Appendix 3 HSCP Profile 2020-21 Argyll and Bute
Argyll and Bute Council · 25 May 2022
Back to Argyll and Bute HSCP Integration Joint Board (IJB) — 25 May 2022 and its agenda
Text extracted from the council's PDF. Layout and reading order may differ from the original.
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HSCP Profile 2020/21 Argyll and Bute December 2021
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PHS LIST HSCP Profiles 2 Table of Contents Table of Contents ..................................................................................................................... 2 Notes for this profile: ................................................................................................................ 3 Demographics .......................................................................................................................... 4 Summary: ...................................................................................................................... 4 Population ..................................................................................................................... 4 Deprivation .................................................................................................................... 6 Households .............................................................................................................................. 7 Summary: ...................................................................................................................... 7 General Health ......................................................................................................................... 9 Summary: ...................................................................................................................... 9 Life Expectancy ............................................................................................................. 9 Deaths, aged 15-44 ..................................................................................................... 10 Long-Term Physical Health Conditions and Multimorbidity ......................................... 11 Cancer Registrations ................................................................................................... 13 Anxiety, Depression, and Psychosis Prescriptions ...................................................... 14 Behavioural Factors ............................................................................................................... 15 Summary: .................................................................................................................... 15 Drug-related Hospital Admissions ............................................................................... 15 Drug-Specific Deaths .................................................................................................. 16 Alcohol-related Hospital Admissions ........................................................................... 17 Alcohol-Specific Deaths .............................................................................................. 18 Bowel Screening Uptake ............................................................................................. 18 Hospital and Community Care ............................................................................................... 20 Emergency Admissions ............................................................................................... 21 Unscheduled Acute Bed Days ..................................................................................... 22 A&E Attendances ........................................................................................................ 23 Delayed Discharge Bed Days ..................................................................................... 24 Emergency Admissions from a Fall ............................................................................. 25 Emergency Readmissions (28 days) ........................................................................... 26 Potentially Preventable Admissions (PPAs) ................................................................ 27 Percentage Last 6 months in a Community Setting..................................................... 28 Footnotes ............................................................................................................................... 29
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PHS LIST HSCP Profiles 3 Notes for this profile: • All years shown are calendar years unless otherwise specified. • Upper and lower 95% confidence intervals are shown throughout this document where available. In charts, these are displayed as shaded areas either side of trend lines, or as black error bars in bar charts. Confidence intervals show the range of possible values and a certainty that the true value falls within them. • Definitions for the indicators shown are available in the Appendices of the accompanying summary document. • Any zero figures for some indicators will indicate either suppression of small data or a complete lack of data available for this health and social care partnership (HSCP) • Data should be interpreted with caution, particularly for areas with relatively small population sizes where indicator data is expected, by chance alone, to have higher variation than in areas of larger population size. Note that differences between areas can relate to multiple factors including, for example, underlying rates of illness, rates of diagnosis and local differences in practice e.g. in data recording.
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PHS LIST HSCP Profiles 4 Page break Demographics Summary: For the most recent time periods available, Argyll and Bute HSCP had: • A total population of 85,430 people, where 50% were male, and 26% were aged over 65. • 11% of people lived in the least deprived SIMD quintile, and 8.7% lived in the most deprived quintile. Population In 2020, the total population of Argyll and Bute HSCP was 85,430. The graph below shows the population distribution of the HSCP. Figure 1: Population breakdown in Argyll and Bute. Figure 2 shows the historical population of Argyll and Bute, along with the NRS population projections. The population has been falling. The population in Argyll and Bute is estimated to decrease by 3% from 2020 to 2025. Figure 2: Population time trend and projection.
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PHS LIST HSCP Profiles 5 Page break Figure 3 shows how population structure has changed between 2015 and 2020. Figure 3: Change in population structure over the last five years.
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PHS LIST HSCP Profiles 6 Deprivation The following section explores the deprivation structure of Argyll and Bute through the Scottish Index of Multiple Deprivation (SIMD). The SIMD ranks all datazones in Scotland by a number of factors; Access, Crime, Education, Employment, Health, Housing and Income. Based on these ranks, each datazone is then given an overall deprivation rank, which is used to split datazones into Deprivation Quintiles (Quintile 1 being the most deprived, and Quintile 5 the least). The most recent SIMD ranking was carried out in 2020. This section mainly focuses on the SIMD 2020 classifications, however the 2016 classifications are used to assess how deprivation has changed in Argyll and Bute when compared to the rest of Scotland. Of the 2020 population in Argyll and Bute, 8.7% live in the most deprived SIMD Quintile, and 11% live in the least deprived SIMD Quintile. The following table details the percent of the population living in the 2016 SIMD Quintiles, the percent living in the 2020 SIMD Quintiles, and their difference for comparison. Table 1: Percentage population living in the 2016 and 2020 SIMD Datazone Quintiles Quintile Percent of Pop (2016) Percent of Pop (2020) Difference SIMD 1 7.5% 8.7% 1.1% SIMD 2 17.1% 16.0% -1.0% SIMD 3 41.1% 41.9% 0.8% SIMD 4 24.4% 22.6% -1.8% SIMD 5 9.9% 10.8% 0.9% Figure 4: Proportion of the population that reside in each 2020 SIMD quintile by domain.
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PHS LIST HSCP Profiles 7 ge Break Households Summary: For the most recent time periods available, Argyll and Bute HSCP had: • 48,176 dwellings, of which: 89% were occupied and 6.5% were second homes. • 33% of dwellers received a single occupant council tax discount, and 2.5% were exempt from council tax entirely. • 56% of houses were within council tax bands A to C, and 16% were in bands F to H. The graph below shows the number of dwellings in Argyll and Bute from 2014 to 2020. Figure 5: Number of dwellings time trend. Of the total number of dwellings in 2020, 33% (15,773 households) were occupied by an individual receiving a single occupant council tax discount. Furthermore, 2.5% (1,216 households) were occupied and exempt from council tax. There were 3,123 dwellings classed as a second home in 2020, these dwellings made up 6.5% of the households in Argyll and Bute.
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PHS LIST HSCP Profiles 8 Page break Table 2: Breakdown of dwelling types by year for Argyll and Bute HSCP. Year Total Dwellings Occupied Dwellings Vacant Dwellings Single Occupant Tax Discount Council Tax Exempt Dwellings Second Homes 2014 47,494 41,764 2,350 15,509 1,197 3,378 2015 47,719 41,918 2,373 15,271 1,211 3,428 2016 47,766 42,007 2,367 15,384 1,215 3,391 2017 47,858 42,499 2,104 15,381 1,199 3,252 2018 47,999 42,604 2,175 15,318 1,245 3,219 2019 48,110 42,784 2,199 15,408 1,297 3,127 2020 48,176 42,819 2,239 15,773 1,216 3,123 The proportion of households within each council tax band are displayed in the chart below, figures are shown in Table 3. Figure 6: Breakdown of households by council tax band for Argyll and Bute in 2020. Table 3: Percentage of households by council tax band for Argyll and Bute in 2020. Tax Band A B C D E F G H Percent of households 15% 21% 20% 13% 16% 9% 6.1% 0.53%
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PHS LIST HSCP Profiles 9 PPagebreak General Health Summary: For the most recent time periods available1, Argyll and Bute HSCP had: • An average life expectancy of 78 years for males and 81.6 years for females. • A death rate for ages 15 to 44 of 106 deaths per 100,000 age-sex standardised population2 • 24% of the HSCPs population with at least one long-term physical health condition. • A cancer registration rate of 609 registrations per 100,000 age-sex standardised population4 • 19.12% of the population being prescribed medication for anxiety, depression, or psychosis. Life Expectancy In the latest time period available from 2018-2020 (3 year aggregate), the average life expectancy in Argyll and Bute HSCP was 78 years old for men, and 81.6 years old for women. A time trend since 2014-2016 can be seen in figure 8. Figure 8: Average life expectancy in men and women over time.
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PHS LIST HSCP Profiles 10 Page break Table 5 provides the average life expectancy for men and women in different areas for the latest time period available. Table 5: Average life expectancy in years for the latest time periods Deaths, aged 15-44 The following chart shows a trend of death rates among 15-44 year olds per 100,000 age-sex standardised population2 by area (i.e. early mortality rate per 100,000). In the most recent aggregate time period available (from 2018-2020), the mortality rate in Argyll and Bute HSCP was 106 deaths per 100,000 population. Figure 9: Deaths aged 15-44 years by geographical area and over time.
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PHS LIST HSCP Profiles 11 Long-Term Physical Health Conditions and Multimorbidity In the financial year 2020/21, in Argyll and Bute HSCP, 24% of the total population had at least one physical long-term condition (LTC). These include: cardiovascular, neurodegenerative, and respiratory conditions, as well as other organ conditions (namely liver disease and renal failure), arthritis, cancer, diabetes, and epilepsy. Please see footnotes for information and caveats on identifying LTCs.3 The co-occurrence of two or more conditions, known as multimorbidity, is broken down in figure 12, distinguishing between age groups. Note that this chart excludes the population in the HSCP who do not have any physical long-term conditions. Figure 12 therefore shows that among the people who have a LTC, 21% of those under the age of 65 have more than one, compared to 50% of those aged over 65. Figure 10: Multimorbidity of physical long-term conditions by age group in 2020/21.
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PHS LIST HSCP Profiles 12 Page break Most common physical Long-Term Conditions (LTCs) Below is a breakdown of the physical LTCs, for the financial year 2020/21. Figure 13 shows the prevalence of different LTCs in each age group in Argyll and Bute HSCP, and Table 6 illustrates the top 5 physical LTCs across all ages at Partnership, Health Board and Scotland level. Figure 11: Percentage people with each physical LTC, split by age group. *COPD: Chronic Obstructive Pulmonary Disease Table 6: Prevalence of the five most common physical LTCs as a percentage of the population across geographical areas (where 1 = most prevalent).
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PHS LIST HSCP Profiles 13 Cancer Registrations For the period 2017-2019, there were 638 new cancer registrations per year on average (609 registrations per 100,000 age-sex standardised population) in Argyll and Bute HSCP. This is a 2.7% decrease in cancer registrations rate from the previous aggregate period 2016-2018. Figure 12 shows changes over time since 2014-2016. Figure 12: Cancer registration rate over time and by geographical area.
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PHS LIST HSCP Profiles 14 Page break Anxiety, Depression, and Psychosis Prescriptions In the 2019/20 financial year, 19.12% of people were prescribed medication for anxiety, depression, or psychosis (ADP) in Argyll and Bute HSCP. This is a 2.8% increase from the previous financial year. Differences over time and between areas may relate to multiple factors, only one of which is underlying disease. Note that data are based on main original licensed use for the prescriptions and some drugs included may be prescribed for other purposes. Figure 13: Percentage population prescribed ADP medication in Argyll and Bute HSCP. Figure 14: ADP prescriptions over time and by geographical area.
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PHS LIST HSCP Profiles 15 Pagebreak Behavioural Factors Summary: Mental and physical wellbeing has close ties with people’s behaviours. Life circumstances including financial security, employment and location are interlinked with behavioural factors. This section provides data on drug-related hospital admissions, alcohol-related hospital admissions, alcohol-specific mortalities and bowel screening uptake, to give an overview of some behaviours known to be associated with health and wellbeing outcomes. For the most recent time periods available1, Argyll and Bute had: • 124 drug-related hospital admissions per 100,000 age-sex standardised population2. This is a lower rate of admissions than for Scotland (221). • 22 drug-specific mortalities per 100,000 age-sex standardised population2. This is a lower rate than for Scotland (25.44). • 638 alcohol-related hospital admissions per 100,000 age-sex standardised population2. • 20 alcohol-specific mortalities per 100,000 age-sex standardised population2. • a 64% uptake of bowel cancer screening for the eligible population. Drug-related Hospital Admissions There were 124 drug-related hospital admissions per 100,000 age-sex standardised population4 in Argyll and Bute HSCP for the most recent time period available (3 year financial year aggregate for 2017/18 - 2019/20). This is a 68% increase since 2014/15 - 2016/17 (3 financial year aggregates). A trend of the change in drug-related hospital admissions for Argyll and Bute HSCP compared with Scotland and NHS Highland is shown in the chart below from 2014/15 - 2016/17 onwards.
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PHS LIST HSCP Profiles 16 Pagebreak Figure 15: Trend of Drug-related Hospital Admission Rates by geographical area. Drug-Specific Deaths Data on alcohol-specific deaths is available per calendar year. The rate of drug-specific deaths is currently higher in Argyll and Bute than the rate in 2015 (74% change). Figure 16: Trend of Drug-Specific Death Rates by geographical area.
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PHS LIST HSCP Profiles 17 Page Break Alcohol-related Hospital Admissions The 2019/20 alcohol-related admissions rate is 638 per 100,000 age-sex standardised population4, which is a 4.6% decrease overall since 2015/16. The chart below shows a trend of alcohol-related hospital admissions for Argyll and Bute HSCP compared with Scotland and NHS Highland from financial year 2015/16 to 2019/20. Figure 17: Trend of Alcohol-related Hospital Admission Rates by geographical area.
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PHS LIST HSCP Profiles 18 Page Break Alcohol-Specific Deaths Data on alcohol-specific deaths is available as 5 year aggregates. The rate of alcohol-specific deaths is currently higher in Argyll and Bute than the rate in 2010 to 2014 (4.4% change). Figure 18: Trend of Alcohol-Specific Death Rates by geographical area. Bowel Screening Uptake Bowel screening is offered every two years to eligible men and women aged between 50-74 years old. Eligible people are posted a test kit which is completed at home. Since 1st April 2013, those aged 75 and over can also self-refer and opt into screening. The uptake target for this program is 60%. A trend of the percentage uptake of bowel screening among the eligible population is shown below for Argyll and Bute HSCP compared with Scotland and NHS Highland. Data is suppressed into 3 year aggregates. The 2017 - 2019 uptake rate for Argyll and Bute is 64%.
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PHS LIST HSCP Profiles 19 Figure 19: Trend of Bowel Screening Uptake for eligible men and women, by geographical area.
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PHS LIST HSCP Profiles 20 Pagebreak Hospital and Community Care This section includes acute hospital data, delayed discharge bed days and A&E attendances. Please note that for 2020 onwards, hospital activity would have been severely affected by the COVID-19 pandemic. Information on how this has had a wider impact is provided in Footnote 4 at the end of the document. For the most recent time periods available, Argyll and Bute had: • 8,601 emergency hospital admissions per 100,000 population. • 63,384 unscheduled acute specialty bed days per 100,000 population. • 13,882 A&E attendances per 100,000 population. • 7,527 delayed discharge bed days per 100,000 population. • 819 emergency hospital admissions from falls per 100,000 population. • 93 emergency readmissions (28 day) per 1,000 discharges. • 1,041 potentially preventable hospital admissions per 100,000 population. • People on average spent 92% of their last 6 months of life in a community setting.
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PHS LIST HSCP Profiles 21 Pagebreak Emergency Admissions Figure 20: Emergency admissions by age group Figure 21: Emergency admissions by geographical area
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PHS LIST HSCP Profiles 22 Pagebreak Unscheduled Acute Bed Days Figure 22: Unscheduled bed days by age group Figure 23: Unscheduled bed days by geographical area
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PHS LIST HSCP Profiles 23 Pagebreak A&E Attendances Figure 24: A&E attendances by age group Figure 25: A&E attendances by geographical area
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PHS LIST HSCP Profiles 24 Pagebreak Delayed Discharge Bed Days Figure 26: Delayed discharge bed days by age group Figure 27: Delayed discharge bed days by geographical area
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PHS LIST HSCP Profiles 25 Pagebreak Emergency Admissions from a Fall Figure 28: Falls by age group Figure 29: Falls by geographical area
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PHS LIST HSCP Profiles 26 Pagebreak Emergency Readmissions (28 days) Figure 30: Emergency readmissions by age group Figure 31: Emergency readmissions by geographical area
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PHS LIST HSCP Profiles 27 Pagebreak Potentially Preventable Admissions (PPAs) Information on which conditions are counted as PPAs is available in Appendix 3 of the summary document. Figure 32: PPAs by age group Figure 33: PPAs by geographical area
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PHS LIST HSCP Profiles 28 Pagebreak Percentage Last 6 months in a Community Setting Figure 34: Last 6 months in a community setting by geographical area
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PHS LIST HSCP Profiles 29 Page Break Footnotes 1. The data used in General Health and Behavioural Factors sections (except for long-term conditions) of this HSCP profile are taken from ScotPHO. There may be more recent data available for the indicators elsewhere. 2. Data taken from ScotPHO is often reported using the European Age-Sex Standardised Rate per 100,000. This allows for comparisons across different areas to be made. For more information on how these rates are calculated, please refer to www.isdscotland.org/Products-and-Services/GPD-Support/Population/Standard- Populations/ 3. Physical long-term conditions data comes from the Source Linkage Files, and the conditions are identified using ICD-9 and ICD-10 codes in the diagnosis fields. Please note that the Source Linkage Files data only contains information on people who have had contact with the NHS through either inpatient admissions, outpatient attendances, day case attendances, A&E attendances or through prescribed items, the data does not show all service users in Scotland who have been diagnosed with an LTC as not all of these individuals will have used these services. Also note that LTC rates are based on an adjusted population indicator in the Source Linkage Files so that population sizes are closer to the official estimates. 4. The 2020 COVID-19 pandemic will have had an effect on the most recent data available. A dashboard has been created by PHS which show the wider impacts of COVID-19 over many areas. You can access this here: https://scotland.shinyapps.io/phs-covid-wider- impact/