Key Health Data for the West Midlands 2002: Chapter 11: National Health Service Priority Areas

Key Health Data for the West Midlands 2002

CHAPTER ELEVEN: NHS PRIORITY AREAS

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Preface

Contents

List of Tables
List of Figures

Abbreviations

Main Body

Annexe

1: The Geography of the West Midlands

2: Life Expectancy and Inequalities

4: Chemical incidents in the West Midlands

11: National Health Service Priority Areas

11.1 Introduction

In previous Key Health Data we have reported on the progress toward the “Saving Lives: Our Healthier Nation” targets. In this year’s report we have modified this section to reflect the NHS’s “Improvement, Expansion and Reform: The Next 3 Years Priorities and Planning Framework 2003 – 2006”. This document lays out the Department of Health’s priorities for the period which are:

improving access to all services through:

better emergency care
reduced waiting, increased booking for appointments and admission and
more choice for patients

focusing on improving services and outcomes in:

cancer
coronary heart disease
mental health
older people

improving life chances for children
improving the overall experience of patients
reducing health inequalities
contributing to the cross-government drive to reduce drug misuse

In each of these priority areas there are key targets for the next three years and every health and social care community must plan to meet each of these targets in the next three years.

This section reports on those targets that can be measured with the routinely collected data available to the authors. These are:

"Objective II: improve health and social care outcomes for everyone. 6. Reduce substantially the mortality rates from the major killer diseases by 2010: from heart disease by at least 40 % in people under 75; from cancer by at least 20% in people under 75.

7. Improve life outcomes of adults and children with mental health problems through year on year improvements in access to crisis and CAMHS (Children and Adolescent Mental health Service) services, and reduce the mortality rate from suicide and undetermined injury by at least 20% by 2010.

Coronary Heart Disease Improve the management of patients with heart failure in line with the NICE Clinical Guideline due in 2003, and set local targets for the consequent reduction in patients admitted to hospital with a diagnosis of heart failure

Older People Each year there will be less than 1% growth in emergency hospital admissions and no growth in re-admissions." (Department of Health, 2002)

11.2. Coronary Heart Disease

Presented here are the annual Coronary Heart Disease (CHD) age sex standardised death rates for the Region and the SHA from 1982 to 2000 with the project target of a 40% reduction by 2010 (Figures 11.1a to 11.1d). The baseline period is 1995-7. These values are used for:

"Objective II: improve health and social care outcomes for everyone. Reduce substantially the mortality rates from the major killer diseases by 2010: from heart disease by at least 40 % in people under 75;" (Department of Health, 2002)

The baseline was determined to be 100.0 deaths per 100,000 and hence the target for the Region is to have a rate of no more than 60 per 100,000 by 2010.

Heart disease was defined as ICD9 410-414 and ICD10 I20-I25. On the CD and website the data are available by PCT.

	Table 11.1a. The five year age sex standardised incidence rate for all malignant neoplasms, 1996 to 2000

	Table 11.1b. The age sex standardised incidence rate for colorectal malignant neoplasms, 1996 to 2000

	Table 11.1c. The age sex standardised incidence rate for malignant neoplasm of trachea, bronchus & lung, 1996 to 2000

	Figure 11.1d The age sex standardised death rates from 1982 to 2000 for West Midlands South SHA from CHD for those aged under 75, with project target of a 40% reduction by 2010.

11.3. Cancer

Presented here are the annual age sex standardised death rates from cancer for the Region and SHAs from 1982 to 2000 with the project target of a 20% reduction by 2010 (Figures 11.2a to 11.2d). The baseline period is 1995-7. These values are used for:

"Objective II: improve health and social care outcomes for everyone. Reduce substantially the mortality rates from the major killer diseases by 2010: from cancer by at least 20% in people under 75." (Department of Health, 2002)

The baseline was determined to be 143 deaths per 100,000 and hence the target for the Region is to have a rate of no more than 115 deaths per 100,000 by 2010. Cancer was defined as ICD9 140-208. On the CD and website the data are available by PCT. In addition to the overall target rates presented here are the incidence rates for the major cancers by Region, SHAs and PCTs in tables 2a to 2e, for all cancer, colorectal, lung, breast and melanoma for those aged under 75 years.

	Figure 11.2a The regional age sex standardised death rates per 100,000 from 1982 to 2000, from cancer, with project target of a 20% reduction by 2010

	Figure 11.2b The age sex standardised death rates from 1982 to 2000 for Staffordshire and Shropshire SHA from cancer, with project target of a 20% reduction by 2010

	Figure 11.2c The age sex standardised death rates from 1982 to 2000 for Birmingham and Black Country SHA from cancer, with project target of a 20% reduction by 2010

	Figure 11.2d The age sex standardised death rates from 1982 to 2000 for West Midlands South SHA from Cancer, with project target of a 20% reduction by 2010

	Table 11.1a The five year age sex standardised incidence rate for all malignant neoplasms, 1996 to 2000

	Table 11.1b The age sex standardised incidence rate for colorectal malignant neoplasms, 1996 to 2000

	Table 11.1c The age sex standardised incidence rate for malignant neoplasm of trachea, bronchus & lung, 1996 to 2000

	Table 11.1d The age sex standardised incidence rate for malignant neoplasm of breast, 1996 to 2000

	Table 11.1e. The age sex standardised incidence rate for malignant neoplasm of skin, 1996 to 2000

11.4. Suicide and undetermined deaths

Presented here are the annual age sex standardised death rates from suicide for the Region and the SHAs from 1982 to 2000 with the project target of a 20% reduction by 2010 (Figures 11.3a to 11.3d). These values are used to address the target:

"Objective II: improve health and social care outcomes for everyone. 7. Improve life outcomes of adults and children with mental health problems through year on year improvements in access to crisis and CAMHS services, and reduce the mortality rate from suicide and undetermined injury by at least 20% by 2010." (Department of Health, 2002)

The baseline was determined to be 8.6 deaths per 100,000 and hence the target for the Region is to have a rate of no more than 6.9 per 100,000 by 2010. Suicide was defined as ICD9 E950-959 and E980-989 excluding E988.8. On the CD and website the data are available by PCT.

	Figure 11.3a The regional age sex standardised death rates from 1982 to 2000, from suicide, with project target of a 20% reduction by 2010

	Figure 11.3b The age sex standardised death rates from 1982 to 2000 for Staffordshire and Shropshire SHA from suicide, with project target of a 20% reduction by 2010

	Figure 11.3c The age sex standardised death rates from 1982 to 2000 for Birmingham and Black Country SHA from suicide, with project target of a 20% reduction by 2010

	Figure 11.3d The age sex standardised death rates from 1982 to 2000 for West Midlands South SHA from suicide, with project target of a 20% reduction by 2010

11.5. Heart Failure

It is up to the individual PCTs to best interpret the guidelines from NICE in regard to heart failure and hence we cannot provide the local targets for the number of heart failure admissions, but we can provide data on the levels of admission for heart failure across the West Midlands region. These values can be used in addressing the target:

" Heart Disease. Improve the management of patients with heart failure in line with the NICE Clinical Guideline due in 2003, and set local targets for the consequent reduction in patients admitted to hospital with a diagnosis of heart failure" (Department of Health, 2002)

Heart failure was defined by a main diagnosis of I50 (ICD10 classification).

Table 11.2. Admissions and age-sex standardised rates for heart failure across the West Midlands, 2000/1

11.6. Emergency admissions

Presented here (Table 11.3) are the levels of emergency admissions for those aged over 64 years across the West Midlands region. This is designed to give an indication of the variation in emergency admissions across the region. These values are used to address the target:

"Older People Each year there will be less than 1% growth in emergency hospital admissions" (Department of Health, 2002)

Table 11.3. Admissions and age-sex standardised rates for emergency admission for those aged over 64 years across the West Midlands, 2000/1

11.7. Re-admissions

Presented here (Table 11.4) are the levels of re-admissions for those aged over 64 years across the West Midlands Region. This is designed to give an indication of the variation in re-admissions across the region. These values are used in addressing the target:

"Older People Each year there will be no growth in re-admissions." (Department of Health, 2002)

Table 11.4. Re-admission rates per 100 admissions, for those aged over 64 years, across the West Midlands, 2000/1

Reference

Department of Health. Improvement, Expansion and Reform: The Next 3 Years Priorities And Planning Framework 2003 – 2006. 2002 (at http://www.doh.gov.uk/planning2003-2006)

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© Department of Public Health and Epidemiology, University of Birmingham