1. Public Health Outcomes Framework (PHOF) update August 2015 London briefing London Knowledge and Intelligence Service, 4 August 2015

2. Contents Removed indicators New indicators New or updated indicators – WORSE than England, baseline year or previous year London’s five priority areas – all relevant PHOF indicators – regardless of update date 2

3. Removed indicators in PHOF 3 Data for indicators 2.11i (% of the population meeting the recommended ‘five-a-day’), 2.11ii (average number of portions of fruit eaten on the previous day) and 2.11iii (average number of portions of vegetables eaten on the previous day) have been removed. An error was discovered with the application of the survey weights. As a result the data for these indicators have been removed and it will be re-published in the November PHOF update.

4. New indicators in PHOF 4 The smoking prevalence estimates from the What About YOUth (WAY) survey are the only source of survey data on smoking at age 15 at local level, but are lower than those seen in the Smoking, Drinking and Drug use (SDD) survey which is only available at national and regional level - indicators 2.09iv (regular smokers) and 2.09v (occasional smokers). The WAY survey also contains equalities and inequalities data at national level. England

5. New PHOF indicator – smoking prevalence at age 15 (WAY survey) 2014/15 (indicators 2.09i, 2.09ii, & 2.09iii) 5 Current smokers - the overall England value was 8.2% and the total London value was significantly better than this at 6.1%. Only Richmond upon Thames had a significantly worse value than England. Regular smokers - the overall England value was 5.5% and the total London value was significantly better than this at 3.4%. No London boroughs had a significantly worse value than England. Occasional smokers - the overall England value was the same as the total London value – 2.7%. Five London boroughs had a significantly worse value than England – Richmond upon Thames, Islington, Lambeth, Kingston upon Thames and Bexley. Current smokers (2.09i) Regular smokers (2.09ii)Occasional smokers (2.09iii) Regular smokers are defined as respondents who ticked either ‘I usually smoke between one and six cigarettes per week’ or ‘I usually smoke more than six cigarettes per week’ and occasional smokers as respondents who ticked the answer ‘I sometimes smoke cigarettes now but I don't smoke as many as one a week’.

6. New and updated indicators – worse than England, worse than baseline year or worse than previous year 6

7. Rate of complaints about noise 2013/14 (indicator 1.14i) 7 As is to be expected in an urban setting such as London, the rate of Londoners who complained about noise in 2013/14 was more than double the England rate – 17.4 compared with 7.4 per 1,000 – with the highest rates being in some of the inner London boroughs. In London rates ranged from 76.9 per 1,000 population (Westminster) to 2.7 per 1,000 population (Havering). Eight London boroughs had the highest rates in England - Westminster, Kensington and Chelsea, Islington, Haringey, Waltham Forest, Lambeth, Barking and Dagenham and Southwark. In London, rates were similar to the previous year (17.6 in 2012/13) but had significantly improved since the base line year (18.6 in 2010/11).

8. NHS Health Checks 2013/14 to 2014/15 (indicator 2.22iii, 2.22iv, 2.22v) 8 NHS Health Checks data are available cumulatively for two years from 2013/14 to 2014/15. The overall London value for NHS Health Check uptake was 48.1% which was significantly worse than England (48.9%). Within London values ranged from 74.1% (Ealing) to 21.3% (Hammersmith & Fulham), however, a higher proportion of Londoners had been offered a NHS Health Check (indicator 2.22iii) than in England (44.6% compared with 37.9%, respectively), with values ranging from 95.8% (Hammersmith and Fulham) to 11.9% (Croydon). A higher proportion also received a NHS Health Check (indicator 2.22v) in London than England (21.5% and 18.6%, respectively) although within London values ranged from 36.7% (Kingston upon Thames) to 6.9% (Croydon). Offered (2.22iii) Uptake (2.22iv)Received (2.22v)

9. Population vaccination coverage – flu 2014/15 (indicators 3.03xiv and 3.03xv) 9 Aged 65 plus (indicator 3.03xiv) - the benchmark is greater than or equal to 75% coverage. In 2014/15, London had 69.2% coverage compared to 71.4% in the baseline year (2010/11) and 70.0% the previous year (2013/14). Only two London boroughs had achieved the benchmark in 2014/15 – Tower Hamlets (75.4%) and Newham (75.2%). Hammersmith and Fulham had the lowest vaccination rate in England (61.7%). At risk individuals (indicator 3.03xv) – in London in 2014/15, 52.0% of at risk individuals were vaccinated against flu. This was significantly worse than for England as a whole (52.3%). In London values ranged from 63.6% (Newham) to 38.4% (Hammersmith & Fulham). Hammersmith and Fulham had the lowest vaccination rate in England. Aged 65 and over (3.03xiv) At risk individuals (3.03xv)

10. Fuel poverty 2013 (indicator 1.17) 10 In 2013 London had a significantly lower proportion of households considered ‘fuel poor’ than the England average – 9.8% compared with 10.4%, however, ten London boroughs had a significantly worse proportion than the England average, the highest being Newham (14.9%). The overall London proportion was significantly better than the baseline year (2011) but statistically worse than the previous year (2012).

11. London five priority areas – all relevant PHOF indicators regardless of update date 11

12. London five priority areas (cont.) 12

13. London’s top five priority areas by borough Immunisation coverage

14. London’s top five priority areas by borough Childhood obesity Mental health

15. London’s top five priority areas by borough Sexual health Tuberculosis