Tools To aid public health decision making Helen Cooke SWPHO

Learning outcomes Familiarisation with a wide variety of on- line tools Strengths and weaknesses

Health Profiles APHO Inequalities Toolkits –Spearheads –Internal inequalities in all Local Authorities Tools for JSNA and others Prevalence models (commissioning toolkits) Slope Index of inequality Programme budgeting tool

For each model: Understand its philosophy Understand the main ways you can use it Understand its strengths and weaknesses Understand how it might help your organisation

Health Poverty Index

Health Profiles One of the most valuable resources – separate session Compact 4-page document or electronic Local Authority level Trends Ethnicity 30 indicators on wider determinants Interpretation provided Also visualised through Instant Atlas

Inequalities Intervention Tool for Spearhead areas This tool provides information on the following: ● The current life expectancy in Spearhead local authorities ● The current gap in life expectancy between the Spearhead local authorities and England ● A breakdown of the causes of the life expectancy gap by disease type and age It allows Spearhead areas to estimate the effect on their life expectancy gap if certain interventions are increased, specifically: ● Interventions to reduce infant mortality ● Smoking cessation ● Antihypertensive prescribing in people without diagnosed cardiovascular disease ● Statin prescribing in people without diagnosed cardiovascular disease These interventions are chosen because they can be influenced by PCT and LA commissioning

Spearhead Group areas Local Authority Districts

Exercises Download model if you can –choose an area Look at the consequences of doubling the number of smoking quitters If you can’t, look at the scarf charts for Wolverhampton What are the age-groups and conditions which should cause you concern?

APHO inequalities tool for all areas Models the life expectancy gap between the most deprived quintile of any Local Authority and: The local authority as a whole The least deprived quintile in the local authority The remainder of the local authority (ie the local authority without the most deprived quintile) England as a whole England's least deprived quintile you can then model interventions either across the most deprived quintile or the authority as a whole as with the Spearhead tool Good help functions

Breakdown of life expectancy gap between the Most Deprived Quintile (MDQ) of Penwith CD and the England average by cause of death

Life expectancy years gained if the Most Deprived Quintile (MDQ) of Penwith CD had the same mortality rate as the England average for each cause of death.

JSNA interactive mapping tool Many JSNA indicators for all Local Authorities in England

Future developments Awaiting APHO tool with national data

Audit commission

APHO Disease prevalence models Cancer Chronic Kidney Disease Chronic Obstructive Pulmonary Disease Coronary Heart DiseaseCancer Chronic Kidney Disease Chronic Obstructive Pulmonary Disease Coronary Heart Disease Dementia Diabetes Hypertension Mental Illness Stroke

Slope index of inequality

Slope index of inequality for life expectancy by deprivation decile Cornwall and Isles of Scilly PCT (used in World Class Commissioning) Guidance on setting trajectories

Sexual Health Balanced Scorecard

Health Inequalities Interventions Toolkit - Infant Mortality Tool

PCT Spend and Outcome Factsheets and Tool (SPOT) Programme Budgeting is a well-established technique for assessing investment in programmes of care rather than services. Allows easy identification of those areas which require priority attention, where relative potential shifts in investment opportunities will optimise local health gains and increase quality. The ability to link expenditure and outcome is explicit in two of the World Class Commissioning competencies; '6 prioritise investment' and '11 make sound financial investments'.

Extract from CIOS programme budgeting report

Observatory lead areas East Midlands Food and Nutrition Renal Disease Teenage Pregnancy Cancer Eastern Primary Care Sustainable Development Chronic Obstructive Pulmonary Disease (COPD) London Black and Ethnic Minorities Tobacco Health Inequalities North East Mental Health Learning Disabilities Offender Health Europe and International North West Drug Misuse Alcohol Crime and Violence Dental Health South East Physical Activity Obesity Transport Coronary Heart Disease Stroke South West Sexual Health Injuries End of Life West Midlands Older People Social Care Environment Yorkshire and Humber Children and Young People Diabetes Health Economics

Learning Tools and Resources Health Knowledge LSHTM – Introductory Epidemiology Course CAST – Computer Assisted Statistical Teaching

Health Knowledge Public Health Textbook E Learning Modules Interactive Learning Teaching

Health Knowledge – E-Learning Modules Applications of Health Information (P, S) Epidemiology (P, S) Population Health Information (P, S) Sickness and Health (P, S) Statistical Methods (S) (P = Practitioner, S = Specialist)

LSHTM – Introductory Epidemiology Course Internet based application Costs £60 (three months) Interactive content Self assessment exercises Certificate upon completion

CAST – Computer Assisted Statistics Teaching Highly interactive statistics teaching tool Ranged from elementary to advanced Contains a biometric statistics set of modules Self assessment exercises Web based or downloadable Available from

Exercise Investigate some of these How would you use them in your organisation? APHO tools at:

What you should have learnt Major models to support decision making Their philosophy Their strengths and weaknesses How you might use them