1. Office for National Statistics & Public Health Dr Azeem Majeed Office for National Statistics & University College London

2. Structure of session Structure & function of ONS Recent developments in government statistics & analysis Small group work on primary care data

3. Learning objectives ONS - structure & function Health related data Future developments in government statistics Opportunities for training & collaborative work DH review of primary care data

4. What is the ONS? Formed in 1996 by the merger of Office of Population Censuses and Surveys & Central Statistical Office Main arm of the government statistical service Responsible for publication of wide range of government statistics

5. Public health related work Health & Care Population & vital statistics

6. Health & Care Mortality Morbidity Child Health Cancer Longitudinal survey Geographical variations

7. Publications Health Statistics Quarterly Population Trends Ad-hoc publications Web site (www.statistics.gov.uk)

8. Opportunities for training ONS approved location for SpR training Previous projects include accidents, deaths from overdose, atrial fibrillation, epilepsy. Development of analytical skills, knowledge of routine data sources & publication of work encouraged SpRs from other specialties

9. Supporting public health I Collection & analysis of routine statistics Decennial census Population estimates Deprivation measures Birth & death rates Cancer incidence & survival Teenage conception rates

10. Supporting public health II Primary care Health inequalities Measuring the burden of disease Reducing suicide New methods of measuring case-mix

11. Primary care Prevalence of chronic diseases Prescribing rates Time trends Variations –Regional, socio-economic, practice Provide information for planning health services for DOH, PCTs etc.

15. Relative risks in AF patients 45-64 yrs65-74 yrs75+ yrs IHD4.52.62.5 Heart failure33.57.53.7 Raised BP2.51.41.5 Diabetes1.61.41.1 Stroke8.63.22.9

16. Prevalence of IHD & use of statins in E & W in 1998

17. Some other diseases examined Heart failure Hypertension Asthma Epilepsy Schizophrenia Peptic ulceration

18. Annual No. of contacts with GPs

19. Referral rates per 1,000 (males)

20. Referral rates per 1,000 (females)

21. Reducing deaths from suicide Reducing deaths from overdose an important component GPs will play an important role New database of deaths from overdose developed by ONS Allows more sophisticated and flexible analyses than previously

23. Toxicity index for antidepressants

25. Measuring case-mix in primary care Comparing performance Examining use of resources Adjusting referral rates Case mix measurement based on patients’ medical history Budget setting

26. Percentage referred in one year

27. Burden of disease Measuring the burden of disease GP consultations Prescribing Referrals Admissions Projections

28. Hip fracture admissions among over 65 year olds in England 19982022Increase Men11,56216,410+42% Women45,98453,126+12% Total57,54669,536+21%

29. Other areas Teenage pregnancy Social & regional variations Health surveys Linkage studies Child health E-Strategy (www.statistics.gov.uk)

30. Conclusions Work of ONS & ONS data important to people working in public health Learn how to use data to help plan & monitor health services and the health of the public

31. Primary care data Department of Health reviewing primary care data Workshop in August/September Report later this year

32. Issues to be considered Who are the users of primary care data? What data are currently available? What are the strengths & limitations of these data? How can primary care data be used? How can data from primary care be improved?