Health & Social Care Maps Tunbridge Wells Overview Chapter
Health and Social Care Map – Tunbridge Wells 1
Introduction Welcome to the Tunbridge Wells locality health and social care maps overview. This document contains information, data and commentaries that together provide a picture of health and social care in the Tunbridge Wells locality, and includes the following: • • • • • • • • •
Transport links Locality map with Mosaic groupings Demographics: population distribution, ethnicity and projections Fertility and Teenage conceptions Life Expectancy Indices of Multiple Deprivation (IMD) Mortality Hospital admissions Lifestyle: Adult obesity, Binge drinking, Smoking prevalence and Fruit and vegetable consumption
Please note this is a top-level look at the locality and much of the information included here can be found, together with more detail, elsewhere in the full chapters of the Tunbridge Wells locality map.
Health and Social Care Map – Tunbridge Wells 2
Statement from Public Health Consultant for Tunbridge Wells “Tunbridge Wells has a similar age profile to Kent, although aged 30 -49 (Male and female) and females over 85 are higher, and 20-24 age group smaller than Kent. The highest aged 85 population appear to be in rural areas, but despite this, most care homes are located in central Tunbridge Wells. There is an expected population increase (5.57%) in all age groups over the next five years with the exception of age 0-4. The highest growth is estimated to be in the over 85 age group (18.29% by 2019). Two wards; Paddock Wood East and Broadwater are predicted to have the highest population increases of over 10%. Life expectancy from birth in Tunbridge Wells is higher than Kent (83.3 and 81.8 years respectively), although there is variance between wards with Culverden being the highest (86.3 years) and St. James being the lowest (79.6 years). All age mortality has been steadily falling since 1993 and is lower than Kent and England. The highest cause of mortality is Cancer (26%) and circulatory (25%). Hospital admissions: • • •
Due to psychoactive substance misuse has been higher than Kent, but now is at similar levels over the past three years. Across Kent, the rate has increased since 2006/07. For elective surgery in over those aged over 65 are higher than the Kent average in ten wards, the highest being Sherwood Emergency admissions for the over 65 population are higher than the Kent average in Capel, St. James, Southborough and High Brooms.
Estimated adult obesity is highest in Sherwood and Southborough and High Brooms (30-35% prevalence). Estimated consumption of fruit and vegetable is estimated to be low along with higher estimates of adult obesity in Sherwood and Southborough and High Brooms. Estimated binge drinking prevalence is highest in Sherwood, Park, St James, Culverden, Southborough and High Brooms. An estimated level of smoking prevalence is also high in Sherwood and Southborough and High Brooms, along with some other wards.”
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Transport links to and from Tunbridge Wells area are generally limited, especially when compared to other towns in Kent that are close to the motorway network. The A21 and A26 connect to M25 and M20 respectively. The mainline railway connects to Tonbridge to the north (and subsequently connections to London and Ashford).
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Mosaic Public Sector – Kent and Medway groupings by location Mosaic Public Sector is a population segmentation tool, designed specifically for use by the public sector. It focuses on the needs of citizens and provides a detailed and accurate understanding of population location, their demographics, lifestyles and behaviours. Mosaic Public Sector provides a common currency that enables the same population to be viewed in the same way by all public bodies, thereby assisting joined-up government and partnership working. To help support the understanding of the population and their service needs, Mosaic Public Sector is linked to a number of specific public sector data sources from criminal justice, education, the environment and health, as well as central and local government. This gives a considerable insight into the UK population and their requirements enabling agencies to deliver better value for money by focussing services around the needs of the individual. • • • • • • • • • • • • • • •
Group A: Country Living - “Well-off owners in rural locations enjoying the benefits of country life” Group B: Prestige Positions – “Established families in large detached homes living upmarket lifestyles” Group C: City Prosperity – “High status city dwellers living in central locations and pursuing careers with high rewards” Group D: Domestic Success – “Thriving families who are busy bringing up children and following careers” Group E: Suburban Stability – “Mature suburban owners living in settled lives in midrange housing” Group F: Senior Security - “Elderly people with assets who are enjoying a comfortable retirement” Group G: Rural Reality - “Householders living in inexpensive homes in village communities” Group H: Aspiring Homemakers - “Younger households settling down in housing priced within their means” Group I: Urban Cohesion - “Residents of settled urban communities with a strong sense of identity” Group J: Rental Hubs - “Educated young people privately renting in urban neighbourhoods” Group K: Modest Traditions - “Mature homeowners of value homes enjoying stable lifestyles” Group L: Transient Renters - “Single people privately renting low cost homes for the short term” Group M: Family Basics - “Families with limited resources who have to budget to make ends meet" Group N: Vintage Value – “Elderly people reliant on support to meet financial or practical needs” Group O: Municipal Challenge – “Urban renters of social housing facing an array of challenges”
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Tunbridge Wells Families – a ‘vignette’ profile There are three dominant groups in Tunbridge Wells, which account for 45.6% of the population: • • •
Group A: Country Living - “Well-off owners in rural locations enjoying the benefits of country life” accounts for 15.1% Group B: Prestige Positions – “Established families in large detached homes living upmarket lifestyles” accounts for 14.8% Group D: Domestic Success – “Thriving families who are busy bringing up children and following careers” accounts for 15.6%
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Maps of wards in Tunbridge Wells:
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The local population is broadly similar in structure to that of Kent, although there is a higher proportion of the population aged between 30 and 49, and more females aged 85 and above. Tunbridge Wells has a considerably smaller proportion of the population age 20 to 24 in comparison to Kent.
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St Johns (571) and St James (603) wards have the highest number of children aged 0 to 4. The wards with the fewest number of children aged 0 to 4 are Capel (131) and Frittenden and Sissinghurst (81). There are 6,910 children aged 0 to 4 in Tunbridge Wells.
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Southborough and High Brooms (2,157), St Johns (2,252) and Benenden and Cranbrook (2,419) have the highest number of people aged 0 to 19. The wards with the fewest number of people aged 0 to 19 are Capel (629) and Frittenden and Sissinghurst (495). There are 29,195 people aged 0 to 19 in Tunbridge wells.
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Culverden (5,856) and Southborough and High Brooms (5,092) wards have the highest number of working aged people (16 to 64). The wards with the fewest number of working aged people are Capel (1,455) and Frittenden and Sissinghurst (1,219). There are 71,324 working aged people in Tunbridge Wells.
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Park (1,673) and Benenden and Cranbrook (1,589) have the highest number of people aged 65 plus. The wards with the fewest number of people 65 plus are Capel (446) and Frittenden and Sissinghurst (522). There are 21,379 people aged 65 plus in Tunbridge Wells.
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Culverden (265) and Park (408) have the highest number of people aged 85 plus. The wards with the fewest number of people aged 85 plus are Capel (51), Paddock Wood West (71) and Frittenden and Sissinghurst (62). There are 3,329 people aged 85 and over in Tunbridge wells.
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The majority of care homes are located in central Tunbridge Wells rather than rural wards.
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Key Provider 471 Hazeldene House Ltd 44 Bupa Care Homes (ANS) Limited 101 Four Seasons (DFK) Limited 102 Four Seasons Homes No 6 Limited 244 Elizabeth Finn Homes Limited 306 Mrs Joan Penelope Gradwell 311 Pilgrim Homes 412 Family Care UK Limited 470 Cornford House Limited 515 Little Court Care Home Limited 554 Caring Homes Healthcare Group Limited 567 Tunbridge Wells Care Centre Limited 583 Rusthall Lodge Housing Association Limited 633 Warwick Park Care Home Limited 41 Leonard Cheshire Disability 116 Avante Partnership Limited 149 Davis Care Limited 198 Mrs L Watts Ms J L Watts 203 Mrs Lynne Weatherly 206 Voyage 1 Limited 274 Malvirt Limited 275 Crossways Community 299 Keychange Charity 309 Chislehurst Care Limited 310 Chislehurst Care Limited 334 Larkfield Hall Limited 335 Larkfield Hall Limited 341 Safe Quarter Limited 426 Mental Health Residential Limited 427 Beulah Lodge Rest Home Limited 437 Sira Care Homes Limited 443 L Fennell 444 L Fennell 531 Regal Care Trading Ltd 603 Greensleeves Homes Trust 630 Hartley House Limited
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Service Type Community Nursing Homes Nursing Homes Nursing Homes Nursing Homes Nursing Homes Nursing Homes Nursing Homes Nursing Homes Nursing Homes Nursing Homes Nursing Homes Nursing Homes Nursing Homes Residential Homes Residential Homes Residential Homes Residential Homes Residential Homes Residential Homes Residential Homes Residential Homes Residential Homes Residential Homes Residential Homes Residential Homes Residential Homes Residential Homes Residential Homes Residential Homes Residential Homes Residential Homes Residential Homes Residential Homes Residential Homes Residential Homes
Ward Pembury Southborough North Speldhurst and Bidborough Park Park Hawkhurst and Sandhurst Pantiles and St Mark's Frittenden and Sissinghurst Pembury Speldhurst and Bidborough St James' St John's Rusthall Pantiles and St Mark's Sherwood Pantiles and St Mark's Southborough North Speldhurst and Bidborough Sherwood Rusthall Speldhurst and Bidborough Culverden Park Culverden Southborough North Park Southborough and High Brooms Capel Southborough North St James' Southborough North Benenden and Cranbrook Benenden and Cranbrook Southborough North Culverden Benenden and Cranbrook
The most populated ward in Tunbridge Wells is St James which has 83.5 people per hectare. The average number of people per hectare across all of Tunbridge Wells is 3.5.
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Across Tunbridge Wells, the Office for National Statistics population projections predict a 4.3% increase in total population between 2015 and 2020. The largest increase is expected in the 85 and above age band, with a rise of 19.4%, representing 681 people. Projected populations by broad age band:
Tunbridge Wells 0-4 0-19 20-64 65-84 85+ All ages
2015 7222 29335 66581 18549 3516 117982
2016 7181 29477 66996 18828 3669 118970
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2017 7202 29601 67424 19094 3809 119929
2018 7237 29749 67827 19420 3941 120937
2019 7260 29962 68129 19823 4068 121981
2020 7284 30220 68454 20175 4198 123047
Paddock Wood East and Broadwater wards show the highest projected population change in Tunbridge Wells by over 10%.
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Figures from Office for National Statistics (ONS) Census 2011 show that the population of Tunbridge Wells is predominantly white (95.0%), and the percentage of BME population varies considerably between age groups. In the 0 to 15 population, 7.0% of residents are of non-white ethnicity, with the majority being of mixed descent (3.6%, 855 people). In the 65 and above age group, 1.0% of the population are of black or minority group ethnicity.
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Fertility and teenage conceptions The General Fertility Rate (GFR) is the number of live births per 1,000 females of childbearing age (between 15 and 44). The GFR for Tunbridge Wells has remained similar to the Kent and England trends; before decreasing in recent years (2011 to present).
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The highest observed rate for General Fertility Rate (GFR) was in Broadwater at 80.9. Two wards in Thanet CCG have a GFR within the top Kent quintile.
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The teenage conception rate for Tunbridge Wells has remained consistently lower than the Kent and England rates and has decreased from 28.7 in 1998 to 13.5 in 2014. The rate for Tunbridge Wells peaked in 2001 at 26.4.
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The map below shows the teenage conception rate at ward level for Tunbridge Wells. Tunbridge Wells has a low teenage conception rate across the Borough; Southborough and High Brooms ward has the highest teenage conception rate at 38.8.
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The South East Public Health Observatory (SEPHO) define life expectancy as ‘the average number of years a baby born in a particular area or population can be expected to live if it experiences the current age-specific mortality rates of that particular area or population throughout its life’. Life expectancy at birth has been calculated at ward level using data relating to the period 2011 to 2015. The ward with the highest life expectancy is Culverden (86.33) which is 6.7 years greater than the lowest life expectancy in St. James’ (79.6).
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Wardname Benenden and Cranbrook Brenchley and Horsmonden Broadwater Capel Culverden Frittenden and Sissinghurst Goudhurst and Lamberhurst Hawkhurst and Sandhurst Paddock Wood East Paddock Wood West Pantiles and St Mark's Park Pembury Rusthall St James' St John's Sherwood Southborough and High Brooms Southborough North Speldhurst and Bidborough Tunbridge Wells Kent
Persons Male Female 85.16 83.94 86.40 84.33 81.15 87.81 85.01 83.99 86.10 80.56 79.57 81.25 86.33 86.45 87.27 83.23 81.70 84.77 85.30 84.11 86.44 86.03 82.85 89.50 85.25 82.26 87.91 85.36 82.35 88.72 84.71 83.26 85.98 83.09 80.57 85.39 81.30 79.58 82.99 82.76 79.78 85.69 79.59 78.74 80.57 81.78 79.09 84.44 82.05 81.28 82.64 81.84 79.05 84.60 83.32 81.61 84.81 83.69 82.03 85.36 83.30 81.60 84.89 81.8 79.9 83.5
Persons: Males: Females:
6.74 7.72 8.92
Tunbridge Wells is similar to all districts in highlighting health inequalities as there is a gap in life expectancy between the affluent and those living in relative deprivation. Life expectancy shows an association with deprivation in Tunbridge Wells. Life expectancy in Tunbridge Wells is 83.3 years, higher than the Kent life expectancy of 81.8 years.
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Indices of Multiple Deprivation (IMD) The Indices of Multiple Deprivation (IMD) measure relative deprivation for small geographical areas within England. The IMD combines information from seven domains (Income, Employment, Education, Skills and Training, Health Deprivation and Disability, Crime, Barriers to Housing and Services and Living Environment Deprivation) to produce an overall relative measure of deprivation. The small areas used are called Lower-layer Super Output Areas (LSOA), of which there are 32,844 in England. They are designed to be of a similar population size with an average of 1,500 residents each and are a standard way of dividing up the country. The number of LSOAs in an electoral ward can vary from one to five depending upon the original size of the electoral ward. For each map in this section, IMD scores have been split into local quintiles (5 equal parts) with the fifth quintile being the most deprived and the first being the least deprived. A population weighted approach has been taken, so that the LSOAs falling within each quintile represent 20% of the Kent population. Ward boundaries are also displayed on the deprivation maps, and wards containing a LSOA within the most deprived quintile have been identified.
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The Income Deprivation Affecting Children Index (IDACI) is the proportion of all children aged 0 to 15 living in income deprived families. Income deprived families are defined as families that either receive Income Support or income-based Jobseekers Allowance or income-based Employment and Support Allowance or Pension Credit (Guarantee) or families not in receipt of these benefits but in receipt of Working Tax Credit or Child Tax Credit with an equivalised income (excluding housing benefit) below 60 per cent of the national median before housing costs.
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The Income Deprivation Affecting Older People Index is the proportion of all those aged 60 or over who experience income deprivation. This includes adults aged 60 or over receiving Income Support or income-based Jobseekers Allowance or income-based Employment and Support Allowance or Pension Credit (Guarantee).
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The main causes of death are circulatory (29%) and caner (28%). 19% of deaths due to cancer have an underlying cause of bronchus or lung cancer and breast cancer accounts for 11% of cancer deaths. Chronic ischaemic heart disease and acute myocardial infarction both accounted for 16% of deaths due to circulatory issues in 2014.
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Trends in all age all-cause mortality (AAACM) have been steadily falling since 1993. The rates for Kent have generally been lower than the rate for England.
Cancer mortality rates in the under 75s in Tunbridge Wells have been steadily falling since 2003; however, have risen slightly since 2011. The Tunbridge Wells rate tends to be lower then that of the South East and England.
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Circulatory mortality rates in the under 75s in Tunbridge Wells have been steadily falling since 1995 and tend to be lower than the Kent rate.
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Trends in infant mortality can be difficult to analyse in small geographical regions due to lower numbers of deaths under one year of age. The national infant mortality rate has been steadily falling since 1998, from 5.6 to 3.9 deaths under a year of age per 1,000 live births. The trend in Kent has been more varied but declined between 2005 and 2011 before increasing slightly then remaining steady for the past couple of years. At district level large fluctuations are seen due to the very small numbers involved.
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The hospital admission rate for mental and behavioural disorder due to psychoactive substances was consistently higher than that of Kent until 2011/12 and has been similar over the past four years. Across Kent, the rate has increased since 2006/07 but has slightly decreased in 2015/16.
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Sherwood has the highest elective admission rate in Tunbridge Wells at 111,449 with the lowest being 25,339, in St James’ ward.
Capel has the highest admission rate for emergency admissions in Tunbridge Wells at 25,618, with the lowest being in Hawkhurst and Sandhurst at 14,352. Five wards are significantly lower than the Tunbridge Wells and Kent averages.
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The synthetic estimate of the prevalence of adult obesity has been mapped across electoral wards in Tunbridge Wells. It was generated from the height and weight of adult respondents (aged 16 years or more), as measured by the Health Survey for England. Obesity is measured using the Body Mass Index (BMI) formula, which is based on an individual’s height and weight. A BMI of 25 to 29.9 is considered overweight; a score of 30 or above is considered obese.
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This estimate was generated from the data collected in the Health Survey for England about the quantities of all the different types of alcoholic drinks (beer, wine, spirits, sherry and alcopops) consumed on a respondent’s heaviest drinking night in the previous week.
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The synthetic estimate for current smoking was generated from the Health Survey for England. Adult respondents (aged 16 years or more) were defined to be smokers if they reported that they were a current cigarette smoker in the survey.
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The healthy lifestyle measure for fruit and vegetable consumption for adults (aged 16 years or more) was generated from the data collected in the 2001 and 2002 Health Surveys for England. It was estimated by modelling data found about the quantities of different types of fruit and vegetables consumed on the previous day. The consumption of fruit and vegetables across Tunbridge Wells is good. In most areas, 30% or more of the population are able to reach their recommended daily intake.
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