Dr. John Radford, Director of Public Health
(9.15 a.m.)
Minutes:
Dr. John Radford, Director of Public Health, gave the following powerpoint presentation on Performance Management:-
Performance Management
- Clear accountability for each performance measure – 1 accountable lead
- Targets, action plans and milestones track progress and direction of travel
- Performance monitoring – current performance, RAG status and direction of travel
- Governance arrangements play a fundamental role managing performance/risk
- Concerns and outliers are identified to prompt necessary action including clinics
- Trigger points for a performance clinic:
· If performance is below target/is predicted to not meet the year end target
· On target but due to a known event/issue is predicted to n ot meet the year end target
- The clinic will develop and agree a remedial action plan with the accountable lead
- Service improvement work takes place immediately upon agreement of the plan
- Progress monitored and reported to provide assurances that issue is under control necessary improvements in performance are delivered
- Latest available Public Health data used as a ‘can opener’ to prompt where performance clinics could take place
Public Health Outcome Framework Scorecard Summary – 110 National Public Health Outcome Framework Measures
- National Benchmark RAG Status
· 32 Indicates rated Red
· 27 Indicators rated Amber
· 35 Indicators rated Green
- Regional Benchmark RAG Status
· 23 Indicators rated Red
· 46 Indicators rated Amber
· 24 Indicators rated Green
Green Measures
- Wider determinants of health
1.02i/ii School Readiness
1.06i LD Settle Accommodation
1.06II MH Settled Accommodation
1.06ii LD/MH Employment (Gap)
1.10 Killed and Seriously injured casualties on England’s roads
1.15i/ii Statutory Homelessness – Acceptances/Households in temporary accommodation
1.17 Fuel Poverty
1.18i Social Isolation
- Health improvement
2.07ii Rate of Emergency Admissions caused by unintentional and deliberate injuries in young people aged 15-24 years
2.20i/ii Cancer Screening Coverage (Breast/Cervical)
2.22i/ii NHS Health Checks – Take up/Offered
2.24i/ii/iii Injuries due to falls in people aged 65 and over
- Health protection
3.02i/ii chlamydia Diagnoses (15-24 year olds)
3.03iii/iv/v/vivii/x/xii/xiii/xiv/xv Vaccination Coverage
3.05ii Incidence of TB
- Healthcare and premature mortality
4.1 Suicide Rate
Amber Measures
- Wider determinants of health
1.09i Sickness Absence – the % of employees who had at least 1 day off in the previous week
1.18ii Loneliness and Isolation Carers
- Health improvement
2.04 Teenage Conceptions
2.06i Excess Weight in 45 year olds
2.07i Rate of Emergency Admissions caused by unintentional and deliberate injuries in children aged 0-14 years
2.12 Excess Weight in Adults
2.13i % of physical active and inactive adults – active adults
2.15ii Successful completion of Drug Treatment – non-opiate users
2.18 Alcohol-related Hospital Admissions
2.23i/ii/iii/iv Wellbeing response from Integrated Household Survey
- Health protection
3.03viii/ix MMR Vaccination Coverage
3.04 People presenting with HIV at a late stage of infection
- Healthcare and premature mortality
4.01 Infant Mortality
4.06i/ii U-75 Mortality Rate from Liver Disease/considered preventable
4.07ii U-75 Mortality Rate from Respiratory Diseased considered preventable
4.14i/ii/iii Hip Fractures in People aged 65 and over
4.15i/ii/iii/iv Excess Winter Deaths Index
Red Measures
- Overarching Indicators
0.1i/ii Health Life Expectancy at Birth
0.2i/ii Life Expectancy at Birth
0.2 vi Gap in Live Expectancy at Birth between each Local Authority and England as a whole
- Wider Determinants of Health
1.01ii % of all dependent children under 20 in relative poverty
1.02ii School Readiness (Y1 pupils)
1.09ii Sickness absence - % of working days lost to sickness absence
1.12i Violent crime (including sexual violence) – hospital admissions for violence
1.14 % of the population affected by noise
1.16 Utilisation of outdoor space for exercise/health reasons
- Health Improvement
2.01 % of all live births at term with low birth weight
2.02i/ii Breastfeeding initiation/prevalence
2.03 Rate of smoking at time of delivery per 100 maternities
2.06ii Excess weight in 10-11 year olds
2.13ii % of physically active and inactive adults – inactive adults
2.14 Smoking prevalence (adults) over 18
2.15i Successful completion of drug treatment – opiate users
2.17 Recorded diabetes
2.21 vii Access to non-cancer screening programmes – diabetic retinopathy
- Healthcare and Premature Mortality
- 4.02 Tooth decay in children aged 5
- 4.03 Mortality rate from causes considered preventable
- 4.04i/ii U-75 mortality rate from all cardiovascular disease/considered preventable
- 4.05i/ii U-75 mortality rate from cancer/considered preventable
- 4.07i U-75 mortality rate from respiratory disease
- 4.08 mortality from communicable diseases
- 4.11 Emergency readmissions within 30 days of discharge
Health and Wellbeing Board Priorities – Red Measures
Smoking
- % smoking at delivery
2012-13 outturn (19.2%)
Last update Q3 2013/14 (21.1%) against a target of 18.2%
Alcohol
- Number of FPN waivers which result in attendance at binge drinking course
2012-13 outturn (86)
Last update Q3 2013/14 (17)
Lower than last year
Fuel Poverty
- The number of properties receiving energy efficiency measures through Community Energy Saving Programme (CESP)
A3 2014-14 (16) against a target of 236
- The number of properties receiving energy efficiency measures through Department of Energy and Climate Change (DECC)
Q2 2013-14 (68) against a target of 320
Obesity
- Percentage of overweight and obese children in Reception
2011-12 outturn (16.1%)
Last update 2012-13 (22.2%)
2013-14 not available but deterioration in direction of travel between 2011-12 and 2012-13
- Percentage of overweight and obese children in Year 6
2011-12 outturn (33.0%)
Last update 2012-13 (35.2%)
2013-14 not available but deterioration in direction of travel between 2011-12 and 2012-13
- Healthy eating prevalence (Integrated Household Survey/Active People Survey)
2011-12 outturn 21.3% against a target of 28.7%
Future Performance Clinics
- The following Indicators have been identified as requiring focus/action – either Red or Amber with deterioration and/or in the bottom quartile regionally:-
Obesity
Low birth weight babies
Breastfeeding
Drug treatment
School readiness
Emergency readmissions
Sickness absence
Smoking
Mortality
Access to non-cancer screening programmes
Children in poverty
Violent crime
Noise
Tooth decay
Alcohol (binge drinking course)
Energy Efficiency
- 3 areas identified as priority areas for first performance clinics – Obesity, Drug Treatment and Breast Feeding
- Obesity and Drug Treatment had taken place during May, 2014 and Breastfeeding to be held shortly
Discussion ensued on the presentation with the following issues raised/clarified:-
· Importance of joint working to develop strategies
· Need to work with the voluntary sector to ascertain what was available in the community in order to maximise resources
· Possible use of local businesses/supermarkets
· The need to think differently/interventions that would hopefully reduce the need for urgent health care
· Engagement with Parish Councils and inclusion in Parish Plans
· Need for performance clinics to be radical – “what would the effect be if stop doing what we are doing?”
· Hold current structures to account – there were a whole host of disparate processes across the Local Authority and partners. Engaging Scrutiny would be extremely positive as they gave a fresh view on issues
· Performance clinic to be held on Maternity Health
Chris Edwards reported that NHS England had requested the CCG to set up a System Resilience Group on which all partners were represented. The membership was clearly defined.
Resolved:- (1) That the report be noted.
(2) That the results of performance clinics, the procedures followed and the work undertaken be reported to future Board meetings.
(3) That a report be submitted to the next Board meeting on the System Resilience Group.
(4) That NHS England submit a report to the next Board meeting on Diabetic Retinopathy screening.
Supporting documents: