Overarching objectives

Healthy people live longer and live longer disability-free.

There are significant inequalities in health between individuals and different groups in society. These inequalities aren't random - in particular there's a ‘social gradient’ in health; areas with higher levels of income deprivation typically have lower life expectancy and disability-free life expectancy.

Improving the time people spend in good health and reducing inequality across the population of Barnsley are our overarching objectives.

In this section

This section includes information on:

  • life expectancy at birth and healthy life expectancy at birth
  • excess winter deaths
  • low birth weight

Life expectancy at birth and healthy life expectancy at birth

Why this is important

Compared to the national average, Barnsley is behind the national average levels for both genders in terms of life expectancy at birth and healthy life expectancy.

Historically there has been a gap between males and females in the area, which continues to the present. In the most recently available information; male life expectancy for Barnsley is 78.1 years. Female life expectancy is 81.9 years; this is significantly behind the national average of 79.6 and 83.2 respectively.

Importantly, this measure in recent times has seen little improvement, suggesting a lack of progress in life expectancy gains for our residents.

Healthy life expectancy, an estimate of how many years a person on average can expect to live free from an illness or injury in their life, has improved for females in the borough. At 63.2 years, female healthy life expectancy in Barnsley is only slightly behind the England average of 63.9. There is a gap of 4.6 years between healthy life expectancy for males in Barnsley (58.8 years) and the England average of 63.4 years. It's important that we continue to monitor this data at an electoral ward and Area Council level to tackle the challenge of health inequalities within the borough.

To understand why Barnsley has a lower life expectancy and healthy life expectancy we've analysed local data. This helps us to identify those causes of death which contribute most to the gap between the borough and the England average. Public Health England’s Segment Tool describes the drivers that contribute to the life expectancy gap between Barnsley as whole and England. The data suggests that the largest contributors to the life expectancy gap in both males and females are circulatory diseases, cancer, respiratory diseases and digestive diseases. These conditions account for over 70% of mortalities.

The Barnsley picture and how we compare: life expectancy at birth

Males

  • Life expectancy at birth for men in Barnsley in 2016-2018 is 78.1 years; lower than the England rate of 79.6 years
  • Barnsley is ranked 86 out of 123 local authorities (where 1 is the best); a slight improvement from 2015-2017 when Barnsley was ranked 87 out of 123. Barnsley’s current rank is higher than Doncaster and Rotherham which are ranked 91 and 95 respectively.
  • The gap in life expectancy at birth for males between Barnsley and England has decreased slightly during the period 2001-2003 to 2016-2018 (from 1.6 years to 1.5 years).
  • When considering the life expectancy gap between Barnsley and England in 2015/17 (updates for 2016-2018 for this section will be added shortly), the three main causes of death which contributed to the gap for men were external causes* (24.4%), circulatory diseases (22.7%) and respiratory disease (16.7%). This means that during 2015/17, there were 25 more deaths from external causes, 95 more from circulatory diseases and 107 more from respiratory disease than if Barnsley men had experienced the same mortality rates as men in England overall.
  • Within Barnsley, life expectancy at birth rates for men range from 75.3 years in Worsbrough ward to 83.0 years in Penistone East (a gap of 7.7 years).
  • When considering the life expectancy gap between the most deprived quintile and the least deprived quintile of Barnsley in 2015/17, the three main causes of death which contributed to the gap for men were circulatory diseases (30.8%), cancer (19.2%) and external causes (11.5%). This means that during 2015/17, there were 118 more deaths from circulatory diseases, 72 more from cancer and 24 more from external causes in men in the most deprived quintile of Barnsley than if it had experienced the same mortality rates as men in the least deprived quintile.

*External causes includes deaths from injury, poisoning and suicide.

Females

  • Life expectancy at birth for women in Barnsley in 2016-2018 is 81.9 years; lower than the England rate of 83.2 years.
  • Barnsley is ranked 92 out of 123 local authorities (where 1 is the best); a decline from 2015-2017 when Barnsley was ranked 88 out of 123. Barnsley’s current rank is higher than Doncaster and Rotherham which were ranked 97 and 93 respectively.
  • The gap in life expectancy at birth for females between Barnsley and England has increased slightly during the period 2001-2003 to 2016-2018 (from 1.1 years to 1.3 years).
  • When considering the life expectancy gap between Barnsley and England in 2015/17 (updates for 2016-2018 for this section will be added shortly), the three main causes of death which contributed to the gap for women were cancer (36.0%), circulatory diseases (20.5%) and respiratory disease (17.2%). This means that during 2015/17, there were 115 more deaths from cancer, 58 more from circulatory diseases and 79 more from respiratory disease than if Barnsley women had experienced the same mortality rates as women in England overall.
  • Within Barnsley, life expectancy at birth rates for women range from 79.3 years in Stairfoot ward to 86.8 years in Penistone East (a gap of 7.5 years).
  • When considering the life expectancy gap between the most deprived quintile and the least deprived quintile of Barnsley in 2015/17, the three main causes of death which contributed to the gap for women were cancer (31.6%), circulatory diseases (19.3%) and respiratory disease (15.7%). This means that during 2015/17, there were 104 more deaths from cancer, 72 more from circulatory diseases and 63 more from respiratory disease in women in the most deprived quintile of Barnsley than if it had experienced the same mortality rates as women in the least deprived quintile.

Data from:

The Barnsley picture and how we compare: healthy life expectancy at birth

Males

  • Men, at birth, in Barnsley could expect to live 58.8 years in 'good' health (4.6 years less than men in England overall).
  • Barnsley is ranked 102 out of 123 local authorities (where 1 is the best); a decline from 2015-2017 when Barnsley was ranked 92 out of 123. Barnsley’s 2016-2018 rank is higher than Wakefield which is ranked 108 out of 123.
  • The gap in healthy life expectancy at birth for males between Barnsley and England has decreased by 0.9 years during the period 2009-2011 to 2016-2018 (from 5.5 years to 4.6 years).

Females

  • Women, at birth, in Barnsley could expect to live 63.2 years in 'good' health (0.7 years less than women in England overall).
  • Barnsley is ranked 51 out of 123 local authorities (where 1 is the best); an improvement from 2015-2017 when Barnsley was ranked 77 out of 123. Barnsley’s 2016-2018 rank is higher than Sheffield, Rotherham, Doncaster and Wakefield.
  • The gap in healthy life expectancy at birth for females between Barnsley and England has decreased by 3.6 years during the period 2009-2011 to 2015-2017 (from 6.4 years to 2.8 years).

Data from:

What we're doing and the assets or services we have

Tackling health inequality is at the heart of ‘Feel Good Barnsley’ - Barnsley’s Health and Wellbeing Strategy 2016-2020. The role of the Barnsley Health and Wellbeing Board is to lead on reducing health inequalities across the population. Preventable differences in health status are caused by a number of interrelated factors including place and type of residence, communities, lifestyle and access to service provision.

We understand that Barnsley’s high levels of deprivation, low educational attainment and unhealthy lifestyle (high smoking, poor diet, and low physical activity) are all interrelated determinants of its poor health outcomes and high level of health inequalities. A range of wider factors are integrally linked in determining ultimate health outcomes. This emphasises both the necessity for effective health and social care as well as working in partnership with a wide range of other sectors to deliver improved outcomes.

In 2017, ‘A Day in the Life of’ captured a snapshot in time to illustrate the health and wellbeing of Barnsley’s residents.  It described people’s daily challenges that affect their physical and mental health, flag up problems and describe how to help themselves, their families and friends live healthier lives. The 2018 Director of Public Health report, ‘Are You Contactless?’ has been written in direct response to this.  As in previous years, the public health team will work with partners and residents to deliver a number of recommendations which are described in the report.

Opportunities for improvement or future development

We continue to focus on understanding our life expectancy and healthy life expectancy data which adds a quality of life dimension to estimates of life expectancy. Investing in prevention, early intervention and addressing lifestyles will help to support our residents to stay healthy and independent. 

Resources and supporting documents



Excess winter deaths

Why this is important

Cold weather has a direct effect on the incidence of heart attack, stroke, respiratory disease, flu, falls and injuries and hypothermia. It also has indirect effects on mental health problems, such as depression, and the risk of carbon monoxide poisoning if boilers, cooking and heating appliances are poorly maintained or ventilated. Overall, the death rate in the UK is higher during winter months (from the start of December to the end of March in the UK) and this is referred to as 'excess winter deaths' (Cold weather plan for England, Public Health England).

In the 2017 to 2018 winter period, there were an estimated 50,100 excess winter deaths (EWD) in England and Wales. The number of EWD observed in 2017 to 2018 was higher than all years since the 1975 to 1976 winter period when there were 58,100 EWD. However, the increase in EWD was similar to peaks observed in previous years such as 2014 to 2015, 1999 to 2000 and 1998 to 1999 (Office for National Statistics).

Most excess winter deaths and illnesses are caused by respiratory and cardiovascular problems during moderate outdoor winter temperatures of 4 to 8°C depending on the region (Cold weather plan for England, Public Health England). The risk of death and illness increases as the temperature falls further.

In many cases, simple preventive action could avoid many of the deaths and illnesses associated with the cold. Many of these measures need to be planned and undertaken before cold weather starts. Public Health England's Cold weather plan for England provides guidance on how to prepare for and respond to cold weather, which can affect everybody's health. It outlines actions for the NHS, public health, social care and other community organisations, to support vulnerable people who have health, housing or economic circumstances that increase their risk of harm.

NICE quality standard for tackling Excess Winter Deaths (QS117) and local actions are expected to contribute to improvements in the following outcomes:

  • excess winter deaths
  • morbidity
  • fuel poverty
  • exacerbation of current health problems
  • timely discharge
  • rates of hospital admissions and re-admissions

The Barnsley picture and how we compare

  • Barnsley’s 2014 to 2017 excess winter deaths rate (30.9%) is significantly higher than the England rate of 21.1%.
  • Out of 16 comparator authorities, Barnsley has the highest rate.
  • Barnsley’s 2014 to 2017 rate of 30.9% is the highest during the period 2001 to 2004 to 2014 to 2017.
  • The main underlying causes of excess winter deaths are respiratory diseases. During 2010 to 2017, in Barnsley, there were 78.7% more deaths from influenza and pneumonia and 66.8% more deaths from chronic lower respiratory diseases in winter months than in non-winter months.
  • There are large variations in excess winter death rates within Barnsley, with rates ranging from 4.4% in St Helen’s ward to 47.4% in Darton East ward.

What we're doing and the assets or services we have

Cold homes and energy efficiency

  • The new Warm Homes service commenced April 2019. The service will establish a single point of access as part of the Assistive Living Team to improve identification of residents who are vulnerable to fuel poverty and EWDs.
  • The Warm Homes and Hospital Discharge service evaluation has been procured. Research commenced in April 2019.
  • North Area Council commissioned DIAL to deliver a new warm homes/EWDs service. This service went live in January 2019. Uptake of the service has been good, 80 home visits were made in the first quarter of the year; this included 23 home energy assessments, 12 households benefited from switching energy supplier resulting in a saving of £2,360 on fuel bills across the 12 properties, averaging at £197.00 per household per year.
  • The Warm Homes campaign that ran from November 2018 to February 2019, included a promotional event for veterans. The Armed Forces Energy Action Day, held in conjunction with National Energy Action (NEA) and other partners, was attended by Dan Jarvis MP and Sir Stephen Houghton, the leader of the council. The Facebook campaign linked with the day reached 45,993 residents and generated 136 unique engagements; on Twitter it reached 17,723 residents and generated 109 unique engagements

Flu vaccination uptake (Sept 18 to Jan 19)

  • High uptake for all eligible children, exceeding regional and national averages. Uptake rates in school age children (Reception to Year 4) exceeded 75% in all year groups.
  • In the 65+ age group, Barnsley’s uptake rate (72.3%) was slightly higher than the England rate (72.0%).
  • Uptake in the under 65’s (at risk) group (50.7%) was higher than regional and national rates.
  • Barnsley Council staff - by bringing the vaccination service in house we increased uptake to 15% of the BMBC workforce compared with 6% in 2017/18.
  • The health care and social worker vaccination programme continues to go from strength to strength through the offer of vaccination in employing health care organisations, social care organisations, local authority organisations, private and community organisations across Barnsley.

Falls prevention

  • Multi-agency working to use Rockwood scoring to identify frail people and those at risk of falling.
  • Delivery of Red Bag Scheme in care homes, with plans to relaunch with further engagement across the system.
  • A new Frailty Assessment Unit is discharging over 75% of frail patients the same day.
  • Application to the Age Friendly Network approved.
  • Berneslai Homes scheme managers are trained to deliver gentle exercise and healthy bones classes to residents of independent living schemes.

BREATHE, Integrated Respiratory Service

As part of the drive to bring closer to home and better integrate the service across settings, Barnsley Clinical Commissioning Group (CCG) is working in collaboration with Barnsley NHS Foundation Trust (BHNFT) and South West Yorkshire Partnership Foundation Trust (SWYPFT) to deliver an integrated respiratory service for patients with Chronic Obstructive Pulmonary Disease (COPD), focusing on exacerbation management (ways to manage flare ups), diagnosis, pulmonary rehabilitation and ongoing care with the ambition to improve the quality of life of the Barnsley respiratory patient. 

Barnsley REspiratory Assessment and THErapy (BREATHE) Service:

  • Key elements of the service include; home oxygen and nebulizer assessment and reviews, seven day exacerbation support service including urgent advice to primary care, early supported discharge, and BREATHE Service Nursing presence in Accident and Emergency departments at peak times.
  • A full schedule of consultant led community BREATHE clinics established in six localities. Furthermore, each locality has a named specialist nurse who supports general practice, will advise on the care of patients with complex needs and provide support to patients having exacerbations, (flare ups).
  • Ongoing communications and marketing to promote the service across primary and community care.

Pulmonary Rehabilitation Service:

  • To improve service accessibility, the programme is now delivered from a number of locations across the borough including, Cudworth, Gawber, Hoyland and the Dearne, alongside a home-based programme.
  • Routine promotional activity is underway to promote the service and increase referrals, this includes active promotion of the self-referral route into the service.
  • Increasing the number of referrals into the service from primary care, including setting practices individual referral targets via the Practice Delivery Agreement (PDA 18/19 and 19/20).
  • The service is exploring roll out of new technology to support service delivery, including use of the MyCOPD app where appropriate.

Resources and supporting documents



Low birth weight

Why this is important

Low birth weight is defined as a birth weight less than 2,500 grams at full gestation; it's associated with an increased risk of infant mortality, childhood morbidity and poorer health later in life.

There are inequalities in low birth weight, with higher proportions of low birth weight babies being born in more deprived populations. This is thought to be associated with higher prevalence of lifestyle issues that increase the risk of low birth weight, such as maternal smoking and alcohol consumption.

The Barnsley picture and how we compare

  • In 2017, 3.01% of full term babies born to mothers from Barnsley had a low birth weight, similar to the England average of 2.82%.
  • The percentage of low birth weight babies has increased slightly since 2014.

Data from:

What we're doing and the assets or services we have

The Public Health nursing service offer the following initiatives and interventions:

  • Promotion of smoking cessation during and after pregnancy.
  • Early initiation and promotion of exclusive breast feeding, supported by an infant feeding peer support team integrated within Public Health.
  • Growth and development monitoring at key stages of child’s early development.
  • Provision of a universal service which supports access to health care and immunisation uptake.

Barnsley Hospital (NHS) Foundation Trust (BHNFT) provides the following services:

  • Maternity Stop Smoking Service, supporting women and their partners who smoke throughout pregnancy.
  • Pathway to Barnsley Wellbeing Programme - a 12 week free physical activity programme.
  • Customised growth charts for all singleton pregnancies, as recommended by the Perinatal Institute.
  • Women who have had a previous ‘small for gestational age’ baby have growth scans in their current pregnancy at 28, 31, 34, 37 and 40 weeks. This enables identification of any growth restriction and identification of babies that may need delivering.
  • Reduced fetal movements are discussed at every antenatal appointment and women are referred into the maternity unit for monitoring if reduced movements are identified. To encourage women to self-refer if needed, a new initiative has been developed. Every woman is given a wristband at 24 weeks gestation which has the words 'don’t just natter, movements matter' printed on it.

Opportunities for improvement or future development

  • Intensive support for teenage mothers.
  • Barnsley Hospital is working towards implementing ‘Saving Babies Lives Version 2’, which recommends changes to the provision for women receiving serial ultrasounds; this will include women with a body mass index (BMI) over 35 and women who smoke.

Resources and supporting documents

  • Antenatal care for uncomplicated pregnancies
    National Institute for Health and Care Excellence, 2008 (NICE) - guidelines cover advice and information to be given to women during pregnancy, including antenatal and newborn screening programmes, screening for clinical conditions such as gestational diabetes and pre-eclampsia, screening for infections, lifestyle advice, provision of care and management of pregnancy symptoms and breastfeeding.