Latest developments in national health surveys EMPHIN Forum 24 th May 2012

Changes to ONS surveys Integrated Household Survey, General Lifestyle Survey, Opinions and Lifestyle Survey Changes to HSCIC surveys Health Survey for England Other surveys PHE National Data Requirements project

Background to the IHS ONS has several separate household surveys – Different samples, fieldwork designs and processing systems All surveys have similar introductions – Names, ages, work history Aim of the IHS is to integrate surveys into one modular survey with a core set of questions and survey modules ‘bolted’ to the core – Leading to ….. The largest social survey ever produced by ONS

Surveys making up the IHS from 2009/10 Annual Population Survey (APS) Labour Force Survey (LFS) Living Costs and Food Survey (LCF) Life Opportunities Survey (LOS) English Housing Survey (EHS) Opinions Survey (OPN) – OPN left the IHS after Dec General Lifestyle Survey (GLF) – More later …….

IHS: Sample Size by Component Survey Common set of core questions Continual sampling Adding up to large scale quarterly datasets. Interview Type2009/2010 achieved interviews GLF18,000 LCF12,000 OPN21,000 EHS41,000 APS +LFS334,000 LOS23,000 Annual Total449,000 The expected breakdown of the annual sample is as follows:

IHS Core Questions Household composition Accommodation Tenure Nationality Country of Birth National identity Ethnicity Sexual identity Religion Period at current address Health Smoking Government training scheme Work Looking for work Education

General Lifestyle Survey Formerly General Household Survey Requirement to harmonise UK and EU data on poverty EU Statistics on Income and Living Conditions (EU-SILC) Feasibility study and consultation 2010 and 2011 Could EU-SILC be collected via Family Resource Survey (FRS)? Efficiency of data collection (duplication GLF and FRS) Cost savings

GLF ceased to run from Jan 2012 EU-SILC information – income, poverty, social exclusion, general health, LLI  Now collected by Family Resources survey  24,000 households Non EU-SILC information – health conditions, smoking and drinking, use of health services  Now collected by Opinions and Lifestyle Survey (merger of non EU-SILC element of GLF and Opinions surveys)  Sponsored questions - subject to funding (HSCIC funding withdrawn)  13,000 households

Health Survey for England

Health Survey for England (HSE, pre 2009) Health and Social Care Survey (HSCS, 2009 and 2010) Health Survey for England: Health, Social Care and Lifestyles (2011+)

Health Survey for England Annual since 1991 Adults age >16 living in private households Children’s data from 1995 onwards Sample size varies 8,000-16,000 adults Clinical examination - height, weight, BP, blood sample - as well as self report data Regional breakdowns - rarely anything sub-region

Health Survey for England 2010 Focus on kidney disease, respiratory disease wellbeing and dental health Core sample – 8,000 adults & 2,000 children Boost sample – 4,000 children Reports published and data deposited in Data Archive

HSE 2011 Focus on social care, CVD, wellbeing, chronic pain, social marketing segmentation Core sample – 8,000 adults & 2,000 children Fieldwork complete, report due Dec 2011 Dec 2012 HSE 2012 Focus on physical activity (accelerometry) and well being Also sexual health, flu preparedness, problem gambling Core sample – 8,000 adults & 2,000 children Fieldwork in progress

New HSE funding arrangements Following the Comprehensive Spending Review the HSCICs central budget allocation (known as 'grant in aid') set to fall by at least 10% per year over three years So, HSCIC now fund core interview and nurse modules for a core sample. Additional modules and boost groups funded by others (primarily DH but also e.g. Gambling Commission).

HSE Core topics (….. limited) 30 minute survey + 40 minute nurse visit Household details Age, ethnicity etc General health (LLI) Smoking and drinking (basic) Height and weight Consents for data linkage Fruit and veg consumption (alternate years)

Health Survey for England 2013 onwards 2013 Health and social care, subjective disability (older people boost) 2014 Ethnic minority boost (10 years on …) 2015 Respiratory (progress since 2010) 2016 CVD (progress since 2011) BUT “there has not been much interest expressed by DH for content in 2013 due to funding constraints”. Perceived lack of co-ordination between DH policy areas.

Other recent and forthcoming HSCIC surveys Chidren’s Dental Health 2013/14 Adult Psychiatric Morbidity 2014 Smoking, drinking and drug use among young people (ongoing – next report due July 2012) Infant Feeding Survey (5 yearly since 1975, 2010 report due summer 2012) Survey on Autistic Spectrum Conditions (released Jan 2012) No longer funded by HSCIC: National Maternity Survey; Mental Health among Children/ Carers/ Ethnic Minorities/ Prisoners etc; survey of adults with learning difficulties

Other useful national surveys … Active People Survey (from 2005, APS6 in 2012, current consultation) British Social Attitudes (annual since 1983, 28 th report 2011) English Longitudinal Study of Ageing (panel survey wave /13) Food and You Survey (wave 1 in 2010, wave , replaced the FSA Consumer Attitudes Survey) Family Food Survey (formerly the Expenditure and Food Survey) National Diet and Nutrition Survey (? extended to 2013) Understanding Society (NEW ….)

Understanding Society Survey Longitudinal panel survey, 100,000 individuals in 40,000 British households £50 million funding 5 waves Includes health, crime, finances, attitudes, social involvement, employment, politics Aims to give insight into the pathways that influence peoples longer term occupational trajectories; their health and well- being, their financial circumstances and personal relationships “The study will capture biomedical data on 20,000 participants and place this alongside rich social histories, helping to weigh the extent to which people's environment influences their health.”

Place Survey Replacement for “Best Value” survey Department of Communities and Local Government Local Authority led Support new National Indicator set Fieldwork September 2008, then bi-annual Cancelled

TellUs National survey to gather views of children and young people School years 6, 8 and 10 (ages 10 – 15) Measures progress against Every Child Matters outcomes: Be healthy, Stay safe, Enjoy and achieve, Make positive contribution, Achieve economic well-being Tellus2 (2007) and Tellus3 (2008) led by Ofsted Tellus4 (2009) led by DCSF Cancelled

PHE National data requirements project Project rationale: there is no coordinated process for defining and agreeing public health data requirements at a national level Project aim: to develop a strategic process (and supporting governance) for specifying and delivering national data requirements to meet the needs of PHE and the new public health system Key partners and stakeholders: DH, the IC, ONS, NHS CB, the local public health system

Functional categorisation of data types The project is covering the following four broad categories of national public health data: – Operational health, social care and public health data from routine practice and service provision; – Surveys and population-based data on how people live their lives; – Indicators of health and social care, and the wider determinants of health; and – New national programmes and services to ensure that public health data requirements are reflected in their development and provision.

Proposed data requirements model National Public Health Data Requirements Board Overall governance and decision-making on data priorities and requirements Specification of data requirements for PHE data services e.g. from NHS IC Local stakeholder networks National data source advisory groups Consider requirements including reviewing existing and identifying new data sources Make recommendations for commissioning and decommissioning data sources Operational data Surveys and population- based data Outcomes and indicators New national programmes and services

Opportunities Seizing the opportunity presented by the establishment of Public Health England to look at the ‘big picture’ of public health data commissioning and provision in a resource constrained environment Support front line delivery of public health services by addressing the national gaps in the supply of public health data Prioritise and rationalise the commissioning of public health data by PHE and key national partners