Shropshire County 2016-17 QOF Data Report by Place Plan Area The following report is based upon the Quality and Outcomes Framework data (QOF) for 2016-17 which records disease prevalence, achievements and exceptions at GP practice level and Clinical Commissioning Group (CCG) level. The 23 place plan areas are based on Lower Level Super Output Areas (LLSOAs) but may have been assigned to a Place Plan Area because it had the largest population where LLSOAs cross geographical boundaries. GP Practices were assigned to place plan areas according to their post code linked to Lower LLSOAs; disease prevalence (%) was calculated on place plan populations. The following maps show the QOF prevalence of disease based as a percentage of the place plan area population 2015 i with red indicating a significantly higher prevalence to the Shropshire average, green significantly lower and yellow similar to the Shropshire average. Asthma Map 1: Prevalence of Asthma by Place Plan Area in Shropshire County 2016-17 QOF Data i - Source: ONS Mid-year population 2015 based on LSOA11
Map 1 shows the areas of higher significance for Asthma highlighted in red; the majority of place plan areas were similar to the Shropshire average of 6.7% but Whitchurch, West & Central and South Shrewsbury Town, Pontesbury & Minsterly, Albrighton and Craven Arms had a significantly higher prevalence of Asthma compared to the Shropshire average. Shropshire average was significantly higher than either the West Midlands at 6.0% and England at 5.9%. Atrial Fibrillation The majority of place plan areas in map 2 were similar to the Shropshire average of 2.6% but Ellesmere, Albrighton, Church Stretton and Ludlow had a significantly higher prevalence of Atrial Fibrillation compared to the Shropshire average and also have significantly higher populations over the age of 65 (see table 1). Both the West Midlands (1.7%) and England (1.8%) were significantly lower than the Shropshire average. Map 2: Prevalence of Atrial Fibrillation by Place Plan Area in Shropshire County 2016-17 QOF Data
Cancer The Shropshire cancer average was 3.4%; however, the majority of place plan areas that were significantly higher than the Shropshire average were in the South of the County and these included: Pontesbury & Minsterley, Church Stretton, Bishop s Castle, Ludlow, Cleobury Mortimer, Bridgnorth and Albrighton. The remaining place plan areas were mainly similar to the Shropshire average except for North East and West & Central Shrewsbury, Whitchurch and Oswestry Town which were lower. Both the West Midlands (2.4%) and England (2.6%) were significantly lower than the Shropshire average Of the seven place plan areas that had a significantly higher prevalence, all except Pontesbury & Minsterley and Cleobury Mortimer also have significantly higher populations over the age of 65 (see table 1). Map 3: Prevalence of Cancer by Place Plan Area in Shropshire County 2016-17 QOF Data
Congenital Heart Disease (CHD) Map 4 shows the areas of significantly higher prevalence of CHD compared to the Shropshire average of 3.7%. Those place plan areas which were significantly higher were Church Stretton, Craven Arms, Ludlow, Bridgnorth and Albrighton; all these areas also have significantly higher populations aged 65 and over (see table 1). Both the West Midlands (3.1%) and England (3.2%) were significantly lower than the Shropshire average. Map 4: Prevalence of Congenital Heart Disease by Place Plan Area in Shropshire County 2016-17 QOF Data
Chronic Kidney Disease (CKD) (Aged 18+) Map 5 shows that the majority of place plan areas with a significantly higher prevalence of CKD were in the South of the county, but West & Central Shrewsbury Town, Ellesmere and Whitchurch in the North were also significantly higher than the Shropshire average of 5.6%. Both the West Midlands (4.5%) and England (4.1%) were significantly lower. Of the 10 place plan areas with a significantly higher prevalence, with the exception of Ellesmere, Whitchurch, Much Wenlock and West & Central Shrewsbury Town, the remaining six areas also have significantly higher populations over the age of 65 (see table 1). Map 5: Prevalence of Chronic Kidney Disease by Place Plan Area in Shropshire County 2016-17 QOF Data
Chronic Obstructive Pulmonary Disease (COPD) The Shropshire average for COPD was 1.8% which was similar to the West Midlands at 1.8% but significantly lower than England at 1.9%. Seven place plan areas were significantly higher than the Shropshire average and these were: Oswestry Town, Ellesmere, Whitchurch, Pontesbury & Minsterely, Albrighton, Craven Arms and Highley. Four of these areas also have higher levels of deprivation (see map 23). Map 6: Prevalence of Chronic Obstructive Pulmonary Disease by Place Plan Area in Shropshire County 2016-17 QOF Data
Cardio-Vascular Disease Primary Prevention (CVD-PP) (Aged 30-74) The majority of place plan areas are either similar to or lower than the Shropshire average of 1.2%. Five place plan areas were significantly higher and these were: Oswestry Town, Pontesbury & Minsterley, Church Stretton, Highley and Ludlow. However, the Shropshire prevalence is significantly lower than either the West Midlands at 1.8% and England at 1.8%. Of the six place plan areas with a significantly higher prevalence, Church Stretton, Highley and Ludlow have a significantly higher population over the age of 65 (see table 1). Map 7: Prevalence of Cardio-Vascular Disease Primary Prevention by Place Plan Area in Shropshire County 2016-17 QOF Data
Dementia Map 8 shows the prevalence of dementia in Shropshire by place plan area. There were six areas which were significantly higher than the Shropshire average of 1.1%: Whitchurch, South Shrewsbury Town, Church Stretton, Bridgnorth, Albrighton and Ludlow. The West Midlands at 0.7% and England at 0.8% were significantly lower than the Shropshire average. Of the six place plan areas with a significantly higher prevalence, all except Whitchurch have a significantly higher population aged over 65 (see table 1). Map 8: Prevalence of Dementia by Place Plan Area in Shropshire County 2016-17 QOF Data
Depression (Aged 18+) The majority of place plan areas were lower than the Shropshire average of 9.9%, however, six areas were significantly higher than the Shropshire average and these were: Oswestry Town, North East Shrewsbury Town, Pontesbury & Minsterley, Craven Arms and Ludlow and with the exception of Pontesbury & Minsterley, the other five areas also have higher levels of deprivation (see map 23). Shropshire was significantly higher than the West Midlands at 8.9% and England at 9.1%. Map 9: Prevalence of Depression by Place Plan Area in Shropshire County 2016-17 QOF Data
Diabetes (Aged 17+) The Shropshire average for diabetes was 6.8% and whilst the majority of place plan areas were similar to the Shropshire average, three areas were significantly higher; these were: Wem, Albrighton and Highley all of which have a significantly higher population of people aged 65+ (see table 1). The West Midlands was significantly higher at 7.7% whilst England was significantly lower at 6.7%. Map 10: Prevalence of Diabetes by Place Plan Area in Shropshire County 2016-17 QOF Data
Epilepsy (Aged 18+) Oswestry Town was the only place plan area that was significantly higher than the Shropshire average of 0.9%; the remainder were either similar or significantly lower. Both the West Midlands and England were significantly lower than the Shropshire average at 0.8%. Oswestry Town is one of the most deprived areas in Shropshire. Map 11: Prevalence of Epilepsy by Place Plan Area in Shropshire County 2016-17 QOF Data
Heart Failure Four place plan areas were significantly higher than the Shropshire average of 0.8% and these were Whitchurch, Albrighton, Bridgnorth and Ludlow. Of the four place plan areas with a significantly higher prevalence, all except Whitchurch have a significantly higher population aged over 65 (see table 1). Map 12: Prevalence of Heart Failure by Place Plan Area in Shropshire County 2016-17 QOF Data
Hypertension Of the 23 place plan areas, six areas had a significantly higher prevalence compared to the Shropshire average of 16.2% all of which also have a significantly higher population over the age of 65 (see table 1); these were: Ellesmere, Church Stretton, Bishop s Castle, Albrighton, Ludlow and Highley. Prevalence in both the West Midlands at 14.2% and England at 13.8% were significantly lower than the Shropshire average. Map 13: Prevalence of Hypertension by Place Plan Area in Shropshire County 2016-17 QOF Data
Learning Disabilities The majority of place plan areas were either similar or lower than the Shropshire average of 0.52%; however, the prevalence in Oswestry Town and Bishop s Castle were significantly higher than the Shropshire average; both these areas also have high levels of deprivation. The West Midlands had similar prevalence levels to the Shropshire average at 0.50% whilst England was significantly lower at 0.47%. Map 14: Prevalence of Learning Disabilities by Place Plan Area in Shropshire County 2016-17 QOF Data
Left Ventricular End-Systolic Dimension (LSVD) The QOF data for LSVD is not available at West Midland or England level so a bench mark comparison cannot be made, however, of the six place plan areas with a significantly higher prevalence, five are in the south of the county and one in the North; these are: Ellesmere, Albrighton, Broseley, Bridgnorth, Craven Arms and Cleobury Mortimer. Of the six with a significantly higher prevalence, Albrighton, Bridgnorth, Craven Arms and Ellesmere also have significantly higher populations over the age of 65 (see table 1). Map 15: Prevalence of Left Ventricular End-Systolic Dimension by Place Plan Area in Shropshire County 2016-17 QOF Data
Mental Health The prevalence of Mental Health in Shropshire is broadly similar or significantly lower than the Shropshire average of 0.8%; however, prevalence in the three place plan areas that constitute Shrewsbury Town (North East Shrewsbury, West & Central Shrewsbury and South Shrewsbury) and Ludlow are significantly higher than the Shropshire average. There are higher levels of deprivation in both these areas (see map 23). Both the West Midlands and England are significantly higher than the Shropshire average at 0.9%. Map 16: Prevalence of Mental Health by Place Plan Area in Shropshire County 2016-17 QOF Data
Obesity (Aged 18+) Six place plan areas had a higher prevalence of obesity compared to the Shropshire average of 9.8%; these were: Oswestry Town, North Oswestry, Ellesmere, Whitchurch, Broseley and Craven Arms. Compared to the Shropshire average, the West Midlands was significantly higher at 10.4%, whilst England was Significantly lower at 9.7%. Map 17: Prevalence of Obesity by Place Plan Area in Shropshire County 2016-17 QOF Data
Osteoporosis (Aged 50+) Map 18 shows that three place plan areas had a significantly higher prevalence of Osteoporosis compared to the Shropshire average of 0.6% and these were: Oswestry Town, Cleobury Mortimer and Ludlow. Both the West Midlands and England were significantly lower at 0.3% compared to the Shropshire average. Map 18 Prevalence of Osteoporosis by Place Plan Area in Shropshire County 2016-17 QOF Data
Peripheral Artery Disease (PAD) Five place plan areas had a significantly higher prevalence compared to the Shropshire average of 0.9% and these were: Ellesmere, Wem, Albrighton, Highley and Ludlow; these five place plan areas also have significantly higher populations over the age of 65 (see table 1). Both the West Midlands and England were significantly lower than the Shropshire average with 0.6%. Map 19: Prevalence of Peripheral Artery Disease by Place Plan Area in Shropshire County 2016-17 QOF Data
Palliative Care The Shropshire prevalence for Palliative Care 0.4%. Six place plan areas had a signficantly higher prevalence compared to the Shropshire average and these were: Market Drayton, Pontesbury & Minsterley, Church Stretton, Bishop s Castle and Ludlow. The West Midlands was significantly lower with 0.3% prevalence and the England prevalence was also significantly lower at 0.37%. Map 20: Prevalence of Palliative Care by Place Plan Area in Shropshire County 2016-17 QOF Data
Rheumatoid Arthritis (Aged 16+) There were only two place plan areas that had a significantly higher prevalence of Rheumatoid Arthritis compared to the Shropshire average of 0.9% and these were: North East Shrewsbury Town and Ludlow. Both the West Midlands and England had a significantly lower prevalence of 0.8% and 0.7% respectively. Both Ludlow and North-East Shrewsbury have higher areas of deprivation (see map 23). Map 21: Prevalence of Rheumatoid Arthritis by Place Plan Area in Shropshire County 2016-17 QOF Data
Stroke TIA The majority of place plan areas were either similar to or Significantly lower than the Shropshire average stroke prevalence of 2.5%. However, four place plan areas had a significantly higher prevalence and these were: Albrighton, Church Stretton, Craven Arms and Ludlow. These four areas also have a significantly higher population over the age of 65 (see table 1). Both the West Midlands and England prevalence s were significantly lower than the Shropshire average at 1.7%. Map 22: Prevalence of Stroke by Place Plan Area in Shropshire County 2016-17 QOF Data
Demographics Table 1 shows the level of significance to the Shropshire average by place plan area for populations under the age of 5, over the age of 65, deprivation and rurality with those highlighted red being significantly higher than the Shropshire average, green significantly lower and yellow similar to the Shropshire average. Table 1: Significance to the Shropshire Average by place plan area by age, deprivation and rurality Place Plan Area Population <5 years % (2015) Population 65+ years % (2015) IMD 2015 (based on rank (2015 population) Rurality (based on rank) 2011 Populations: Albrighton 6.6% 29.1% 3 2 Bishop's Castle 4.0% 31.0% 1 1 Bridgnorth 4.4% 27.2% 2 2 Broseley 4.8% 22.8% 2 3 Church Stretton 3.0% 31.4% 3 1 Cleobury Mortimer 3.2% 23.9% 2 1 Craven Arms 5.9% 32.9% 1 1 Ellesmere 4.8% 29.2% 2 2 Highley 6.2% 26.3% 1 3 Ludlow 4.6% 29.4% 1 3 Market Drayton 5.8% 20.6% 1 2 Much Wenlock 2.4% 18.0% 3 2 North East Shrewsbury 6.7% 16.9% 1 3 North Oswestry 4.4% 22.8% 2 2 Oswestry Town 5.6% 21.3% 1 3 Pontesbury and Minsterley 4.3% 24.9% 3 3 Shifnal 4.9% 24.8% 3 2 Shrewsbury Rural 4.8% 25.0% 2 3 South & East Oswestry 5.0% 22.9% 2 1 South Shrewsbury 4.4% 25.3% 3 3 Wem 5.3% 25.9% 2 1 West and Central Shrewsbury 4.9% 20.5% 3 3 Whitchurch 5.2% 23.5% 1 3 Source: IMD2015, ONS Resident Populations 2015, ONS Rural & Urban Classification 2011 Deprivation Map 23 shows the Shropshire County electoral wards by deprivation quintiles: SC1 being the most deprived areas through to SC5 being the least. Ward map data is based on smaller geographical Lower Super Output Areas (LSOAs), whereas the 23 place plan areas are also based on Lower Level Super Output Areas (LLSOAs), but may have been assigned to a Place Plan Area because it had the largest population where LLSOAs cross geographical boundaries and therefore there may be slight differences when comparing deprivation by ward map and the place plan table.
Map 23: Shropshire County Deprivation Map by Electoral Ward (IMD2015) Source: IMD2015