Appendix 4 List Profiles 2020-21 HSCP and Localities Summary
Argyll and Bute Council · 25 May 2022
Back to Argyll and Bute HSCP Integration Joint Board (IJB) — 25 May 2022 and its agenda
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LIST Profile 2020/21 HSCP and Localities Summary December 2021
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PHS LIST HSCP and Locality Profiles 2 Table of Contents Table of Contents ..................................................................................................................... 2 Notes for this profile: ................................................................................................................ 2 Figure 1: Map of GP practices by profile area in Argyll and Bute HSCP1................................. 3 Table 1: Number of each type of services by area1.................................................................. 4 Table 2: Summary data – snapshot2 ........................................................................................ 5 Footnotes ...................................................................................................................... 8 Appendices .............................................................................................................................. 9 Appendix 1: Indicator Definitions ................................................................................... 9 Appendix 2: Date of Indicator Data Extractions ........................................................... 12 Appendix 3: Conditions included as Potentially Preventable Admissions (PPAs) ....... 14 Notes for this profile: • The island of Colonsay is located in the HSCP locality of ‘Oban, Lorn and the Isles’ (OLI) and within the local area of ‘Mull, Iona, Coll, Tiree and Colonsay’. This reflects the organisation and delivery of HSCP services to Colonsay from OLI. However, to compile these profiles, data are aggregated from small geographical areas called datazones, for which different data are made available across Scotland. Colonsay is included within a datazone with Jura. This reflects the political multi-councillor ward in which Colonsay is placed with Islay, Jura and Kintyre (and falls within the Argyll and Bute Council Administrative Area of ‘Mid-Argyll, Kintyre and Islay’). Colonsay is therefore included with Islay and Jura in the profile area of ‘Islay, Jura and Colonsay’. • All years shown are calendar years unless otherwise specified. • Data sources are provided in the notes and the full profiles. • Definitions for the indicators shown are available within the Appendices. • The data here is a snapshot at one point in time. 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. Please see full profiles for trends and confidence data. 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 and Locality Profiles 3 Figure 1: Map of GP practices by profile area in Argyll and Bute HSCP1. Profile Area
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PHS LIST HSCP and Locality Profiles 4 Table 1: Number of each type of services by area1. Service Type Service Bute Cowal H&L Islay, Jura & Colonsay Kintyre Mid Argyll Mull, Iona, Coll & Tiree Oban and Lorn Argyll and Bute HSCP Primary Care GP Practice 1 7 5 5 3 3 3 4 31 A&E Emergency Department 0 0 0 0 0 0 0 1 1 Minor Injuries Unit 1 1 0 1 1 1 1 0 6 Care Home Elderly Care 2 4 4 1 1 1 1 3 17 Other 0 1 4 0 0 0 0 3 8
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PHS LIST HSCP and Locality Profiles 5 Table 2: Summary data – snapshot2 Indicator Data Type Time Period Bute Cowal H&L Islay, Jura + Kintyre Mid Argyll Mull, Iona, Coll + Oban and Lorn Argyll and Bute HSCP Scotland Demographics Total population count 2020 5,986 14,014 25,715 3,380 7,375 9,118 3,747 16,095 85,430 5,466,000 Population over 65 % 2020 32.0 31.0 23.0 28.0 28.0 26.0 28.0 22.0 26.0 19.0 Population in least deprived SIMD quintile % 2020 12.0 0.0 33.0 0.0 0.0 0.0 0.0 0.0 11.0 20.0 Population in most deprived SIMD quintile % 2020 36.0 13.0 7.3 0.0 15.0 0.0 0.0 2.8 8.7 20.0 Housing Total number of households count 2020 4,250 8,703 12,100 2,175 4,407 5,417 2,519 8,605 48,176 2,653,521 Households with single occupant tax discount % 2020 36 34 32 29 35 32 28 33 33 38 Households in Council Tax Band A-C % 2020 81 63 41 68 69 55 50 50 56 59 Households in Council Tax Band F-H % 2020 4 8 29 6 6 14 17 18 16 13
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PHS LIST HSCP and Locality Profiles 6 Table 2: Summary data – snapshot3,4,5 *At HSCP and Scotland level, the time period is a 3-year aggregate (2018-2020). Indicator Data Type Time Period Bute Cowal H&L Islay, Jura + Kintyre Mid Argyll Mull, Iona, Coll + Oban and Lorn Argyll and Bute HSCP Scotland General Health Male average life expectancy in years mean 2016-2020* 75.4 77.1 80 77.4 77.1 78.4 76.9 77.4 78 76.8 Female average life expectancy in years mean 2016-2020* 81.7 80.1 82.5 82.3 81.5 82.6 85.5 82.2 81.6 81 Early mortality rate per 100,000 rate 2018-2020 225 152 77 30 151 110 66 95 106 116 Population with long-term condition % 2020/21 26 27 21 25 26 24 23 24 25 20 Cancer registrations per 100,000 rate 2017-2019 604 610 627 472 642 539 697 629 609 644 Anxiety, depression & psychosis prescriptions % 2019/20 22 23 16 24 21 18 19 18 19 20 Behavioural Factors Drug-related hospital admissions per 100,000 rate 2017/18 - 2019/20 122 188 130 18 48 65 18 187 124 221 Alcohol-related hospital admissions per 100,000 rate 2019/20 623 871 536 726 590 620 333 800 638 673 Alcohol-specific mortality per 100,000 rate 2015 - 2019 22 14 18 28 34 24 21 19 20 20 Bowel screening uptake % 2017 - 2019 59 62 65 69 63 63 66 63 64 62
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PHS LIST HSCP and Locality Profiles 7 Table 2: Summary data - snapshot6 Indicator Data Type Time Period Bute Cowal H&L Islay, Jura + Kintyre Mid Argyll Mull, Iona, Coll + Oban and Lorn Argyll and Bute HSCP Scotland Hospital and Community Care Emergency admissions per 100,000 rate 2020/21 8,002 9,890 7,482 7,959 8,990 8,763 7,259 9,668 8,601 9,368 Unscheduled acute bed days per 100,000 rate 2020/21 66,338 81,183 52,487 65,592 72,081 54,859 54,337 66,685 63,384 61,622 A&E attendances per 100,000 rate 2020/21 3,508 4,645 19,541 2,751 2,237 4,891 7,686 30,947 13,882 20,422 Delayed discharge bed days per 100,000 rate 2020/21 4,162 9,291 5,159 6,728 6,632 9,837 7,767 9,921 7,527 8,080 Falls emergency admissions per 100,000 rate 2020/21 936 921 568 1,154 651 998 934 969 819 658 Emergency readmissions per 1,000 rate 2020/21 70 88 82 66 103 92 75 136 93 115 Last 6 months of life spent in community % 2020/21 94 93 93 93 90 92 94 92 92 90 Potentially Preventable Admissions per 100,000 rate 2020/21 952 1,249 863 740 976 823 827 1,441 1,041 1,181
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PHS LIST HSCP and Locality Profiles 8 Footnotes 1. Care Home Data included in the Services Map and Table was sourced from the Care Inspectorate. GP Practice data from October 2021, and Hospital and A&E data was sourced from Public Health Scotland Open Data. Only services that are within the physical boundary of the HSCP or Locality are included in the map and table, so there may be services outside Argyll and Bute which people may use but are not shown. 2. The data used in Demographics and Housing sections (except SIMD) are taken from National Records of Scotland (NRS). SIMD data from PHS incorporates SIMD information from Scottish Government and population data from NRS. 3. The data used in General Health and Behavioural Factors sections (except for long-term conditions) of this locality profile are taken from ScotPHO. There may be more recent data available for the indicators elsewhere. 4. 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/ 5. Physical long-term conditions (LTC) 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, daycase 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. 6. Hospital and Community care data are sourced from PHS data sources and NRS death records.
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PHS LIST HSCP and Locality Profiles 9 Page Break Appendices Appendix 1: Indicator Definitions Indicator Definition % last 6 months of Life Spent in a Community Setting The percentage of time spent by people in their last 6 months of life in the community. Community includes care home residents as well as those living in their own home. Considers all hospital activity (e.g. geriatric long stay (GLS), mental health, acute). Inpatient activity with a care home location code recorded in SMR is included within the Community percentage for all years presented. This activity represents beds funded by the NHS which are located within a care home. A&E Attendances Attendance rates to A&E departments for patients by residence per 100,000 population. Includes all ages. Alcohol-related hospital admissions General acute inpatient and day case stays with diagnosis of alcohol misuse in any diagnostic position (ICD-10 code: E24.4, E51.2, F10, G31.2, G62.1, G72.1, I42.6, K29.2, K70, K85.2, K86.0, O35.4, P04.3, Q86.0, R78.0, T51.0, T51.1, T51.9, X45, X65, Y15, Y57.3, Y90, Y91, Z50.2, Z71.4, Z72.1). All rates have been standardised against the European standard population (ESP2013) and 2011- based population estimates. Alcohol-specific deaths Alcohol related deaths (based on new National Statistics definition): 5-year rolling average number and directly age-sex standardised rate per 100,000 population. (ICD-10 codes from the primary cause of death: E24.4,F10,G31.2,G62.1,G72.1,I42.6,K29.2,K70,K85.2,K86.0,Q86.0, R78.0,X45,X65,Y15). Bowel Screening Uptake Bowel screening uptake for all eligible men and women invited (aged 50-74): 3-year rolling average number percentage. Eligible men and women are posted a guaiac-based faecal occult blood test kit (FOBT) which should be completed at home. This involves collecting 2 samples from each of 3 separate bowel movements. The kit is returned in a pre-paid envelope to the central screening centre in Dundee and tested for hidden traces of blood in the stool. Individuals who have a positive FOBT result are referred to their local hospital for assessment and, where appropriate, offered a colonoscopy as the first line of investigation. Cancer Registrations New cancer registrations: 3 year rolling average number and directly age-sex standardised rate per 100,000 population. All rates have been standardised against the European standard population (ESP2013) and 2011-base population estimates. ICD10: C00-C96 excluding C44 (principal diagnosis only). Death, aged 15-44 Deaths from all causes (ages 15-44 years), 3 year rolling average number and directly age sex standardised rate per 100,000 population. All rates have been standardised against the European
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PHS LIST HSCP and Locality Profiles 10 standard population (ESP2013). Deaths assigned to year based on death registration date. Delayed Discharge Bed days Number of days people aged over 18 spend in hospital when they are ready to be discharged per 100,000 population. Note that this may not always reflect the council area responsible for the person's post hospital discharge planning. The HSCP total is based on the area responsible for the person's post hospital discharge planning, which reflects what is published nationally. Drug-related hospital admissions General acute inpatient and day case stays with diagnosis of drug misuse in any diagnostic position (ICD10: F11-F16, F18, F19, T40.0- T40.9), 3-year rolling average number and directly age-sex standardised rate per 100,000 population. All rates have been standardised against the European standard population (ESP2013) and 2011-based population estimates. Emergency Admissions Rate of emergency (non-elective) admissions of patients of all ages per 100,000 population. This has been separated into two indicators – one for acute specialty and one for mental health specialty stays. An emergency admission is defined as being a new continuous spell of care in hospital where the patient was admitted as an emergency. The total number of emergency admissions is then calculated by counting the number of continuous spells in hospital within a financial year. (See also the "Hospital Care in Mental Health Specialities" definition). Emergency Admissions from a Fall Rate of acute emergency admissions (non-elective) of patients of all ages where a fall was logged as an ICD-10 code. ICD-10 codes W00-W19 were searched for in all diagnostic positions, in conjunction with the admission type codes 33 (Patient injury, home accident), 34 (Patient injury, incident at work) and 35 (Patient injury, other). Emergency Readmissions (28 day) The rate of readmissions of all adults (18+) within 28 days of an admission per 1,000 discharges. An emergency readmission is where the subsequent admission is an emergency and occurs up to and including 28 days from the initial admission. The initial admission can be of any type but must end within the time period of interest Hospital Care in Mental Health Specialties Mental health admission data is taken from SMR04, which holds records on patients receiving inpatient care in mental health (psychiatric) facilities. Episodes beginning with a transfer have also been included in these figures, as well as emergency admissions as many of these episodes will have started as unplanned acute admission. Therefore the initial unscheduled admission need not have been to a mental health long stay speciality. Life expectancy, females Estimated female life expectancy at birth in years, multi-year average (over 3 years for NHS Boards and Local Authorities, 5 years for Intermediate zones). Mortality data are based on year of registration. They also include non-Scottish residence so the number of deaths match those produced by NRS.
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PHS LIST HSCP and Locality Profiles 11 Life Expectancy, males Estimated male life expectancy at birth in years, multi-year average (over 3 years for NHS Boards and Local Authorities, 5 years for Intermediate zones) Mortality data are based on year of registration. They also include non-Scottish residence so the number of deaths match those produced by NRS. Physical Long-Term Conditions Health conditions that last a year or longer, impact a person's life, and may require ongoing care and support. The LTCs presented are: Arthritis, Atrial Fibrillation, Cancer, Coronary Heart Disease, Chronic Obstructive Pulmonary Disease (COPD), Cerebrovascular Disease, Dementia, Diabetes, Epilepsy, Heart Failure, Liver Failure, Multiple Sclerosis, Parkinson's, and Renal Failure. Population prescribed drugs for anxiety/depression/ps ychosis Estimated number and percentage of population being prescribed drugs for anxiety, depression or psychosis. Potentially Preventable Admissions (PPA) Emergency admissions (non-elective) of patients of all ages for conditions based on 19 “ambulatory care sensitive conditions” from “The health of the people of NEW South Wales - Report of the Chief Medical Officer". These conditions result from medical problems that may be avoidable with the application of public health measures and/or timely and effective treatment usually delivered in the community by the primary care team. Please see complete list of ICD-10 codes included in Appendix 3. Unscheduled Bed days Rate of unscheduled bed days of patients of all ages per 100,000 population. Takes the bed days spent only within the year of measurement – stays that overlap financial years will have their respective days counted either side. This has been separated into two indicators – one for acute speciality and one for mental health specialty stays.
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PHS LIST HSCP and Locality Profiles 12 Page break Appendix 2: Date of Indicator Data Extractions Section Indicator Date of data extraction Demographics Population structure 2021-09-09 Demographics Population projection 2021-09-09 Demographics SIMD2016 2021-09-09 Demographics SIMD2020 2021-09-09 Households Household estimates 2021-10-06 Households Household in each council tax band 2021-10-06 Services GP Practice locations 2021-10-08 Services Care Home locations 2021-10-08 Services A&E locations 2021-10-08 General Health Life expectancy males 2021-10-08 General Health Life expectancy females 2021-10-08 General Health Deaths ages 15-44 years 2021-10-09 General Health LTC multimorbidity 2021-10-09 General Health New cancer registrations 2021-10-09 General Health % and number of people with a prescription for anxiety, depression or psychosis 2021-10-09 Behavioural Factors Drug-related hospital admissions 2021-10-18 Behavioural Factors Alcohol-related hospital admissions 2021-10-18 Behavioural Factors Alcohol-specific mortality 2021-10-18 Behavioural Factors Bowel screening uptake 2021-10-18 Hospital and Community Care Emergency Admissions (Acute) 2021-10-18 Hospital and Community Care Unscheduled bed days (Acute) 2021-10-18 Hospital and Community Care A&E Attendances 2021-10-18 Hospital and Community Care Delayed discharge bed days 2021-10-18 Hospital and Community Care Fall emergency admissions 2021-10-18 Hospital and Community Care Emergency Readmissions (28 day) 2021-10-18
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PHS LIST HSCP and Locality Profiles 13 Hospital and Community Care % last 6 months in community setting 2021-10-18 Hospital and Community Care Potentially Preventable Admissions (PPAs) 2021-10-18
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PHS LIST HSCP and Locality Profiles 14 Page Break Appendix 3: Conditions included as Potentially Preventable Admissions (PPAs) Condition ICD10 codes included Comments Ear Nose And Throat H66, J028, J029, J038, J039, J06, J321 NA Dental K02, K03, K04, K05, K06, K08 NA Convulsions And Epilepsy G40, G41, R56, O15 NA Gangrene R02 NA Nutritional Deficiencies E40, E41, E43, E550, E643, M833 NA Dehydration And Gastroenteritis E86, K522, K528, K529 NA Pyelonephritis N10, N11, N12 NA Perforated Bleeding Ulcer K250, K251, K252, K254, K255, K256, K260, K261, K262, K264, K265, K266, K270, K271, K272, K274, K275, K276, K280, K281, K282, K284, K285, K286 Excludes episodes with following main OPCS4 codes: S06, S57, S68, S70, W90, X11 Cellulitis L03, L04, L080, L088, L089, L980 NA Pelvic Inflammatory Disease N70, N73 NA Influenza And Pneumonia J10, J11, J13, J181 NA Other Vaccine Preventable A35, A36, A370, A379, A80, B05, B06, B161, B169, B26 NA Iron Deficiency D501, D508, D509 NA Asthma J45, J46 NA Diabetes Complications E100, E101, E102, E103, E104, E105, E106, E107, E108, E110, E111, E112, E113, E114, E115, E116, E117, E118, E120, E121, E122, E123, E124, E125, E126, E127, E128, E130, E131, E132, E133, E134, E135, E136, E137, E138, E140, E141, E142, E143, E144, E145, E146, E147, E148 NA Hypertension I10, I119 Exclude episodes with following main OPCS4 codes: K01 - K50, K56, K60 - K61 Angina I20 Exclude episodes with main OPCS4 codes:
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PHS LIST HSCP and Locality Profiles 15 K40, K45 K49, K60, K65, K66 COPD J20, J41, J42, J43, J44, J47 J20 only included if secondary diagnosis has one of J41 - J44, J47 Congestive Heart Failure I110, I50, J81 Exclude episodes with following main OPCS4 codes: K01 - K50, K56, K60 - K61