Network Profile · 2019-11-25 · 2 | Page READER INFORMATION Title Network Profile – Childwall & Wavertree Team Liverpool CCG Business Intelligence Team; Liverpool City Council

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Network Profile

Childwall & Wavertree

November 2019

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READER INFORMATION

Title Network Profile – Childwall & Wavertree

Team Liverpool CCG Business Intelligence Team; Liverpool City Council Intelligence & Data

Analytics Team

Author(s) Sophie Kelly, AnnMarie Daley, Danielle Wilson, Karen Jones

Contributor(s) Liverpool City Council Social Services Analysis Team; Liverpool Community Health Analysis Team

Reviewer(s) Network Clinical Leads; Locality Clinical Leads; Liverpol CCG Primary Care Team;

Liverpool CCG Business Intelligence Team: Liverpool City Council Public Health Team;

Mersey Care Community Health Intelligence and Public Health Teams

Circulated to Network Clinical and Managerial Leads; Liverpool GP Bulletin; Liverpool CCG

employees including Primary Care Team and Programme Managers; Adult Social

Services (LCC); Public Health (LCC); Mersey Care, Provider Alliance

Version 1.0

Status Final

Date of release November 2019

Review date Annual update

Purpose The packs are intended for Primary Care Networks to use to understand the needs of

the populations they serve. They will support networks in understanding health

inequalities that may exist for their population and subsequently how they may want

to configure services around patients.

Description This series of reports contains Population Segmentation intelligence about each of the

14 Primary Care Network Units in Liverpool. The information benchmarks each

network against its peers so they can understand the the relative need, management

and service utilisation of people in their area. The pack contains information on wider

determinants of health, health, social care and community services.

Reference Documents

JSNA The Joint Strategic Needs Assessment (JSNA) identifies the key issues affecting the health and wellbeing of local people, both now and in the future. The JSNA looks at the strategic needs of Liverpool, as well as issues such as inequalities between different populations who live in the city. It is the main source of information on health and wellbeing, and acts as a reference for commissioners and policy makers across the Health & Care system. All the JSNA material is available via: www.liverpool.gov.uk/jsna

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Contents 1. Introduction............................................................................................................................................................... 4

1.1 Network Profiles ..................................................................................................................................................... 4

1.2 Population segmentation .................................................................................................................................. 4

1.4 Population segment profile (Total registered population) ..................................................................................... 6

1.5 Headline Opportunities ........................................................................................................................................... 7

1.6 GP Practice ........................................................................................................................................................ 8

1.7 Registered Population ....................................................................................................................................... 9

1.8 Registered Patient Ward Alignment ................................................................................................................. 9

1.9 Service Provision ............................................................................................................................................... 9

1.10 Service Assets for Health and Wellbeing ....................................................................................................... 10

2. Network Maps ......................................................................................................................................................... 12

3. Population Map ....................................................................................................................................................... 13

4. Demographics and Wider Determinants of Health ................................................................................................. 15

4.1 Demographics ................................................................................................................................................. 15

4.2 Wider Determinants of Health .............................................................................................................................. 15

5. Potential Areas of Focus .......................................................................................................................................... 15

5.1 Healthy Adults and Children (Segment 1) ............................................................................................................. 15

5.2 Long Term Conditions (Segment 2) ....................................................................................................................... 15

5.3 Frailty, Dementia and End of Life (Segment 5&6) ................................................................................................ 16

5.4 Care Settings ......................................................................................................................................................... 16

6 Network Profile Spine Chart .................................................................................................................................... 16

See separate Metadata document for indicator definitions, sources and timeframes

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1. Introduction

1.1 Network Profiles The Network profiles are intended for Primary Care Networks to use to understand the needs of the populations they serve. They will support networks in understanding health inequalities that may exist for their population and subsequently how they may want to configure services around patients.

This series of reports contains Population Segmentation intelligence about each of the 14 Primary Care Network Units (PCN) in Liverpool. The information benchmarks each network against its peers to help understand population need, management and service utilisation across PCNs. The pack contains information on individual network demographics, wider determinants, population segments and care setting utilisation.

1.2 Population segmentation For the purposes of this profile the population has been segmented into the following groupings according to similar

health need. The below are the emerging Population Segments for Liverpool. Technical definitions for each segment

are in development. Intelligence to date is based on working definitions.

This is an All Age model. Therefore, definitions for each segment have been considered in respect of both adults, children and families. So, except for Frailty and Dementia, which is an elderly specific segment, the other segments include children. Intelligence for each segment covers adults and children where available.

This model can evolve as the thinking of the system evolves. That means definitions, outcomes, profiles etc will be adapted based on feedback.

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1.3 Care setting usage rates by population segments (Total registered population)

Below is a summary of contacts to secondary and community care settings by population segmentation for Liverpool CCG registered patients.

Rate of Use Of Different Care Settings By Population Segment

Date Range is 1st October 2018 to 30th September 2019, apart from Community Contacts, where data range is 1st April 2018 to 31st March 2019 Rates are number of contacts in 12 months per 100 people in the segment Elective admissions include overnight and day case admissions and regular day/night attendances (e.g. dialysis)

Secondary Care Contacts Face -to-Face Community Contacts

EOL

Frailty & Dementia

Complex Lives

Cancer

LTC

Pre-Conditions

Learning Disability

Physical Disability

Healthy People

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1.4 Population segment profile (Total registered population) Data below is based on all registered patients for whom data is extracted in the monthly primary care dataflow, so anyone who dissents from the data sharing is not included below.

Segments are mutually exclusive, e.g. if a person's dominant segment is 'End of Life' then they will not be counted in any other segment. Cancer segment represents people coded

with Cancer in the last 2 years, rather than anyone who has ever had cancer.

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1.5 Headline Opportunities Using the latest data available for measures included within the network spine chart (Section 6), the following

opportunities have been calculated for measures where statistically this network reports a significantly worse rate

than the Liverpool average. The opportunity has been calculated based on the Network rate moving in line with the

Liverpool average rate. Below is a high‐level summary, further analysis is provided in section 5 of this report;

If Childwall and Wavertree Network moved in line with the Liverpool average rate potentially there could be;

1. 591 more patients aged 45+ with BP recorded

2. 287 more patients (65+) with a pulse check (excluding AF patients)

3. 292 more smokers offered support and treatment

4. 626 more patients with alcohol consumption recorded

5. 201 less patients drinking alcohol above indicated levels

6. 91 more patients drinking alcohol above indicated levels offered brief interventions

7. 125 more patients under 65 ‘at risk’ having flu jab

8. 381 more undiagnosed diabetes patients diagnosed

9. 48 more diabetes patients on Diabetes specialist nurse caseload

10. 137 more undiagnosed PAD patients diagnosed

11. 304 more undiagnosed CHD patients diagnosed

12. 46 more undiagnosed HF patients diagnosed

13. 767 more hypertension patients who don’t meet recommended physical activity levels referred for brief

interventions

14. 399 more undiagnosed COPD patients diagnosed

15. 90 more asthma patients with a review

16. 197 more referrals to community mental health team and 200 more referrals to Psychiatric liaison team

17. 87 more undiagnosed Dementia patients diagnosed

18. 487 fewer GP outpatient referrals, 61 per practice. Main specialities; Cardiology, Dermatology, ENT and

Urology

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1.6 GP Practice

The network is made up of the following GP practices:

Practice Code CCG Lead Address and Postcode

N82014 Dr S Sreeguru 19 Lance Lane, Wavertree, L15 6TS

N82026 Felicity Mattocks 7 Smithdown Place, Wavertree, L15 9EH

N82059 Brian O'Connor 8 Greenbank Drive, Liverpool, L17 1AW

N82079 Rob Barnett 1B Greenbank Road, Liverpool, L18 1HG

N82092 Dr Ayokunle Adebanjo 75 Hartsbourne Avenue, Childwall, L25 1RY

N82107 Martin Binder 73 Queens Drive, Mossley Hill, L18 2DU

N82108 Lucy Joyes 1 Rutherford Road, Mossley Hill, L18 0HJ

N82664 Galina Artioukh 80 Rocky Lane, Childwall, L16 1JD

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1.7 Registered Population

The registered population is 44,960.

1.8 Registered Patient Ward Alignment

The wards that this network is most aligned to are:

1.9 Service Provision

Childwall and Wavertree Wards %

Dominant Ward Wavertree 20.3%

Second Ward Church 17.1%

Third Ward Childwall 16.8%

Fourth Ward Greenbank 13.3%

Fifth Ward Belle Vale 8.3%

Sixth Ward Woolton 5.7%

Seventh Ward Mossley Hill 3.3%

Eighth Ward St Michael's 3.2%

Ninth Ward Picton 2.2%

Tenth Ward Cressington 2.1%

Other Wards 7.7%

National Code N82059 N82079 N82100 N82014 N82026 N82664 N82108 N82107 N82092

QOF 1 1 1 1 1 1 1 1 1DES signup returned 1 1 1 1 1 1 1 1 1LES signup returned 1 1 1 1 1 1 1 1Extended Hours Access 1 1 April & May onlyLearning Disabilities 1 1 1 1 1 1 1 1 1Out of Area RegistrationZero Tolerance SchemeMinor surgery own patients excisions and incisions 1 1 1 1 1 1 1Minor surgery own patients injections 1 1 1 1 1 1 1 1 1Learning Disabilities Health Check Scheme 1 1 1 1 1 1 1 1 1GMS/PMS Core Contract Data Collection 1 1 1 1 1 1 1 1 1Alcohol Risk Reduction 1 1 1 1 1 1 1 1 1Liverpool Quality Improvement Scheme 1 1 1 1 1 1 1 1 1Minor surgery FOR OTHER PRACTICES excisions and incisionsMinor surgery FOR OTHER PRACTICES injectionsDrug Misusers 1 1Near Patient 1 1 1 1 1 1 1 1Sexual Health 1 1 1 1 1 1HomelessAsylum Seekers 1 1 1TravellersABPI 1 1 1 1ABPI - For other practices 1H Pylori 1 1 1 1 1 1 1 1H Pylori for other practices 1 1 1Health checks 1 1 1 1 1 1 1 1 1IGR 1 1 1 1 1 1 1 1Gonadorelin Therapy LES 1 1 1 1 1 1 1 1Latent TB 1 1 1 1 1 1 1

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1.10 Service Assets for Health and Wellbeing Asset‐based working is an approach that aims to strengthen individuals and communities so they can stay well or

better deal with illness. Asset mapping is a process for pulling together the people, places and services that are

available locally that can improve health and wellbeing and reduce preventable health inequities. The LiveWell

Directory, maintained by Healthwatch can be used to support patients and residents to access local services

https://www.thelivewelldirectory.com/ For people without internet access or who need to talk through their

situation the Healthwatch enquiry service (0300 7777007) can help.

The infographic below shows some of the physical assets that lie within the network boundary (lower super output

areas with population density => 1,000 registered patients per sq km) which may include GP practices from outside

the network:

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2. Network Maps1

1 Maps Icons Collection https://mapicons.mapsmarker.com

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3. Population Map

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4. Demographics and Wider Determinants of Health

4.1 Demographics 44,960 currently registered in this network, 8.3% of CCG registered population

Childwall and Wavertree has the lowest deprivation score across all networks; 21.7 compared to Liverpool average of 41.1

Within this network there is a significantly lower proportion of people aged 0‐25 (29%), however a significantly higher proportion of older people aged over 65; 16.8% compared to 14.4%.

Childwall and Wavertree has the highest Healthy life expectancy (64 years) and Life expectancy (84 years) average age compared to all other networks.

4.2 Wider Determinants of Health A significantly lower proportion of households have no access to a car/van (30%) compared to the

Liverpool average (second lowest rate in the city).

Two thirds (66.7%) of the population are economically active which is significantly higher than the Liverpool average rate of 62.4%

Unemployment rates are significantly lower in this network

The highest median household income (£33,290) value is reported in this network

The lowest rates of domestic violence (8.9%) and Violent crime (5.7%) are reported in this network

5. Potential Areas of Focus

5.1 Healthy Adults and Children (Segment 1) Prevention Health Checks are designed to spot early signs of stroke, kidney disease, heart disease, type

2 diabetes or dementia. As we get older, we have a higher risk of developing one of these conditions, health checks help to find ways to lower risk of developing diseases. In this network, of the 9,824 patients offered a health check, under half (46.1%) took up the offer (significantly lower proportion compared to the Liverpool average 48.3%). Smoking prevalence rates and obesity rates are amongst the lowest in the city. Compared to the Liverpool average, Childwall and Wavertree network have a significantly higher proportion of people who drink alcohol above the indicated levels (10.6%) and significantly fewer under 65s at risk of flu receiving seasonal flu vaccination (47.7%).

5.2 Long Term Conditions (Segment 2) People with long term conditions can often be intensive users of health and social care services,

including community services, urgent and emergency care and acute services and account for half of all GP appointments. In Aintree a significantly higher proportion of people aged 40+ have at least one long term condition, however a lower proportion have 2 or more LTCs.

Cancer Early detection of cancers is essential to ensure prompt appropriate treatment thus reducing premature deaths. Cancer prevalence rates are amongst the highest in the city with a rate of 5,909 per 100,000 population. However, uptake rates for all three cancer screening programmes are significantly higher, than the Liverpool average and cancer mortality is significantly lower than the city average, suggesting early detection of cancer and successful treatment.

Diabetes Prevalence of diabetes is significantly lower in this network, however the observed to expected rate of diabetes is significantly lower suggesting that there are cases of undiagnosed diabetes in this network. Diabetes disease management measures are generally comparable to or better than the Liverpool average rate. A significantly lower rate of diabetes patients from Childwall and Wavertree network are on the community diabetes caseload – likely linked to lower prevalence, however case finding those potentially undiagnosed could improve caseload rates.

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Cardiovascular Disease Primary prevention of CVD requires that patients at risk are identified before disease has become established. Risk assessments in those likely to be at high risk of CVD, such as people with hypertension and other modifiable risk factors, should be performed periodically. Only a third (34.7% n=4,529) of patients eligible had a health check completed in this network. Blood pressure management is significantly below the city average with 87.9% of 45+ population managing BP to <150/90. Prevalence of CKD is significantly higher in this network. The ratio of observed to expected prevalence for CHD and PAD is significantly lower in this network suggesting that are more undiagnosed cases than in other areas across the city. Generally, CVD disease management measures for CHD, HF, AF and Stroke are generally comparable to or significantly better than the Liverpool average.

Respiratory Recorded COPD prevalence is lower than the city average yet, the ratio of observed to expected prevalence suggests there may be undiagnosed cases in the network. Asthma patients with an annual review is significantly lower than the city average with 72% of patients registered with asthma receiving a review compared to 76% reported for Liverpool.

5.3 Frailty, Dementia and End of Life (Segment 5&6) Frailty This neighbourhood has significantly higher proportion of older people aged over 65 (16.8%

compared to 14.4%). Of the patients with a recorded frailty score, a significantly higher proportion are reported to have ‘Moderate’ frailty; 55.9% compared to Liverpool average of 51.3%. Permanent admissions to residential or care home rates are significantly lower in this network with 409.9 placements per 100,000 residents compared to 724.3 across Liverpool. Prevalence of dementia is significantly lower in this network compared to the Liverpool average. However, observed to expected prevalence of dementia is also significantly lower suggesting there are undiagnosed cases in this network. Compared to the Liverpool average, demand for social services is significantly lower for services supporting older people, support with memory and cognition, physical and sensory support and domiciliary care.

5.4 Care Settings Emergency Care A significantly higher proportion of walk in centre attendances are reported for people

registered in Childwall and Wavertree network compared to other networks; 254.5 attendances per 1,000 population compared 213.6. The highest rate of emergency admissions from care homes are reported from this network with 72.8 admissions per 1,000 population compared to 27.6.

Outpatient Referrals This network reports the second highest outpatient referral rate, 90.5 per 1,000 compared to city average rate of 80.3. By speciality, Cardiology, Dermatology, ENT and Urology referral rates are amongst the highest compared to all other networks. Over half of Cardiology and Dermatology appointments are discharged after first appointment, suggesting that these maybe inappropriate referrals. This network has the highest rate of Gynae referrals discharged after 1st appointment; 28% compared to city average of 20.6%.

General Practice and Community Services Need Compared to other networks, a significantly lower rate of patients are on community caseloads for the following services, community respiratory teams, diabetes specialists, district nursing, heart failure teams and IV therapy.

Social Care Need Demand for social services is significantly lower in this with 83.2 users per 1,000 population compared to 185.9 reported for Liverpool. At service level, a significantly lower proportion of users are reported to use older persons services, Mental health services, memory services, Physical and sensory support, Domiciliary care (65+). Residential and Nursing placements are also significantly lower.

6 Network Profile Spine Chart

Key:

Liverpool Key

Low

IndicatorNetwork

Number

Network

Rate

Liverpool

Average

Liverpool

LowestLiverpool Range

Liverpool

Highest

National

Average

1 DEMOGRAPHICS AND WIDER DETERMINANTS OF HEALTH

2 DEMOGRAPHICS n/a

3 Deprivation Score (IMD) 2015 - 21.7 41.1 21.7 60.8 21.8

4 Income Deprivation Affecting Children Index (IDACI) 2015 - 16.3% 32.0% 16.3% 47.6% 17.6%

5 Income Deprivation Affecting Older People Index (IDAOPI) 2015 - 21.9% 34.2% 21.4% 47.0% 15.3%

6 Not White British or Irish ethnic group (%) 5,289 11.8% 15.0% 4.6% 35.1% 19.2%

7 White Other ethnic group (%) 971 2.2% 2.7% 0.9% 5.6% 4.6%

8 Mixed/Multiple ethnic group (%) 1,302 2.9% 2.6% 0.9% 6.4% 2.3%

9 Asian/Asian British ethnic group (%) 1,730 3.9% 4.7% 1.2% 16.7% 7.8%

10 Black/African/Caribbean/Black British ethnic group (%) 755 1.7% 2.9% 0.6% 9.1% 3.5%

11 Other ethnic group (including Arab) (%) 531 1.2% 2.0% 0.3% 7.6% 1.0%

12 Main language not English (%) 1,847 4.1% 7.1% 2.1% 20.9% 8.0%

13 People registered as asylum seekers or refugees (%) 201 0.4% 1.0% 0.0% 6.4% n/a

14 Live births per 1,000 female population aged 15-44 (General Fertility Rate) 459 52.2 53.4 21.1 71.1 62.5

15 Children aged 0-4 years (%) 2,319 5.2% 5.5% 1.3% 6.8% 5.5%



18 Young People aged 19-25 years (%) 4,441 9.9% 13.2% 6.9% 56.0% 8.8%

19 Children and Young People aged 0-25 years (%) 13,024 29.0% 33.2% 26.4% 61.5% 30.3%

20 Population 65+ (%) 7,558 16.8% 14.4% 1.8% 20.4% 17.9%

21 Population 75+ (%) 3,405 7.6% 6.3% 0.5% 9.4% 8.1%

22 Population 85+ (%) 940 2.1% 1.7% 0.1% 2.9% 2.4%

23 Population 95+ (%) 75 0.2% 0.1% 0.0% 0.2% 0.2%

24 WIDER DETERMINANTS -

25 No car or van in household (%) - 30.6% 47.3% 29.2% 62.6% 25.8%

26 Economically active (%) 22,845 66.7% 62.4% 50.4% 68.8% 69.9%

27 Economically active: Unemployed (%) 1,455 4.2% 6.6% 3.6% 9.0% 4.4%

28 Economically active: Long-term unemployed (%) 571 1.7% 2.7% 1.4% 3.8% 1.7%

29 Economically inactive (%) 11,409 33.3% 37.6% 31.2% 49.6% 30.1%

30 Economically inactive: Long-term sick or disabled (%) 1,543 4.5% 7.9% 4.2% 11.7% 4.0%

31 Housing Tenure: Social or Private Rented (%) - 34.7% 52.9% 32.2% 77.9% 36.7%

32 One person household: Aged 65 and over (%) - 12.5% 11.8% 6.4% 14.0% 12.4%

33 Median Household Income £ - £33,290 £23,249 £17,754 £33,290 £32,650

34 Domestic violence rate per 1,000 371 8.9 16.7 8.9 26.5 -

35 Violent crime rate per 1,000 236 5.7 13.1 5.7 24.2 -

36 SEGMENT 1. HEALTHY ADULTS AND CHILDREN -

37 HEALTHY LIFE EXPECTANCY at birth - males (3 Year Pooled) - 63.6 61.5 59.5 63.6 63.4

38 HEALTHY LIFE EXPECTANCY at birth - females (3 Year Pooled) - 65.1 63.1 61.2 65.1 63.8

39 HEALTHY LIFE EXPECTANCY at birth - all persons (3 Year Pooled) - 64.4 62.3 60.6 64.4 63.6

40 LIFE EXPECTANCY at birth - males (3 Year Pooled) - 82.4 78.2 74.5 82.4 79.6

41 LIFE EXPECTANCY at birth - females (3 Year Pooled) - 85.4 81.4 77.9 85.4 83.1

42 LIFE EXPECTANCY at birth - all persons (3 Year Pooled) - 84.0 79.8 76.6 84.0 81.4

43 ALL CAUSE Mortality - DSR per 100,000 population 954 794.2 1,101.2 794.2 1,420.3 959.0

44 ALL CAUSE Mortality Under 75 Years - DSR per 100,000 population 303 257.9 425.5 257.9 595.2 332.0

45 Population 40+ with no LTCs (%) 10,016 45.3% 40.4% 35.6% 53.2% n/a

46 Population 40+ with 1 LTC (%) 5,870 26.5% 27.7% 25.4% 29.6% n/a


48 Population 40+ with 3 or more LTC (%) 2,981 13.5% 15.9% 10.2% 19.4% n/a

49 Percentage of the population 40+ with risk score >=50% 217 1.0% 2.1% 1.0% 2.9% n/a

50 Percentage of the population 40+ with risk score >=70% 61 0.3% 0.7% 0.3% 1.6% n/a

51 Percentage of the population 40+ with risk score >=50% <=90% 212 1.0% 2.0% 1.0% 2.7% n/a

52 RISK FACTORS AND INTERVENTIONS -

53 People aged 45+ with a record of blood pressure in the preceding 5 years (QOF) (%) 17,083 87.9% 90.9% 86.2% 93.1% 89.2%

54 HYPERTENSION Prevalence DSR per 100,000 population 6,817 16,233.0 17,355.1 15,143.5 19,591.8 n/a

55 People aged 65 years and over excluding People with AF who have received a pulse check (%) 4,857 71.5% 75.8% 64.8% 82.0% n/a

56 ATRIAL FIBRILLATION Prevalence DSR per 100,000 population 1,042 2,435.9 2,518.6 2,194.0 3,012.8 n/a

57 Prevalence of IMPAIRED GLUCOSE REGULATION (IGR) (%) 1,118 3.1% 3.4% 0.8% 4.8% n/a

58 CURRENT SMOKERS aged 15+ (QOF) (%) 4,614 12.1% 20.1% 12.1% 27.8% 17.2%

59 CURRENT SMOKERS aged 15+ offered support and treatment in last 24 months (QOF) (%) 3,859 83.6% 90.0% 75.9% 98.6% 89.2%

60 Child Excess Weight Reception (age 4-5 years) (%) 266 22.4% 26.1% 21.7% 29.6% 22.4%

61 Child Excess Weight Year 6 (age 10-11 years) (%) 325 33.3% 38.8% 33.1% 44.2% 34.3%

62 Persons aged 18 or over with a BMI ≥30 in the last 12 months (QOF) (%) 3,568 9.7% 12.0% 3.9% 16.1% 9.8%

63 People with BMI >=40 recorded in the last 12m (%) 895 1.9% 2.7% 0.9% 4.0% n/a

64 People with BMI>= 40 offered weight mgmt advice in the last 12m (%) 349 39.0% 46.6% 25.1% 61.2% n/a

65 Undertake vigorous PHYSICAL ACTIVITY prevalence (%) 132 29.6% 22.8% 14.9% 31.1% n/a

66 People aged 18+ who have their level of ALCOHOL consumption recorded (%) 23,632 64.0% 65.7% 63.5% 70.0% n/a

67 People aged 18+ who have ALCOHOL above indicated levels (%) 2,496 10.6% 9.7% 6.1% 12.2% n/a

68 People aged 18+ with ALCOHOL above indicated levels offered brief interventions (%) 2,119 84.9% 88.5% 80.4% 99.9% n/a

69 Eligible persons 40-74 years offered a HEALTH CHECK (letters sent) (%) 5 years cumulative 9,824 75.2% 70.5% 47.6% 94.1% 90.0%

70 Eligible persons 40-74 years with a HEALTH CHECK completed (uptake) (%) 5 years cumulative 4,529 46.1% 48.3% 29.8% 81.0% 48.1%

71 Eligible persons 40-74 years with a Health Check completed as % of eligible population 5 years cumulative 4,529 34.7% 34.0% 19.9% 51.5% 43.3%

72 Health Trainer Referral rate per 1,000 persons 18+ 280 7.6 6.8 3.8 15.2 n/a

73 BOWEL Screening Coverage (Population Aged 60-69 Screened Over 2.5 Years) (%) 2,882 59.5% 52.2% 42.8% 61.2% 57.4%


75 Females aged 25-64 who have had CERVICAL SMEAR Coverage Over 3.5/5.5 years (%) 8,737 74.0% 68.1% 52.2% 75.2% 72.1%

76 36 month coverage for BREAST screening aged 50-70 4,203 74.4% 65.5% 54.5% 74.4% 72.5%

77 VACS AND IMMS -

78 Children's DtaPipVHib at 1 Yr (%) 468 96.5% 92.0% 87.6% 96.5% 93.4%

79 Children's PCV at 2 Yrs (%) 437 94.2% 89.2% 80.6% 94.2% 91.5%

80 Children's MMR1 at 2 Yrs (%) 437 94.2% 90.2% 81.3% 94.2% 91.6%

81 Children's Hib Men C at 2 Yrs (%) 442 95.3% 90.9% 83.8% 95.3% 91.5%

82 Children's Pre School Booster at 5 Yrs (%) 451 92.8% 88.2% 77.9% 95.5% n/a

83 Children's MMR2 at 5 Yrs (%) 449 92.4% 87.6% 78.2% 94.6% 87.6%

84 DTaP/IPV/Hib at 1 yr, MMR1 / PCV booster / Hib/MenC booster at 2 yrs - combined achievement (%) 1,784 95.0% 90.6% 83.5% 95.0% n/a

85 Seasonal Flu Vaccine Uptake - Children aged 2 years (%) 229 46.9% 29.5% 16.2% 46.9% 43.8%

86 Seasonal Flu Vaccine Uptake - Children aged 3 years (%) 211 47.1% 33.2% 20.9% 47.1% 45.9%

87 Seasonal Flu Vaccine Uptake - Persons aged 65 and over (%) 5,469 72.6% 71.4% 64.8% 74.6% 72.0%

88 Seasonal Flu Vaccine Uptake - Under 65 at risk (%) 2,931 47.7% 49.7% 42.5% 54.2% 48.0%

89 Seasonal Flu Vaccine Uptake - Carers (%) 281 51.8% 48.8% 35.3% 58.6% n/a

Childwall & Wavertree Primary Care Network

Significantly better than Liverpool average

Not significantly different from Liverpool average

Significantly worse than Liverpool average

No significance can be calculated

25th percentile

England

Liverpool

75th percentile

IndicatorNetwork

Number

Network

Rate

Liverpool

Average

Liverpool


Liverpool

Highest

National

Average

90 SEXUAL HEALTH -

91 GP prescribed user dependent contraception per 1,000 females aged 15-44 1,398 150.4 125.5 84.8 152.0 n/a

92 GP prescribed long acting reversible contraception (LARC) per 1,000 females aged 15-44 211 22.7 28.0 18.8 48.3 n/a

93 GP prescribed condoms rate per 1,000 32 0.7 0.7 0.0 3.9 n/a

94 Uptake of HIV testing in specialist sexual health services rate per 1,000 206 4.6 4.5 1.2 13.5 n/a

95 MATERNITY -

96 Live births per 1,000 female population aged 15-44 (General Fertility Rate) 459 52.2 53.4 21.1 71.1 62.5

97 Low birthweight of all babies <2500g (3 year pooled) (%) 84 6.4% 8.5% 6.4% 10.3% 7.3%

98 Breastfeeding Initiation Rates (%) 252 61.0% 48.1% 34.0% 68.1% 74.5%

99 Breastfeeding at 6-8 weeks (%) 205 50.2% 38.4% 23.6% 59.7% 42.7%

100 Smoking Status at Time of Delivery (SATOD) % 24 5.8% 12.9% 5.8% 19.9% 10.8%

101 Seasonal Flu Vaccine Uptake - Pregnant Women (%) 242 46.7% 41.0% 33.0% 46.7% 45.2%

102 EDUCATIONAL ATTAINMENT -

103 Pupils achieving the expected standard in reading, writing and mathematics at Key Stage 2 (%) 263 63.4% 56.4% 45.5% 64.1% 61.6%

104 Pupils gaining 5+ GCSEs A*-C grades including English and Maths (%) 166 48.4% 34.9% 23.0% 48.4% 56.6%

105 Children who are receiving Special Educational Needs (SEN) Support (%) 801 13.2% 16.4% 13.2% 20.1% 14.4%

106 Children with an Education Health and Care Plan - Rate per 10,000 under 18 years 112 0.02 0.02 0.02 0.03 n/a

107 Children's Speech and language Therapy referrals - Rate per 1,000 154 15.8 20.3 3.5 51.5 n/a

108 SEGMENT 2. LONG TERM CONDITIONS -



111 Population 40+ with 3 or more LTC (%) 2,981 13.5% 15.9% 10.2% 19.4% n/a

112 People on proactive care (%) 58 0.1% 0.1% 0.0% 0.3% n/a

113 People on 1 to 5 or more prescriptions (%) 25,266 57.7% 56.2% 38.4% 64.4% n/a

114 People on 5 or more prescriptions (%) 8,207 18.7% 21.9% 4.0% 28.4% n/a

115 People on 10 or more prescriptions (%) 2,350 5.4% 7.2% 1.0% 10.0% n/a

116 Antibiotic Prescribing rate per 1,000 population 1,889 39.9 43.2 33.1 52.2 n/a

117 Broad Spectrum antbiotic prescribing rate per 1,000 population 161 3.4 3.5 2.8 4.4 n/a

118 Proportion of people who use services who have control over their daily life (ASCOF 1B) 37 72.5% 79.4% 50.0% 90.0% n/a

119 The proportion of users and carers receiving self directed support (ASCOF 1C1A) 328 86.3% 86.1% 64.3% 92.5% n/a

120 The proportion of carers who receive self directed support (ASCOF 1C1B) 83 50.9% 49.2% 37.6% 55.4% n/a

121 The proportion of people who use services who receive direct payments (ASCOF 1C2A) 68 17.9% 19.9% 14.3% 31.9% n/a

122 The proportion of carers who receive direct payments (ASCOF 1C2B) 63 38.7% 36.8% 28.1% 44.0% n/a

123 The outcome of short term service: sequel to service (ASCOF 2D) 91 59.5% 60.7% 47.3% 67.3% n/a

124 Permanent admission to residential and nursing CARE HOMES ages 65+ rate per 100,000 residents 30 409.9 724.3 306.0 1,220.8 n/a

125 CANCER -

126 New CANCER cases (Crude incidence rate: new cases per 100,000 population) 244 521.4 505.9 88.9 640.4 520.8

127 People with a review within 6 mths of CANCER diagnosis 186 94.9% 93.0% 83.0% 96.6% 69.3%

128 Percentage reporting CANCER in the last 5 years 15 2.7% 3.6% 1.6% 4.9% 3.2%

129 CANCER Prevalence DSR per 100,000 population 2,497 5,909.7 5,601.0 4,302.0 6,470.9 n/a

130 CANCER Mortality - DSR per 100,000 population 316 258.0 303.7 246.8 391.1 268.0

131 LUNG CANCER - DSR per 100,000 population 60 49.2 85.7 49.2 148.3 56.3

132 ALL DIGESTIVE DISEASES CANCER Mortality - DSR per 100,000 population 105 83.7 87.5 63.7 119.4 n/a

133 CANCER Mortality Under 75 Years - DSR per 100,000 population 140 119.8 157.3 119.8 201.8 134.6

134 LUNG CANCER Mortality Under 75 Years - DSR per 100,000 population 26 22.9 45.4 22.9 84.0 n/a

135 ALL DIGESTIVE DISEASES CANCER Mortality Under 75 Years - DSR per 100,000 population 57 48.0 46.4 32.2 59.8 n/a



138 Females aged 25-64 who have had CERVICAL SMEAR Coverage Over 3.5/5.5 years (%) 8,737 74.0% 68.1% 52.2% 75.2% 72.1%

139 36 month coverage for BREAST screening aged 50-70 4,203 74.4% 65.5% 54.5% 74.4% 72.5%

140 Emergency admissions for CANCER 241 5.1 5.6 2.9 6.8 n/a

141 DIABETES -

142 Children with DIABETES 0-17 years (%) 12 0.2% 0.2% 0.1% 0.4% n/a

143 DIABETES Prevalence DSR per 100,000 population 2,191 5,204.8 6,483.7 5,101.5 7,872.4 n/a

144 Ratio of Observed (QOF) to Expected DIABETES Prevalence 2,144 65.0% 76.6% 29.1% 97.1% 81.6%

145 Prevalence of IMPAIRED GLUCOSE REGULATION (IGR) (%) 1,118 3.1% 3.4% 0.8% 4.8% n/a

146 Prevalence of MI last 12m, Stroke, CKD stage 5 in people with DIABETES aged 17+ (%) 39 1.9% 1.5% 0.4% 2.2% n/a

147 People with DIABETES in whom the latest HbA1c is 7.5 or less previous 12m (%) 1,295 63.4% 58.7% 50.2% 63.4% 79.4%

148 People with DIABETES who have had all 8 care processes in the previous 12m (%) 1,370 66.8% 63.8% 53.1% 73.9% n/a

149 People with DIABETES and HbA1c (%) 1,898 92.5% 92.8% 88.4% 95.9% n/a

150 People with DIABETES and BP recorded (%) 1,908 93.0% 94.0% 90.7% 96.7% n/a

151 People with DIABETES and Cholesterol recorded (%) 1,790 87.2% 88.8% 84.2% 92.4% n/a

152 People with DIABETES and Microalb recorded (%) 1,524 74.3% 72.3% 62.5% 79.5% n/a

153 People with DIABETES and Creatinine recorded (%) 1,860 90.6% 91.7% 86.8% 94.8% n/a

154 People with DIABETES and Foot Check (%) 1,724 84.0% 85.4% 79.3% 90.1% 81.2%

155 People with DIABETES and BMI recorded (%) 1,776 86.5% 86.9% 79.9% 92.8% n/a

156 People with DIABETES and Smoking Status recorded (%) 1,847 90.0% 89.8% 83.1% 95.1% n/a

157 People with DIABETES achieving all 3 treatment targets (Chol, BP, HbA1c) (%) 1,041 44.2% 43.1% 37.5% 46.2% n/a

158 People with DIABETES who have CHD and/or CKD (%) 775 32.9% 33.6% 28.5% 38.1% n/a

159 People with CKD and DIABETES or ACR>=70 with BP managed to 130/80 211 37.9% 40.9% 33.1% 52.0% n/a

160 Preventable sight loss - DIABETIC eye disease rate per 1,000 634 26.9% 29.0% 23.1% 36.4% n/a

161 Newly diagnosed DIABETICS aged 17+ in previous 12m offered structured education (%) 115 81.0% 75.5% 38.1% 93.2% n/a

162 Emergency admissions for DIABETIC COMPLICATIONS 9.00 0.19 0.45 0.19 0.92 n/a

163 DIABETES Specialist Nurses Face to Face Contacts 451 20.2 33.6 20.2 54.9 n/a

164 DIABETES Case Load 149 6.66 8.84 6.48 12.16 n/a

165 CARDIOVASCULAR DISEASE -

166 Eligible persons 40-74 years offered a HEALTH CHECK (letters sent) (%) 5 years cumulative 9,824 75.2% 70.5% 47.6% 94.1% 90.0%

167 Eligible persons 40-74 years with a HEALTH CHECK completed (uptake) (%) 5 years cumulative 4,529 46.1% 48.3% 29.8% 81.0% 48.1%

168 Eligible persons 40-74 years with a Health Check completed as % of eligible population 5 years cumulative 4,529 34.7% 34.0% 19.9% 51.5% 43.3%

169 People 40-74 with HYPERTENSION, CKD, BMI>30 who have had a risk score ever (%) 4,495 78.6% 78.1% 72.8% 85.4% n/a

170 People with Stage 3 CKD who have received a CVD risk score & ACR in the last 12m (%) 760 36.1% 33.0% 19.6% 50.3% n/a

171 Over 40 prevalence of PERIPHERAL VASCULAR DISEASE (%) 270 1.2% 1.8% 1.2% 2.7% n/a

172 Ratio of Observed (QOF) to Expected PAD Prevalence 279 51.6% 76.9% 39.8% 305.6% 57.9%

173 PERIPHERAL ARTERIAL DISEASE (PAD) Prevalence DSR per 100,000 population 310 734.5 1,047.4 734.5 1,514.8 n/a

174 GP ref, 1st outpatient attendances VASCULAR 84 1.76 1.90 0.82 2.37 n/a

175 GP ref, 1st outpatient attendances VASCULAR - % discharged after 1st appt 59 70.2% 70.5% 59.6% 87.7% n/a

176 HYPERTENSION -

177 CKD Prevalence DSR per 100,000 population 3,113 7,330.6 6,549.4 4,653.5 8,229.4 n/a

178 Ratio of Observed (QOF) to Expected CKD STAGE 3-5 Prevalence 2,339 103.3% 99.8% 52.7% 117.6% 62.3%

179 HYPERTENSION Prevalence DSR per 100,000 population 6,817 16,233.0 17,355.1 15,143.5 19,591.8 n/a

180 Ratio of Observed (QOF) to Expected HYPERTENSION Prevalence 6,744 57.3% 52.9% 18.4% 61.3% 50.6%

181 People aged 45+ with a record of blood pressure in the preceding 5 years (QOF) (%) 17,083 87.9% 90.9% 86.2% 93.1% 89.2%

182 People with HYPERTENSION whose latest BP reading is <150/90 (QOF) (%) 5,131 81.7% 82.7% 78.5% 86.9% 86.8%

183 People aged <80 with HYPERTENSION whose latest blood pressure reading is < 140/90 (%) 3,740 71.4% 71.1% 67.3% 76.1% n/a

184 People aged >=80 with HYPERTENSION whose latest blood pressure reading is < 150/90 (%) 1,175 90.0% 89.6% 86.7% 93.7% 86.8%

185 People with HYPERTENSION with physical activity recorded (%) 3,031 57.9% 57.4% 36.7% 82.0% n/a

186 People with HYPERTENSION who do not meet recommended activity levels who have received brief advice (%) 971 32.0% 57.4% 32.0% 70.1% n/a

IndicatorNetwork

Number

Network

Rate

Liverpool

Average

Liverpool


Liverpool

Highest

National

Average

187 CHD -

188 CVD Mortality - DSR per 100,000 population 201 168.1 239.8 168.1 320.8 n/a

189 CVD Mortality Under 75 Years - DSR per 100,000 population 65 56.0 90.2 56.0 150.9 72.5

190 CHD Prevalence DSR per 100,000 population 1,513 3,593.1 4,434.2 3,593.1 5,614.3 n/a

191 Ratio of Observed (QOF) to Expected CHD Prevalence 1,417 36.2% 44.0% 20.5% 110.5% 41.5%

192 People with CHD whose latest blood pressure reading (previous 12m) is 150/90 or less (%) 1,164 91.5% 91.6% 88.9% 95.4% 92.4%

193 People with CHD taking aspirin/anti-platelet therapy/anti-coagulant in last 12 months (QOF) (%) 1,227 96.2% 96.9% 94.2% 99.4% n/a

194 People with CHD whose latest total cholesterol (previous 12m) is 5mmol or less (%) 896 67.8% 66.6% 58.0% 74.3% n/a

195 People with CHD prescribed statins (%) 1,038 78.5% 79.3% 75.6% 83.0% n/a

196 Emergency admissions for ANGINA 29 0.6 0.9 0.6 1.7 n/a

197 GP ref, 1st outpatient attendances CARDIOLOGY 846 17.7 14.1 9.8 17.7 n/a

198 GP ref, 1st outpatient attendances CARDIOLOGY - % discharged after 1st appt 524 0.6 0.6 0.5 0.7 n/a

199 HEART FAILURE -

200 HEART FAILURE Prevalence DSR per 100,000 population 477 1,119.9 1,343.3 1,096.6 1,760.9 n/a

201 Ratio of Observed (QOF) to Expected HEART FAILURE Prevalence 378 82.2% 92.1% 59.8% 122.1% 72.8%

202 People with HEART FAILURE eligible who are prescribed a beta blocker (%) 88 93.6% 92.1% 86.3% 100.0% n/a

203 Emergency admissions for CONGESTIVE HEART FAILURE 53 1.1 1.3 0.6 1.9 n/a

204 HEART FAILURE Team Face to Face Contacts 147 6.6 13.3 6.6 33.3 n/a

205 HEART FAILURE Team Case Load <5 0.1 0.4 - 1.1 n/a

206 ATRIAL FIBRILLATION and STROKE -

207 ATRIAL FIBRILLATION Prevalence DSR per 100,000 population 1,042 2,435.9 2,518.6 2,194.0 3,012.8 n/a

208 People on the AF case finding search who have had their notes reviewed 30 9.5% 11.9% 3.5% 32.1% n/a

209 People with AF with CHADS2-VASc score 2 or more treated with anti-coagulation or anti-platelets therapy (%) 665 76.0% 77.7% 60.2% 81.1% 84.0%

210 People with AF with stroke risk assessed using CHA2DS2-VASc system in last 12 mths (excl. prev score of 2+) (QOF) % 348 39.8% 42.4% 34.6% 71.2% 93.6%

211 People on Warfarin who have INR recorded in last 12 months (%) 357 94.7% 96.9% 92.8% 100.0% n/a

212 STROKE/TIA Prevalence DSR per 100,000 population 809 1,909.9 2,317.6 1,909.9 2,907.9 n/a

213 Ratio of Observed (QOF) to Expected STROKE Prevalence 797 56.6% 56.2% 10.8% 73.4% 56.8%

214 People with STROKE/TIA prescribed antiplatelet or anticoag (%) 678 89.7% 89.7% 86.0% 93.3% 91.7%

215 People with STROKE/TIA referred for further investigation after last stroke or first TIA (QOF) % 306 87.7% 88.3% 78.1% 94.3% 83.4%

216 People with STROKE/TIA whose latest total cholesterol (prev 12m) is 5mmol or less (%) 445 58.9% 60.0% 54.4% 66.9% n/a

217 Emergency admissions for STROKE 63 1.32 1.39 0.56 1.74 n/a

218 EPILEPSY -

219 Children with EPILEPSY 0-17 years (%) 18 0.2% 0.3% 0.2% 0.4% n/a

220 EPILEPSY Prevalence DSR per 100,000 population 298 693.0 969.5 693.0 1,137.6 n/a

221 Emergency admissions for EPILEPSY 45 0.9 1.4 0.5 3.6 n/a

222 MENTAL HEALTH -

223 COMMON MENTAL HEALTH PROBLEMS -

224 Children and Young People with COMMON MENTAL HEALTH PROBLEMS (CMHP) 0-25 years (%) 346 2.7% 3.3% 2.3% 4.7% n/a

225 CMHP (Depression, Anxiety and Stress) Prevalence (GP Recorded) DSR per 100,000 population 5,391 12,409.6 15,284.2 12,409.6 19,842.4 n/a

226 People with CMHP with no other LTCs (%) 3,124 57.9% 57.2% 50.7% 76.0% n/a

227 People with CMHP with 1 other LTC (%) 1,200 22.3% 22.1% 15.0% 23.8% n/a

228 People with CMHP with 2 other LTCs (%) 548 10.2% 10.9% 5.6% 12.8% n/a

229 People with CMHP and CHD (%) 315 5.8% 6.3% 2.2% 8.2% n/a

230 People with CMHP and COPD (%) 285 5.3% 7.4% 4.0% 9.5% n/a

231 People with CMHP and Cancer (%) 427 7.9% 7.1% 2.0% 10.0% n/a

232 People with CMHP and Diabetes (%) 426 7.9% 9.1% 3.5% 11.1% n/a

233 People with CMHP and Hypertension (%) 1,226 22.7% 21.8% 7.7% 28.0% n/a

234 People with CMHP and SMI (%) 284 5.3% 4.7% 3.4% 6.7% n/a

235 People with CMHP and Current Smoker 15+ (%) 1,070 19.9% 31.5% 19.9% 39.1% n/a

236 Children and Adolescent Mental Health Services (CAMHS) Referrals per 1,000 310 23.8 22.5 2.1 40.3 n/a

237 Children and Adolescent Mental Health Services (CAMHS) Assessments per 1,000 249 19.1 15.7 1.5 27.7 n/a

238 Children and Adolescent Mental Health Services (CAMHS) 1st Interventions per 1,000 220 16.9 13.4 1.4 23.5 n/a

239 People 18+ with a new diagnosis of DEPRESSION who have been reviewed 10-56 days after diagnosis (QOF) (%) 439 75.2% 79.3% 55.9% 86.9% 64.2%

240 Access to early intervention teams rate per 1,000 18 0.40 0.60 0.35 0.99 n/a

241 IAPT referral rate per 1,000 1,175 31.3 33.1 27.0 39.3 n/a

242 SERIOUS MENTAL ILLNESS -

243 Children and Young People with SERIOUS MENTAL ILLNESS (SMI) 0-25 years (%) 23 0.2% 0.2% 0.1% 0.2% n/a

244 SMI Prevalence (Schizophrenia, Bipolar or Other Psychosis) DSR per 100,000 population 480 1,117.5 1,443.2 1,034.5 2,704.9 n/a

245 People with SMI with no other LTCs (%) 106 22.1% 27.8% 21.4% 35.5% n/a

246 People with SMI with 1 other LTC (%) 204 42.5% 39.0% 33.3% 43.0% n/a

247 People with SMI with 2 other LTCs (%) 83 17.3% 18.3% 12.1% 23.3% n/a

248 People with SMI and CHD (%) 27 5.6% 5.0% 2.6% 8.1% n/a

249 People with SMI and COPD (%) 36 7.5% 8.1% 5.1% 11.3% n/a

250 People with SMI and CANCER (%) 40 8.3% 5.1% 1.8% 8.3% n/a

251 People with SMI and Diabetes (%) 44 9.2% 12.9% 7.0% 16.2% n/a

252 People with SMI and CMHP (%) 284 59.2% 50.5% 43.8% 59.2% n/a

253 People with SMI and Hypertension (%) 111 23.1% 18.7% 10.6% 23.1% n/a

254 People with SMI and Current Smoker 15+ (%) 164 34.2% 49.8% 34.2% 63.6% n/a

255 People with SMI receiving list of physical checks previous 12 months (%) 145 34.1% 34.5% 21.6% 40.2% n/a

256 People on lithium therapy with a record of serum creatinine and TSH in last 9 mths (QOF) (%) 50 98.0% 97.3% 94.1% 100.0% 94.2%

257 People with SMI who have a comprehensive care plan documented in the record, in last 12 mths (QOF) (%) 317 90.8% 88.5% 70.4% 94.2% 78.2%

258 People with SMI who have a record of blood pressure in last 12 mths (QOF) (%) 311 87.4% 86.8% 77.9% 93.6% 81.5%

259 People with SMI who have a record of alcohol consumption in last 12 mths (QOF) (%) 311 86.6% 87.7% 75.7% 96.5% 80.6%

260 Women aged 25-64 with SMI with a cervical screening test performed in last 5 years (QOF) (%) 80 81.6% 84.4% 76.4% 95.5% 69.6%

261 Referrals to Community MENTAL HEALTH rate per 1,000 596 13.3 17.7 10.1 23.1 n/a

262 Community MENTAL HEALTH contacts rate per 1,000 596 13.3 17.7 10.1 23.1 n/a

263 Referrals to PSYCHIATRIC LIAISON rate per 1,000 261 5.82 10.29 5.74 16.27 n/a

264 Social Services Users MENTAL HEALTH as a % of persons with a serious mental illness 30 5.7% 34.1% 5.7% 53.9% n/a

265 Child AED attendances - MENTAL HEALTH (3 Year Pooled) 75 3.03 3.45 1.96 6.69 n/a

266 Emergency admissions for MENTAL HEALTH 79 1.66 2.30 1.55 3.63 n/a

267 MUSCULOSKELETAL -

268 RHEUMATOID ARTHRITIS prevalence 221 0.6% 0.7% 0.1% 1.0% 0.7%

269 RHEUMATOID ARTHRITIS estimated prevalence <5 100.0% 100.0% 100.0% 100.0% n/a

270 People with RHEUMATOID ARTHRITIS having a face by face review in last 12 months (QOF - RA002) 202 91.8% 93.5% 86.2% 97.5% 84.1%

271 People with OSTEOPOROSIS aged 50-74 with a fragility fracture (QOF) 35 74.5% 80.9% 42.9% 97.7% n/a

272 People with OSTEOPOROSIS aged 75 and over with a fragility fracture (QOF) 76 64.4% 67.0% 33.3% 87.5% n/a

273 People with OSTEOPOROSIS aged 50-74 with a fragility fracture treated with bone-sparing agent (QOF) 30 88.2% 82.1% 66.7% 100.0% 71.3%

274 People with OSTEOPOROSIS aged 75 and over with a fragility fracture treated with bone-sparing agent (QOF) 61 82.4% 70.7% 50.0% 100.0% 59.7%

275 Admission rate FACET JOINT INJECTIONS (3+ Admissions) 6 0.13 0.23 0.00 0.66 n/a

276 Admission rate EPIDURAL/SPINAL NERVE ROOT INJECTIONS FOR NON ESPECIFIC BACK/ PAIN (3+ admissions) 6 0.13 0.04 0.00 0.13 n/a

277 GP ref, 1st outpatient attendances RHEUMATOLOGY 180 3.77 3.38 2.09 4.72 n/a

278 GP ref, 1st outpatient attendances RHEUMATOLOGY - % discharged after 1st appt 105 58.3% 51.6% 39.5% 66.9% n/a

279 RESPIRATORY -

280 RESPIRATORY Mortality - DSR per 100,000 population 143 122.3 180.0 122.3 276.4 n/a

281 RESPIRATORY Mortality Under 75 Years - DSR per 100,000 population 27 23.7 58.2 23.7 119.3 34.3

282 Community RESPIRATORY team Face to Face contacts 219 9.8 26.1 9.8 44.5 n/a

283 Community RESPIRATORY Team Case Load 8 0.36 0.31 - 0.79 n/a

284 Child AED attendances - LRTI 387 47.8 63.2 47.8 80.1 n/a

285 Emergency admissions for LOWER RESPIRATORY TRACT INFECTION (LRTI) rate per 1,000 aged 0-18 years 41 4.8 5.3 3.8 7.9 n/a

286 Emergency admissions for FLU & PNEUMO 155 3.25 4.21 3.21 5.37 n/a

287 GP ref, 1st outpatient attendances RESPIRATORY 213 4.47 4.42 2.76 5.35 n/a

288 GP ref, 1st outpatient attendances RESPIRATORY - % discharged after 1st appt 43 20.2% 22.3% 14.8% 32.8% n/a

IndicatorNetwork

Number

Network

Rate

Liverpool

Average

Liverpool


Liverpool

Highest

National

Average

289 COPD -

290 COPD Prevalence DSR per 100,000 population 1,048 2,499.2 4,118.6 2,499.2 5,885.0 n/a

291 Ratio of Observed (QOF) to Expected COPD Prevalence 907 71.1% 102.4% 58.0% 1923.8% 61.9%

292 People with COPD and diagnosis confirmed by post bronchodilator spirometry (QOF) (%) 470 84.8% 88.0% 84.8% 91.1% 80.8%

293 People with COPD and MRC dyspnoea grade ≥3 and oxygen saturation value in last 12 months (QOF) (%) 357 98.9% 96.1% 92.8% 98.9% 95.6%

294 People with COPD and an influenza vaccination in the preceeding Aug-March (QOF) (%) 626 90.9% 93.5% 86.3% 98.7% 80.0%

295 People with COPD with record of FEV1 in previous 12 mths (QOF) (%) 543 80.3% 77.3% 61.6% 83.1% 71.1%

296 People with COPD reviewed, including assessment of MRC dyspnoea in last 12 mths (QOF) (%) 752 88.4% 88.7% 80.8% 93.3% 79.4%

297 People with COPD & MRC dyspnoea scale >=3 offered pulmonary rehab EVER (%) 357 98.9% 96.1% 92.8% 98.9% n/a

298 Emergency admissions for COPD 92 1.93 3.43 1.66 5.53 n/a

299 ASTHMA -

300 Children with ASTHMA 0-17 years (%) 351 4.4% 4.1% 3.4% 4.8% n/a

301 Young People with ASTHMA aged 18-25 years (%) 208 4.4% 3.9% 2.4% 5.9% n/a

302 ASTHMA Prevalence DSR per 100,000 population 2,580 5,986.4 6,692.0 5,986.4 7,696.2 n/a

303 Ratio of Observed (PCQF) to Expected ASTHMA Prevalence 2,678 64.9% 60.0% 30.9% 74.8% 117.4%

304 People with ASTHMA Day and Night Symptoms Recorded (%) 1,784 69.1% 68.4% 59.7% 75.0% n/a

305 People with ASTHMA aged 8+ with measures of variability or reversibility recorded (QOF) (%) 856 91.4% 93.0% 90.1% 94.9% 84.9%

306 People with ASTHMA with asthma review, including assessment using 3 RCP questions (QOF) (%) 1,750 72.7% 76.4% 71.1% 82.2% 70.2%

307 People with ASTHMA aged 14-19 years with record of smoking status in last 12 months (QOF) (%) 148 90.8% 90.8% 85.6% 95.7% 83.5%

308 Emergency admissions for ASTHMA 26 0.55 1.26 0.55 2.01 n/a

309 SEGMENT 3. DISABILITY -

310 Children on the Voluntary Disability Register - Rate per 10,000 under 18 years 79 106.0 123.2 75.8 175.8 n/a

311 LEARNING -

312 LEARNING DISABILITIES Prevalence DSR per 100,000 population 176 400.9 412.7 106.3 606.4 n/a

313 Persons 18+ with a LEARNING DISABILITY and HEALTH CHECK completed (%) 105 61.8% 58.2% 35.1% 76.4% 48.1%

314 Persons 18+ with a LEARNING DISABILITY eligible for a Health Check and health action plan completed (%) 42 24.7% 28.9% 6.4% 48.6% n/a

315 Social Services Users LEARNING DISABILITIES as a % of persons with a learning disability 104 77.7% 84.8% 49.3% 110.5% n/a

316 PHYSICAL -

317 VISUAL IMPAIRMENT Prevalence DSR per 100,000 population 472 1,092.5 1,538.9 1,092.5 2,223.6 n/a

318 HEARING IMPAIRMENT Prevalence DSR per 100,000 population 2,837 6,585.9 6,941.5 5,045.5 7,917.7 n/a

319 Social Services Users PHYSICAL & SENSORY SUPPORT per 1,000 65+ resident population 414 57.4 76.4 43.4 112.3 n/a

320 Social Services Users DOMICILIARY CARE per 1,000 65+ resident population 268 37.1 43.8 24.8 60.0 n/a

321 Social Services Users EQUIPMENT AND ADAPTATIONS per 1,000 65+ resident population 154 21.4 26.1 15.9 35.1 n/a

322 SEGMENT 4. COMPLEX LIVES -

323 Children in Need - Rate per 10,000 under 18 years 156 209.3 375.9 192.3 571.4 330.4

324 Looked After Children - Rate per 10,000 under 18 years 43 57.7 128.2 55.6 233.1 62.0

325 Child Protection Plan - Rate per 10,000 under 18 years 29 38.9 58.9 38.9 87.6 43.3

326 Early Help Assessment Tool (EHAT) Family Assessments (%) 146 2.0% 3.0% 2.0% 0.0 n/a

327 Troubled Families - Rate per 1,000 population 550 12.8 25.9 12.8 49.8 n/a

328 Child AED attendances - ACCIDENTS 775 95.8 116.0 74.7 155.6 n/a

329 Emergency admissions due to UNINTENTIONAL and DELIBERATE INJURIES (0-24 years) DSR per 100,000 143 1,135.2 1,298.1 685.9 1,869.6 n/a

330 Emergency admissions for SELF HARM under 18s 13 1.6 1.5 - 2.4 n/a

331 Hospital admissions as a result of SELF-HARM (10-24 years) DSR per 100,000 25 323.7 403.1 113.5 723.9 421.2

332 Persons under 18 admitted to hospital for ALCOHOL-SPECIFIC conditions crude rate per 100,000 (3 Year Pooled) 10 39.4 49.1 21.8 106.7 32.9

333 Hospital admissions due to SUBSTANCE MISUSE (15-24 years) DSR per 100,000 (3 Year Pooled) 5 30.6 84.0 21.6 190.5 87.9

334 MH emergency admissions MENTAL & BEHAVIOURAL - ALCOHOL 33 0.7 1.6 0.7 2.6 n/a

335 MH emergency admissions Mental and Behavioural - OTHER PSYCHOACTIVE SUBSTANCES 34 0.8 1.8 0.8 2.9 n/a

336 Emergency admissions for VIOLENCE 53 1.1 2.6 1.1 6.6 n/a

337 Emergency admissions for SELF HARM over 18s 51 1.4 2.9 1.4 5.5 n/a

338 ALCOHOL RELATED (F10 or K70) inpatient admission in last 2 years DSR per 100,000 195 459.3 868.9 459.3 2,269.5 n/a

339 ALCOHOL SPECIFIC admissions DSR per 100,000 56 118.6 315.1 118.6 875.9 118.3

340 ALCOHOL RELATED admissions [BROAD] DSR per 100,000 837 1,963.6 2,914.7 1,963.6 6,096.5 2,224.0

341 People registered as homeless by their GP rate per 1,000 6 0.1 1.9 0.1 14.8 -

342 People with 10 or more Accident and Emergency attendances in last 12 months rate per 1,000 70 1.6 2.4 1.6 3.1 n/a

343 SEGMENT 5. FRAILTY AND DEMENTIA -

344 FRAILTY -

345 Income Deprivation Affecting Older People Index (IDAOPI) 2015 - 21.9% 34.2% 21.4% 47.0% 15.3%

346 Population 65+ (%) 7,558 16.8% 14.4% 1.8% 20.4% 17.9%

347 Population 75+ (%) 3,405 7.6% 6.3% 0.5% 9.4% 8.1%

348 Population 85+ (%) 940 2.1% 1.7% 0.1% 2.9% 2.4%

349 Population 95+ (%) 75 0.2% 0.1% 0.0% 0.2% 0.2%

350 People with a MILD frailty score (%) 407 18.2% 17.3% 0.8% 35.7% n/a

351 People with a MODERATE frailty score (%) 1,249 55.9% 51.3% 40.1% 65.5% n/a

352 People with a SEVERE frailty score (%) 577 25.8% 31.3% 24.2% 47.6% n/a

353 Injuries due to FALLS 65+ 198 26.3 33.0 25.5 51.0 n/a

354 Emergency admissions for HIP FRACTURES aged over 65 43 5.7 7.2 5.2 9.4 n/a


356 Emergency admissions for CELLULITIS 70 1.5 1.7 1.4 2.3 n/a


358 Emergency admissions for DEMENTIA aged over 65 10 1.7 1.7 0.2 7.3 n/a


360 Emergency admissons for GASTRO/DEHYDRATION 11 0.2 0.2 - 0.5 n/a

361 Emergency admissions for PYLO NEFRITIS 18 0.4 0.6 0.4 1.0 n/a


363 RESIDENTIAL & NURSING placements TOTAL per 1,000 65+ resident population 90 12.4 28.8 9.4 56.7 n/a

364 Emergency admissions from CARE HOMES 84 14.1 22.6 2.3 81.6 n/a


366 OLDER PEOPLE still at home 91 days after discharge from hospital into reablement/rehabilitation service (residents) % 23 85% 84% 74% 96% n/a

367 Social Services Users OLDER PERSONS per 1,000 65+ resident population 617 85.7 115.9 85.7 147.2 n/a

368 Social Services Users SUPPORT WITH MEMORY AND COGNITION per 1,000 65+ resident population 43 6.0 9.2 4.3 14.5 n/a




372 Social Services Users OTHER COMMUNITY per 1,000 65+ resident population 110 15.3 40.3 15.3 71.2 n/a

373 CARERS Prevalence (GP Recorded) DSR per 100,000 population 1,034 2,440.7 2,854.9 1,781.5 3,873.6 n/a

374 DEMENTIA -

375 DEMENTIA Prevalence DSR per 100,000 population 282 642.6 792.0 565.2 1,142.9 n/a

376 Ratio of Observed (QOF) to Expected DEMENTIA (Dementia UK 2014) Prevalence 254 48.3% 64.7% 43.1% 92.0% 60.0%

377 Ratio of Observed (QOF) to Expected DEMENTIA (CFAS II) Prevalence 254 54.4% 73.0% 48.7% 104.2% 67.4%

378 People with DEMENTIA with no other LTCs (%) 21 7.4% 9.3% 4.8% 14.3% n/a

379 People with DEMENTIA with 1 other LTC (%) 62 22.0% 19.3% 14.3% 26.9% n/a

380 People with DEMENTIA with 2 other LTCs (%) 90 31.9% 25.5% 17.7% 31.9% n/a

381 People with DEMENTIA whose care has been reviewed in a face-to-face review in last 12 mths (QOF) (%) 207 84.5% 83.2% 70.8% 89.9% 77.5%

382 People with a new diagnosis of DEMENTIA and a record of tests in primary care (QOF) (%) 58 86.6% 84.3% 50.0% 92.0% 68.0%



IndicatorNetwork

Number

Network

Rate

Liverpool

Average

Liverpool


Liverpool

Highest

National

Average

385 SEGMENT 6. END OF LIFE -

386 SHORT PERIOD OF DECLINE AND DYING (CANCER) -

387 END OF LIFE / Palliative Care Prevalence DSR per 100,000 population 259 609.4 642.8 430.0 1,071.9 n/a

388 Emergency admissions END OF LIFE 111 14.7 19.4 13.3 23.9 n/a

389 CANCER Mortality - DSR per 100,000 population 316 258.0 303.7 246.8 391.1 268.0

390 LUNG CANCER - DSR per 100,000 population 60 49.2 85.7 49.2 148.3 56.3

391 ALL DIGESTIVE DISEASES CANCER Mortality - DSR per 100,000 population 105 83.7 87.5 63.7 119.4 n/a

392 CANCER Mortality Under 75 Years - DSR per 100,000 population 140 119.8 157.3 119.8 201.8 134.6

393 LUNG CANCER Mortality Under 75 Years - DSR per 100,000 population 26 22.9 45.4 22.9 84.0 n/a

394 ALL DIGESTIVE DISEASES CANCER Mortality Under 75 Years - DSR per 100,000 population 57 48.0 46.4 32.2 59.8 n/a

395 CANCER Prevalence DSR per 100,000 population 2,497 5,909.7 5,601.0 4,302.0 6,470.9 n/a

396 NEUROLOGICAL (PARKINSONS, MND) -

397 ORGAN FAILURE (HEART, LUNG, LIVER) -

398 HEART FAILURE Prevalence DSR per 100,000 population 477 1,119.9 1,343.3 1,096.6 1,760.9 n/a

399 Ratio of Observed (QOF) to Expected HEART FAILURE Prevalence 378 82.2% 92.1% 59.8% 122.1% 72.8%

400 CKD Prevalence DSR per 100,000 population 3,113 7,330.6 6,549.4 4,653.5 8,229.4 n/a

401 Ratio of Observed (QOF) to Expected CKD STAGE 3-5 Prevalence 2,339 103.3% 99.8% 52.7% 117.6% 62.3%

402 ACUTELY ILL -

403 EMERGENCY CARE/GP Enhanced Access -

404 111 call rate per 1,000 weighted population 5,039 112.3 149.7 99.1 179.0 n/a

405 Walk in Centre attendances 12,139 254.5 213.6 107.4 324.2 n/a

406 A&E not admitted (using discharge method, discharge with no treatment, no follow up) 11,627 243.8 246.6 187.7 329.1 n/a

407 Total NEL admissions <=1 day LOS rate per 1,000 2,760 57.9 72.0 55.1 97.1 n/a

408 Total NEL admissions >2 day LOS rate per 1,000 1,888 39.6 53.0 39.6 61.9 n/a

409 Child AED attendance rate per 1,000 population aged 0-4 years 1,386 567.4 740.7 567.4 878.2 n/a

410 Child AED attendances - ACCIDENTS 775 95.8 116.0 74.7 155.6 n/a

411 Child AED attendances - LRTI 387 47.8 63.2 47.8 80.1 n/a

412 Child AED attendances - MENTAL HEALTH (3 Year Pooled) 75 3.0 3.4 2.0 6.7 n/a

413 Child Emergency Admission Average Length of Stay <1 day 383 47.3 56.7 47.3 77.5 n/a

414 Rate per 1,000 HCHS weighted pop for GP Spec AE attendances 233 4.9 7.4 4.0 12.0 n/a

415 Rate per 1,000 HCHS weighted pop for GP Spec ACS admissions 378 7.9 12.2 7.9 14.5 n/a

416 ALCOHOL RELATED admissions [BROAD] DSR per 100,000 837 1,963.6 2,914.7 1,963.6 6,096.5 2,224.0

417 ALCOHOL SPECIFIC admissions DSR per 100,000 56 118.6 315.1 118.6 875.9 118.3


419 Emergency admissions for ASTHMA 26 0.5 1.3 0.5 2.0 n/a

420 Emergency admissions for ASTHMA, DIABETES and EPILEPSY Rate per 1,000 aged 0-18 years 6 0.7 0.8 0.3 1.3 n/a

421 Emergency admissions for CANCER 241 5.1 5.6 2.9 6.8 n/a

422 Emergency admissions for CELLULITIS 70 1.5 1.7 1.4 2.3 n/a


424 Emergency admissions for COPD 92 1.9 3.4 1.7 5.5 n/a


426 Emergency admissions for DIABETIC COMPLICATIONS 9 0.2 0.5 0.2 0.9 n/a

427 Emergency admissions for ENT 97 2.0 2.0 0.9 3.6 n/a

428 Emergency admissions for EPILEPSY 45 0.9 1.4 0.5 3.6 n/a


430 Emergency admissons for GASTRO/DEHYDRATION 11 0.2 0.2 - 0.5 n/a

431 Emergency admissions for HIP FRACTURES aged over 65 43 5.7 7.2 5.2 9.4 n/a

432 Emergency admissions for LOWER RESPIRATORY TRACT INFECTION (LRTI) rate per 1,000 aged 0-18 years 41 4.8 5.3 3.8 7.9 n/a

433 Emergency admissions for MENTAL HEALTH 79 1.7 2.3 1.6 3.6 n/a

434 Emergency admissions for PYLO NEFRITIS 18 0.4 0.6 0.4 1.0 n/a

435 Emergency admissions for SELF HARM over 18s 51 1.4 2.9 1.4 5.5 n/a


437 Emergency admissions for VIOLENCE 53 1.1 2.6 1.1 6.6 n/a

438 Injuries due to FALLS 65+ 198 26.27 32.96 25.54 51.05 n/a

439 Emergency re-admissions within 30 days to hospital (%) 741 0.1 0.1 0.1 0.2 0.1

440 Emergency admissions END OF LIFE 111 14.7 19.4 13.3 23.9 n/a

441 Emergency admissions from CARE HOMES 84 14.1 22.6 2.3 81.6 n/a

442 GP REFERRED 1st OUTPATIENT ATTENDANCES (rate per 1,000 HCHS population) -

443 GP ref, 1st outpatient attendances 4,316 90.5 80.3 69.5 91.7 n/a

444 GP ref, 1st outpatient attendances CARDIOLOGY 846 17.7 14.1 9.8 17.7 n/a

445 GP ref, 1st outpatient attendances CARDIOLOGY - % discharged after 1st appt 524 61.9% 62.6% 53.1% 72.9% n/a

446 GP ref, 1st outpatient attendances DERMATOLOGY 816 17.1 12.6 8.8 17.4 n/a

447 GP ref, 1st outpatient attendances DERMATOLOGY - % referred on 2WW 416 51.0% 54.1% 41.7% 63.8% n/a

448 GP ref, 1st outpatient attendances DERMATOLOGY - % discharged after 1st appt 223 27.3% 33.1% 27.3% 41.5% n/a

449 GP ref, 1st outpatient attendances ENT 857 18.0 16.1 11.8 18.1 n/a

450 GP ref, 1st outpatient attendances ENT - % referred on 2WW 112 13.1% 15.6% 10.2% 21.8% n/a

451 GP ref, 1st outpatient attendances ENT - % discharged after 1st appt 375 43.8% 42.7% 37.6% 48.2% n/a

452 GP ref, 1st outpatient attendances GASTRO 437 9.2 9.4 7.6 11.0 n/a

453 GP ref, 1st outpatient attendances GASTRO - % referred on 2WW 124 28.4% 31.7% 14.2% 52.6% n/a

454 GP ref, 1st outpatient attendances GASTRO - % discharged after 1st appt 167 38.2% 41.5% 29.6% 56.4% n/a

455 GP ref, 1st outpatient attendances GYNAECOLOGY 429 9.0 8.9 5.8 10.3 n/a

456 GP ref, 1st outpatient attendances GYNAECOLOGY - % discharged after 1st appt 120 28.0% 20.6% 16.3% 28.0% n/a

457 GP ref, 1st outpatient attendances RESPIRATORY 213 4.5 4.4 2.8 5.3 n/a

458 GP ref, 1st outpatient attendances RESPIRATORY - % discharged after 1st appt 43 20.2% 22.3% 14.8% 32.8% n/a

459 GP ref, 1st outpatient attendances RHEUMATOLOGY 180 3.8 3.4 2.1 4.7 n/a

460 GP ref, 1st outpatient attendances RHEUMATOLOGY - % discharged after 1st appt 105 58.3% 51.6% 39.5% 66.9% n/a

461 GP ref, 1st outpatient attendances UROLOGY 503 10.5 9.0 6.3 10.5 n/a

462 GP ref, 1st outpatient attendances UROLOGY - % discharged after 1st appt 166 33.0% 41.6% 30.8% 53.5% n/a

463 GP ref, 1st outpatient attendances UROLOGY - % referred on 2WW 184 36.6% 34.5% 25.2% 46.8% n/a

464 GP ref, 1st outpatient attendances VASCULAR 84 1.8 1.9 0.8 2.4 n/a

465 GP ref, 1st outpatient attendances VASCULAR - % discharged after 1st appt 59 70.2% 70.5% 59.6% 87.7% n/a

466 COMMUNITY AND GENERAL PRACTICE SERVICES NEED AND EXPERIENCE -

467 Patient Experience: Overall good experience of making an appointment (%) 407 76.2% 70.4% 60.4% 80.3% n/a

468 Patient experience: Overall Experience of General Practice (%) 539 90.1% 85.7% 77.8% 92.0% n/a

469 Community Matrons Face to Face Contacts 1,287 57.6 59.4 22.9 106.4 n/a

470 Community Matrons Case Load 24 1.1 0.9 0.4 2.9 n/a

471 Community RESPIRATORY team Face to Face contacts 219 9.8 26.1 9.8 44.5 n/a

472 Community RESPIRATORY Team Case Load 8 0.4 0.3 - 0.8 n/a

473 DIABETES Specialist Nurses Face to Face Contacts 451 20.2 33.6 20.2 54.9 n/a

474 DIABETES Case Load 149 6.7 8.8 6.5 12.2 n/a

475 District Nursing Face to Face Contacts 16,096 719.9 1,102.6 719.9 1,402.3 n/a

476 District Nursing Case Load 230 10.3 12.8 10.3 16.7 n/a

477 HEART FAILURE Team Face to Face Contacts 147 6.6 13.3 6.6 33.3 n/a

478 HEART FAILURE Team Case Load <5 0.1 0.4 - 1.1 n/a

479 IV Therapy Face to Face Contacts 244 10.9 17.4 3.7 43.6 n/a

480 IV Therapy Case Load 5 0.2 0.2 - 0.3 n/a

481 Therapy Face to Face Contacts 6,816 304.8 388.1 195.2 483.1 n/a

482 Therapy Case Load 1,209 54.1 67.4 30.5 84.5 n/a

483 Treatment Rooms Face to Face Contacts 4,921 220.1 216.3 73.3 332.5 n/a

484 Treatment Rooms Case Load 106 4.7 5.8 1.0 13.3 n/a

485 Telehealth referrals rate per 1,000 adult registered pop 820 36.7 23.8 1.0 125.8 n/a

486 Referrals to Community MENTAL HEALTH rate per 1,000 596 13.3 17.7 10.1 23.1 n/a

IndicatorNetwork

Number

Network

Rate

Liverpool

Average

Liverpool


Liverpool

Highest

National

Average

487 SOCIAL CARE NEED (LIVERPOOL CITY COUNCIL) -

488 Social Services Users TOTAL per 1,000 40+ resident population 731 83.2 185.9 71.7 348.5 n/a

489 Social Services Users OLDER PERSONS per 1,000 65+ resident population 617 85.7 115.9 85.7 147.2 n/a

490 Social Services Users MENTAL HEALTH as a % of persons with a serious mental illness 30 5.7% 34.1% 5.7% 53.9% n/a

491 Social Services Users LEARNING DISABILITIES as a % of persons with a learning disability 104 77.7% 84.8% 49.3% 110.5% n/a













504 OLDER PEOPLE still at home 91 days after discharge from hospital into reablement/rehabilitation service (residents) % 23 85.3% 84.2% 74.0% 96.0% n/a