Friarage Hospital - Hambleton, Richmondshire and Whitby · PDF fileAiredale, Wharfedale &...

Friarage HospitalChildren's and Maternity Services Needs Assessment Pack

Contents Paediatrics

– What does the age and ethnicity profile 0-19 yrs look like– What are the projected population changes?– How ‘healthy’ are children in Hambleton and

Richmondshire – Risk factors in childhood– Current usage of hospital paediatric services

Maternity– What does the current and projected age profile 15-44 yrs

look like– What is the fertility rate?– How ‘healthy’ are pregnancies?– Current usage of hospital maternity services

Paediatrics

What does the current population aged 0-19 yrs look like?

Current population aged 0-19 yrs

0

500

1,000

1,500

2,000

2,500

3,000M

ales

Fem

ales

Mal

es

Fem

ales

Mal

es

Fem

ales

Mal

es

Fem

ales

Ages 0-4 Ages 5-9 Ages 10-14 Ages 15-19

Age and gender

Num

ber

HambletonRichmondshire

Total 31,610 people aged 0-19 yrs within Hambleton and Richmondshire Districts

There are more males than females in all age bands, but particularly in the 15-19 yr age band in Richmondshire

In Richmondshire, 94.7% people aged 0-19 yrs are White. The largest ethnic minority group of children and young people in Richmondshire is Mixed.

Of the population aged 0-19 years in Hambleton, 96.1% are White. The largest ethnic minority group of children and young people in Hambleton is Mixed

Ethnicity

What are the projected population changes?Population Projections for Children Aged 0-19

0

5000

10000

15000

20000

25000

30000

35000

2010 2015 2020 2025 2030 2035

Popu

latio

n

Hambleton Richmondshire Hambleton & Richmondshire

Source: ONS 2010-based subnational population projections

Population Projections for Children Aged 0-4

0

1000

2000

3000

4000

5000

6000

7000

8000

2010 2015 2020 2025 2030 2035

Popu

latio

n


Source: ONS 2010-based s ubnational population projections


0

1000

2000

3000

4000

5000

6000

7000

8000

9000

2010 2015 2020 2025 2030 2035

Popu

latio

n




0

1000

2000

3000

4000

5000

6000

7000

8000

9000

2010 2015 2020 2025 2030 2035

Popu

latio

n




0

1000

2000

3000

4000

5000

6000

7000

8000

9000

10000

2010 2015 2020 2025 2030 2035

Popu

latio

n


Source: ONS 2010-based s ubnational population projections

0-4yrs

5-9yrs

10-14yrs

15-19yrs

The total population projections for 0-19 yrs shows a slight reduction by 2035.

There is a slight increase projected in 0-4 yr olds in the next 5 yrs, which follows through to the 5-9 yr age band in 10 yrs (particularly for Hambleton), and similarly for the 10-14 yr age band in 15 years

?any other known changes eg military

How ‘healthy’ are children in Hambleton and Richmondshire

Infant mortality rates in Hambleton and Richmondshire are lower than England. The numbers are small so the rates can vary and have wide confidence intervals

Although Richmondshire has the highest rate of low birth weight babies in North Yorkshire, the rates of low birth weight babies born in Hambleton and Richmondshire are not statistically different from England. Low birth weight is a marker of poor maternal health.

Infant mortality rates 2007-2009Hambleton Richmondshire

Yorks and Humber England

4.24 3.11 5.5 4.7

Number of deaths within first year per 1000 live births

Risk factors in childhood - childhood obesityPrevalence of children at risk of being obese - Reception

0%

2%

4%

6%

8%

10%

12%

2006/07 2007/08 2008/09 2009/10 2010/11

Hambleton Richmondshire North Yorkshire EnglandSource: National Child Measurement Programme

Prevalence of children at risk of being obese - Year 6

0%

2%

4%

6%

8%

10%

12%

14%

16%

18%

20%

2006/07 2007/08 2008/09 2009/10 2010/11


Prevalence of children at risk of being overweight - Reception

0%

2%

4%

6%

8%

10%

12%

14%

16%

18%

2006/07 2007/08 2008/09 2009/10 2010/11


Prevalence of children at risk of being overweight - Year 6

0%

2%

4%

6%

8%

10%

12%

14%

16%

18%

20%

2006/07 2007/08 2008/09 2009/10 2010/11


The levels of childhood obesity in Hambleton and Richmondshire are generally below the England average. The levels of children who are overweight is similar to the England average.

Risk factors in childhood – immunisations and teenage pregnancy

Coverage of Diphtheria, Tetanus, and Pertussis (DTaP), Polio (IPV) and Haemophilus influenza (HiB) vaccines

2010/11Age 1 Age 5

Scarborough CCG 94.8% 86%Harrogate & Rural District CCG 94.9% 90%Airedale, Wharfedale & Craven CCG 96.6% 76%Hambleton, Richmondshire & Whitby CCG 95.0% 82%

MMR coverage for 2 year olds2010/11

Scarborough CCG 89%Harrogate & Rural District CCG 88%Airedale, Wharfedale & Craven CCG 88%Hambleton, Richmondshire & Whitby CCG 91%

MMR coverage for 5 year olds2010/11

Scarborough CCG 86%Harrogate & Rural District CCG 86%Airedale, Wharfedale & Craven CCG 85%Hambleton, Richmondshire & Whitby CCG 86%

Immunisation coverage rates for childhood diseases compare favourably with the rest of North Yorkshire. North Yorkshire’s rates are better than England

Under 18 Conceptions, rate per 1,000 female population aged 15-17

0

10

20

30

40

50

60

1998-00 2001-03 2004-06 2005-07 2006-08 2007-09 2008-10Hambleton Richmondshire North Yorkshire Yorkshire & The HumberEngland

Source: ONS and DfE

Teenage pregnancy rates for Hambleton and Richmondshire are lower than England and Yorks and Humber. Teenage pregnancy is associated with worse maternal and child health outcomes.

Teenage pregnancy ‘hotspots’

Hotspots around Northallerton, Catterick and SW Thirsk

Risk factors in childhood – breastfeeding and smoking

Breastfeeding Initiation at time of delivery (NYY registered patients)

Provider 2006/07 2007/08 2008/09 2009/10 2010/11Newcastle 75% 100%Hull & East Yorkshire 0% 93% 88% 94% 93%Harrogate 73% 85% 85% 84% 86%Airedale 78% 78% 77% 82% 83%Morecambe Bay 0% 35% 85% 84% 82%South Tees 77% 74% 76% 75% 79%Mid Yorkshire 76%County Durham & Darlington 55% 74% 79% 70% 72%York 70% 68% 67% 66% 72%Scarborough & NE Yorkshire 27% 57% 54% 59% 69%Leeds 74% 64% 66%

Women known to have been smokers at time of delivery (NYY registered patients)

Provider 2006/07 2007/08 2008/09 2009/10 2010/11Morecambe Bay 39% 6% 5% 7% 46%Scarborough & NE Yorkshire 20% 23% 22% 21% 20%County Durham & Darlington 30% 26% 18% 18% 19%York 19% 19% 19% 17% 17%Mid Yorkshire 15%South Tees 15% 13% 13% 14% 11%Airedale 9% 8% 10% 7% 9%Leeds 98% 7% 8%Harrogate 11% 9% 10% 9% 8%Hull & East Yorkshire 0% 0% 6% 6% 0%Newcastle 50% 0%

Breast feeding initiation rates at Friarage are not collated as they are collated at Trust level. South Tees has a rate (79%) which is mid range compared to the other main providers in North Yorkshire.

Smoking rates at time of delivery (11%) are mid range compared to other main providers in North Yorkshire. Smoking in pregnancy causes low birth weight and is a main preventable cause of inequalities in child health

Risk factors - child poverty

Looked after children

Risk factors - injury

NI – 70

Area NameChildren and young people admitted to hospital as a result of injury (Rate per 1000) 2008 - 2009

Craven 122.70Hambleton 145.60Harrogate 95.60Richmondshire 155.80Ryedale 67.60Scarborough 54.70Selby 99.80York 110.30England 117.40Yorkshire and The 129.40

Hambleton and Richmondshire have high rates of hospital admissions in children as a result of injury

These are statistically significantly worse than the England rates

(2010/11)

Current service usage (0-19 yrs): in-patients

In patient activity at FHN per month has decreased over the past 2 years

Non-elective in-patient activity shows seasonal variation with winter having higher numbers of admissions

Elective admissions over the last 2 years have been steady at around 33 admissions per month

0-19 yrs NYY patients admitted to FHN

Current service usage (0-19 yrs): in-patientsFriarage Inpatient Activity, Ages 0-19 years by Specialty (NYY Registered Patients only) (Feb 11 - Jan 12)

Activity %Specialty EL NEL Total EL NEL TotalPAEDIATRICS 164 1258 1422 41.3% 80.4% 72.5%GENERAL SURGERY 56 112 168 14.1% 7.2% 8.6%OBSTETRICS 83 83 5.3% 4.2%GENERAL MEDICINE 64 64 4.1% 3.3%ORAL SURGERY 56 1 57 14.1% 0.1% 2.9%TRAUMA & ORTHO 50 1 51 12.6% 0.1% 2.6%GYNAECOLOGY 30 9 39 7.6% 0.6% 2.0%NEONATOLOGY 30 30 1.9% 1.5%PLASTIC SURGERY 11 2 13 2.8% 0.1% 0.7%UROLOGY 12 1 13 3.0% 0.1% 0.7%ENT 7 2 9 1.8% 0.1% 0.5%GASTROENTEROLOGY 8 8 2.0% 0.4%CLINICAL HAEMATOLOGY 2 2 0.5% 0.1%RESPIRATORY MEDICINE 1 1 0.1% 0.1%RHEUMATOLOGY 1 1 0.3% 0.1%Total 397 1564 1961 100% 100% 100%

There were 1422 admissions of NYY patients to paediatrics over the last full year. 88.5% were non-elective

For the age group 0-19 yrs, 72.5% of the admissions were to paediatrics.

37% of all admissions 0-19 yrs were emergency admissions by GP. 25% were through A+E

Use of Children's ward by specialty Elective Admissions

Emergency Admissions by sourceWard attendersA&E GP Other Sub-total Total

General Surgery 50 19 12 1 32 82Urology 5 0 0 0 0 5Orthopaedics 49 6 0 0 6 55ENT 0 0 0 0 0 0Ophthalmology 0 1 0 0 1 1Oral Surgery 44 0 0 0 0 44Community Dental 86 0 0 0 0 86Plastic Surgery 74 0 0 0 0 74Pain Management 1 0 0 0 0 1General Medicine 0 0 0 0 0 0Gastroenterology 1 0 0 0 0 1Total of all non-medical paediatric admissions 310 26 12 1 39 349 0Paediatrics 174 446 665 195 1,306 1,480 536Total for 2010-2011 484 472 677 196 1,345 1,829 536

19% of all children's ward admissions were for specialties other than paeds (mainly elective admissions for surgery)

Current service usage – time of day

Oct 2010 - Sept 2011

Oct 2010 - Sept 2011 Admissions to the paediatric ward at FHN were mainly from 8am to 8pm although 33% non-elective admissions were between 8pm and 8pm.

A total of 482 admissions were between 8pm and 8am

A+E activity for 0-18 yr olds appears busiest from 8am to 8pm. However, 21% of A+E activity was from 8pm to 8am, with 77% of that activity between 8pm and midnight.

On average, there were 13.5 A+E attendances per day between 8am and 8pm, 3.6 attendances between 8pm and 8am, and 2.8 between 8pm and midnight

Admissions by day of the week and geographical spread of admissions

A+E activity by day of the week (Oct 2010 to Sept 2011)

0

200

400

600

800

1000

1200

Mon Tues Wed Thurs Fri Sat Sun

Day

Num

ber

of a

ttend

ance

s

SelfAmbulance

A+E Activity 0-18 years appears greater on Mondays and Sundays. Bank holidays may account for some of this increased activity. Ambulance activity is flat across the week

Elective Admissions

Emergency Admissions by sourceA&E GP Other Sub-total Total

DL6 - Northallerton East 48 88 109 39 236 284DL7 - Northallerton West 51 91 118 43 252 303DL8 - Bedale & Wensleydale 65 50 93 16 159 224DL9 – Catterick 39 65 96 22 183 222DL10 - Richmond 63 51 47 26 124 187DL11 - Swaledale 7 3 5 1 9 16HG4 – Masham 12 10 16 26 38TS9 - Stokesley 14 4 18 3 25 39TS15 – Yarm 5 5 17 1 23 28YO62 - Helmsley 2 5 6 3 14 16YO7 – Thirsk 61 66 117 27 210 271Other 117 34 35 15 84 201Total 484 472 677 196 1,345 1,829

Inpatient activity 0-19 yrs(Pts registered with Hambleton and Richmondshire GPs Feb 11 – Jan 12)

For practices within Hambleton and Richmondshire, more elective admissions go to James Cook than FHN (419 vs 348 in one year) , whereas for emergency admissions, more go to FHN (1267 vs 419)

Most of the emergency admissions at FHN are in the 0-4 age range, followed by the 15-19 age range.

There are more elective admissions at JCUH in the 5-9 age range than other age ranges

Inpatient activity 0-19 yrs by specialty (Pts registered with Hambleton and Richmondshire GPs Feb 11 – Jan 12)

Current service usage (0-19 yrs): out-patients

Outpatient activity over the last 2 years has remained stable both for new patients and follow ups.

The average number of new patients per month is 279.

The average number of follow ups per month is 571.

There is little seasonal variation in outpatient activity

Outpatient activity 0-19 yrs by provider (Pts registered with Hambleton and Richmondshire GPs Feb 11 – Jan 12)

Most OP activity for GP practices in Hamb and Rich is at FHN and JCUH.

58% of all first OP are at FHN and 26% at JCUH.

First to Follow up ratio is 0.59 for FHN and 0.58 for JCUH.

At FHN, the 0-4 age range has the largest number of first OP appts. The largest number of follow up appts are in the 5-9 yr age range.

At JCUH, the 15-19 age range has the largest number of both first and follow up OP appts.

Outpatient activity 0-19 yrs by speciality (Pts registered with Hambleton and Richmondshire GPs Feb 11 – Jan 12)

32% of all OP activity at FHN is with paediatrics for the 0-19 yr age range.

Ophthalmology and Orthopaedics takes up the next largest proportions (20% and 19% respectively)

At JCUH, orthopaedics has the highest proportion of OP activity (21%) with paediatrics at 16%, followed by ENT (10%)

Maternity

What does the current and projected age profile for females aged 15-44 yrs look like?

Population estimate (2010) for females aged 15-44 years

0

500

1,000

1,500

2,000

2,500

3,000

3,500

4,000

15-19 20-24 25-29 30-34 35-39 40-44

Age band

Num

ber

HambletonRichmondshire

Looking at 5-yr age bands, there are fewer females in the 20-35 age bands than 15-19 and 35-44 yrs

The number of 15-24 yr olds is set to decrease in both Hambleton and Richmondshire over the next 15 yrs, and then increase. In Hambleton, the 25-34 yr old age band is set to increase to 2020, then drop. The number of 35-44yr olds is set to drop over the next 10 yrs and then increase

What is the current and projected fertility rate?

Projected change in number of births – Hambleton is projected to remain around 900 births per year

The general fertility rate (number of live births per 1,000 females aged 15-44 years) is similar for Hambleton and Richmondshire and is comparable to England

Projected change in number of births –Richmondshire is projected to remain between 600 and 700 births per year.

Changes in birth rates by age band

There has been a shift both nationally and within North Yorkshire to women giving birth when older.

However, the rates after the age of 40 years old has decreased.

The change across the ages in North Yorkshire has been less than in England

The 25-34 yr old age group has the highest rates of childbirth in North Yorkshire as a whole

Current service usage - maternity

Births to Hambleton & Richmondshire Residents by Provider, Feb 11 - Jan 12 (NYY Registered Patients only)

Provider EL NEL TOTALFriarage 3 1065 1068 81%York 95 95 7%James Cook 84 84 6%County Durham & Darlington 42 42 3%Harrogate 14 14 1%Other Providers 14 14 1%

Total 3 1314 1317

The number of births of NYY patients at FHN has increased over the last 2 years.

The average number of births per month is 94.5

19% of Hambleton and Richmondshire residents give birth at other hospitals. York and James Cook have the highest numbers outside FHN

Current service usage: C-sections

The number of C-sections per month has been increasing steadily over the last 2 years at FHN.

The average number is 17.6 per month

Only a very small number (3) were classified as elective c-sections

The % of total births that are C-sections has been steadily increasing over the last 2 years (although previously the rate was higher).

The average rate is 18.6%. National Average for 2009-2010 was 24.8%)

Friarage Hospital - Hambleton, Richmondshire and Whitby · PDF fileAiredale, Wharfedale &...

Documents

Transcript of Friarage Hospital - Hambleton, Richmondshire and Whitby · PDF fileAiredale, Wharfedale &...