the differences are not statistically significant.

Killed and seriously injured (KSI) on roads: At 70.3 per 100,000 population, South Northamptonshire’s 2012-

14 rate of people KSI on roads was significantly higher than the national average of 38.5 per 100,000. There

has been a decrease compared to the baseline rate of 76.3 in 2009-11, but this change is not statistically

significant.

Violent crime: South Northamptonshire’s rate of hospital admissions for violent crime was 19.1 per 100,000

population in 2013/14-15/16, which was significantly lower than the national average of 47.5. There has

been an increasing trend since the baseline of 2010/11-12/13, when the rate was 15.5, but this difference is

not statistically significant.

The rates of violent offences and sexual offences have increased significantly both locally and nationally since

2013/14. In 2015/16 South Northamptonshire’s rates of violent offences and sexual offences were

significantly lower than the national averages. These indicators are not RAG rated as they may be influenced

by recording practices.

Re-offending levels: In 2014, 15.1% of South Northamptonshire’s offenders went on to re-offend, which was

significantly lower the national average of 25.4%. There has been a decrease compared to the 2010 baseline

of 17.5%, but this difference is not statistically significant.

The average number of re-offences per offender was 0.50, which is a slight increase compared to 2013 and

the 2010 baseline; the differences are not statistically significant. The local rate for 2014 was significantly

lower than the national average of 0.82.

Complaints about noise: South Northamptonshire’s rate of complaints about noise for 2014/15 was 4.2 per

1,000 population, which has not changed significantly compared to the baseline of 4.1 per 1,000 population

in 2010/11. The rate of complaints has consistently been significantly lower than the national average since

baseline.

Homelessness: South Northamptonshire’s rate of eligible homeless people not in priority need has not been

calculated since 2012/13 due to low numbers; at that time, it was 0.2 per 1,000 population, which was

significantly lower than the national average.

The rate of households in temporary accommodation has remained relatively steady since 2012/13 and at

0.5 per 1,000 population in 2015/16 it was significantly lower than the national average of 3.1.

May




Fuel poverty: The proportion of households in South Northamptonshire experiencing fuel poverty has

increased significantly from 8.1% in 2013 to 9.5% in 2014. However, compared to the baseline of 11.2% in

2011, the proportion has decreased significantly. The current proportion in fuel poverty was significantly

lower than the national average of 10.6%.

Of Concern:

• Children in low income families

• Pupil absence

• Employment rate

• Killed and seriously injured on roads

• Violent crime

• Re-offending levels

• Statutory homelessness – households in temporary accommodation

• Fuel poverty

Domain 2: Health Improvement

Indicator

Unit of

measure-

ment

Tolerance:

lower or

higher is

better?

Latest


DOT

since

last

period

DOT

since

base-

line

2.01 - Low birth weight of term babies % Lower 2015 1.7 1.0 - 2.9 ��

2.02i - Breastfeeding - breastfeeding initiation % Higher 2014/

15 - - ��

2.02ii - Breastfeeding - breastfeeding prevalence at

6-8 weeks after birth - historical method % Higher

2014/

15 - - ��

2.04 - Under 18 conceptions Crude rate

per 1000 Lower 2015 10.8 6.3 - 17.3 ��

2.06i - Child excess weight in 4-5 and 10-11 year olds

- 4-5 year olds % Lower

2015/

16 17.6 15.3 - 20.1 ��

2.06ii - Child excess weight in 4-5 and 10-11 year

olds - 10-11 year olds % Lower

2015/

16 26.5 23.8 - 29.3 ��


and deliberate injuries in children (aged 0-14 years)

Crude rate

per

10,000

Lower 2015/

16 101.1

86.0 -

117.9 ��


and deliberate injuries in children (aged 0-4 years)

Crude rate

per

10,000

Lower 2015/

16 95.0

69.8 -

126.4 ��

2.07ii - Hospital admissions caused by unintentional

and deliberate injuries in young people (aged 15-24

years)

Crude rate

per

10,000

Lower 2015/

16 159.7

134.6 -

188.1 ��

2.10ii - Emergency Hospital Admissions for

Intentional Self-Harm - Female

DSR per

100,000 Lower

2015/

16 259.8

211.6 -

315.4 ��

May




Indicator

Unit of

measure-

ment

Tolerance:

lower or

higher is

better?

Latest


DOT

since

last

period

DOT

since

base-

line


Intentional Self-Harm - Male

DSR per

100,000 Lower

2015/

16 116.9

84.7 -

156.9 ��


Intentional Self-Harm - Persons

DSR per

100,000 Lower

2015/

16 184.3

155.6 -

216.6 ��

2.11i - Proportion of the population meeting the

recommended '5-a-day' on a 'usual day' (adults) % Higher 2015 61.3 55.3 - 66.9 ��

2.11ii - Average number of portions of fruit

consumed daily (adults) Mean Higher 2015 2.8 2.6 - 3.0 ��

2.11iii - Average number of portions of vegetables

consumed daily (adults) Mean Higher 2015 2.4 2.2 - 2.6 ��

2.12 - Excess weight in Adults % Lower 2013 -

15 66.6 64.0 - 69.1 ��

2.13i - Percentage of physically active and inactive

adults - active adults % Higher 2015 63.6 59.5 - 67.8 ��

2.13ii - Percentage of physically active and inactive

adults - inactive adults % Lower 2015 20.6 17.1 - 24.1 ��

2.14 - Smoking Prevalence in adult in routine and

manual occupations - current smokers (APS) % Lower 2015 26.8 10.7 - 42.9 ��

2.14 - Smoking Prevalence in adults - current

smokers (APS) % Lower 2015 12.2 7.5 - 16.8 ��

2.15iv - Deaths from drug misuse DSR per

100,000 Lower

2013 -

15 - - ��

2.17 - Recorded diabetes % Lower 2014/

15 5.4 5.3 - 5.6 ��


conditions - narrow definition - Female

DSR per

100,000 Lower

2015/

16 395.9

338.9 -

459.6 ��


conditions - narrow definition - Male

DSR per

100,000 Lower

2015/

16 609.0

535.8 -

689.3 ��


conditions - narrow definition - Persons

DSR per

100,000 Lower

2015/

16 495.9

449.9 -

545.2 ��

2.19 - Cancer diagnosed at early stage (experimental

statistics) % NA 2015 58.2 52.8 - 63.3 ��

2.20i - Cancer screening coverage - breast cancer % Higher 2016 82.6 81.9 - 83.3 ��

2.20ii - Cancer screening coverage - cervical cancer % Higher 2016 79.1 78.6 - 79.6 ��

2.20iii - Cancer screening coverage - bowel cancer % Higher 2016 62.5 61.7 - 63.3 ��

2.20iv - Abdominal Aortic Aneurysm Screening -

Coverage - Male % Higher

2015/

16 88.4 85.3 - 91.0 ��


people aged 65 and over - Female

DSR per

100,000 Lower

2015/

16 2804.2

2473.8 -

3166.1 ��

May




Indicator

Unit of

measure-

ment

Tolerance:

lower or

higher is

better?

Latest


DOT

since

last

period

DOT

since

base-

line


people aged 65 and over - Male

DSR per

100,000 Lower

2015/

16 1863.8

1550.3 -

2220.8 ��


people aged 65 and over - Persons

DSR per

100,000 Lower

2015/

16 2378.5

2149.2 -

2625.4 ��


people aged 65 and over - aged 65-79 - Female

DSR per

100,000 Lower

2015/

16 1521.2

1227.9 -

1862.9 ��


people aged 65 and over - aged 65-79 - Male

DSR per

100,000 Lower

2015/

16 786.7

579.5 -

1043.1 ��


people aged 65 and over - aged 65-79 - Persons

DSR per

100,000 Lower

2015/

16 1156.9

973.7 -

1364.2 ��

2.24iii - Emergency hospital admissions due to falls

in people aged 65 and over - aged 80+ - Female

DSR per

100,000 Lower

2015/

16 6524.9

5580.7 -

7582.8 ��


in people aged 65 and over - aged 80+ - Male

DSR per

100,000 Lower

2015/

16 4987.4

3945.4 -

6215.7 ��


in people aged 65 and over - aged 80+ - Persons

DSR per

100,000 Lower

2015/

16 5921.0

5213.0 -

6698.2 ��

Commentary

Low birth weight of term babies: In 2015, 1.7% of live births in South Northamptonshire were low birth

weight, which was not significantly different to the national average of 2.8%. There has been an decrease

from 1.4% in 2014 and while the difference is not statistically significant the indicator has gone from green

to amber as a result.

Breastfeeding: Prevalence of breastfeeding initiation and breastfeeding at 6-8 weeks after birth have not

been published for South Northamptonshire due to data quality issues.

Teenage conceptions: The rate of under 18 conceptions in South Northamptonshire was 10.8 per 1,000

population in 2014, which was significantly lower than the national average of 22.8 per 1,000. The rate

increased very slightly compared to 10.7 per 1,000 in 2014; this is not statistically significant. There has been

an overall downwards trend since the baseline of 17.4 per 1,000 in 2010.

Excess weight in children: In 2015/16, the proportion of 4 to 5 year olds who were overweight or obese was

significantly lower than the national average at 17.6% compared to 22.1%. There has been an increase

compared to 17.1% in 2014/15, but this is not statistically significant and overall there has been a downwards

trend since the 2010/11 baseline.

The proportion of 10 to 11 year olds who were overweight or obese has decreased from 30.2% in 2014/15

to 26.5% in 2015/16. While this decrease is not statistically significant, the proportion is significantly lower

than the national rate and so the indicator has gone from amber to green as a result.

May




Hospital admissions caused by unintentional and deliberate injuries in children: In 2015/16, South

Northamptonshire’s rate of hospital admissions caused by unintentional and deliberate injuries in children

aged 0 to 14 was similar to the national average at 101.1 per 10,000 population compared to 104.2 per

10,000. The rate for children aged 0 to 4 was significantly lower than the national average and had decreased

compared to 2014/15, albeit not significantly. The rate for 15 to 24 year olds was significantly higher than

the national average at 159.7 per 10,000 population compared to 134.1 per 10,000.

Emergency hospital admissions for intentional self-harm: South Northamptonshire’s 2015/16 rate of

emergency admissions for intentional self-harm was similar to the national average at 184.3 per 100,000

compared to 196.5 per 100,000. There have been no significant changes since the 2010/11 baseline.

Healthy eating: In South Northamptonshire, 61.3% of adults were typically eating the recommended 5

portions of fruit and vegetables a day in 2015, which was significantly higher than the national average of

52.3%. There has been an increase from 57.6% in 2014, but the difference is not statistically significant.

The average number of portions of fruit eaten daily has increased between 2014 and 2015 and was

significantly higher than the national average, whereas the average number of portions of vegetables eaten

daily has decreased and was similar to the national average. Neither of these changes are statistically

significant.

Excess weight in adults: In 2013-15, 66.6% of adults in South Northamptonshire were overweight or obese.

This is similar to the national average of 64.8%. There has been a decrease compared to 68.2% 2012-14, and

while this difference is not statistically significant this indicator has gone from red to amber as a result.

Physically active: 63.6% of adults in South Northamptonshire reported being physically active in 2015, which

was significantly higher than the national average of 57.0%. There has been a decrease from 64.8% in 2014,

but this is not statistically significant. The proportion of physically inactive adults was significantly lower than

the national average at 20.6% compared to 28.7%. There was a slight increase from 20.1% in 2014, but this

is not statistically significant either.

Smoking prevalence: In 2015, 12.3% of adults in South Northamptonshire were current smokers, which was

significantly lower than the national average. There has been an increase from 10.4% in 2014, but this

difference is not statistically significant. Amongst routine and manual workers, 26.8% smoked, which was

similar to the national average of 26.5%. There has also been an increase to this indicator compared to 2014,

and while this is not statistically significant this indicator has gone from green to amber as a result.

Deaths from drug misuse: The rate of drug related deaths for South Northamptonshire could not be

calculated due to low numbers. There is no historical trend data for the same reason.

Recorded diabetes: 5.4% of South Northamptonshire’s GP registered patients had diabetes in 2014/15. This

was significantly lower than the national average of 6.4%, but has increased significantly from 4.8% in the

baseline year of 2010/11.

May




Alcohol related admissions: The overall rate of alcohol related admissions in South Northamptonshire has

consistently been significantly lower than the national average since the baseline year of 2010/11. The rates

for males, females and persons have all decreased compared to 2014/15, but none of the changes are

statistically significant.

Cancer diagnosed at an early stage: In 2015, 58.2% of cancer cases were diagnosed at stage 1 or 2. This

increased compared to 51.6% in 2014 and was significantly higher than the national average of 52.4%. This

indicator is not RAG rated as it is susceptible to data quality issues.

Cancer screening coverage: The 2016 coverage for breast cancer screening was 82.6%, which was

significantly higher than the national average of 74.5% and similar to the 82.6% reported for 2015. South

Northamptonshire’s coverage has consistently been above the national average since the baseline in 2010.

Coverage for cervical cancer screening has also consistently been significantly above the national average

since the 2010 baseline. In 2016, South Northamptonshire’s coverage was 79.1%, compared to 72.7%

nationally.

2016 coverage for bowel cancer screening was 62.5%, which was significantly higher than the national

average of 57.9% and a significant increase compared to 60.3% in 2015.

Abdominal Aortic Aneurysm screening: Coverage for Abdominal Aortic Aneurysm screening was at 88.4%

in 2015/16, which was significantly higher than the national average. Coverage increased compared to

2014/15, but the difference is not statistically significant.

Falls: In 2015/16, South Northamptonshire’s overall rate of injuries due to falls in people aged 65 and over

was 2,378 per 100,000 population. This was similar to the national average of 2,125, but continues the

increasing trend seen in recent years; this indicator has increased significantly compared to the baseline of

1,644 per 100,000 in 2010/11. The increasing trend was mirrored in both the 65 to 79 and 80+ age brackets,

and the rate for people aged 80+ has increased significantly since the baseline (5,921 per 100,000 in 2015/16

compared to 3,725 per 100,000 in 2010/11).

The rate of injuries due to falls in females aged 65 and over and females aged 65-79 were both significantly

higher than the national averages. All other 2015/16 rates for falls were similar to the national averages.

Of Concern:

• Low birth weight of term babies

• Under 18 conceptions

• Excess weight in children

• Emergency admissions for intentional self-harm

• Average number of portions of vegetables consumed daily

• Excess weight in adults

• Physical activity and inactivity in adults

• Smoking prevalence

May




• Recorded diabetes

• Cancer screening coverage – breast and cervical

Action Required:

• Hospital admissions caused by unintentional and deliberate injuries in young people aged 15-24 years

• Hospital admissions due to falls in people aged 65 and over

Domain 3: Health Protection

Indicator

Unit of

measure-

ment

Tolerance:

lower or

higher is

better?

Latest


DOT

since

last

period

DOT

since

base-

line

3.01 - Fraction of mortality attributable to

particulate air pollution % Lower 2015 4.8 - ��


Female

Crude rate

per

100,000

NA 2015 1347.8 1020.8 -

1746.3 ��


Male

Crude rate

per

100,000

NA 2015 771.3 543.1 -

1063.2 ��


Persons

Crude rate

per

100,000

Higher 2015 1041.0 841.6 -

1274.5 ��

3.04 - HIV late diagnosis % Lower 2013 -

15 - - ��

3.05ii - Incidence of TB

Crude rate

per

100,000

Lower 2013 -

15 1.5 0.4 - 3.9 ��

3.08 - Adjusted antibiotic prescribing in primary care

by the NHS

Indirectly

standard-

ised ratio -

per STAR-

PU

Lower 2016 1.0 1.0 - 1.0 ��

Commentary

Air pollution: In 2015, 4.8% of deaths in South Northamptonshire were attributable to air pollution. This was

a slight decrease from 5.0% in 2014. The national average was 4.7%. As no confidence intervals are published

for this indicator it is not possible to determine whether any of these differences are statistically significant.

Chlamydia detection: In 2015, the chlamydia detection rate in 15 to 24 year olds was 1,041 per 100,000,

which was below the goal of at least 1,900 and significantly lower than the national rate. While this indicator

has been consistently below target since the baseline in 2012, the national average also fell to below the

target of 1,900 in 2015.

May




HIV late diagnosis: The proportion of HIV cases diagnosed at a late stage has not been published for South

Northamptonshire since the period 2009-11 due to low numbers. In 2009-11 the proportion was 20.0%,

which was below the goal of 25%-50%.

Tuberculosis: In 2013-15, the rate of incidence of tuberculosis was 1.5 per 100,000, which was in the 10th

percentile of UTLAs and therefore rated green. It is also significantly lower than the national incidence rate.

This is a decrease from 4.3 per 100,000 in 2010-12, although this difference is not statistically significant.

Antibiotic prescribing: This is a new indicator measuring the ratio of antibiotic prescriptions in primary care

settings by STAR-PU (Specific Therapeutic group Age-sex weightings Related Prescribing Unit) population. In

2016, South Northamptonshire’s ratio was 1.01, which was significantly lower than the national average of

1.08 and below the benchmark of the mean England prescribing for 2013/14.

Action Required:

• Chlamydia detection

Domain 4: Healthcare and premature mortality

Indicator

Unit of

measure-

ment

Tolerance:

lower or

higher is

better?

Latest


DOT

since

last

period

DOT

since

base-

line

4.01 - Infant mortality Crude rate

per 1000 Lower

2013 -

15 6.3 3.6 - 10.2 ��

4.02 - Proportion of five year old children free from

dental decay % Higher

2014/

15 71.3 63.8 - 78.9 ��


preventable - Female

DSR per

100,000 Lower

2013 -

15 110.6

93.5 -

129.9 ��


preventable - Male

DSR per

100,000 Lower

2013 -

15 164.0

142.6 -

187.6 ��


preventable - Persons

DSR per

100,000 Lower

2013 -

15 137.3

123.5 -

152.2 ��

4.04i - Under 75 mortality rate from all

cardiovascular diseases - Female

DSR per

100,000 Lower

2013 -

15 31.3 22.2 - 42.7 ��


cardiovascular diseases - Male

DSR per

100,000 Lower

2013 -

15 77.2 62.4 - 94.5 ��


cardiovascular diseases - Persons

DSR per

100,000 Lower

2013 -

15 54.1 45.3 - 64.1 ��


diseases considered preventable - Female

DSR per

100,000 Lower

2013 -

15 21.3 14.0 - 31.0 ��

May




Indicator

Unit of

measure-

ment

Tolerance:

lower or

higher is

better?

Latest


DOT

since

last

period

DOT

since

base-

line


diseases considered preventable - Male

DSR per

100,000 Lower

2013 -

15 57.0 44.5 - 72.0 ��


diseases considered preventable - Persons

DSR per

100,000 Lower

2013 -

15 39.1 31.7 - 47.7 ��

4.05i - Under 75 mortality rate from cancer - Female DSR per

100,000 Lower

2013 -

15 97.0

80.3 -

116.2 ��

4.05i - Under 75 mortality rate from cancer - Male DSR per

100,000 Lower

2013 -

15 133.3

113.6 -

155.5 ��

4.05i - Under 75 mortality rate from cancer - Persons DSR per

100,000 Lower

2013 -

15 115.1

102.0 -

129.4 ��


considered preventable - Female

DSR per

100,000 Lower

2013 -

15 62.2 48.9 - 77.9 ��


considered preventable - Male

DSR per

100,000 Lower

2013 -

15 69.2 55.2 - 85.7 ��


considered preventable - Persons

DSR per

100,000 Lower

2013 -

15 65.8 56.0 - 76.9 ��


Female

DSR per

100,000 Lower

2013 -

15 - - ��


Male

DSR per

100,000 Lower

2013 -

15 - - ��


Persons

DSR per

100,000 Lower

2013 -

15 10.4 6.8 - 15.2 ��


considered preventable - Male

DSR per

100,000 Lower

2013 -

15 - - ��


considered preventable - Persons

DSR per

100,000 Lower

2013 -

15 10.0 6.5 - 14.7 ��


disease - Female

DSR per

100,000 Lower

2013 -

15 21.0 13.7 - 30.9 ��


disease - Male

DSR per

100,000 Lower

2013 -

15 29.4 20.5 - 40.8 ��


disease - Persons

DSR per

100,000 Lower

2013 -

15 25.2 19.2 - 32.3 ��


disease considered preventable - Female

DSR per

100,000 Lower

2013 -

15 - - ��


disease considered preventable - Male

DSR per

100,000 Lower

2013 -

15 - - ��


disease considered preventable - Persons

DSR per

100,000 Lower

2013 -

15 12.5 8.4 - 17.9 ��


communicable diseases, including influenza -

Female

DSR per

100,000 Lower

2013 -

15 - - ��

May




Indicator

Unit of

measure-

ment

Tolerance:

lower or

higher is

better?

Latest


DOT

since

last

period

DOT

since

base-

line


communicable diseases, including influenza - Male

DSR per

100,000 Lower

2013 -

15 - - ��


communicable diseases, including influenza -

Persons

DSR per

100,000 Lower

2013 -

15 10.4 6.8 - 15.2 ��

4.10 - Suicide rate - Female DSR per

100,000 Lower

2013 -

15 - - ��

4.10 - Suicide rate - Male DSR per

100,000 Lower

2013 -

15 - - ��

4.10 - Suicide rate - Persons DSR per

100,000 Lower

2013 -

15 - - ��


discharge from hospital - Female % Lower

2011/

12 10.3 9.3 - 11.4 ��


discharge from hospital - Male % Lower

2011/

12 11.4 10.3 - 12.5 ��


discharge from hospital - Persons % Lower

2011/

12 10.8 10.1 - 11.6 ��

4.13 - Health related quality of life for older people Score Higher 2015/

16 0.8 0.7 - 0.8 ��


Female

DSR per

100,000 Lower

2015/

16 763.3

596.5 -

962.0 ��


Male

DSR per

100,000 Lower

2015/

16 381.4

246.3 -

562.5 ��


Persons

DSR per

100,000 Lower

2015/

16 603.5

490.1 -

735.2 ��

4.14ii - Hip fractures in people aged 65 and over -

aged 65-79 - Female

DSR per

100,000 Lower

2015/

16 - - ��

4.14ii - Hip fractures in people aged 65 and over -

aged 65-79 - Persons

DSR per

100,000 Lower

2015/

16 249.8

167.9 -

357.5 ��


aged 80+ - Female

DSR per

100,000 Lower

2015/

16 1884.7

1397.5 -

2486.4 ��


aged 80+ - Male

DSR per

100,000 Lower

2015/

16 - - ��


aged 80+ - Persons

DSR per

100,000 Lower

2015/

16 1629.1

1267.0 -

2062.2 ��

4.15i - Excess winter deaths index (single year, all

ages) - Female Ratio Lower

Aug

2014 -

Jul

2015

50.5 22.7 - 84.6 ��


ages) - Male Ratio Lower

Aug

2014 -

Jul

2015

30.4 6.2 - 60.2 ��

May




Indicator

Unit of

measure-

ment

Tolerance:

lower or

higher is

better?

Latest


DOT

since

last

period

DOT

since

base-

line


ages) - Persons Ratio Lower

Aug

2014 -

Jul

2015

40.1 21.2 - 61.9 ��


85+) - Female Ratio Lower

Aug

2014 -

Jul

2015

23.5 -9.7 - 68.9 ��


85+) - Male Ratio Lower

Aug

2014 -

Jul

2015

24.5 -19.1 - 91.8 ��


85+) - Persons Ratio Lower

Aug

2014 -

Jul

2015

23.9 -3.9 - 59.7 ��

4.15iii - Excess winter deaths index (3 years, all ages)

- Female Ratio Lower

Aug

2012 -

Jul

2015

36.9 20.9 - 55.1 ��


- Male Ratio Lower

Aug

2012 -

Jul

2015

26.7 12.1 - 43.3 ��


- Persons Ratio Lower

Aug

2012 -

Jul

2015

31.6 20.6 - 43.7 ��

4.15iv - Excess winter deaths index (3 years, age 85+)

- Female Ratio Lower

Aug

2012 -

Jul

2015

44.3 21.3 - 71.5 ��


- Male Ratio Lower

Aug

2012 -

Jul

2015

17.8 -6.0 - 47.7 ��


- Persons Ratio Lower

Aug

2012 -

Jul

2015

33.7 16.6 - 53.4 ��

Commentary

Infant mortality: Infant mortality in South Northamptonshire has increased from 1.5 per 1,000 in 2010-12

to 6.3 per 1,000 in 2013-15. This difference is not statistically significant and South Northamptonshire’s rate

of infant mortality is not significantly different to the national average.

Proportion of five year old children free from dental decay: In 2014/15, 71.3% of five year olds in South

Northamptonshire were free from dental decay, which is similar to the national average of 75.2%. This was

May




a decrease compared to 80.8% in 2011/12 when this indicator was last calculated, although the difference

is not statistically significant.

Preventable mortality: Rates of mortality due to preventable causes were significantly lower than the

national averages, with the overall rate being 137.3 per 100,000 population. There has been a consistent

decrease in the rate of preventable mortality since the baseline in 2009-11, although the difference is not

statistically significant.

Under 75 mortality: South Northamptonshire’s 2013-15 rates of under 75 mortality are generally

significantly lower than the national average and had no significant changes compared to either the last

period or the baseline.

Mortality rate from a range of specified communicable diseases, including influenza: The rate in 2013-15

was 10.4 per 100,000 population, which is similar to the national rate. It is a decrease compared to 12.9 per

100,000 in 2010-12 when this indicator was last calculated, but the decrease is not significant.

Suicides: This indicator has not been calculated for South Northamptonshire due to low numbers.

Emergency readmissions to hospital: 10.8% of all admissions in 2011/12 resulted in emergency

readmissions within 30 days of discharge, which was significantly lower than the national average and similar

to the baseline year of 2010/11. As this indicator has not been updated for many years, it may not reflect

the current situation.

Health related quality of life for older people: The average health status score on the EQ-5D scale for adults

aged 65 and over was 0.756 in 2015/16, which was similar to the national average of 0.733. There was a

decrease compared to 0.770 in 2014/15, and although the difference is not statistically significant the

indicator has gone from green to amber as a result.

Hip fractures: South Northamptonshire’s rate of hip fractures in people aged 65 and over was similar to the

England average at 603 per 100,000 population compared to 589 per 100,000 population nationally. There

was a decrease compared to 2013/14 and 2014/15, which was mirrored in the rates for both males and

females. None of the differences are statistically significant.

Excess winter deaths: All measures of excess winter deaths have increased compared to both the last period

and the baseline, albeit not significantly. Generally excess winter deaths were similar to the national average

but the 3 year index covering Aug 2012-Jul 2015 was significantly worse than the national average at 31.6

compared to 19.6.

Of Concern:

• Infant mortality

• Proportion of five year old children free from dental decay

• Mortality from preventable causes

May




• Under 75 mortality

• Emergency readmissions within 30 days of discharge from hospital

• Hip fractures in people aged 65 and over

Action Required:

• Excess winter deaths

Appendix A

E07000155 South Northamptonshire May 2017 PHOF at a glance.pdf Appendix B

Table_of_PHOF_updates_May_2017.pdf

Public Health Outcomes Framework – South Northamptonshire · lost due to sickness absence...

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