All-Age All-Cause Mortality Estimates

1. All-Age All-Cause Mortality Estimates   12 Months Rolling Average to January 2011PCT level

2. Near Real-time monitoring of All-age All-cause Mortality • ONS provide SHA and Department of Health analysts, on a restricted basis, with provisional monthly deaths counts by age and sex for local authority district and PCT populations. • These data are not ‘national statistics’, as they will eventually be superseded by the standard deaths extract file produced for each calendar year in the following September, and consequently cannot be placed in the public domain. • They are however much more timely - the latest data for January 2011 having been circulated in the final week of March . Checking the provisional monthly figures for 2009 against the counterpart definitive figures for the same months from the annual deaths extract shows that total deaths counts for any one local authority are rarely revised by more than one or two. Calculation • The calculation requires a counterpart mid-period estimate of denominator populations by age and sex; for the most recent data these estimates would need to be for populations as at July 2010. We can proxy this population from the published ONS 2008-base mid-year population projections, from which we can extract local populations for the months off June 2010 and June 2011. The July 2010 population can then be estimated by ‘mixing’ the two projections in proportion of 11 parts June 10 and 1 part June 11. Our estimates of month-by-month AAACM for each PCT (male and female) are then compared against the target trajectories for improvement in local mortality that were incorporated into the former Vital Signs monitoring approach. • For the months up to December 2010, this is in effect a moving target; splitting the annual trajectories agreed in Vital Signs down to equal monthly parts. After December 2010, the counterpart targets are being held constant. Eventually, it may be expected, the general improvement in mortality will result in all localities crossing the line. For further information: thomas.hennell@dh.gsi.gov.uk

3. Slide No Slide Pack • Cumbria4 • Lancashire PCTs (3 PCTs) 5 • Central Lancs6 • East Lancs7 • North Lancs8 • Blackburn with Darwen9 • Blackpool 10 • Greater Manchester PCTs (10 PCTs) 11 • Ashton, Leigh & Wigan 12 • Bolton 13 • Bury 14 • Heywood, Middleton & Rochdale 15 • Manchester 16 • Oldham 17 • Salford 18 • Stockport 19 • Tameside & Glossop 20 • Trafford 21 • Central & Eastern Cheshire 22 • West Cheshire 23 • Halton & St.Helens24 • Knowsley25 • Liverpool26 • Sefton27 • Warrington 28 • Wirral 29 • Spine Plots - progress in improvement in PCT mortality 30

30. Spine Plots for PCTs • Show the progress in improvement in PCT mortality – for the months of: - September 2009 - March 2010 - September 2010 - January 2011 • Where a bar projects to the right of the vertical axis, this shows a mortality that is worse than trajectory , where a bar projects to the left of the vertical axis this shows a mortality that is better than trajectory. • September 2009 - the majority of PCTs were reporting mortality rates worse than trajectory. Exceptions were : Stockport, Trafford, Warrington, Knowsley– for both male and female. In addition, Central Lancashire and Seftonwere both within 1% of the target. • March 2010 - there had been a further degree of improvement. Six PCTs – Sefton, Central Lancashire, North Lancashire, Cumbria, Knowsley, Warrington, were now on track for achieving their mortality targets for both male and female, with a further one, Stockport nearly so. Unfortunately, the rate of mortality improvement seen in the early part of 2010, was not capable of being sustained. • By September 2010 - only three PCTs clearly on track for both male and female mortality - Central Lancashire, , North Lancashire, Knowsley • The 12-month mortality rates for the periods to November and December 2010 tended to show a deterioration compared to trajectory, as these two months showed the impact both of seasonal flu and early severe winter weather. However, the impact on the North West was substantially less severe than the counterpart national average; and consequently, 2010 in total saw a small reduction in overall deaths in the North West, compared to 2009, whereas the rest of England showed a small increase. • By January 2011 - only two PCTs on track for both male and female mortality - Central Lancashire, North Lancashire. However overall deaths counts – both nationally and locally, continue to show a significant improvement; which is apparent in the published monthly total deaths counts for February and March 2011 (total locality counts are released about a month earlier than those broken down by age and sex). • In 2010 we saw an improvement in the early months. If in 2011, the rate of improvement can be maintained, then it is likely that successive spine plots will show an increasing number of PCTs with provisional mortality better than the 2010 trajectory.