1. Diabetes Health Intelligence A Summary of Information: South Central SHA

2. The Local Burden – Some Facts & Figures 161,000 people aged 17+ diagnosed with diabetes in the South Central SHA area (Source: Quality and Outcomes Framework 2009-10) This equates to 4.7% of the 17+ population (Source: Quality and Outcomes Framework 2009-10) The diagnosed prevalence rate in PCT's varied from 4.0% in Berkshire West PCT to 5.6% in NHS Isle of Wight (Source: Quality and Outcomes Framework 2009-10) Modeling suggests that the current diagnosed prevalence is 74% of the total prevalence, giving a further 56,000 undiagnosed cases across the region, raising the total estimated prevalence to 217,000 or 6.6% of the population (APHO Diabetes Prevalence Model based on 2009-10 QOF data) By 2030 this total prevalence is expected to rise by 110,000 to 327,000 or 8.6% of the population. Approximately half of this rise is due to the aging population and half due to rises in obesity (APHO Diabetes Prevalence Model)

3. The Local Burden – Some Facts & Figures Amputations of the foot or leg for those aged 17+ with diabetes are undertaken at an annual rate of 2.6 per 1,000 people diagnosed with diabetes in South Central SHA. The rate for England is 2.5 per 1,000 people aged 17+ diagnosed with diabetes (Source aggregated Hospital Episode Statistics Database 2007-08 to 2009-10 [to ensure a sufficient quantity of procedures]& Quality and Outcomes Framework 2007-10) Emergency admission rates for those aged 17+ for ketoacidosis and coma for the region are 5.1 per 1,000 people diagnosed with diabetes. This is the same as the national rate (based on aggregated Hospital Episodes Statistics data for 2007-08 and 2008-09 and Quality and Outcomes Framework 2007-08 and 2008-09) Amongst the PCTs in the region, the highest rate is seen in Milton Keynes PCT (6.6 per 1,000) and the lowest rate in NHS Isle of Wight (1.6 per 1,000) (based on aggregated Hospital Episodes Statistics data for 2007-08 and 2008-09 and Quality and Outcomes Framework 2007-08 and 2008-09)

4. Primary Care TrustDiagnosed Diabetes Prevalence NHS ISLE OF WIGHT 5.6% BERKSHIRE EAST PCT 5.3% HAMPSHIRE PCT 5.0% PORTSMOUTH CITY PCT 4.9% SOUTHAMPTON CITY PCT 4.8% BUCKINGHAMSHIRE PCT 4.7% MILTON KEYNES PCT 4.6% OXFORDSHIRE PCT 4.3% BERKSHIRE WEST PCT 4.0% ENGLAND5.4% Source: Office for National Statistics Crown copyright material is reproduced with the permission of the Office of Public Sector Information (OPSI). Contains Ordnance Survey data © Crown copyright and database right 2010 The Local Burden – Today

5. The Local Burden – Tomorrow Total diagnosed and undiagnosed diabetes prevalence estimates for 2010 and 2030 with associated uncertainty limits (Source APHO: Diabetes Prevalence Model)

6. The Local Burden - Variation in Outcomes 2009-10 QOF: percentage of diabetes 17+ register with HbA1c of less than 9% Source: Office for National Statistics Crown copyright material is reproduced with the permission of the Office of Public Sector Information (OPSI). Contains Ordnance Survey data © Crown copyright and database right 2010 2009-10 QOF: percentage of diabetes 17+ register with HbA1c of less than 7%

7. The Local Burden – Variation in Outcomes & Costs Programme budget spending against HbA1c outcomes for 2008/09 for PCTs in the region. (Diabetes Outcomes Versus Expenditure toolkit – DOVE) Values have been standardised, resulting in PCTs which are outside the 95% confidence box having statistically significantly different levels of outcomes and/or expenditure to the national average.

8. The Local Burden – Variation in Outcomes & Costs Total spend on prescribing against HbA1c outcomes for 2008/09 for PCTs in the region. (Diabetes Outcomes Versus Expenditure toolkit – DOVE) Values have been standardised, resulting in PCTs which are outside the 95% confidence box having statistically significantly different levels of outcomes and/or expenditure to the national average.

9. Source: Office for National Statistics Crown copyright material is reproduced with the permission of the Office of Public Sector Information (OPSI). Contains Ordnance Survey data © Crown copyright and database right 2010 The Local Impact – Diabetes Attributable Deaths Primary Care TrustDiabetes Attributable Deaths % Isle of Wight NHS11.8% Southampton City11.8% Berkshire East11.6% Portsmouth City Teaching11.6% Buckinghamshire11.3% Milton Keynes10.7% Hampshire10.2% Berkshire West10.0% Oxfordshire9.3% ENGLAND11.6% Excess deaths between 20 and 79 years attributable to diabetes, 2005 Note: Excess deaths are deaths that would not have occurred if people with diabetes had the same mortality rate as people without diabetes within a given area

10. References Slides 2, 4 & 6: Current prevalence and HbA1c data from the Quality and Outcomes Framework (QOF) for 2009-10, published by The Information Centre for Health and Social Care: http://www.ic.nhs.uk/qof http://www.ic.nhs.uk/qof Slides 2 & 5:Future prevalence estimates from Association of Public Health Observatories Diabetes Prevalence Modelling: http://www.yhpho.org.uk/resource/view.aspx?RID=81090 Slide 3: Data analysis of the Hospital Episodes Statistics Database by Yorkshire and Humber Public Health Observatory. The amputations data is as yet unpublished and covers all admissions between 2007-08 and 2009-10, the emergency admissions for ketoacidosis, 2007-08 & 2008-09, are published in the Diabetes Community Health Profiles (which also contain a previous version of amputation rate data) http://www.yhpho.org.uk/resource/view.aspx?RID=8470 Slides 7 & 8: Information on outcomes and expenditure taken from the Yorkshire and Humber Public Health Observatory Diabetes Outcomes Versus Expenditure (DOVE) toolkit. http://www.yhpho.org.uk/default.aspx?RID=8467 Slide 9: Yorkshire and Humber Public Health Observatory Diabetes Attributable Deaths Report, 2005. http://www.yhpho.org.uk/resource/item.aspx?RID=9909

11. Key to PCT codes on variation in outcomes and costs slides Primary Care Trust Code Primary Care Trust Name 5QGBerkshire East 5QFBerkshire West 5QDBuckinghamshire 5QCHampshire 5QTIsle of Wight NHS 5CQMilton Keynes 5QEOxfordshire 5FEPortsmouth City Teaching 5L1Southampton City