Isleworth & Brentford Area CommitteeIsleworth & Brentford Area CommitteeIsleworth & Brentford Area CommitteeBrentford Area DevelopmentHealth Impact Assessment Update30 August 2007

Sharon Daye, Acting Director of Public Health Maggie McNab, Assistant Director of Public Health

Format of Presentation• Introduction and Summary of the original process• Outline of health priorities• Explanation of how health priorities are addressed• NHS primary care services, including GPs and

patient numbers • Primary Care premises, capacity and costs• The HUDU model• Future plans e.g. Wallis House, Brentford Football

Club and Hospital services in the context of our 5 year Commissioning Strategy Plan

• Further detail about the outcomes of the original recommendations affecting health services

Health Priorities

Female life expectancy at birth, by ward, Hounslow, 2000-2004

Source: Office for National Statistics and Greater London Authority; analysis by London Health Observatory

Causes of premature death, Hounslow, 2005

14.912.0Other causes

4.78.3Accidents and Suicide

5.65.2Digestive Disease

10.110.5Respiratory Disease

35.629.1Cancers (malignant neoplasms)

9.88.9Other Circulatory Diseases

6.56.0Cerebrovascular disease (stroke)

12.820.0Coronary Heart Disease

WomenMen

Percentage of deaths aged under 75 attributable to causeCause of Death

Source: Office for National Statistics, Vital Statistics 2005, Table VS3

Deaths from cancer (SMRs), under the age of 75, by electoral ward, Hounslow 2000-2004

Source: ONS Death registrations; 2000-2004 ward level GLA population projections, scenario 8.07 (2001 populations were used for 2000 and 2001)analysis by London Health Observatory

Uptake of Breast Screening, by Area Committee, Round 5 Year 1 (2002/03)

52%

54%

56%

58%

60%

62%

64%

66%

68%

CentralHounslow Area

Chiswick Area Heston &Cranford Area

Isleworth &Brentford Area

West Area Hounslow PCT

Deaths from coronary heart diseases (CHD) (SMRs), under the age of 75, by electoral ward, Hounslow, 2000-2004

Source: ONS Death registrations; 2000-2004 ward level GLA population projections, scenario 8.07 (2001 populations were used for 2000 and 2001); analysis by London Health Observatory

Deaths from Circulatory Disease (SMRs) under the age of 75, by electoral ward, London Borough of Hounslow, 1999-2003

Source: ONS mortality data; GLA 2003 Round-based Ward Projections

Deaths from stroke (SMRs) under the age of 75, by electoral ward, Lodon Borough of Hounslow, 1999-2003

Source: ONS mortality data; GLA 2003 Round-based Ward Projections

Deaths from Respiratory Disease (SMRs) under the age of 75, by electoral ward, London Borough of Hounslow, 1999-2003

Teenage Conception rate by ward, 2001-03

Expected prevalence of Obesity, by PCT in North West London, compared with England, 2000-2002

PCT Expected prevalence of obesity Brent 19.65% Ealing 19.01% Harrow 19.52% H&F 15.78% Hillingdon 21.16% Hounslow 20.09% K&C 14.55% Westminster 14.91% England 22.10%

Source: Department of Health, Health Survey for England data

Prevalence of obesity in reception and year 6 children, by school and Index of Multiple Deprivation, Hounslow, 2005/06

Estimated of expected prevalence of obesity in adults, by ward, Hounslow 2000-2002

Some of the key health outcomes which the PCT has facilitated include:

Reducing mortality from Cancer - During 2003-05 the cancer mortality rate was 113.7 which is ahead of our LDP target of 119.3;

Reducing mortality from Cardiovascular Disease - The CVD mortality rate during 2003-05 was 113.9 ahead of the LDP target of 114.2;

Reducing inequalities in health outcomes - the initiation of breastfeeding has improved with a level of 83.7%, which is ahead of the LDP target of 76.1%.

People aged 18 to 64 (resident in households)* with limiting long-term illness or disability, by electoral ward, London Borough of

Hounslow, 2001

Source: 2001 Census, Office for National Statistics

How are health priorities being addressed

A range of activities eg:

Brentford School for Girls ‘Health Drop-in’Primary Angioplasty for patients with heart attacksPCT NHS Stop Smoking Service Clinics (Group work at West Middlesex University Hospital Trust, and 1-1 support via Brentford GP Practices and Community Pharmacy)Health Forecasting for COPD Patients (supported by the recent Council initiative for individual information on air pollution, ‘Air Text’)See PCT’s most recent Annual Public Health Reports 2005 and 2006:

www.hounslowpct.nhs.uk

Primary Care Structure & Capacity

Brentford Health Centre (PCT Freehold) 4 General Practices

52Rai &Stevens List size 1970

71Dr Yasin List size 2504

55Dr Lane List size 7124

105Dr Crowe List size 6225Other staffGPsPractice

No known major issues re access to GPs. No issues about formal assignments (allocations) due to patients being unable to register in normal manner

Chiswick• Dr Williams (2 GPs), Dr Burbidge (3 GPs),

Dr Hirst (7 GPs), Dr Thakrar (2 GPs)Isleworth• Dr Heffernan (3 GPs), Dr Kooner (2 GPs),

Luthra (3), Badget (6), Edwards (2), Ho (2)Ealing - (across the border)• Dr Keen (1), Weber (1), Bhatt/Szyszko (2),

Yin (1), Dr Farley (4), James (4)

Bordering Practices serving Brentford

Hounslow PCT Patient Registrations

LOCALITY LIST SIZE(as 1.7.07)

NUMBER OF GPS(on basis of full-time GPs)

Average population per GP

Chiswick 35,870 27.5 1304

Isleworth 34,494 17 2029

Brentford 17,823 13 1371

Hounslow Central

87,024 43.5 2000

Feltham 57,262 24 2386

TOTAL 232,473 125 1860

Other Primary Health Care

Pharmacy: 3 community pharmacies are currently operating in the area - no known access issues

Dental Care: 3 local General Dental Services (commissioned NHS) and Community Dental Services currently operating at the Heart of Hounslow for specialised treatments.The Albany practice reopened after a fire so current NHS capacity is good with no known issues about access to care, and extended emergency evening sessions

Brentford Future Plans• Wallis House

£200k Section 106 to expand and invest in better services, increasing capacity and access within Brentford Health Centre

• Brentford Football ClubHealth Campus proposals welcomed, open to principle of joint working and support

• West Middlesex Front EndEarly stages of negotiations for a joint Intermediate Care Facility

HUDU Guide to Healthy Communities

1. Healthy Lifestyles2. Housing Quality3. Access to Work4. Accessibility5. Food Access6. Crime Reduction and Community Safety7. Air Quality and Neighbourhood Amenity8. Social Cohesion and Social Capital9. Public Services10. Resource Minimisation11. Climate Change

Future of NHS Services‘A Framework for Action’ (Healthcare for London) a plan from Sir Ara Darzi outlines 6 proposed models of provision for health care in the future:

1. home, 2. polyclinic, 3. local hospital, 4. elective centre (booked operations), 5. major acute hospital, 6. specialist hospital.

PCT 5 year Commissioning Strategy - Key Initiatives

• Unscheduled (emergency) care– Increasing alternatives to local A&E

• Planned care– Hub & spoke primary care service– Less hospital outpatient visits, more community

clinics.

• Maternity– Increasing capacity across NW London

• Sustainable financial balance

Collaborative Commissioning Initiatives

• Unscheduled care• Planned care• Long term conditions• Paediatrics • Obstetrics• Cancer• Stroke• Standard primary care procedures &

pathways

Update on HIA Recommendations

particularly affecting Health Services

Recommendations affecting Health Services

2. Co-ordinationJoint Health and LBH Executive Directorates

Quarterly meetings now in place6. FundingHealth and Planning

Quarterly meetings and specific inclusion in the sustainability policy

Update on Recommendations cont’d13. Community services & health facilitiesHealth and Children’s Services• Funding and Section 106 - Included in (6) above• Statutory sector support for community and

voluntary organisations engaged in informal maternal and child-care - Nursery Nurse support for local playgroups now provided

• Explore possibility of a local Children’s Centre in supporting the co-ordination monitoring and evaluation of services – A Children’s Centre is being developed on Green Dragon Primary School site, completion due March 08. A Parent and Toddler Group and Baby Group already established

Update on Recommendations cont’d13. Community services & health facilities

Health and Children’s Services, continued………• Review of existing services to support larger local

population – PCT Children’s Services (0-19s) now re-organised into clusters of skill mix teams that will enhance professional leadership and enable flexible provision

• Discussions with TVU re services for future student needs - To be included as a core element in CSP

Update on Recommendations cont’d

14. Individuals and community groupsPlanning, Developers and Health Services• Inclusion of facilities and services for the needs of

the broader community including: infants, children, young people, adults, older people, and families.Addressed via Quarterly meetings as in (2.) above

• Adequate assistance for voluntary sector and community organisations to continue to provide support and advocacy for individuals and groups. In view of the PCT current financial situation we need to review support in this area