health and wellbeing board meeting 11th march 2019...

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Health and Wellbeing Board Meeting 11th March 2019

Performance Scorecard Q3 2018/19Generated on: 01 March 2019

Priority 1 : People will live longer, and have healthier lives

Description PI Code Latest Value

Latest Target

Last Update

RAG Status Performance Data Trend Chart Commentary Ownership

The rate of Alcohol related hospital admissions 'broad measure'. (per 100,000)

DAAT 65 C

509.28 520.0 Q1 2017/18

Alcohol related hospital admissions decreased during Q1 2017/18 to 509.28, achieving the minimum performance standard of 520.00. Solihull is performing well compared to West Mids (593.48) and national data (570.64). (Note, data is published 9 months after reporting period). The substance misuse service has been re-designed with a new model in place by 1st April 2019 provided by current provider SIAS (Solihull Integrated Addiction Service). The service will continue to focus on the unmet need of Solihull alcohol dependent adults into treatment as a priority, hospital stays for alcohol related harm in Chelmsley Wood are 40% above the England average, but 11% below average in St Alphegei. The SIAS service model focus on prevention, engagement and early intervention, treatment and recovery and includes hospital liaison and brief intervention for alcohol. The aim of dedicated hospital practitioners and support workers is to fast-track and support into treatment. The Hospital service will increase identification, screening and brief advice and detox in the acute setting and actively engage patients in community drug and alcohol services at discharge as well as providing up to date information, trends and support available to hospital staff. In addition to the currently proposed service model the council has submitted a bid for capital funding. The capital bid seeks funding to develop a local

Health and Wellbeing Board

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family facility as an outreach service of SIAS to improve access to and integrated support for alcohol dependent parents and their children. Solihull has been selected to the final stages of interview.

Proportion of the population meeting the recommended '5 a day'.

PHOF 02.11i

55.1 55 2016/17 Annual data only. Data collection started in 2014. Latest England average is 57.4%.(2016/17)


Smoking prevalence – adults (over 18s)

PHOF02.14

10.5 14.9 2017/18 The England average is 14.9 and Solihull is 10.5 performing well as an average. Smoking prevalence is generally lower across Solihull than the national average but smoking prevalence is higher than the national average in certain wards. Prevalence of smoking is higher in the more deprived areas than in the least deprived areas. Solihull continues to commission a Specialist Stop Smoking Service as part of the new Integrated Lifestyle Service which has been redesigned as part of new community wellbeing model. The new model effective from 1St April 2019 will continue to target key priority groups who have a higher prevalence of smoking, e.g. smokers with identified or self-diagnosed mental health conditions, pregnant women who smoke as well as routine and manual groups. Operating as part of community wellbeing will increase assessment of smoking status as part of the holistic assessment of clients accessing all CWB services, increasing referrals into the service and will offer a more flexible, tailored offer to clients through a step up / step down model of support.


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Latest Target

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Mortality from causes considered preventable

PHOF4.03

161.5 184.5 2016/17 Rate represents 2015-17 figures (Calendar years). Rate decreased slightly since the previous year and remains significantly lower than the England and West Midlands rates. The basic concept of preventable mortality is that deaths are considered preventable if, in the light of the understanding of the determinants of health at the time of death, all or most deaths from the underlying cause could potentially be avoided by public health interventions in the broadest sense. Indicator represents mortality aged under 75 years.


Slope index of Inequality (SII) for life expectancy at birth (Years) - males

PH 01aNGAP09 01a

12.2 2016/17 Data is for 3 years, 2015 – 17 (Calendar years).

The gap in life expectancy has narrowed since 2014-16 although the difference is not statistically significant and remains higher than the gap in the West Midlands (9.5 years) and England (9.4 years). Solihull is ranked 139th out of 149 local authorities. The deprivation score (Index of multiple deprivation) hasn't been updated since 2015 although this is due to be refreshed in Summer 2019. Overall life expectancy in Males in Solihull is increasing in line with national and regional rates while the gap in the least and most deprived areas has been widening - with the exception of the most recent data.

The SII is a measure of the social gradient in life expectancy, i.e. how much life expectancy varies with deprivation. It takes account of health inequalities across the whole range of deprivation within each area and summarises this in a single number. This represents the range in years of life expectancy across the social gradient from most to least deprived, based on a statistical analysis of the relationship between life expectancy and deprivation across all deprivation deciles.

Life expectancy at birth is a measure of the average number of years a person would expect


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Latest Target

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to live based on contemporary mortality rates. For a particular area and time period, it is an estimate of the average number of years a newborn baby would survive if he or she experienced the age-specific mortality rates for that area and time period throughout his or her life.

Slope index of Inequality (SII) for life expectancy at birth (Years) - females

PH 01bNGAP09 01b

10.5 2016/17 Data is for 3 years, 2015 – 17 (Calendar years).

The gap has narrowed since 2014-16 although the difference is not statistically significant. The gap in years between the most and least deprived is greater in Solihull than that in England and the West Midlands (7.4 years for both). Solihull is ranked 144th out of 149 local authorities. The deprivation score (Index of multiple deprivation) hasn't been updated since 2015 although this is due to be refreshed in Summer 2019. Overall the past 7 years overall life expectancy in Females in Solihull has increased in line with national and regional rates while the gap in the least and most deprived areas has been widening (with the exception of the most recent data).

This indicator measures inequalities in life expectancy at birth within England as a whole, each English region, and each local authority. Life expectancy at birth is calculated for each deprivation decile of lower super output areas within each area and then the slope index of inequality (SII) is calculated based on these figures. The SII is a measure of the social gradient in life expectancy, i.e. how much life expectancy varies with deprivation. It takes account of health inequalities across the whole range of deprivation within each area and summarises this in a single number. This represents the range in years of life expectancy across the social gradient from most to least deprived, based on a statistical analysis of the relationship between life expectancy and deprivation across all deprivation deciles.

Life expectancy at birth is a measure of the average number of years a person would expect to live based on contemporary mortality rates. For a particular area and time period, it is an estimate of the average number of years a newborn baby would survive if he or she


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experienced the age-specific mortality rates for that area and time period throughout his or her life.

An increase in the number of people living beyond 75 years of age

HWBB PR1 : 01

9.84% 2017 Proportion aged 75 years and over in 2017 is similar to that observed in 2016 and 2015. Recent analysis has confirmed that Solihull does not have a significant increase of people moving into the borough after retirement. Any increase in this indicator will therefore reflect the increasing life expectancy. Concentrating on narrowing the gap between the most and least deprived will also impact on this indicator. Health and

Wellbeing Board

% of adult population with a healthy weight.

HWBB PR1 : 07

36.4 2016/17 Information is taken from Sport England Active Lives Survey - currently there are no updates for 2017/18.

36.4% of Solihull population have a BMI between 18-25 (range for healthy weight). England average is 35.2%. Solihull has lower levels of adult obesity (BMI ≥30) and higher levels of people classified as overweight (BMI ≥25 ≤30) than the national average.


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Percentage of physically active adults

PHOF02.13i

58.9% 2017/18 The PHOF data has not been published for 2017-18. The figure provided is the Active Lives Survey figure published by Sport England. This measure excludes gardening. Once the PHOF data is published this indicator will be updated. Currently, physical activity marketing and publicity is being reviewed with a view to increasing awareness of local physical activity opportunities and assets. This includes maximising the usage of existing channels through digital platforms as well as more traditional channels. As part of the Sport England Pilot work a new approach will be taken by inviting local people to sign up to ‘The Crowd’ to be able to receive more information and contribute to the development of new ideas in their communities. The new leisure centre contract will be increasing accessibility for those on low incomes, people with disabilities, looked after children and care leavers through a new concession pricing structure from April 2019. The utilisation of the new leisure card also allows us to transform the accessibility for older people within Solihull as anyone over the age of 75 years and looked after children will be able to take up free membership within our leisure centres.The Sport England Active Communities Pilot work is a whole system-based approach focussing on reducing physical inactivity levels across the most deprived communities in Birmingham and Solihull. Our ongoing work with Birmingham City Council and its leisure provider has been successful in developing an offer that will draw down significant funds/capacity and expertise into Solihull, which will contribute significantly to both increasing the % of physically active adults and decreasing the % of physically inactive in deprived localities within the borough.Recent wider work with the WMCA has led to a jointly commissioned programme with Good Gym to commence a three year running programme that has a focus on carrying out physical activity related good deeds or befriending as part of the physical activity. Further planning and reshaping of the physical activity offer for Solihull will also take into account additional upcoming opportunities such as the commonwealth games legacy and the


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Velo.

Percentage of physically inactive

PHOF02.13ii

28.8% 2017/18 Commentary as for indicator above.


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Priority 2 : Give every child the best start in life


Latest Target

Last Update


% of 2-2.5yr development checks carried out by a health visitor by the age of 2.5 years

PH 07

81.74% 95.00% Q3 2018/19

Whilst it has improved, performance on this indicator remains below target at 81.74% (target- 95%) but above the England average of 75.7% (in 2017-8). In areas across England, there are issues with non-attendance for the 2 year check and when removing non-attenders from the Solihull denominator for comparison purposes only (not reporting), the coverage for this check would be 96.75% recognising the 74 families who did not attend the planned appointment. It has been pressed on the provider to be tenacious in their follow-up of non-attendance which they have shown they are (particularly in low income areas).16 children seen late this is largely due to previous Did Not Attend (DNAs) and cancellations.


% of face-to-face New Birth Visits (NBV) undertaken between 10-14 days by a Health Visitor

HWB02

93.55% 95% Q3 2018/19

These visits are slightly below the target of 95% with 93.55% of babies being seen by Health Visitors by 14 days. There has been a data validation issue flagged by the provider (analysis is undertaken by University Hospitals Birmingham whilst the service provider is South Warwickshire NHS Foundation Trust) which is currently being investigated. It is thought that performance will be on target following this process. There have been a number of non-attenders for this check in this quarter and these are being followed up with babies being seen in the early part of quarter 4 to ensure the highest coverage.


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Latest Target

Last Update


Breastfeeding prevalence at 6-8 weeks after birth

PHOF02.02ii

45.54% 45.00% Q3 2018/19

Performance is on target. There has been a lack of antenatal notifications that will have impacted on this quarter and potentially next quarter which is being resolved. A new breastfeeding session is being established at Chelmsley Wood library to replace the previous session at You+. Breastfeeding rates have remained above target for Q3 2018-9 at 45.54% with breastfeeding rates in north Solihull also above target at 27.7% (target – 22%). Breastfeeding peer support and consistent messaging by Health Visitors on responsive feeding has been integral in keeping the rates high. It is hoped that gaining access to the Maternity Information System (Badgernet) will further enhance antenatal contacts and prepare women to breastfeed their babies.

Early Help

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Under 18 conceptions (rate of conceptions per 1,000 females aged 15-17)

PHOF02.04

14 22.5 Q2 2017/18

Teenage pregnancy rates continue to fall at a faster rate in Solihull than is the case nationally. This data was released on 15/11/2018 and covers the three months July, August, September 2017. For comparison, the England Quarterly rate was 16.6, and 18.5 in the West Midlands region this Quarter. In Solihull there was 36.1% drop on the same period in the previous year, compared with a 6.8% fall for England and 12.3% in the West Midlands. The rolling annual rate in Solihull has fallen to 13.7, the lowest ever for the Authority, and compares with rolling annual rates of 17.9 for England and 20.2 for the West Midlands.

One of the factors behind this success is the comprehensive provision from Umbrella across Birmingham and Solihull (Birmingham’s teenage conception rate is also reducing at a faster rate than nationally). Umbrella has increased access to effective contraception, including LARC, which is now available from two clinics in the borough, including in Chelmsley Wood. Umbrella promotes services and sexual health messages through social media, and local campaigns, as well as attending colleges during Fresher’s Week and other events. In schools they part fund Loudmouth Theatre in Education to perform in local schools, with performances covering all aspects of sexual health, including contraception, unplanned pregnancy and relationship readiness. Schools in the areas with higher rates of teenage pregnancy are prioritised. SMBC Education Improvement and Public Health are putting on an event next month to support schools with adopting the new requirements on statutory relationships education (primary), relationships and sex education (secondary).


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Proportion of children aged 10 -11 classified as overweight or obese (Year 6) (%)

NGAP08 03

29.7% 2015/16 In Solihull, we ensure that the parents of all children who are measured as part of the NCMP are written to with their child’s results. We have modified our family weight management programme - Eat Well Move More – so that it delivers sessions in schools as well as community groups and 1:1 interventions.

In summer 2018 training in how to raise the issue of weight and obesity was delivered to 40 health visitors and school nurses following recommendations from research commissioned from Warwick University.


Smoking status at time of delivery

PHOF02.03

7.9% Q2 2018/19

Figure for BSol CCG. The percentage where smoking status was not known was 17% in this quarter - 681 women had no data on smoking at time of delivery. This was the highest rate in the country.Targeting pregnant women who smoke is a key priority for the new Integrated Lifestyle Service with a service development improvement plan to be agreed with the provider to increase focus on smoking in pregnancy. The Solihull specialist stop smoking service achieves high success rates in supporting women to quit smoking however referrals into the service remain low from maternity services. Birmingham does not commission a specialist stop smoking service; only a primary care service. Different offers dependent on the postcode of pregnant women has been raised as an issue of concern by midwives.

A number of initiatives have been agreed through BUMP workstream as part of the STP to address smoking in pregnancy as a priority including an electronic referral system on an ‘opt out’ basis, CO monitoring completed in 1st, 2nd and 3rd trimester and at time of delivery (currently self-reported), pilot of smoking cessation support to be delivered on site. Timescales to implement the electronic referrals have been slow to implement this due to Hospital Trust information governance assurances required to put system in place for the referrals. Birmingham are trailing a pilot for maternity


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Latest Target

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support worker (MSW) trained to deliver smoking cessation on site to be put in place for instant offer of support instead of signposting or referral on. This pilot will be in place shortly, evaluated and reviewed for success. Commissioners are working on a contract variation to capture requirement for midwives to undertake training as part of the contract held with CCG to increase engagement with smoking services.

Proportion of children aged 4-5 classified as overweight or obese. EARLY HELP

PHOF02.06i

18.2% 2017/18 Prevalence of overweight (including obese) in children at reception is statistically significantly lower than the national average (22.4%) In Solihull, we ensure that the parents of all children who are measured as part of the NCMP are written to with their child’s results. We have modified our family weight management programme - Eat Well Move More – so that it delivers sessions in schools as well as community groups and 1:1 interventions.

In summer 2018 training in how to raise the issue of weight and obesity was delivered to 40 health visitors and school nurses following recommendations from research commissioned from Warwick University.


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Priority 3 : Ageing well - Healthy older life


Latest Target

Last Update


Community Dementia Diagnosis Rate (Local Measure)

ICASS06 BCF

65.7% 68.6% December 2018

Performance has remained stable throughout 2018-19, currently at 65.7%, although below the minimum performance standard of 68.6%.

Solihull Together

Reduce the level of Solihull CCG Emergency Readmissions following any Elective or Non Elective admission for Heart Of England NHS Foundation Trust commissioned by Solihull CCG

ICASS07

1,170 3,310 December 2018

Birmingham & Solihull CCG are no longer able to provide readmissions data at Solihull CCG level, as the source readmissions data is no longer available at practice level. As a result we have been reporting on at a BSOL CCG level from April 2018 onwards. As this change in reporting has occurred mid way through the year, there will be no targets to report against for the remainder of 2018/19. Performance has remained relatively stable during 2018-19, currently at a level of 1170.

Solihull Together

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Proportion of people who use services who reported that they had as much social contact as they would like.

ASCOF_1I1 SURVEY

39.3% 2017/18 This measure is based on Question 8a of the Adult Social Care Survey: "Thinking about how much contact you've had with people you like, which of the following best describes your social situation?" The measure is defined by the percentage of users responding "I have as much contact as I want with people I like."

Proportionally, 377 respondents answered the question, with 144 responding with the answer above.

This represents a decrease of 1% to this indicator compared to last year.

Note:-Actual ASCOF results are based on a weighted population calculation by the NHS Digital, this can create small discrepancies compared to survey answers.


Overall satisfaction of people who use service with their care and support

ASCOF_3A SURVEY

56.3% 2017/18 This measure is based on Question 1 of the Adult Social Care Survey:

(Standard version) "Overall, how satisfied or dissatisfied are you with the care and support services you receive?"(Easy read version) "How happy are you with the way staff help you?"

The measure is defined by determining the percentage of all those responding who choose the answers "I am extremely satisfied" or "I am very satisfied" in the standard version, and "I am very happy with the way staff help me, it's really good" in the easy read version.

Proportionally, 388 people answered the question, of which 216 responded with one of the above answers.

This is down (just over 4%) on last year.

Note:-Actual ASCOF results are based on a weighted population calculation by the NHS Digital, this can create small discrepancies compared to survey answers.


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A decrease in the proportion of people who die in hospitals.

HWBB PR3 : 03

48.6 February 2018

Access to deaths data has been reinstated although the data has changed slightly making this analysis more difficult. Monitoring place of death by month has not been re-established as a piece of work needs to be done around calculating the place of death in the new dataset via a new method and comparing it with our previous figures. Health and

Wellbeing Board

Priority 4 : Healthy & sustainable places and communities


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Step Into Solihull - Number of new participants

Leisure SIS 01

29 70 Q3 2018/19

We have seen another decrease in the number of participants across our walking and gentle exercise sessions for older people.

The Tai Chi session taking place at Bentley Heath is now self-sustainable meaning we no longer receive the new participant information or attendance registers for this session. This will also impact on the performance figures.

To help improve performance of the number of new participants we have plans to increase the online presence and promote the activities on a weekly basis via our different channels (Facebook, Twitter, and website). We continue to promote our activities via our monthly newsletter.

We have also started a new gentle exercise class in a new area, which commenced in January so we should see the benefit of the new participants in the next quarter. We are supporting the session financially for 12 weeks with the aim that

Leisure Services Division

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participation increases to sustainable levels; thereafter our support will continue via marketing and publicity channels.

To further improve performance a walk leader training course was delivered in February to help recruit more volunteers to help with the walking programmes. This will help us to create new walks, e.g. the planned Smith’s Wood walk, once volunteers have been trained.

SIS - Total number of participants (previously LEIS067014 Step Into Solihull - Total Number of Participants)

Leisure SIS 02

537 450 Q3 2018/19

The total number of participants continues to achieve above the target KPI's, however we have seen a slight dip this quarter. We continue promoting our sessions, lately we have had a particular focus on lower attended sessions and we have provided libraries with larger posters to highlight the activities available to those in the area. We are also planning extensive online presence to promote the lower attended sessions.

Although we are still reaching above target, it is key to continue to grow the total number of participants and to continue to keep them engaged in the programme. To achieve this we are increasing our posts on Facebook and Twitter ensuring that we have a consistent online presence for our residents to benefit from, as part of our marketing strategy.

We have increased awareness of our local training courses, which will lead to increasing sustainability of our current walking programme as well as being able to enhance the offer in the future.

Leisure Services Division

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The number of cold homes and energy surveys of vulnerable residents completed per year.

HWBB PR4 : 03

196 150 2018/19 135 new assessments completed, and 61 reassessments completed in 2018/19, which exceeds the annual target.

These assessments are carried out throughout the year to contribute towards delivery of the annual winter warmth campaign that is designed to enable residents to remain warm and well in their own homes during the winter months, thereby contributing to the reduction in the number of hospital related admissions during this period.


Number of cases of homelessness prevented or relieved

HWBB PR4 : 08

118 102 Q3 2018/19

Data for quarter 3 shows a higher number of positive outcomes at the prevention and relief stage than reported for quarter 1 (a 181% increase in total positive prevention and relief outcomes in Q3 compared to Q1). This is partly a result of the time lag for the cases taken on in the first quarter when the new legislation was implemented to work through the process but is also due to the fact that staff are getting used to new ways of working and a number of prevention and relief options have been developed to support officers to work with customers to achieve a positive outcome at this stage. In particular the following activities have taken place to support this work: . Re-launch of the safer homes scheme for victims of Domestic Abuse which enables households threatened with homelessness to remain in their existing property with security enhancements (where this is their choice and it is safe to do so). . Launch and delivery of Solihome from April 2018 which assists homeless households to access the private rented sector, and to also sustain tenancies in the private rented sector. . Partnership with Income & Awards to provide a full-time financial inclusion officer co-located with the Housing options team and a flexible prevention fund which can be used to support households to remain in existing accommodation or secure suitable alternative provision (e.g.


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payment of arrears, deposits, rent in advance). . Increased resources for the Housing Options Team and St. Basil’s, who support young singles aged 16-24 who are homeless or at risk of homelessness, to respond to the implications of HRA implementation. . Expansion of the housing advice and outreach service for adults aged 25+ who are rough sleeping, homeless or at risk of becoming homeless provided by SIAS. . Enhanced scope for the Turnaround floating support service provided by St. Basil’s to work with and support young people placed out of Borough and support local young people to move-on into independent tenancies.

Cumulatively between April & December 2018 of the prevention cases which have ended (178) prevention was achieved in 59% of cases (N= 105). Of the relief cases which have ended (302) relief was achieved in 55% of cases (N= 166). However this is still below previous year’s performance levels and relates to the impact of the implementation of the Homelessness Reduction Act (HRA) from April 2018. The HRA has brought about significant changes to the delivery of homeless services by SCH on behalf of SMBC. There are new duties relating to the prevention and relief of homelessness, an emphasis on assisting all those who are homeless and eligible and an extension from 28 to 56 days to the period in which a household is defined as ‘threatened with homelessness’. These are accompanied by new reporting processes and performance management. One particular contributory factor to the reduction has been that last years reported figures included cases that had gone through SCH’s Money Advice Service, received assistance to prevent their homelessness and as a result did not have to make a homeless application, however, with HRA these cases are not all captured because they have to be formally recorded as making an approach for an outcome to be reported. In addition more time is needed to see longer term trends as each prevention and relief duty lasts for up to 56 days (a combined total of 112

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days if someone moves from prevention into relief) meaning most applicants who approach in one quarter may not have achieved an outcome by the end of the quarter and hence the total is a rolling one.

The total number of Anti Social Behaviour (ASB) incidents reported to the ASB Private Sector Team irrespective of which tenure they are related to (cumulative for year)

NS CS 01a

208 Q3 2018/19

The number of calls has reduced during Quarter 3; there were 208 calls, of which 31 became a case or incident. Council and SCH officers are currently considering the best way to interpret and report information about the private sector ASB service performance outcomes. At this point in time the context behind the figures below is limited. It is hoped that a more in depth way for reporting for the private sector ASB service will be available from April 2019.

The service is working to try to understand the reduction in reports progressing to cases. It could be that the reduction in numbers reflects an accurate improvement in the number of ASB occurring in the borough or for another reason. Whilst this work is being done we note that the satisfaction level for the outcome of cases and satisfaction of case handling remains high.

Safer Board

health and wellbeing board meeting 11th march 2019...

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