LGID Customer Led Transformation10 March 2011

“A healthy society”

Ged GreavesPolicy and Performance Manager

The challenge

• Place Survey 2008:– Almost a third of residents dissatisfied with dental

services– Greatest for “Municipal Dependency”

• Analysis of ambulatory sensitive care data revealed high admissions from groups O and K

• Groups eligible for free or low cost dental care

The prize at stake

• Reduce the number of avoidable admissions to hospital for dental procedures in Group O households (child and adult patients) by 40% over two years.

• 2 target wards:• Hospital treatment £982/patient = £110k per year.• Reduce by 40% in costs over two years.

• What if we…..scaled up?

Broader outcomes

• Increased registration at dental practices – positive cycle.

• Wider health and well being benefits.• Opportunities for collaboration between partners at

at a time of widespread reform.

Governance

• Steered by councillor led task group– Helped discover the issue– Local ward members– Cross party– Experience with health issues– Champions for scrutiny committees

• Project team; Council, NHS, V&CS

How?

1. Analysis of hospital attendance data by Mosaic group and type

2. Local community sector commissioned to undertake health needs assessment

3. Customer experiences mapped using CJM4. Feedback information from above to service

providers and design improvements

Where to start?Admissions to hospital for avoidable dental conditions in Newark & Sherwood

2009 electoral wards. Standardised for age. Nottinghamshire County =100.

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100

150

200

250

300

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400

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Newark & Sherwood Nottinghamshire rate

Admissions to hospital for avoidable dental conditions, Mosaic groupsStandardised by age, Nottinghamshire County =100

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100

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up B

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up C

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up D

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up E

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up F

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up I

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up J

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up K

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up L

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Mosaic groups County rate

Devon ward

0% 10% 20% 30% 40% 50% 60%

Wealthy people living in the most sought after neighbourhoods

Residents of isolated rural communities

Successful professionals living in suburban or semi-rural homes

Couples and young singles in small modern starter homes

Lower income workers in urban terraces in often diverse areas

Middle income families living in moderate suburban semis

Residents of small and mid-sized towns with strong local roots

Owner occupiers in older-style housing in ex-industrial areas

Young people renting flats in high density social housing

Elderly people reliant on state support

Families in low-rise social housing with high levels of benefit need

Residents with sufficient incomes in right-to-buy social houses

Mosaic Group by Percentage of Ward Population

Bridge ward

0% 5% 10% 15% 20% 25%

Young, well-educated city dwellers

Elderly people reliant on state support

Residents of small and mid-sized towns with strong local roots

Couples and young singles in small modern starter homes

Couples with young children in comfortable modern housing

Young people renting flats in high density social housing

Families in low-rise social housing with high levels of benefit need

Middle income families living in moderate suburban semis

Owner occupiers in older-style housing in ex-industrial areas

Lower income workers in urban terraces in often diverse areas

Residents with sufficient incomes in right-to-buy social houses

Mosaic Group by Percentage of Ward Population

Target segments

Group O – Families in low rise social housing with high levels of benefit need

Group K – Residents with sufficient incomes in right to buy social houses

Progress so far

• 600 surveys issued – 114 returns• 4 community (world café) events• 50 residents interviewed at Sure Start

Children’s Centres • 7 CJM interviews scheduled

Early findings?• Fear• Cost• Inconsistent service quality• Perceived shortage of NHS places less

prevalent• Text message reminders• Advice on dental emergencies

Influencing decisions?

• Topic of discussion at dinner tables• Reform of the NHS Dental Contract• Fluoridation of the water supply?

Admissions to hospital for avoidable dental conditions, Local authoritiesStandardised by age, Nottinghamshire County=100

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Local authorities County rate

Ged GreavesPolicy and Performance Manager

ged.greaves@nsdc.infoDirect dial: 01636 655231