The Board considered a report of the Director of Public Health which presented information relating to Halton’s Respiratory Health Profile 2014 and provided an analysis regarding the findings from a local perspective.
The Board was advised that the Halton Respiratory Health Profile 2014 showed that for both COPD and asthma the proportion of Halton’s population who have these conditions was higher than the England average. Some of this may be accounted for by local efforts to increase case finding. However, as the Borough had high levels of deprivation and many respiratory diseases were linked to this, it was likely Halton had higher levels than the national average.
The Board was further advised that Halton’s profile was set out in the Appendix to the report which showed that there was a mixed picture. Levels of disease were thought to be higher than the England average but after diagnosis the majority were managed in line with the best clinical evidence. However, high levels of emergency (unplanned) hospital admissions continued to place a significant burden on the local population and healthcare system.
The data for Halton showed that:
· It was estimated about 3,916 people aged 16+ living in Halton had Chronic Obstructive Pulmonary disease (COPD) in 2010. By 2020 this figure maybe as many as 4,420;
· There had been improvements in case finding since 2009/10 closing the gap between estimated number of people with COPD and those of GP disease registers. However, the number of people on the asthma register remained lower than the expected number;
· The management of patients with COPD and asthma were similar or slightly better than the North West and England averages;
· There was a significant ward level variation in emergency hospital admission rates and at GP practice level. There was also a relationship with temperature, with a greater percentage of admissions seen in the winter months; and
· Death rates for COPD have been falling but were above the North West and England rates. Death rates from respiratory causes in those aged under 75 years and pneumonia were also higher than England but similar to the North West. COPD was also a significant cause of excess winter deaths.
The Board noted the programmes to address the areas of concern set out in the report.
The following comments arose from the discussion:-
· Page 96 – It was noted that the statistics in Halton relating to Chronic Obstructive Pulmonary disease (COPD) was related to Halton’s industrial legacy and the number of people who had previously smoked. It was also noted that there were changes in the classifying of COPD within contracts and that it would need to be monitored;
· It was suggested that more information could be available on asthma services in order to ensure the residents of Halton had a greater understanding of the condition i.e. prescriptions could be collected from pharmacies outside of the Borough which enabled individuals to have greater control over the day to day management of their condition. It was noted that the number of people on the asthma register in Halton was relatively low. The impact that asthma could have on other diseases/illnesses was also noted. It was reported that these wider issues would be incorporated within the Strategy; and
· It was agreed that the Strategy be presented to a future meeting of the Board.
RESOLVED: That the contents of the report, comments raised and the programmes to address the areas of concern be noted.