Agenda item

5     a) HWB Strategy Performance Dashboard

b) Reducing Emergency Readmissions for People with Long

               Term Conditions

c) Update on Cancer priority outcome in the Health and Wellbeing   

    Strategy

5.1      HWB Strategy Performance Dashboard

Dr Danny Ruta (Director of Public Health, LBL), presented the report, highlighting the following points:

·           A review of Lewisham’s Health and Wellbeing Strategy Delivery Plan shows that good progress is being made in implementing the strategy, with the majority of actions rated as green. Plans are in place to address actions rated amber or red.

·           Potential years of life lost (PYLL) from causes considered amenable to healthcare has significantly reduced in Lewisham.

·            Human Papilloma Virus has decreased significantly.

·           The alcohol related admission rate is increasing.

·           The smoking quit rate is decreasing, although Lewisham is still performing better than the London average.

·           The rate of new admissions to long-term care is decreasing, but the percentage of older people (65+) still at home 91 days after discharge from hospital has not changed significantly.

·           The avoidable emergency admission rate is reducing and the emergency admission rate for acute conditions that should not usually require hospital admission is decreasing.

5.2       The following issues were raised or highlighted in the discussion:

·           Future reports need only focus on exceptions.

·           The time-lag between flagging actions and the recording of the outcomes of those actions can sometimes be as long as ten (10) years. A more refined monitoring schedule is needed to explain the overall direction of travel.

5.3       Reducing Emergency Readmissions for People with Long-Term Conditions

Martin Wilkinson (Chief Officer, Lewisham CCG) updated the Board on the progress towards the objectives and outcomes to date on reducing emergency admission for people with long-term conditions, highlighting the following points:

• The work aligns well to the joint work being undertaken through the Adult Integration Programme and the Better Care Fund, with the report updating on the actions against each of the 4 deliverables underpinning Priority 9 attributed to Lewisham CCG.

• The Lewisham Neighbourhood Primary Care Improvement Scheme (LNPCIS) has been structured to support a reduction in emergency admissions with a specific focus on long-term conditions. It also directly supports practices to work collaborative together to improve the quality of and reduce variation in the delivery of services and care to patients with diabetes, COPD, hypertension and cancer.

• Wider pathway work has focused on conditions like Diabetes, COPD and Dementia.

5.4      In the discussion, it was agreed that future reports will supply quantitative data (supplementary to the high-level data already in the dashboard) to measure the local impact of the intervention.

5.5      Update on Cancer priority outcome in the Health and Wellbeing Strategy

Katrina McCormick (Deputy Director of Public Health, LBL) updated the Board on the progress towards achieving the outcome of Lewisham’s Health and Wellbeing Strategy, Priority Area 2:  Increasing the number of people who survive colorectal, breast and lung cancer for 1 and 5 years in the Health and Wellbeing Strategy.

She also provided an overview of activity in relation to cancer in Lewisham.

The report highlighted the following points:

·           A range of activity has been undertaken to promote early diagnosis by Lewisham Council, Lewisham CCG , the Community Health Improvement Team and community and voluntary organisations. The “Be clear on Cancer” campaigns, run periodically by Public Health England, have been promoted.

·           Lewisham CCG has successfully secured funding from Macmillan to employ a GP Cancer lead. The CCG clinical facilitators will be working with the GP, once in post, to promote screening and early diagnosis in primary care.

5.6       The following issues were raised or highlighted in the discussion:

·           Because the impact of the same intervention can vary from one demographic to another, the Lewisham data, to be instructive, also needs to be compared to data from boroughs with similar demographics, e.g. Haringey. Such comparisons might help to explore if there are differences in coverage of screening programmes and, if so, what lessons can be learnt.

·           One of the reasons why the coverage rate for Breast Screening in Lewisham is below national rates could include the fact that, because of the churn in Lewisham’s population, some people do not receive appointment reminders. Cervical screening coverage rates have increased in the past year, but this is partly due to the cleansing of GP registers, thereby reducing the denominator.

5.7       The Board noted the reports.