1. GOVERNMENT OFFICE FOR THE SOUTH WEST South West Public Health Observatory GOVERNMENT OFFICE FOR THE SOUTH WEST South West Public Health Observatory Joint working between a Public Health Observatory and Cancer Registry The South West Experience

2. GOVERNMENT OFFICE FOR THE SOUTH WEST South West Public Health Observatory GOVERNMENT OFFICE FOR THE SOUTH WEST South West Public Health Observatory Outline  Who are we  Our Stake holders / Relationships  Scope of our work  Last year’s successes  The future

3. GOVERNMENT OFFICE FOR THE SOUTH WEST South West Public Health Observatory GOVERNMENT OFFICE FOR THE SOUTH WEST South West Public Health Observatory Structure of Public Health Observatories  Not standard across each region  Evolved at different rates from different starting points.  South West different in many ways

4. GOVERNMENT OFFICE FOR THE SOUTH WEST South West Public Health Observatory GOVERNMENT OFFICE FOR THE SOUTH WEST South West Public Health Observatory Key players  Regional Public Health (RDPH, DoH at GOSW)  Cancer Intelligence  Public Health Observatory  Health Protection Agency (HPA)  Regional Health Emergency Planning  Congenital Anomalies Register  NDTMS (National Drug Treatment Monitoring Service)  Screening Programme Quality Assurance  Others e.g. CF Register

5. GOVERNMENT OFFICE FOR THE SOUTH WEST South West Public Health Observatory GOVERNMENT OFFICE FOR THE SOUTH WEST South West Public Health Observatory Other significant partners  Regional Observatory  Environment Module (Environment Agency)  GOSW  Regional Intelligence Unit  Home Office  DEFRA  DCMS  ODPM

6. GOVERNMENT OFFICE FOR THE SOUTH WEST South West Public Health Observatory GOVERNMENT OFFICE FOR THE SOUTH WEST South West Public Health Observatory

7. GOVERNMENT OFFICE FOR THE SOUTH WEST South West Public Health Observatory GOVERNMENT OFFICE FOR THE SOUTH WEST South West Public Health Observatory Developments  NDTMS moved to SWPHO  SWCIS merged with SWPHO  Tighter relationship with RDPH (Business plan, SLA)  Continued closer working between SWCIS component and Cancer Screening QA  Memoranda of Understanding between SWPHO/SWCIS and HPA and Environment Agency Closer working with others too

8. GOVERNMENT OFFICE FOR THE SOUTH WEST South West Public Health Observatory GOVERNMENT OFFICE FOR THE SOUTH WEST South West Public Health Observatory Partnerships  Regional Public Health Group  Association of Public Health Observatories  Other regional health intelligence bodies  South West Observatory  Academia  Government Office

9. GOVERNMENT OFFICE FOR THE SOUTH WEST South West Public Health Observatory GOVERNMENT OFFICE FOR THE SOUTH WEST South West Public Health Observatory Functions of Public Health Observatories Set up as a result of Saving Lives: Our Healthier Nation to: Provide a robust intelligence function to underpin decision making and monitoring impact Monitoring health and disease trends and identifying gaps in health information Advising on methods for health and health inequality impact assessments Drawing together information from different sources in new ways Projects to highlight particular health issues Evaluating progress by local agencies in improving health and cutting inequality Early warning of future public health problems.

10. GOVERNMENT OFFICE FOR THE SOUTH WEST South West Public Health Observatory GOVERNMENT OFFICE FOR THE SOUTH WEST South West Public Health Observatory Role of Cancer Registries  UK Network of cancer registries - UKACR  Collect data on all new cases of cancer diagnosed within the region  More than one million records on database  Over 25,000 new cases of cancer registered every year  Check the accuracy of the information by comparing different sources  Monitor patterns of cancer especially over time and across geographical areas  Early warning of possible public health problems highlighting areas for action  Audit of the quality of care  Research

11. GOVERNMENT OFFICE FOR THE SOUTH WEST South West Public Health Observatory GOVERNMENT OFFICE FOR THE SOUTH WEST South West Public Health Observatory South West Public Health Observatory and Cancer Intelligence Service are integral parts of SW RPHG  Benefits to SW PHO/CIS  Communications Support  Policy Support  Reduced risk of ‘Ivory Tower’ phenomenon  Shared expertise  Links to GOSW  Issues awareness  Policy context  Benefits to RPHG  RPHG quick access to stats, spokesperson  Shared skills, expertise  Evidence  Skills & expertise for analysis  Benchmarking & Trends  Communications

12. GOVERNMENT OFFICE FOR THE SOUTH WEST South West Public Health Observatory GOVERNMENT OFFICE FOR THE SOUTH WEST South West Public Health Observatory Association of Public Health Observatories  Ability to do things once for all  Regional PH Indicators  Basket of local inequalities indicators  GIS  Exchange of expertise and ideas  National leads  e.g. SWPHO, Injury, Sexual health  E.g. WMPHO Cancer

13. GOVERNMENT OFFICE FOR THE SOUTH WEST South West Public Health Observatory GOVERNMENT OFFICE FOR THE SOUTH WEST South West Public Health Observatory UK Association of Cancer Registries (UKACR)  England  Wales  Scotland  N.Ireland  Eire  ONS

14. GOVERNMENT OFFICE FOR THE SOUTH WEST South West Public Health Observatory GOVERNMENT OFFICE FOR THE SOUTH WEST South West Public Health Observatory Cancer Registry Advisory Group CRAG  Prof Mike Richards (Chair)  Chris Carrigan National CR Co-ordinator  RDPH lead  APHO representation  UKACR  DH  ONS

15. GOVERNMENT OFFICE FOR THE SOUTH WEST South West Public Health Observatory GOVERNMENT OFFICE FOR THE SOUTH WEST South West Public Health Observatory Other Regional Health Intelligence Functions  Cancer Intelligence Service (CIS) merger  1 st region to take this step  +ve step for the future of non-communicable disease surveillance in the SW  NDTMS merger  HPA : infectious diseases, chemical hazards, poisons and radiation hazards  Strong links – advice/support  Collaborative projects  MOU

16. GOVERNMENT OFFICE FOR THE SOUTH WEST South West Public Health Observatory GOVERNMENT OFFICE FOR THE SOUTH WEST South West Public Health Observatory South West Observatory  Multi-Disciplinary  Public Health  Environment  Planning  Skills and learning  Business & Economy  Core Unit

17. GOVERNMENT OFFICE FOR THE SOUTH WEST South West Public Health Observatory GOVERNMENT OFFICE FOR THE SOUTH WEST South West Public Health Observatory South West Observatory  Ability to do things once for all  Exchange of expertise and ideas and data  SWID – multi-disciplinary online database  Ability to raise PH on other agendas  cross-cutting work  e.g. Impact of literacy on health

18. GOVERNMENT OFFICE FOR THE SOUTH WEST South West Public Health Observatory GOVERNMENT OFFICE FOR THE SOUTH WEST South West Public Health Observatory Academia Academic partnership with Department of Social Medicine, University of Bristol  Scientific Director  Academic guidance (e.g. methodologies)  Peer support  Training  Data/analysis expertise E.g. HES Safe Haven & analysis

19. GOVERNMENT OFFICE FOR THE SOUTH WEST South West Public Health Observatory GOVERNMENT OFFICE FOR THE SOUTH WEST South West Public Health Observatory Government Office for the South West  Communications & Intelligence Team  Neighbourhood Renewal  DEFRA  DCMS  Home Office / Crime Reduction  Housing  Transport  Sure Start many more areas to be examined……. But already some very successful engagement.

20. GOVERNMENT OFFICE FOR THE SOUTH WEST South West Public Health Observatory GOVERNMENT OFFICE FOR THE SOUTH WEST South West Public Health Observatory Skills based work  Public Health (including statistical) advice, analysis and support to South West Public Health Community and others – SWINPHO  Communications  Publications  Website(s)  Media  Public Meetings

21. GOVERNMENT OFFICE FOR THE SOUTH WEST South West Public Health Observatory GOVERNMENT OFFICE FOR THE SOUTH WEST South West Public Health Observatory Common interests and functions  Non-communicable disease surveillance  Spatial and temporal variations and trends  Predicting Health problems  Determinants of disease  Demographic  Deprivation  Environmental Factors  Quality of Health Services  Equity of provision/access  Effectiveness of intervention

22. GOVERNMENT OFFICE FOR THE SOUTH WEST South West Public Health Observatory GOVERNMENT OFFICE FOR THE SOUTH WEST South West Public Health Observatory Common interests and functions  Links with NHS  Data protection and confidentiality  Human Resources/Budgets  Data handling skills  Statistical/GIS skills  Career progression

23. GOVERNMENT OFFICE FOR THE SOUTH WEST South West Public Health Observatory GOVERNMENT OFFICE FOR THE SOUTH WEST South West Public Health Observatory Common interests and functions  Accountable to RDPH  Regional Audience/Stakeholders  SHAs  PCTs  LAs  Researchers  Public  National Networks  APHO  UKACR  Links with ONS/HPA/HDA

24. GOVERNMENT OFFICE FOR THE SOUTH WEST South West Public Health Observatory GOVERNMENT OFFICE FOR THE SOUTH WEST South West Public Health Observatory Key differences  SWCIS collects Primary Data  SWPHO uses data form multiple sources but till now rarely if ever collected primary data  But NDTMS does collect primary data  NDTMS has to move from paper to electronic data collection within ? 1 year

25. GOVERNMENT OFFICE FOR THE SOUTH WEST South West Public Health Observatory GOVERNMENT OFFICE FOR THE SOUTH WEST South West Public Health Observatory Invisible examples of joint working  Confidentiality and data protection  Datasources  Database manager  Skills sharing  Website  Provision of routine data  Protocols and monitoring of ad-hoc enquiries

26. GOVERNMENT OFFICE FOR THE SOUTH WEST South West Public Health Observatory GOVERNMENT OFFICE FOR THE SOUTH WEST South West Public Health Observatory Visible examples of joint working SWCIS/SWPHO  Website  Melanoma  Cancer Clusters  Hinkley Point  Emerging Public Health Problems  Mesothelioma  Prostate Cancer  Smoking /deprivation and cancer  Environmental risk and cancer  Access to cancer services

27. GOVERNMENT OFFICE FOR THE SOUTH WEST South West Public Health Observatory GOVERNMENT OFFICE FOR THE SOUTH WEST South West Public Health Observatory Examples of work

28. GOVERNMENT OFFICE FOR THE SOUTH WEST South West Public Health Observatory GOVERNMENT OFFICE FOR THE SOUTH WEST South West Public Health Observatory The Prostate Cancer Epidemic

29. GOVERNMENT OFFICE FOR THE SOUTH WEST South West Public Health Observatory GOVERNMENT OFFICE FOR THE SOUTH WEST South West Public Health Observatory Standardised registration ratios English Regions 2002 England

30. GOVERNMENT OFFICE FOR THE SOUTH WEST South West Public Health Observatory GOVERNMENT OFFICE FOR THE SOUTH WEST South West Public Health Observatory Incidence rates by age band 1992-2002 in the South West

31. GOVERNMENT OFFICE FOR THE SOUTH WEST South West Public Health Observatory GOVERNMENT OFFICE FOR THE SOUTH WEST South West Public Health Observatory Male population of South West

32. GOVERNMENT OFFICE FOR THE SOUTH WEST South West Public Health Observatory GOVERNMENT OFFICE FOR THE SOUTH WEST South West Public Health Observatory South Wiltshire PCTWest of Cornwall PCT

33. GOVERNMENT OFFICE FOR THE SOUTH WEST South West Public Health Observatory GOVERNMENT OFFICE FOR THE SOUTH WEST South West Public Health Observatory Standardised Incidence Ratio in PCTs 2000-2002 compared to England

34. GOVERNMENT OFFICE FOR THE SOUTH WEST South West Public Health Observatory GOVERNMENT OFFICE FOR THE SOUTH WEST South West Public Health Observatory Incidence / mortality of prostate cancer in 42 PCTs in SW England according to the income domain of IMD 2004.

35. GOVERNMENT OFFICE FOR THE SOUTH WEST South West Public Health Observatory GOVERNMENT OFFICE FOR THE SOUTH WEST South West Public Health Observatory Number of total prostatectomies / cystectomies carried out to treat cancer by Trust in 2002. Excludes endoscopic resections.

36. GOVERNMENT OFFICE FOR THE SOUTH WEST South West Public Health Observatory GOVERNMENT OFFICE FOR THE SOUTH WEST South West Public Health Observatory Number of radical prostatectomies carried out to treat cancer by Trust in 1993* and 2002.

37. GOVERNMENT OFFICE FOR THE SOUTH WEST South West Public Health Observatory GOVERNMENT OFFICE FOR THE SOUTH WEST South West Public Health Observatory Proportion of patients in the South West having radical surgery by age group

38. GOVERNMENT OFFICE FOR THE SOUTH WEST South West Public Health Observatory GOVERNMENT OFFICE FOR THE SOUTH WEST South West Public Health Observatory NICE epidemiological and service needs assessment  NICE NCCC Cardiff  SWPHO (SWCIS)  NATCANSAT (HES)  BAUS  Mark Baker  NHS Cancer Screening Programme

39. GOVERNMENT OFFICE FOR THE SOUTH WEST South West Public Health Observatory GOVERNMENT OFFICE FOR THE SOUTH WEST South West Public Health Observatory Predicting the mesothelioma peak

40. GOVERNMENT OFFICE FOR THE SOUTH WEST South West Public Health Observatory GOVERNMENT OFFICE FOR THE SOUTH WEST South West Public Health Observatory Children

41. GOVERNMENT OFFICE FOR THE SOUTH WEST South West Public Health Observatory GOVERNMENT OFFICE FOR THE SOUTH WEST South West Public Health Observatory Older adults

42. GOVERNMENT OFFICE FOR THE SOUTH WEST South West Public Health Observatory GOVERNMENT OFFICE FOR THE SOUTH WEST South West Public Health Observatory Cancer clusters / HIA  Hinkley Point  Osteosarcoma  Heavy Metals  Radiomasts  Landfill sites  Composting

43. GOVERNMENT OFFICE FOR THE SOUTH WEST South West Public Health Observatory GOVERNMENT OFFICE FOR THE SOUTH WEST South West Public Health Observatory Environmental risk factors  IPPC mapping project  Joint SWPHO/EA/HPA/DEFRA project  Emergency Planning  Epidemiological studies  662 of the most polluting factories are in areas with average household incomes £30,000

44. GOVERNMENT OFFICE FOR THE SOUTH WEST South West Public Health Observatory GOVERNMENT OFFICE FOR THE SOUTH WEST South West Public Health Observatory Access to Cancer Services Most of Devon and Cornwall is within 1 hour drive of one of the hospitals. Lands End and the area around Bude have poor access. Reproduced from Ordnance Survey digital map data © Crown copyright 2002. All rights reserved. HH If Exeter became the treatment centre for gynae. cancers, approximately 120 patients referred there each year would be outside the 1 hour isochrone (time line). The map shows isochrones (time lines) around the Royal Devon & Exeter Hospital and location of gynae. patients 1995-1999 Travelling times to Exeter Reproduced from Ordnance Survey digital map data © Crown copyright 2002. All rights reserved.

45. GOVERNMENT OFFICE FOR THE SOUTH WEST South West Public Health Observatory GOVERNMENT OFFICE FOR THE SOUTH WEST South West Public Health Observatory Estimated proportion of deaths from lung cancer in males and females aged 35–69 attributable to tobacco smoking in PCTs in the South West

46. GOVERNMENT OFFICE FOR THE SOUTH WEST South West Public Health Observatory GOVERNMENT OFFICE FOR THE SOUTH WEST South West Public Health Observatory NICE implementation  Head and Neck  Skin  Child and Adolescent  Brain and Neuro  Sarcoma

47. GOVERNMENT OFFICE FOR THE SOUTH WEST South West Public Health Observatory GOVERNMENT OFFICE FOR THE SOUTH WEST South West Public Health Observatory CMO reports  Skin Cancer  Mesothelioma

48. GOVERNMENT OFFICE FOR THE SOUTH WEST South West Public Health Observatory GOVERNMENT OFFICE FOR THE SOUTH WEST South West Public Health Observatory Rare Cancer Commissioning  Sarcoma  Head and Neck  Endocrine  Haematology  Urology  PET

49. GOVERNMENT OFFICE FOR THE SOUTH WEST South West Public Health Observatory GOVERNMENT OFFICE FOR THE SOUTH WEST South West Public Health Observatory Audit of Cancer Services

50. GOVERNMENT OFFICE FOR THE SOUTH WEST South West Public Health Observatory GOVERNMENT OFFICE FOR THE SOUTH WEST South West Public Health Observatory IT  Redevelopment Cancerbase  Quality  Functionality  MDS  Merger Issues  Interoperability  Inform NDTMS database development

51. GOVERNMENT OFFICE FOR THE SOUTH WEST South West Public Health Observatory GOVERNMENT OFFICE FOR THE SOUTH WEST South West Public Health Observatory The future  Work programme  Performance Management  LAAs  Freedom of Information  Making a difference !