Findings and recommendations from the Tartan Rug

Key findings

• Overall, for many residents across Cheshire East, health and wellbeing is similar to or better than the England average, other local authorities across Cheshire and Merseyside, and geographically neighbouring local authorities.
• However, stark health inequalities remain across Cheshire East with some wards in Crewe and Macclesfield experiencing significantly worse health and wellbeing compared to the England average and other areas of Cheshire East.
• The extent of difference is particularly highlighted by selecting Crewe Central, and Macclesfield Gawsworth within the Tartan Rug dashboard.
• Also, the Cheshire East average is significantly worse than the England average for:
  • Emergency admissions aged 0-4 years (2017/18 - 2019/20)
  • Admissions for injury aged 0-4 years
  • Emergency admissions all causes
  • Emergency admissions for hip fractures
  • Hospital stays for self harm
  • Whilst only very old data exists, during 2006-2008 Cheshire East was also significantly worse than the England average for binge drinking alcohol. Furthermore, it continues to be significantly worse than the England average with regards to hospital admissions for alcohol-specific conditions. ¹

• Overall, Crewe Care Community is the only Care Community to experience significantly worse health and wellbeing than the England average.
• Monitoring of changes in the number of indicators that are better or worse than the national average can be achieved through the new Tartan Rug dashboard. However, currently only a one-year comparison is possible (comparing 2022 to 2021). Making longer term comparisons will be feasible in future years. These will be more meaningful and reduce the risk of chance variation.
• Compared to 2021, overall, the health and wellbeing picture has worsened for:
  • Nantwich and Rural
  • Congleton and Holmes Chapel (CHOC)
  • Knutsford
• Compared to 2021, overall, the health and wellbeing picture has improved for:
  • Chelford, Handforth, Alderley Edge and Wilmslow (CHAW)
  • Bollington, Disley and Poynton (BDP)
• Compared to 2021, changes in the health and wellbeing picture were mixed in:
  • Crewe
  • Sandbach, Middlewich, Alsager, Scholar Green and Haslington (SMASH)
  • Macclesfield

Recommendations

• The latest Tartan Rug should be shared widely with key stakeholders across Cheshire East, Care Communities and at smaller area levels.
• The Tartan Rug should be promoted more amongst less familiar audiences, for examples our school and libraries.
• There remains a need for sustained and long-term focus on:
  • Early intervention and community interventions to prevent injuries and admissions in our children and young people
  • Self harm and mental health and self-harm
  • Alcohol
  • Hip fractures, frailty and healthy ageing
  • Crewe
• The Health and Wellbeing Board and Cheshire East Place need to consider this Tartan Rug in combination with the more in-depth JSNA reviews, for example, our Crewe JSNA, and reviews of smoking, substance misuse, falls, and emotional and mental wellbeing in children and young people.
• The Tartan Rug dashboard should be refreshed annually, and comparisons should be made over longer time scales once feasible.
• It is important to note that reducing inequalities will take many years and that sustained attention is required to achieve this.

So how will we reduce inequalities?

Health inequalities can only be reduced by working together to improve health and wellbeing starting from pregnancy right through to the last days of life. We need to consider not just health and care services but all the important wider determinants of health that feed in to giving our residents the best possible opportunity for health and wellbeing. The Joint Strategic Needs Assessment and Joint Health and Wellbeing Strategy can help us to do this.

The Tartan Rug should be used in combination with our more in-depth topic specific reviews, which are also published on our website, but also in conjunction with your own expertise and experiences, so that we can make the very best of our efforts to improve the health and wellbeing of all our residents across Cheshire East.

¹ Office for Health Improvement & Disparities. Public Health Profiles. [1 August 2023] https://fingertips.phe.org.uk © Crown copyright [2023]