Hull Public Health 

The Deep, Hull The Guildhall, Hull King William Statue, Market Place, Hull City Hall, Hull Spurn Lightship, The Marina, Hull

 

 

Diabetes


Documents

The main documents providing information on cancer are as follows:

JSNA
Hull JSNA Toolkit: Diabetes
Diabetes Equity Audit completed October 2008

Other documents which include information on diabetes are as follows:

Public Health Outcomes Framework Main Report (to open this report on a particular PHOF indicator, click here)
Public Health Outcomes Framework Summary

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Assessing Need

The risk factors, prevalence and modelled prevalence for each general practice, inpatient admissions and mortality rates are given in Hull JSNA Toolkit: Diabetes. The prevalence, inpatient admission rate and mortality rate are also given in relation to deprivation.

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Diabetic Retinopathy Screening

Uptake rates for diabetic retinopathy screening is an indicator within Public Health Outcomes Framework and further analysis is given within the Public Health Outcomes Framework Main Report (to open this report on a particular PHOF indicator, click here) and Public Health Outcomes Framework Summary.

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Expenditure and Programme Budgeting

Expenditure and Programme Budgeting is given in Hull JSNA Toolkit: Diabetes for diabetes.

Programme Budgeting is a well-established technique for assessing investment in health programmes rather than services. It can provide an overall view of how Hull PCT expenditure (from Department of Health Programme Budgeting information) and health outcomes compare with other PCT's in England, and to identify programmes that may require further investigation. Quadrant charts are available which plot expenditure and outcomes (in standardised units) for different disease areas.

There are also specific programme budgeting and marginal analysis reports for diabetes which examines expenditure in relation to outcomes for Hull and compares these with other comparator areas:

PBMA Diabetes 2009/10
PBMA Diabetes 2008/09
PBMA Diabetes 2007/08

The Yorkshire and Humber Public Health Observatory (YHPHO) led a Programme Budgeting and Marginal Analysis (PBMA) pilot project in NHS Hull with diabetes (for persons aged over 16 years) chosen as the area of care. The aim of the pilot was to test the model of PBMA at the micro level (within the diabetes programme budget of Hull PCT) as proposed in a seven stage process. Details are given within Hull JSNA Toolkit: Diabetes and Diabetes Equity Audit.

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Future Projections

The Projecting Older People Population Information (POPPI) System provides population projections for people aged 65+ years for 2011, 2015, 2020, 2025 and 2030. It provides estimates of the number of people aged 65+ years in Hull are predicted to have diabetes. These estimates are available in Hull JSNA Toolkit: Diabetes and Hull JSNA Toolkit: Older People.

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Health Equity Audit

The Diabetes Equity Audit was completed October 2008. This document includes information on risk factors, prevalence, inpatient admissions and mortality for diabetes. This information is examined in relation to age, gender and deprivation to assess potential inequalities that might exist among these groups. The document also examined potential programmes that could reduce health inequalities.

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Influenza Vaccination

As well as offering influenza vaccinations for those aged 65 and over, it is also recommended that influenza vaccinations are offered for particular 'at risk' groups such as patients on the QOF disease registers for diabetes mellitus, CHD, stroke and chronic obstructive pulmonary disease. Uptake rates for the influenza vaccination for these 'at risk' groups for Hull are given within Hull JSNA Toolkit: Diabetes, Hull JSNA Toolkit: Coronary Heart Disease , Hull JSNA Toolkit: Stroke and Hull JSNA Toolkit: Chronic Obstructive Pulmonary Disease.

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Inpatient Admissions

The number of inpatient admissions and admission rate are given in Hull JSNA Toolkit: Diabetes for each ward. Admission rates are also examined in relation to deprivation.

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NHS Health Check

Screening for diabetes or risk factors for diabetes is one of the checks of the NHS Health Check. There are two indicators relating to the NHS Health Check Programme within the Public Health Outcomes Framework and further analysis is given within the Public Health Outcomes Framework Main Report (to open this report on a particular PHOF indicator, click here) and Public Health Outcomes Framework Summary. The indicators are the percentage of Health Checks offered out of the eligible population and the percentage of Health Checks completed out of those offered health checks.

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PBS Model

The PBS model was used to estimate the number of people with diabetes in Hull. This was compared with the actual number of people diagnosed with diabetes on the Quality and Outcomes Framework GP disease registers. The modelled numbers at practice level are given in Hull JSNA Toolkit: Diabetes (and older estimates within the Diabetes Equity Audit). Details of the model and the methodology are also given in Hull JSNA Toolkit: Diabetes as well as the Diabetes Equity Audit and Glossary.

Modelled prevalence in the context of the local reports and documents refers to prevalence estimates that are produced through modelling and synthetic data, where an accurate reliable prevalence estimate is not known. The PBS model is one such model. A modelled or synthetic estimate is only as good as the model and as good as the underlying data from which the model is produced. A full discussion of the Problem of Synthetic Estimates is available, and it is also discussed within Hull JSNA Toolkit: Diabetes and Glossary.

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Prevalence

As part of the Quality and Outcomes Framework (QOF), practices need to have registers of patients who have had a diagnosis of specific diseases. More information about QOF is given in the disease-specific Hull JSNA Toolkit reports and Glossary. The QOF general practice disease registers cover a range of medical conditions and diseases including diabetes, and the prevalence of the disease is reported within the disease-specific Hull JSNA Toolkit reports. These are also presented by deprivation.

Some of the issues associated with comparing prevalence figures over all the Hull practices are discussed within the General Practice Comparator Groupings, disease-specific Hull JSNA Toolkit reports and Glossary, with more detailed information within the Why QOF Differs Among Practices report. Details of grouping practices into eight groups for benchmarking are given in the General Practice Comparator Groupings.

This actual diagnosed prevalence is compared with modelled prevalence estimates (see PBS Model above). These modelled estimates and the difference between the modelled estimates and the numbers diagnosed at practice level are given within Hull JSNA Toolkit: Diabetes. A modelled or synthetic estimate is only as good as the model and as good as the underlying data from which the model is produced. A full discussion of the Problem of Synthetic Estimates is available, and it is also discussed within Hull JSNA Toolkit: Diabetesand Glossary.

The Projecting Older People Population Information (POPPI) System provides population projections for people aged 65+ years for 2011, 2015, 2020, 2025 and 2030. It provides estimates of the number of people aged 65+ years in Hull are predicted to have diabetes. These estimates are available in Hull JSNA Toolkit: Diabetes and Hull JSNA Toolkit: Older People.

The prevalence of behavioural and lifestyle risk factors is summarised within Hull JSNA Toolkit: Smoking, Hull JSNA Toolkit: Alcohol Consumption, Hull JSNA Toolkit: Diet, Hull JSNA Toolkit: Exercise and Hull JSNA Toolkit: Overweight and Obesity, with more detailed information in the Adult and Young People Health and Lifestyle Survey reports (see Prevalence for more information).

The diagnosed prevalence of diabetes for those aged 17+ years is an indicator within Public Health Outcomes Framework and further analysis is given within the Public Health Outcomes Framework Main Report (to open this report on a particular PHOF indicator, click here) and Public Health Outcomes Framework Summary. The diagnosed prevalence is presented at ward level in the JSNA Hull Atlas. It is given based on the ward of the GP practice rather than the ward of the actual patient.

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Public Health Outcomes Framework

The diagnosed prevalence of diabetes as for those aged 17+ years and patients aged 12+ screened for diabetic retinopathy are indicators within Public Health Outcomes Framework and further analysis is given within the Public Health Outcomes Framework Main Report (to open this report on a particular PHOF indicator, click here) and Public Health Outcomes Framework Summary. Diagnosed prevalence is also given at ward level in the JSNA Hull Atlas. It is given based on the ward of the GP practice rather than the ward of the actual patient.

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Risk Factors

Risk factors for diabetes are discussed within the Diabetes Equity Audit and Hull JSNA Toolkit: Diabetes.

The prevalence of behavioural and lifestyle risk factors is summarised within Hull JSNA Toolkit: Smoking, Hull JSNA Toolkit: Alcohol Consumption, Hull JSNA Toolkit: Diet, Hull JSNA Toolkit: Exercise and Hull JSNA Toolkit: Overweight and Obesity, with more detailed information in the Adult and Young People Health and Lifestyle Survey reports (see Prevalence for more information).

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Quality of Care

Information on the quality of care is available within the Diabetes Equity Audit.

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Screening

Screening for diabetes or risk factors for diabetes is one of the checks of the NHS Health Check. There are two indicators relating to the NHS Health Check Programme within Public Health Outcomes Framework and further analysis is given within the Public Health Outcomes Framework Main Report (to open this report on a particular PHOF indicator, click here) and Public Health Outcomes Framework Summary. The indicators are the percentage of Health Checks offered out of the eligible population and the percentage of Health Checks completed out of those offered health checks.

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Survey

A survey of people with diabetes was conducted (nationally) with further details given in the Diabetes Equity Audit.

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