Last week we released the Public Health and Prevention report, providing an overview of public health outcomes in recent years. The report came in the same month that Public Health England (PHE) set out Strategic Plans on how it intends to continue to protect and improve the public’s health and reduce inequalities to 2020.
Our report looked at trends across sexual and reproductive health (SRH) and HIV, substance misuse, smoking, childhood obesity and immunisations, and considered the opportunities and challenges in maintaining the quality of services in light of recent reforms and financial pressures. Here, we focus on some of the key quality indicators covered in the report.
Follow the links to the interactive charts to examine the data in more detail.
Smoking and substance misuse
Smoking is the leading cause of preventable death and disease in England, responsible for 17% of all deaths in people aged 35 and over. It costs the NHS an estimated £3.3 billion a year. Tobacco control interventions are considered to be the most cost-effective of all public health interventions. The absolute number of people setting a quit date with NHS Stop Smoking Services gradually increased from 2003/04 to a peak of over 800,000 in 2011/12. Since then, the number has plummeted, hitting roughly 450,000 in 2014/15. Anecdotal evidence suggests that people increasingly smoke e-cigarettes in lieu of quitting. The declining prevalence of smoking may also contribute to the decreasing number of quitters, although this trend outlasts the period of decline.
In the United Kingdom, the rate of alcohol-related deaths increased from 9.1 to 14.3 per 100,000 population between 1994 and 2014. This represents an increase in the absolute number of alcohol-related deaths in the UK from 4,525 in 1994 to 8,697 in 2014. The alcohol-related death rate varies across the UK and is considerably higher in Scotland than the other four constituent countries. In March 2016, NHS Scotland released a report evaluating the successes of its alcohol strategy.
There has been a large increase in the number of men aged 45-64 and women aged 65+ who reported drinking heavily in the past week. PHE has identified the publication of an independent evidence-based report on alcohol as a priority for 2016/17.
Waiting times to adult substance misuse services have improved and since 2013/14, over 95% of first interventions started within three weeks of referral, with an average waiting time of 3.3 days to access services. Of those adults in treatment, the proportion who exited treatment in each year free of dependence increased from 43% in 2009/10 to 53% in 2011/12, where it remained stable.
Child and maternal health
The proportion of reception aged children who are overweight or obese was approximately 22% in 2014/15. Overall, the percentage of reception aged children who are overweight, obese or underweight has remained broadly stable between 2006/07 and 2014/15. One in three children in year 6 was overweight or obese in 2014/15, which is considerably higher than the proportion of obese children in reception year. There is strong evidence that, once established, obesity is difficult to reverse through interventions and tracks through into adulthood, so early intervention is necessary.
Vaccination coverage in children by their first and second birthday is consistently over 90% and varies little across England, Wales and Scotland. Pertussis vaccine coverage for pregnant women has seen variation in uptake since it has been offered to pregnant women since 2012.
The current UK policy is to breastfeed exclusively for the first 6 months. Roughly 74% of new mothers have initiated breastfeeding since 2010/11. However, the proportion of all infants due for their 6-8 week check who are still at least partially breastfeeding is only 44%.
Sexual health and reproductive health
Over the five years from 2009 to 2014, there was a worrying increase in incidence rates of new STI diagnoses in gonorrhoea (a 109.8% increase from 30.9 to 64.9 per 100,000 population), syphilis (a 46.9% increase from 5.5 to 8.0 per 100,000 population) and genital herpes (a 12.2% from 52.6 to 59.0 per 100,000 population). Increasing trends in STIs may be attributed both to more routine testing and case finding in genitourinary medicine and sexual and reproductive health services, but also to continued unsafe sexual behaviour.
The rate of conception in under-18s has been decreasing over time from 47.7 per 1,000 population in 1990, to 22.9 per 1,000 population in 2014 – this is a decrease of 52%. The rate of decline seems to have accelerated since 2007. Despite this positive trend, when compared to other countries, UK still has one of the highest birth rates to women aged 15-17.