Skip to content

Cluster working: Data

Using data to support planning and prioritisation of resources requires up to date, robust and reliable data sources, which is accessible at the appropriate level e.g., cluster footprint.

Tools to support thinking on data and evidence include:

Driscoll’s 3 question approach:

  • What does the data say (needs assessment/ local intelligence)?
  • So what – which is the priority area, where do you take action?
  • Now what – what is the evidence for action / awareness or advocacy?

3 A’s approach:

  • Action – Identify the people/ population, what is the intervention required, how should this be implemented.
  • Advocacy – what is beyond my immediate control but is something I need to advocate for with strategic partners e.g., housing that supports health.
  • Awareness – what do I need to be aware of or make others aware of e.g., impact of current, and emerging threats to health and wellbeing in Wales, the factors which influence inequalities.  

Population needs assessment tools

Work is underway in Wales, to develop Population Health Management, where data can be segmented and stratified to identify population groups at risk groups, who may benefit from a health and social care intervention. As this work progresses it may provide a useful approach to identifying need and prioritising action.

Further work is required in Wales, to strengthen the collation, analysis and sharing of data between strategic partners to inform population health approaches to planning, the launch of the National Data Resource (NDR) may support this.

There are numerous dashboards which contain data relevant to primary and community care, that are useful for planning purposes including:

Equitable primary care

Everyone in Wales deserves to enjoy a healthy and long life, but right now, some people’s lives are being cut short because of the circumstances related to where they grow, live or work in Wales. Some groups have less opportunity to participate/have their voice heard during the conduct of needs assessments or in conversations around service redesign. Therefore, embedding the health inequalities approach within the primary care system in Wales is essential.

The Primary Care Division of Public Health Wales has developed a Health Equity and Inclusion Health Toolkit to help those working in or with primary and community care consider inequalities in all areas of planning and/or implementation of services, or specific and targeted interventions.

The Primary Care Division is also in the process of co-developing an Action Framework for primary and community care with key stakeholders to address health inequalities with the expectation that an action framework with a strategic action plan will be developed by April 2025. The final version of the action framework will be available in Reducing Health Inequalities Webpages.

Further information includes:

The Primary care Inequalities and inclusion health webpages provides analysed data charts and graphs for all the health inclusion groups by Health Board.

Additional data links relevant to health inclusion groups include:

Homelessness

Refugees and asylum seekers

People in contact with Criminal Justice

  • The criminal justice system data dashboard brings together a range of criminal justice data. It gives an overview of the justice system; from the point a crime is recorded by the police, to when a case is completed in court
  • Justice data includes information on: Justice in numbers, Criminal Justice System Statistics, Prison data, probation data, contracted services, courts and legal aid data and life after prison data on accommodation and employment in England and Wales.
  • Wales approved premises provides a list of approved premises located in the Wales region of the Probation Service, with phone numbers of each building.
  •  Probation Service England and Wales regional maps describe Probation Service regions.

Gypsy, Roma and Travellers

Health behaviours

Health Behaviours

Information on lifestyle behaviours among adults in Wales comes from the National Survey for Wales. It Provides data and analysis on people’s health status, illness and health behaviours including, alcohol, smoking, healthy eating, physical activity and weight.

There are few other useful sources of data and statistics on health behaviours including:

  • Public Health Wales Observatory, includes data on the level of physical activity, smoking in Wales, Alcohol in Wales and Obesity in Wales.
  • Drug misuse and dependency provides information on services and guidance.
  • Wales Public Health Rapid Overview Dashboard looks at the big picture on population health and health inequalities in Wales, and to track how these are changing over time.
  • Alcohol in Wales (2019) is an interactive profile including an overview of the pattern of alcohol consumption and its impacts along with the option to explore consumption, hospital admission and mortality data in further depth at the health board and local authority level.
  • Primary Care Information Portal includes the following data by Health Board and Cluster:
    • Percentage of Newly Registered patients with an alcohol consumption value recorded since registration by health board and cluster.
    • Percentage of patients with a long-term chronic condition where alcohol unit’s consumption / week by the health board and cluster
    • Percentage of patients to whom advice was offered.
    • Percentage of patients sign posted to an alcohol management service.
    • Percentage of patients referred to alcohol management service.
    • Percentage of patients who declined referral to alcohol management service.

Please note that the Primary Care Information Portal is not an open access site. However primary and community care staff should have access to it.  If you do not have access to the portal, you will be redirected to an access denied screen to complete a form. For any further queries you can contact [email protected].

Clinical risk factors

The main clinical risk factors for non-communicable diseases include Hypertension, Hyperglycaemia, Hypercholesterolemia and Obesity. Information on clinical risk factors include:

Chronic conditions

This section provides information on a range of chronic conditions.

Please note that the Primary Care Information Portal is not an open access site. However primary and community care staff should have access to it.  If you do not have access to the portal, you will be redirected to an access denied screen to complete a form. For any further queries you can contact [email protected].

Children and young people
Vaccination and immunisation

Vaccines prevent up to 3 million deaths worldwide every year. Vaccine Preventable Disease Programme (VPDP) in Public Health Wales have a variety of information and resources for both health and social care professionals and the public including information about the data on the uptake of vaccination programmes in Wales.

The health care professionals page also provides information and resources to support health professionals in delivering vaccine programmes. Including, vaccine information; training and procedures; storage, distribution, and disposal of vaccines; vaccine safety, key contacts for queries and other guidance and information.

Data on vaccination uptake and all relevant past and present reports can be accessed through VPDP Surveillance page. The page includes links to national public facing surveillance reports and links to local level reports (including GP and Cluster level data) for health boards.  The COVID equity reports on the uptake of vaccines for health boards can be accessed through surveillance pages.

Influenza Vaccine Online Reporting (IVOR) dashboard summarises flu immunisation uptake, submitted by general practices.

VPDP also produce two flu eLearning modules annually ahead of the flu season, one is a clinical update for vaccinators and those providing vaccination advice and the other is a short interactive module aimed at health and social care staff aiming to improve awareness of the importance of annual flu vaccination for staff, this module also provides information of how to access a free flu vaccination for all staff groups. The flu eLearning modules are available on the VPDP training resources and events page.

Data on the uptake on equity of routine childhood vaccinations in Wales is accessible through the national Coverage of Vaccination Evaluation Rapidly (COVER) scheme. COVER reports are published quarterly summarising uptake for children and teenagers. The COVER also includes annual reports and trends in inequalities in coverage according to level of socio-economic deprivation.

Screening

Screening is a process of identifying apparently healthy people who may be at increased risk of a disease or condition. They can then be offered information, further tests, and appropriate treatment to reduce their risk and/or any complications arising from the disease or condition.

All colleagues working within primary and community care, have a role in advocating for screening and in supporting their population to take up screening opportunities, address any questions or concerns they may have and to work with communities and partners to consider ways to increase uptake where rates are lower than expected.

Public Health Wales screening division, delivers eight population based national screening programmes across Wales:

Screening Information for Professionals provides healthcare professionals with resources, information, policies and standards, news, and updates. The screening information for professionals are only available to colleagues with the relevant permissions. If you are working with/ within clusters in Wales and require access, please contact [email protected]

Public Health Wales has produced screening uptake/ coverage summaries for Bowel Screening which are presented at GP cluster level.

Suicide and self harm

Suicide poses a significant public health challenge in Wales and worldwide, with 339 registered deaths in Wales in 2022. The Office for National Statistics (ONS) provide data by country and region.

Despite underreporting and data collection difficulties, self-harm results in 5,500 annual hospital admissions, highlighting the urgent need for better reporting and prevention strategies.

In England and Wales, a Coroner certifies suicides after conducting an inquest, and these cases are officially recorded once the inquest concludes. The Office for National Statistics (ONS) publishes annual reports on registered suicide deaths, typically in the autumn. The ONS figures are derived from deaths recorded in a specific year, rather than those that took place in that year.

Since April 2022, there is an additional dataset related to suicide deaths. A national surveillance system has been established in Wales to track deaths that law enforcement suspects are suicides, offering a more immediate overview (pre-inquest). The Real Time Suspected Suicide Surveillance (RTSSS) system is becoming increasingly vital for enhancing our understanding of suicide deaths and identifying the segments of society most impacted. Public Health Wales oversees this dataset and collaborates closely with the Police, who provide monthly reports.