JSNA Live Well - Long term conditions

Abdominal Aortic Aneurysm Screening

Abdominal Aortic Aneurysm Screening Coverage: In 2022/23, Wandsworth’s rate was 68.1% (n=840), which was the 6th lowest in London, 13.0% lower than the England average and 9.3% lower than the London average. The latest Borough figure for 2022/23 was also 24.7% higher than in 2021/22, in comparison with 11.5% increase in England’s rate in the equivalent time period.

Source: OHID: Public Health Profiles

Source: OHID: Public Health Profiles

Diabetic Eye Screening

In 2019, 68.7% of people with diabetes on GP registers had a record of retinal screening in the preceding 12 months ¹. This is lower than London and England (73.7% and 77.3% respectively).

Aims and Delivery Model

For Wandsworth, the NHS Health Checks Programme aims to improve health outcomes and quality of life of residents. It does this by identifying individuals at an earlier stage of vascular change and provide opportunities to encourage them to substantially reduce their risk of CVD morbidity or mortality. All 40 Wandsworth GP Practices provide NHS Health Checks, giving good geographical coverage across Wandsworth. GPs can prioritise invitations for people identified with a high predicted CVD risk score (based on QRISK prediction). As the number of NHS Health Checks increase during 2021-22 towards pre-COVID levels, the Public Health Division will explore adopting a proportionate universalism approach. The service will remain available to all eligible residents, groups and communities at increased risk of CVD and related illnesses. Those who may be disproportionately affected by COVID are prioritised for a health check.

During 2019/20, Wandsworth exceeded its annual target to invite 20% of the eligible population for an NHS Health Check; 16,279 patients were invited, and 6,733 eligible Wandsworth residents received a Health Check.

Of those 6,733 who received an NHS Health Check in 2019-20:

• 3,757 (55.8%) 40-50 years
• 2,168 (32.2%) 51-60 years
• 1,104 (16.4%) 61-74 years
• 3,737 (55.5%) female
• 2,996 (44.5%) male
• 2,114 (31.4%) BAME
• 2,208 (32.8%) of attendees were recall patients, post five-years
• 263 (3.9%) registered to addresses in the most deprived areas of the Borough ²
• 1,145 (17%) not resident in the Borough but registered with a Wandsworth GP.

According to the data, 55.5% of service users were female. This shows that women are more likely to attend the health checks service than men. Females account for 49.3% of the borough profile. People aged 40-50 years are the highest age group (55.8%), followed by people aged 51-60 years check post five-years.

32.8% of service users were BAME; the proportion was smaller when compared to the percentage of borough BAME population within 40-74 age range (34.7%). 3.9% were registered to addresses in the 20% most deprived areas of the Borough compared to the borough profile at 4.5%. 17% of patients registered with a Wandsworth GP do not live in the Borough.

NHS Health Checks Outcomes

During 2019/20, from the 6,733 patients who received a Health Check, outcomes included:

• 22 residents were identified with a high QRISK score (>20%)
• 243 residents were identified as having high blood pressure
• 232 residents were diagnosed hypertensive
• 6 patients diagnosed with stage 3 or higher chronic kidney disease (CKD)
• 3,747 patients were classified as obese (BMI > 30kgm2)
• 808 were identified with a Q-Diabetes score greater than 5.6%
• 98 residents were diagnosed Type 2 Diabetic.

Referrals from an NHS Health Check to lifestyle support services during 2019/20 included:

• 57 patients were referred to the National Diabetes Prevention Programme (NDPP), 19 people (25%) declined
• 192 people were referred to the Exercise on Referral Programme, 221 people (54%) declined
• 113 patients were referred to Weight Management Programme, 126 people (53%)declined
• 93 patients were referred to Smoking Cessation Services 53 people (36%) patients declined.

Cumulative percentage of the eligible population aged 40 to 74 offered an NHS Health Check: In 2018/19 - 22/23, Wandsworth’s rate was 82.3% (n=65290), which was the 12th highest in London, 27.3% higher than the England average and 16.4% higher than the London average. The latest Borough figure for 2018/19 - 22/23 was also 37.8% lower than in 2013/14 - 17/18, in comparison with 28.8% decrease in England’s rate in the equivalent time period.

Source: OHID: Public Health Profiles

Source: OHID: Public Health Profiles

Cumulative percentage of the eligible population aged 40 to 74 offered an NHS Health Check who received an NHS Health Check: In 2018/19 - 22/23, Wandsworth’s rate was 46.4% (n=30284), which was the 15th lowest in London, 9.7% higher than the England average and 3.8% lower than the London average. The latest Borough figure for 2018/19 - 22/23 was also 11.2% lower than in 2013/14 - 17/18, in comparison with 13.2% decrease in England’s rate in the equivalent time period.

Source: OHID: Public Health Profiles

Source: OHID: Public Health Profiles

Cumulative percentage of the eligible population aged 40 to 74 who received an NHS Health check: In 2018/19 - 22/23, Wandsworth’s rate was 38.2% (n=30284), which was the 13th highest in London, 39.6% higher than the England average and 12.0% higher than the London average. The latest Borough figure for 2018/19 - 22/23 was also 44.8% lower than in 2013/14 - 17/18, in comparison with 38.2% decrease in England’s rate in the equivalent time period.

Source: OHID: Public Health Profiles

Source: OHID: Public Health Profiles

Diabetes Identification Through the NHS Health Check

In 2019/20, Wandsworth completed 6,602 NHS Health Checks; blood test results showed that 58 people had an HbA1c result in the diabetic range ³. Nationally, it is estimated that NHS Health Checks could prevent 4,000 people a year from developing diabetes ⁴. For every 80 – 200 NHS Health Checks, one person is diagnosed with Type 2 Diabetes (0.5%–1.25% of checks) ⁵. Wandsworth was within this range with 0.87% of checks resulting with a diabetes diagnosis.

In 2019/20, 4,951 (75%) of people having an NHS Health Check had an HbA1c result recorded, and of these 326 (6.6%) had an HbA1c reading in the non-diabetic hyperglycemia (NDH), 5% of all NHS Health Checks. Thirty percent of people had a QDiabetes score greater than 5.6, indicating they are at high risk of Type 2 Diabetes. 23% of people within this group did not have an HbA1c result recorded. A further 5% of people did not have a QDiabetes or HbA1c result recorded. This shows missed opportunities for NDH identification and early intervention (see the figure below ⁶).

Type 2 Diabetes Prevalence

Diabetes: QOF prevalence (17+ yrs): In 2022/23, Wandsworth’s rate was 4.7% (n=16044), which was the 7th lowest in London, 37.5% lower than the England average and 32.2% lower than the London average. The latest Borough figure for 2022/23 was also 9.7% higher than in 2012/13, in comparison with 23.9% increase in England’s rate in the equivalent time period.

Source: OHID: Public Health Profiles

Source: OHID: Public Health Profiles

The figure below provides the demographic breakdown of people diagnosed with Type 2 Diabetes. At individual GP practice level, the prevalence of diagnosed diabetes ranges from around 1% to 12%.

Source: NHS Digital. National Diabetes Audit. 2018/19

• Type 2 Diabetes is more common in males than females; 55% are male. While there is little difference in the prevalence of NDH by sex, males have a higher prevalence of diabetes overall compared to females.
• Just under half of Type 2 registrations are amongst the 40-64 years age group and over one third in the 65-79 years age group.
• Similar to NDH, over one third of people diagnosed with Type 2 diabetes are from the two most deprived quintiles.
• Around 35% of people diagnosed with Type 2 diabetes are white, 60% minority ethnic origin, with a further 5% unknown or not stated. As BAME groups make up around 30% of the population in Wandsworth, this reflects the health inequality of diabetes among minority ethnic groups.

Comparing prevalence of NDH to Type 2 diabetes, a higher proportion of males and BAME groups develop Type 2 diabetes.

Undiagnosed Diabetes

It is estimated that 22,854 people in Wandsworth have diabetes (all types of Diabetes) ¹². This includes people that have already been diagnosed by their GP, and those who have diabetes but do not know it (undiagnosed). Around 60% of people living with diabetes are diagnosed. This is lower than the diagnosis rates for England 78%, and London 71.4%.

Approximately 40% (8749)of people live with undiagnosed diabetes and do not receive vital health monitoring, checks and treatment.

NDH estimates show that 18,650 people have high blood sugar. They are unaware the risk of developing diabetes and miss out on intervention or annual monitoring.

Projected Diabetes Prevalence

Projections for diabetes prevalence up to 2035 show an increase in the number of people living with diabetes in Wandsworth, as well as in London and England at a similar rate. By 2035, it is estimated that 8.2% of people in Wandsworth will have diabetes. This is less than a 1% increase but amounts to a further 5,960 people living with diabetes in Wandsworth over the next 15 years (the figure below).

Source: Prevalence estimates of Diabetes, Public Health England, 2016

Risk of Type 2 Diabetes

The risk factors for being at high risk of type 2 diabetes and developing type 2 diabetes are the same. These factors include:

• Overweight or obesity - there is a seven times greater risk in people who are obese and three times if overweight
• High Blood Pressure - people are more at risk if they have ever had high blood pressure
• Certain ethnicities - People of South Asian origin are six times more likely to develop Diabetes and Black-Caribbean and Black African are three times more likely
• Age - Risk increases with age. People are more at risk if they are older than 40 or older than 25 if they are Black Caribbean, Black African, or South Asian
• Family History - People are two to six times more likely to get type 2 diabetes if they have a parent, brother, sister or child with diabetes
• Smoking - Smoking has been proven to be an independent risk factor for Diabetes, and amongst diabetics it increases the risk of complications. The highest risk is among heavy smokers and risk remains elevated for about 10 years after smoking cessation, reducing more quickly for lighter smokers ¹³.
  
• Deprivation is strongly associated with higher levels of obesity, physical inactivity, unhealthy diet, smoking and poor blood pressure control, all of which are linked to the risk of developing type 2 diabetes. Prevalence of type 2 diabetes is 60% more common among individuals in the most deprived quintile compared with those in the least deprived quintile in England
• Gestational Diabetes - Gestational Diabetes affects around 5% of all pregnancies ¹⁴. Women who have had Gestational Diabetes are at a sevenfold increased risk of developing type 2 diabetes later in life, especially if they gain weight. Children born to mothers with diabetes during pregnancy tend to have a greater BMI, raised fasting glucose levels and an increased risk of developing type 2 diabetes later in life
• Children born to mothers with diabetes during pregnancy tend to have a greater BMI, raised fasting glucose levels and an increased risk of developing Type 2 Diabetes later in life *People at high risk of Type 2 Diabetes have a greater chance of developing Type 2 Diabetes in the future. One out of four people with high risk will develop Type 2 Diabetes in the next 10 years ¹⁵.

Complications

People who develop Type 2 Diabetes are at greater risk of developing complications from the disease including:

• CVD including heart attack and stroke – Type 2 Diabetes leads to a 2-fold excess risk of CVD. In Wandsworth, people with diabetes are 51.1% more likely to have a heart attack, and 57.9% more likely to have a stroke
  
• blindness – a leading cause of preventable slight loss among people of working age
• nerve damage - most often in legs or feet
• Kidney Disease and Failure - Diabetes is the leading cause of Kidney Disease
• diabetic foot disease- a potential consequence of nerve damage and the complication of peripheral vascular disease.
• foot problems are the most frequent reasons for hospitalisation amongst people who have diabetes. Latest figures for Wandsworth show that between 2016/2017 and 2018/2019, there were 580 hospital spells for Diabetic Foot Disease; this was significantly better than the England average. The median length of stay in hospital was 5.5 days.
  
• diabetes is one of the leading causes of amputation of the lower limbs. From 2016/2017- 2018/2019 there were 25 major amputation procedures, above or below the knee (an age and ethnicity standardised rate of 8.0 major amputations per 10,000 population-year).
• there were 80 minor amputation procedures (removal of toes or feet) with a directly age and ethnicity standardised rate of 22.0 per 10,000 population-year. These were similar to the England averages.

The figure below shows that out of 19,500 Wandsworth’s patients that are expected to have type 2 diabetes, 13,500 (69%) patients have been identified as diabetic and recorded on GP diabetes registers. Only 4,300 have been recorded to meet the 3 diabetes treatment targets for blood sugar level, blood pressure and cholesterol (22% of the estimated population of people with diabetes).

Source: SWL CCG, 2021 from QOF data and ONS estimates of type 2 diabetes prevalence for Wandsworth.

Current Services

A range of services are available for people at high risk of developing or being Type 2 diagnosed with Type 2 Diabetes. The services offer support to people to help prevent Type 2 Diabetes, as well as to diagnose people with diabetes early, ensuring quality of care and effective management.

Treatment Targets

NICE recommends treatment targets for Hba1c (glucose control), blood pressure and serum cholesterol:

• measuring and managing Hba1c helps reduce the risk of all diabetic complications
• managing high blood pressure can reduce the risk of vascular complications and the progression of eye disease and kidney failure
• reducing cholesterol can reduce the risk of vascular complications. Meeting all three treatment targets’ is achieved where a patient has HbA1c ≤58mmol/mol, cholesterol <5mmol/L and blood pressure ≤140/80.

Around 60% of people with Type 2 Diabetes have not achieved all three treatment targets (for blood glucose, blood pressure, cholesterol). The table below shows that in comparison with similar CCGs, the Sustainability and Transformation Plan (STP) and England, Wandsworth is performing similarly to CCGs and England, but slightly lower than the STP.

There was a variation in the achievement between GP Practices, ranging from 25%–60%.

Source: National Diabetes Audit (NDA) 2018/19

Data Limitations

The estimated NDH prevalence is based on modelled data. PHOF states “with all modelled data, there is a degree of uncertainty associated with these estimates therefore should be considered indicative only.” Additionally, ward level or LSOA breakdown of the data is not available for both data sets.

Like the estimated NDH prevalence data, diabetes prevalence is based on modelled data and does not include confidence intervals. The data has not been interpreted beyond borough level. This data includes Type 1 Diabetes and does not make a distinction between the types of diabetes.

GP Recorded Hypertension Prevalence

Early diagnosis and treating hypertension significantly reduces the risk of CVD.

Hypertension: QOF prevalence (all ages): In 2022/23, Wandsworth’s rate was 8.6% (n=35319), which was the 5th lowest in London, 40.3% lower than the England average and 21.2% lower than the London average. The latest Borough figure for 2022/23 was also 0.2% higher than in 2012/13, in comparison with 5.5% increase in England’s rate in the equivalent time period.

Source: OHID: Public Health Profiles

Source: OHID: Public Health Profiles

GP Recorded CHD Prevalence

CHD: QOF prevalence (all ages): In 2022/23, Wandsworth’s rate was 1.4% (n=5693), which was the 5th lowest in London, 53.5% lower than the England average and 25.4% lower than the London average. The latest Borough figure for 2022/23 was also 6.9% lower than in 2012/13, in comparison with 10.6% decrease in England’s rate in the equivalent time period.

Source: OHID: Public Health Profiles

Source: OHID: Public Health Profiles

CHD Admissions

Hospital admissions due to coronary heart disease: In 2022/23, Wandsworth’s rate was 374.1 per 100,000 (n=725), which was the 11th lowest in London, 3.4% lower than the England average and 0.0% higher than the London average. The latest Borough figure for 2022/23 was also 54.9% lower than in 2003/04, in comparison with 46.2% decrease in England’s rate in the equivalent time period.

Source: OHID: Public Health Profiles

Source: OHID: Public Health Profiles

GP Recorded Prevalence of Stroke

Stroke: QOF prevalence (all ages): In 2022/23, Wandsworth’s rate was 0.9% (n=3678), which was the 6th lowest in London, 51.5% lower than the England average and 18.6% lower than the London average. The latest Borough figure for 2022/23 was also 14.0% higher than in 2012/13, in comparison with 8.7% increase in England’s rate in the equivalent time period.

Source: OHID: Public Health Profiles

Source: OHID: Public Health Profiles

Stroke Admissions

Hospital admissions due to stroke: In 2022/23, Wandsworth’s rate was 165.5 per 100,000 (n=315), which was the 8th lowest in London, 1.7% lower than the England average and 0.0% higher than the London average. The latest Borough figure for 2022/23 was also 0.7% higher than in 2003/04, in comparison with 6.8% decrease in England’s rate in the equivalent time period.

Source: OHID: Public Health Profiles

Source: OHID: Public Health Profiles

Stroke Mortality

Mortality rate from stroke, all ages: In 2020 - 22, Wandsworth’s rate was 41.7 per 100,000 (n=215), which was the 10th lowest in London, 17.1% lower than the England average and 9.9% lower than the London average. The latest Borough figure for 2020 - 22 was also 61.8% lower than in 2001 - 03, in comparison with 58.6% decrease in England’s rate in the equivalent time period.

Source: OHID: Public Health Profiles

Source: OHID: Public Health Profiles

GP Recorded Prevalence of COPD

COPD: QOF prevalence (all ages): In 2022/23, Wandsworth’s rate was 0.8% (n=3405), which was the 7th lowest in London, 55.0% lower than the England average and 18.7% lower than the London average. The latest Borough figure for 2022/23 was also 7.9% lower than in 2012/13, in comparison with 6.0% increase in England’s rate in the equivalent time period.

Source: OHID: Public Health Profiles

Source: OHID: Public Health Profiles

Emergency Hospital Admissions for COPD

Emergency hospital admissions for COPD (35+): In 2019/20, Wandsworth’s rate was 401.6 per 100,000 (n=415), which was the 11th highest in London, 3.3% lower than the England average and 12.3% higher than the London average. The latest Borough figure for 2019/20 was also 18.3% lower than in 2010/11, in comparison with 1.3% increase in England’s rate in the equivalent time period.

Source: OHID: Public Health Profiles

Source: OHID: Public Health Profiles

Asthma Recorded Prevalence

Asthma: QOF prevalence (6+ yrs): In 2022/23, Wandsworth’s rate was 4.4% (n=16928), which was the 6th lowest in London, 33.0% lower than the England average and 7.6% lower than the London average. The latest Borough figure for 2022/23 was also 3.8% higher than in 2020/21, in comparison with 2.3% increase in England’s rate in the equivalent time period.

Source: OHID: Public Health Profiles

Source: OHID: Public Health Profiles

GP Recorded Prevalence of Mental Illness

GP Mental Health Registers include patients with a diagnosis of schizophrenia, bipolar affective disorder and other psychoses.

Mental Health: QOF prevalence (all ages): In 2022/23, Wandsworth’s rate was 1.0% (n=4215), which was the 13th lowest in London, 3.0% higher than the England average and 9.8% lower than the London average. The latest Borough figure for 2022/23 was also 11.1% higher than in 2012/13, in comparison with 18.6% increase in England’s rate in the equivalent time period.

Source: OHID: Public Health Profiles

Source: OHID: Public Health Profiles

Estimated Prevalence of Common Mental Disorders

Estimated prevalence of common mental disorders: % of population aged 16 & over: In 2017, Wandsworth’s rate was 18.8% (n=49805), which was the 16th lowest in London, 11.0% higher than the England average and 2.5% lower than the London average. Time series data were not available for this indicator.

Source: OHID: Public Health Profiles

Mental Health Service Users Living In Stable Accomodation

Adults in contact with secondary mental health services who live in stable and appropriate accommodation: In 2020/21, Wandsworth’s rate was 77.0%, which was the 9th highest in London, 32.8% higher than the England average and 26.2% higher than the London average. The latest Borough figure for 2020/21 was also 4.7% lower than in 2011/12, in comparison with 6.2% increase in England’s rate in the equivalent time period.

Source: OHID: Public Health Profiles

Source: OHID: Public Health Profiles

Key Findings from Wandsworth Sexual Health Needs Assessment, 2018 (STIs):

• the 2018 STI diagnosis rate for England was784/100,000 population, and higher in Wandsworth at 1976/100,000 population
• newly diagnosed STIs (excluding chlamydia aged <25) at 2195/100,000 population is significantly higher than both England at 851/100,000 population and London at 936/100,000
• trends have stabilised since 2012
• diagnostic rates of gonorrhoea is 328.5/100,000 population, with recent trends showing a slow increase in diagnosis which is higher than the London average of 279.4
• London is currently witnessing an increase in the rate of Syphilis. In Wandsworth in 2018, the syphilis diagnostic rate was at 54.8/100,000 population which is higher than the other London boroughs and significantly higher than the rest of England
• an HIV prevalence rate of 5.49/1000 people aged 15–59 years, Wandsworth is now classed as an ‘extremely high’ prevalence area for HIV in accordance with NICE guidance
• a larger proportion of white gay/lesbian are newly diagnosed with STIs
• the 2018 chlamydia infection rate represents a 16% increase from the previous year (3,063/100,000 population).
• on-line screening activity is beginning to grow, rising to 439 by the end of quarter two, with positivity increasing from 4.9% to 6.2%. This provides good evidence to suggest that the channel shift form clinic to e-services is starting to take hold.
• national and local evidence clearly demonstrates that sexual health need varies according to factors such as age, gender, sexuality and ethnicity with inequalities in sexual health disproportionately affecting Black & Asian, Minority Ethnic (BAME) communities, those identifying as LGBTQ+, men who have sex with men (MSM).

MSM are among the largest groups diagnosed with a new STI diagnosis. BAME communities in Wandsworth also experience a significantly higher proportion of STI infection compared to the proportion of the population from other ethnic groups. Moreover, with an HIV prevalence rate of 5.49/1000 people aged 15–59 years, Wandsworth is classed as an ‘extremely high’ prevalence area for HIV in accordance to NICE guidance. This compares with an England rate of 2.4/1000, and 5.7/1000 across London. While this rate has remained stable over the last 5 years universal testing is recommended for high prevalence areas ²⁰. National analysis shows that two-thirds of late HIV diagnoses occur in high-and extremely-high-prevalence local authorities . More intensive testing is recommended in areas exceeding the 5/1000 threshold.

Age and Gender Distribution of New STI Diagnoses

The age and gender distribution of new STI diagnoses (chlamydia, gonorrhoea, herpes, syphilis, warts) in Wandsworth residents in 2018 highlights that the largest number of newly diagnosed STI’s are in the 25 to 34-year-old age cohort (figure below).

Source: GUMCAD Extracted Feb 2020

Sexual Orientation

People identifying as LGBTQ+ can experience a greater degree of health inequalities, including sexual health ²¹. National data shows where gender and sexual orientation are known. MSM account for 29% of London residents diagnosed with a new STI in a specialist health clinic. 90% have syphilis and 63% have gonorrhoea. In line with the national picture, the amount of diagnoses of gonorrhoea and syphilis are higher in gay men compared to heterosexual men (figure below).

Source: GUMCAD Sep ’18–Oct ’19

When comparing new diagnosis of STIs by ethnic origin and sexual orientation a larger proportion of white gay/lesbian are newly diagnosed.

New STI Diagnoses (Excluding Chlamydia) in People Aged Under 25 Years

New STI diagnoses (excluding chlamydia aged under 25) per 100,000: In 2023, Wandsworth’s rate was 1745.7 per 100,000 (n=5744), which was the 10th highest in London, 235.8% higher than the England average and 42.1% higher than the London average. The latest Borough figure for 2023 was also 15.5% higher than in 2012, in comparison with 8.5% decrease in England’s rate in the equivalent time period.

Source: OHID: Public Health Profiles

Source: OHID: Public Health Profiles

Genital chlamydia trachomatis is the most commonly reported bacterial STI in England. Infection is asymptomatic in at least 70% of women and 50% of men. As a result, most infections remain undiagnosed ²².

Untreated chlamydia infection has significant health consequences. It is associated with considerable health risks in women of reproductive age, including pelvic inflammatory disease, ectopic pregnancy and infertility. In men, complications can include urethritis, epididymitis and Reiter’ Syndrome. The chlamydia detection rate is one of the Health Protection, part the Public Health Outcomes Framework (PHOF). In 2013 the department of Health set a recommended chlamydia detection rate of ≥2300 per 100.000 population requiring high volumes of screening and diagnosis.

Gonorrhoea Diagnostic Rate

Gonorrhoea diagnostic rate per 100,000: In 2023, Wandsworth’s rate was 540.1 per 100,000 (n=1777), which was the 11th highest in London, 261.9% higher than the England average and 35.9% higher than the London average. The latest Borough figure for 2023 was also 172.0% higher than in 2012, in comparison with 196.9% increase in England’s rate in the equivalent time period.

Source: OHID: Public Health Profiles

Source: OHID: Public Health Profiles

Syphilis Diagnostic Rate

Syphilis diagnostic rate per 100,000: In 2023, Wandsworth’s rate was 52.0 per 100,000 (n=171), which was the 12th highest in London, 212.0% higher than the England average and 4.8% higher than the London average. The latest Borough figure for 2023 was also 184.7% higher than in 2012, in comparison with 195.7% increase in England’s rate in the equivalent time period.

Source: OHID: Public Health Profiles

Source: OHID: Public Health Profiles

HIV Prevalence

HIV diagnosed prevalence rate per 1,000 aged 15 to 59: In 2022, Wandsworth’s rate was 4.9 per 1,000 (n=1139), which was the 16th highest in London, 108.4% higher than the England average and 7.6% lower than the London average. The latest Borough figure for 2022 was also 2.6% higher than in 2011, in comparison with 19.1% increase in England’s rate in the equivalent time period.

Source: OHID: Public Health Profiles

Source: OHID: Public Health Profiles

The rate of new HIV diagnosis per 100,000 population among people aged 15 years and above was 25.9% compared to 20.9% across London, and 8.7% in England. This year, 70 adult residents were newly diagnosed with HIV. Since 2015, Wandsworth has seen a 34.4% decrease in new HIV diagnoses. The decrease implies the success of a combination HIV prevention which includes condom provision, pre-exposure prophylaxis (PrEP), expanded HIV testing, and prompt initiation of treatment after diagnosis.

In Wandsworth the E-Service during this period had HIV detection rates for over 24 year olds of non-reactive 7,018 (99.7%) and reactive 21 (0.3%) while the numbers of postal test kits sent out by the newly commissioned SH:24 service totalled 26 with 11 being processed. Most of these kits were requested by people in the 25-34 age group (48.39%) and by males (64.34%). 2 reactive results were produced from those kits processed.

The vast majority (79.6%) of newly diagnosed patients with HIV in the borough were put on Antiretroviral treatment (ART) within 91 days of their diagnosis. Successful ART decreases a person’s viral load, significantly reduces the risk of future transmission and transforms HIV from a fatal infection to a chronic but manageable condition. However, between 2016 and 2018, 34.5% HIV diagnoses were made at a late stage of infection (CD4 count =<350 cells/mm 3). Late diagnosis is the most important predictor of HIV-related morbidity and short-term mortality and is a key component of valuating the success of HIV testing efforts.

Contact with Sexual Health Services

In addition to accessing services at the local Integrated Sexual Health, ISH service, borough residents can also choose to access sexual health service anywhere in the country. Latest available service data shows that there has been good and improving access to the variety of sexual health services offered across the borough. In Wandsworth from October 2018 to September 2019 over 55,500 people accessed a sexual health service for the first time (figure below). Access was greater amongst females who represented 59% of attendees ²³.

Source: GUMCAD Extracted Feb 2020