Children & Young Persons Health Index Nick Germain, Senior Public Health Analyst, NHS Doncaster

Why create a local index? Overall measure of health for children & young people. Broad strategic picture for service design and decision making across the partnership. Limitations to current sources, i.e. Child Wellbeing Index. Flexible ; oContent – choose indicators that are relevant to local priorities, oFrequency – produce updates whenever needed, oWeighting – alter the focus for different projects, oGeography – calculated for bespoke areas not fixed administrative boundaries. oInternal – comparison against Doncaster so measures internal variation.

88 geographies created to reflect the natural communities that people identify with.

Aligns with 16 Council neighbourhood areas.

Also aligns with most Sure Start areas.

Crime Antisocial Behaviour - Nuisance Youths Smoking & Substance Misuse Smoking Prevalence Aged 16+yr First Time Entrants To YJS (10-17yr) Alcohol Specific Emergency Admissions Aged 15-24yr Education Not Achieving Key Stage 2 Alcohol Attributable Hospital Admissions Aged 15-24yr Not achieving GCSE Drug Specific Emergency Admissions Aged 15-24yr Special Educational Needs Births & Vaccinations Low Birth Weights NEETMothers Not Breastfeeding At 6-8 Weeks Social Aspects Child Social Care Referrals Children Not Receiving Primary Immunisations Children In Poverty Children Not Receiving Pre School Vaccination Child Wellbeing IndexChildren Not Receiving MMR Vaccination Income Household IncomeSexual HealthConceptions to Females <18yr Children receiving FSM A&E And Emergency Admissions A&E Attendance Aged <18yr HousingProperties in Council tax band AEmergency Admissions Aged <18yr Obesity Obese And Overweight Children In ReceptionAdmissions for Gastroenteritis <1yr Obese And Overweight Children In Year 6 Admissions for Lower Resp. Tract Infections <16yr

Sources & method Mainly health indicators plus social care, economy, education, crime and housing; All relatively available and LA very supportive. Simple process, most time is spent calculating rates. All indicators in same ‘direction’; low = good, high = bad. Divide community by Doncaster for individual scores; ( 1=Doncaster, 1= ‘worse’ than Doncaster) Add indicators up into domains, add domains up into the final score. Apply weighting at indicator and/or domain level.

Abridged example of the final scores Worst index score Equivalent to Doncaster average Community NameIndex Score Highfields1.67 Denaby Main1.53 Hyde Park1.43 Stainforth1.37 Edlington1.21 Mexborough1.20 New Rossington1.15 Carcroft1.12 Clay Lane1.10 Scawthorpe1.02 Cantley1.02 Askern1.00 Thorne0.98 Conisbrough0.95 Auckley0.66 Tickhill0.66 Bawtry0.61 Dunsville0.58 Cusworth0.58 High Melton0.57 Edenthorpe0.57 Branton0.57 Loversall0.37 Fenwick0.30 Braithwell0.29 Micklebring0.21 Best index score

Use mapping to compare results Local Doncaster IndexChild Wellbeing Index

Early access to maternity services As discussed, aim was to increase engagement with services before 12 weeks gestation. Identify indicators relevant to the issue. Calculate the score and split into population quintiles. This identifies 1/5 th of the population most in need of engagement – not necessarily following CWI or IMD. Follows principles of QIPP targeting use of resources.

Crime Antisocial Behaviour - Nuisance Youths Smoking & Substance Misuse Smoking Prevalence Aged 16+yr First Time Entrants To YJS (10-17yr) Alcohol Specific Emergency Admissions Aged 15-24yr Education No Achieving Key Stage 2 Alcohol Attributable Hospital Admissions Aged 15-24yr Not achieving GCSE Drug Specific Emergency Admissions Aged 15-24yr Special Educational Needs Births & Vaccinations Low Birth Weights NEET Mothers Not Breastfeeding At 6-8 Weeks Social Aspects Child Social Care Referrals Children Not Receiving Primary Immunisation Children In Poverty Children Not Receiving Pre School Vaccination Child Wellbeing IndexChildren Not Receiving MMR Vaccination Income Household IncomeSexual Health Conceptions to Females <18yr Children receiving FSM A&E And Emergency Admissions A&E Attendance Aged <18yr HousingProperties in Council tax band AEmergency Admissions Aged <18yr Obesity Obese And Overweight Children In Reception Admissions for Gastroenteritis <1yr Obese And Overweight Children In Year 6 Admissions for Lower Resp. Tract Infections <16yr

Again, use mapping to aid interpretation

Targeted Interventions (NHS Doncaster). Informed the proposed Integrated Family Support Service (DMBC). Family Nurse Partnership (Local Strategic Partnership). Use current scores as a baseline to measure changes in health outcomes and inequalities. All contribute to QIPP agenda directing effective use of resources. Other uses identified

Does not yet include a measure of statistical significance. Some small communities have very low figures, they have not suppressed but it does need a caveat. Cannot use indicators with extreme outliers. Use as a inequality measure needs to be validated. Limitations

Any Questions?