Effective public health intelligence for London

1. Effective public health intelligence for London Justine Fitzpatrick, Allan Baker London Health Observatory

2. Learning objectives Understand the networks and partnerships working to provide public health intelligence for London Understand the LHO and its role in supporting public health and commissioning in London

3. What will be covered? What is the London Health Observatory? Overview of health intelligence partners in London Overview of current work at London Health Observatory An example: the health inequalities indicator in the World Class Commissioning Framework A discussion: What are the current priorities for public health intelligence in London?

4. APHO: The Observatory Network and Lead Areas LHO lead areas: • Health inequalities • Ethnicity • Smoking • NICE

5. The functions of PHOs in England To work in partnership with researchers, regional and local health policy makers and practitioners to: Monitor trends in health and its determinants, highlighting areas for action Highlight future health problems Assess the health impact of potential and past policies Draw together information from different sources and to identify gaps in information Provide standard sets of community health information at local government and regional level To support the development of skills in public health practitioners and NHS staff, for example in equity audits and health impact assessments, and build capacity in public health intelligence. Adapted from “Saving Lives - Our Healthier Nation” a “Choosing Health – Making Healthier Choices Easier”

6. What sort of work does LHO do? : RESPONSIVE PRO-ACTIVE Support health practitionerand intelligence networks Enquiry serviceSignposting dataand information Tools and methodsfor data analysis Communication and advocacy for better public health information. Widening access to data In depth analysis/interpretation of health data Public healthperformance monitoring

7. Role of PHOs in health intelligence Collecting Data/ Information Using Health Intelligence To Improve Health & Care Collating/ Processing Data Turning Data into Health Intelligence Other Agencies Public Health Observatory role

8. Universities Department of Health Office for National Statistics National Organisations HealthProtectionAgency Regional Office of DH and NHS London GovernmentOffice for London Regional Organisations Thames Cancer Registry LHO (CSL) Greater London Authority AcuteTrusts PrimaryCareTrusts Local Authorities Local Organisations

9. Commissioning Support for London

10. LHO Governance LHO Core Work LHO PCT Intelligence Work APHO Executive LHO Advisory Board

11. Examples of current LHO Work • London Programme • London boost of the Health Survey for England (mental health and social capital) • Child health profiles • Local authority health profiles 2009 • Enquiry service (HES and general enquiries) • Small area indicators for PCTs • Practice profiles refresh • Public health performance reports • CSL (PCT Intelligence) • Health needs assessment toolkit • Health performance dashboard • National Programme • Local smoking profiles • The Health Inequalities Intervention Tool • The Local Basket of Inequalities Indicators • Physical activity social marketing tool

12. Who uses our services?

13. How is LHO work commissioned? • LHO enquiry service • Individual PCTs • CSL business partners • London’s DsPH • Other London partners (NHS London, RPHG, GOL, GLA etc) • APHO Executive • Department of Health • Information Centre

14. Useful links • Recommended to explore website! • Enquiry service: lho.enquiries@csl.nhs.uk • LHO website www.lho.org.uk • APHO website www.apho.org.uk • CSL website www.csl.nhs.uk

15. World Class CommissioningAssurance Framework - Health Inequalities Indicator Allan Baker London Health Observatory

16. WCC Assurance Framework 54 Indicators PCTs select 8 to reflect strategic priorities 2008 – 2 compulsory indicators: Life expectancy Index of Multiple Deprivation DH requested advice for replacing IMD

17. Selection of a new indicator • 30th July – APHO meet with DH • London Health Observatory – leads on health inequalities • East Midlands PHO – recently researched methods for measuring health inequalities within a PCT

18. Criteria • Mortality indicator to show extent of inequalities within PCTs • Easy to understand and interpret • Robust • Relate to other health inequality resources • Consistent over time • Available quickly

19. Options • Which measure of mortality • All ages, all causes - or subsets • Sex-specific – or all persons • Time period • Geography

20. Options – type of indicator • Range indicator • Lorenz curve based indicator • Slope indices

21. Recommendation for a new indicator • 7 August – recommendation to DH • Life expectancy at birth – 5 years data • Deprivation deciles within PCTs • Deciles based on LSOAs • Sex-specific • Slope index of inequality

22. Slope Index of Inequality

23. Timetable for delivery • 18th August – DH agree to proposal • 7th Sept – APHO provide data • 15th Sept – APHO provide metadata • 16th Sept – WCC Datapacks launched

24. WCC Datapack – SII results for London

25. SII Results by IMD scores

26. SII results by Life Expectancy

27. Distribution of deprivation – percentage of population in national deprivation quintiles • Barking and Dagenham – 92% in Q4 & Q5 • Richmond – 82% in Q1 & Q2 • Westminster – spread between Q2 – Q5 • Tower Hamlets – 90% in Q4 & Q5

28. Next steps • Analysis of results • Trend data – 2001-05 and 2002-06 • Latest data – 2004-2008 • Guidance on trajectory setting

29. APHO website www.apho.org.uk/resource/view.aspx?RID=75050 APHO recommendation Slope Index of Inequality dataset Guide to interpretation Life expectancy results for deprivation deciles Summary charts for each PCT LSOA to deprivation decile look-up

30. Questions?Discussion: what are the current priorities for public health intelligence in London?