A summary of health issues affecting the people of East Hampshire Primary Care Group area

East Hampshire Primary Care Group (PCG) includes Havant Borough Council area, those electoral wards of East Hampshire and Winchester lying within Portsmouth and South East Hampshire Health Authority, and the three wards of mainland Portsmouth.

The People 215,792 people live in East Hampshire PCG area and this will slightly increase by 0.7% by 2004. 5.8% of the population living in these wards is aged under five, and 17.1% aged 65 years or over. 225,574 people are registered with East Hampshire PCG GPs. During 1998, there were 2,409 births to women living in East Hampshire PCG electoral wards.

Perinatal Mortality The perinatal mortality rate is the number of stillbirths and deaths in the first week of life per 1,000 total births. Between 1996 and 1998, there was an average of 20 perinatal deaths each year in East Hampshire PCG electoral wards. The three year average perinatal mortality rate for these wards was 8.3 per 1,000 total births which was lower than that of Portsmouth and South East Hampshire (8.5 per 1,000 total births). (Fig 1)

Major causes of deaths There were 2,272 deaths to people in East Hampshire PCG electoral wards in 1998: of these, 356 were to people aged under 65. Cancers (559), coronary heart disease (492), other cardiovascular diseases (220), strokes (214) and accidents (31) were the principal causes of deaths. (Fig 2)

Lifestyle preferences The lifestyle preferences of East Hampshire PCG residents mirrored those of Portsmouth and South East Hampshire as a whole with respect to taking no physical activity (13%) and smoking (28%). However, higher percentages of this PCG's residents were obese and drank alcohol above sensible limits compared with district residents. (Fig 3)

Access to preventive services The uptake rate of the cervical screening programme for East Hampshire PCG is 87% compared with the district uptake rate of 85%. In 1998/99 East Hampshire PCG had a high percentage of inadequate smears (9.8%) and also of smears not taken from the transformation zone (18.9%). Between 1995 and 1998, East Hampshire PCG’s breast screening uptake was 77.5%. The average practice childhood immunisation uptake rates in1998 ranged from 90.9% to 100%; the average practice pre-school booster uptake rates ranged from 84.2% to 100%. There is evidence that the infant immunisation uptake rates across the district (and nationally) have fallen following adverse publicity.

Hospital utilisation The hospital episode rates per 100,000 age specific populations for East Hampshire PCG residents are compared with those of Portsmouth and South East Hampshire. Residents of this PCG had lower rates for total hospital episodes, emergency episodes, episodes for people aged 75 and over and mental health episodes. The hospital episode rate for children under five was the lowest of all PCGs. (Fig 4)

Access to selected operations The NHS Executive has chosen a number of operations as indicators of the success of health authorities in securing clinically effective and appropriate services for their population. Effective operations include coronary artery bypass grafts and coronary angioplasties (CABGs and PTCAs), cataracts and hip and knee replacements. Ineffective operations include dilatation and curettage for menorrhagia, surgical interventions for glue ear (grommets), extraction of asymptomatic wisdom teeth and varicose vein surgery. Operations with effective alternatives include hysterectomies and elective caesarian sections.

The East Hampshire PCG elective operation rate per 100,000 age specific population for certain clinically effective operations is compared with the England rate (Table 1). East Hampshire PCG residents undergo higher rates of knee replacements and cataract surgery, but lower rates of CABGs and PTCAs.

Residents of this PCG undergo higher rates of grommet surgery and wisdom teeth extraction. They also undergo higher rates for hysterectomies to women aged 15 to 49 and elective caesarian sections - both of which have effective alternatives.

Residents of East Hampshire PCG also undergo higher rates of hip revisions, which are widely regarded as a marker for the quality of the primary surgery.

Communicable Disease Between 1991 and 1998, communicable disease notifications in East Hampshire (pt) and Havant increased from 76 to 346. Part of this increase is due to improved reporting. However, there is still evidence of under-reporting of notifiable diseases. Notifications for meningitis increased over this period, Conversely, notifications for most vaccine preventable diseases declined. (Fig 5)

Suggestions for health and other agencies working in East Hampshire PCG area

• Work with the local authority to tackle poverty in urban and rural areas
• Encourage people to eat a healthier diet, reduce alcohol intake, stop smoking and take regular exercise
• Encourage primary care teams and pathology departments to work together to improve smear taking techniques
• Work with the Health Authority to achieve a more equitable allocation of resources to PCGs – taking account of differences in health needs
• Work with hospital clinicians to review elective operation rates for CABGs and PTCAs, grommet surgery, hysterectomies to women aged 15 to 49, wisdom teeth extraction, hip revisions and elective caesarian sections
• Raise patient and practitioner awareness of the effectiveness or otherwise of certain elective operations
• Encourage GPs to notify all cases of notifiable diseases
• Continue to provide clear and consistent messages to all members of the primary care team and to the public about the effectiveness and safety of childhood vaccinations
• Raise public, patient and food business awareness of food poisoning and how it can be avoided
• Raise patients’ and parents’ awareness of the symptoms of meningitis.

Produced by Public Health and Strategy Directorate, Portsmouth and South East Hampshire Health Authority, Finchdean House, Milton Road, Portsmouth, PO3 6DP. August 1999.

Produced by Ann Edmeades, IT Services, Hampshire County Council
for Portsmouth and South East Hampshire Health Authority
© Copyright Portsmouth and South East Hampshire Health Authority 1998
Last Updated 1st September, 1999