East Sussex county area profile

Introduction

This profile should be used to inform decisions and plans and to identify priorities to improve local people’s health and reduce health inequalities in East Sussex.

The profile identifies needs (which may also be referred to or seen as deficits) as well as assets (which may also be referred to or seen as strengths) from key indicators that have been bench marked against the England average.

Causes of premature mortality and inequalities in life expectancy are also presented.

This profile forms part of the East Sussex Joint Strategic Needs Assessment (JSNA) and draws together data and analysis from East Sussex public health reports and various health profiles produced by Public Health England. It brings together existing data and analysis, from a variety of sources, at Clinical Commissioning Groups (CCGs), Primary Care Networks (PCNs), district/borough councils and East Sussex levels.


Understanding the data

The geographies

This profile contains data for geographies in East Sussex. Most charts, tables and maps present data at both upper tier and lower tier local authority geographies. However, some datasets are only available at other geographies (for example some of the primary care datasets are only available by NHS geographies) and so this information will be presented by those geographies.

Significance testing

Where possible, data has been benchmarked and compared against England, or in some cases specific targets. Where differences are observed and found to be significant, then this will refer to statistical significance at the 95% confidence level. However, it is important to bear in mind that:

  • where values are based on high counts, even small, possibly unimportant, differences may be statistically significant, and
  • where values are based on low counts, even large, possibly important differences may not be statistically significant.

Rates

Where rates are used, some rates may not be age standardised. If crude rates are reported and the condition mainly affects older people, it is important to also take into account the age profile of the population. Where age standardised rates are presented, then this will be noted in the title of the chart/table.


The county

The geography of East Sussex

East Sussex is located on the south east coast of England. It is a two tier local authority, with an upper tier local authority (East Sussex County Council) and five lower tier local authorities (Eastbourne Borough Council, Hastings Borough Council, Lewes District Council, Rother District Council and Wealden District Council) covering a population of approximately 560,000 residents.

East Sussex lies between Kent to the north and east, and Brighton and West Sussex to the west. The most populated areas are along the coast with other inland towns surrounded by more rural areas.  The county includes the iconic Seven Sisters coastline, the South Downs National Park and the High Weald area of Outstanding Natural Beauty. Within Lewes district there is a port at Newhaven with cross channel connections to Dieppe for both commercial and private passengers.

Map 1 shows the county of East Sussex and details the major towns and roads within its boundary

Map 1 East Sussex showing the key towns and major roads

Map of East Sussex showing where all the key towns are located, the district and borough boundaries  and the main road networks.

Rural & urban

Within East Sussex there are 329 Lower Super Output Areas (LSOAs).

Lower Super Output Areas (LSOAs) are small areas designed to be of a similar population size, with an average of approximately 1,500 residents or 650 households in each LSOA. They were produced by the Office for National Statistics (ONS) for the reporting of small area statistics.

The ONS have classified all LSOAs as either Urban, Rural or Fringe. East Sussex has a mixture of urban and rural areas. Map 2 shows the distribution of the rural and urban areas across the county.

Map 2 Urban and rural classification of each LSOA in East Sussex 2011

Map 2 Urban and rural classification of each LSOA in East Sussex, 2011
  • Chart 1 shows that all of the LSOAs in Eastbourne and Hasting are urban. The other districts within the county have a mixture of rural and urban towns and villages, with Rother having over 50% of its towns and villages classified as rural or fringe.

Chart 1 The population who live in urban or rural areas for each district/borough in East Sussex,2011

Health and care sites

Within East Sussex the health and care infrastructure across the county includes:

  • 2 acute hospitals and 5 community hospitals
  • 52 GP practices, 38 Branch practices and 12 primary care networks
  • 102 community pharmacies
  • 305 care homes
  • 30 independent schools, 186 maintained schools and 3 colleges

We have developed an online mapping tool using Tableau which will allow you to select different geographies and health and care settings to create bespoke maps. To access this mapping tool go to the East Sussex Health and Care Tableau Mapping Tool to look at these maps in more detail.

Tableau is a data visualisation tool. For more information about Tableau visit Visualise public data | Explore, learn, share | Tableau Public.

Map 3 An example of the East Sussex Health and Care Tableau Mapping Tool highlighting where the hospitals and pharmacies are across the county

East Sussex Health and Care Tableau Mapping Tool

Map 4 Primary care networks in East Sussex, 2023

Map 4 Primary care networks in East Sussex, 2022

There are 12 Primary Care Networks (PCNs) in East Sussex covering a registered population size of 566,900 (April, 2023). PCNs are groups of GP practices which work together with community, mental health, social care, pharmacy, hospital and voluntary services in their local area. In each PCN there are usually approximately 30,000 to 50,000 patients.

There are no strict geographical boundaries for PCNs as their reach and coverage is based on where each GP’s registered population live. Some patients who live geographically next door to one another may be registered with different GP practices, which in turn may be part of different PCNs, and so there is no obvious geographical border.

However, to show a PCN on a map we have carried out a mapping exercise to try to highlight the geographical areas which contain the majority of patients for each PCN. Map 4 shows the areas where the majority of each PCN’s registered patients live. The different colours on the map represent the different PCN areas. Note that certain PCNs (e.g. ALPS Group) are represented by 2 separate areas on the map. Some areas in East Sussex (mainly on the boarders of the county) show PCNs from outside of East Sussex. This is because the majority of East Sussex residents in those areas are registered with non-East Sussex GP practices, and so belong to non-East Sussex PCNs.


Population demographics

Deprivation

  • East Sussex most deprived areas are mainly in urban coastal areas.
  • Table 1 shows that there is a higher proportion (24%) of younger people (0-19) in the most deprived quintile compared to the other quintiles.
  • The most deprived quintile has the highest percentage of people aged 20-64 and lowest of those aged 65+ compared to the other quintiles.

Map 5 Areas of deprivation in East Sussex showing the LSOAs ranking according to their deprivation quintile, 2019

Map 5 Areas of deprivation in East Sussex showing the LSOAs ranking according to their deprivation quintile, 2019

Age structure

  • East Sussex has an older population structure compared to England, with 2.4% of females aged 85 years or over compared to 1.5% for England.
  • It also has a lower percentage of 20 to 44 year olds (both males and females) than England.

Chart 2 East Sussex population profile (total population 545,846), 2021

East Sussex population pyramid (total population 558,852), 2020

Population for different age groups

  • Map 6 shows the highest percentage of children aged 0-4 are mainly in more urban areas and coastal towns.

Map 6 The percentage of children aged 0 to 4 in East Sussex LSOAs, 2021

Map 6 The percentage of children aged 0 to 4 in East Sussex LSOAs, 2020

  • The urban areas have the highest percentage of people aged 5 to 19 (Map 7). Almost 40% of the LSOAs in Rother have the lowest percentages of people aged 5 to 19.

Map 7 The percentage of people aged 5 to 19 in East Sussex LSOAs, 2021

Map 7 The percentage of people aged 5 to 19 in East Sussex LSOAs, 2020

  • Urban areas in East Sussex have some of the highest percentages of working age people (Map 8).

Map 8 The percentage of people aged 20 to 64 in East Sussex LSOAs, 2021

Map 8 The percentage of people aged 20 to 64 in East Sussex LSOAs, 2020

  • Approximately a third of Rother’s LSOAs are in the highest quintile for those aged 65+.
  • In Eastbourne one fifth of their LSOAs are in the highest quintile.
  • However, in Hastings nearly half of its LSOAs are in the lowest quintile.

Map 9 The percentage of people aged 65+ in East Sussex LSOAs, 2021

Map 9 The percentage of people aged 65+ in East Sussex LSOAs, 2020

Ethnicity

  • Data from the 2021 census shows that East Sussex has a higher percentage (approximately, 88%) of White British and Northern Irish compared to England (approximately, 74%).

  • Chart 3 shows a comparison of all other ethnicities in East Sussex compared to England.

Chart 3 Ethnic groups other than White British or Northern Irish, 2021

Chart 4 Ethnicity and broad age group in East Sussex, 2021

Birth rate

  • There has been a general decline in the live birth rate in East Sussex over the past 5 years (Chart 5), similar to what has been observed in England.

  • East Sussex and most of its districts and boroughs have had lower birth rates (all ages) than England, however Hastings has had higher birth rates than England.

  • In 2020 birth rates in East Sussex were generally lower than England (all ages) but Hastings had a higher birth rate than England and East Sussex (all ages).

Chart 5 Live birth rate (per 1,000 women in the age group) - all ages, 2014-2020

Live birth rate (per 1,000 women in the age group).

Table 2 shows that for women aged 35+ birth rates were generally lower than England for all districts and boroughs apart from Lewes and Rother. All districts and Boroughs had a higher birth rate compared to England in women aged 20-34 years apart from Lewes.

Table 2 Live Birth rate (per 1,000 women in the age group), 2020
Location Under 20 20-24 25-29 30-34 35-39 40 & Over all ages
England 10 45 85 103 60 16 55
East Sussex 10 50 92 104 56 13 53
Eastbourne 15 54 101 107 47 12 54
Hastings 17 68 94 99 50 15 59
Lewes 7 39 88 102 63 13 51
Rother  7 52 90 96 63 15 53
Wealden 6 39 90 110 57 13 51

Population change

  • There is projected to be 18,100 more people living in East Sussex in 2026 compared to 2022 which is a 3% increase.
  • Over 11,000 of the increase will be for people aged 65-84 (9% increase) and nearly 2,000 aged 85+ (8% increase).

Wider determinants of health

Housing

  • Hastings and Eastbourne have the lowest percentage of owner occupied housing, with Hastings also having the highest percentage of socially rented housing.
  • Wealden and Rother have the highest percentage of owner occupied housing.

Chart 6 Dwelling stock by tenure, 2021

  • Chart 7 shows that overcrowding of households was higher for socially rented (15%), than privately rented houses (11%) and owner occupied households (2%).

  • Within East Sussex, Eastbourne had the highest rates of overcrowding.

Chart 7 Overcrowded households in East Sussex by tenure, 2021

Income

  • East Sussex average (median) earnings are similar to that of the average (median) for England.

  • Lewes district has the highest full time (median) earnings (£33,607) while Hastings has the lowest with (£28,667).

Chart 8 Resident-based average (median) full time and part time earnings, 2022

Please note: the data for part-time workers for Eastbourne, Lewes, Rother, and Wealden was unavailable for 2022 so 2021 data was used.

Employment

Rother has the highest percentage of working age people in employment (77%) while the two most urban areas Hastings and Eastbourne have the lowest (72.9% and 74.5%).

Chart 9 Working age (16-64) people in employment, 2020

Education

  • Qualification levels are broadly in line with England.

Chart 10 Qualifications of working age population, 2021

Source: ONS Nomis Annual Population Survey: Qualifications of working age population, 2021. 

The data shown in Chart 10 shows the percentage of people who have “up to” a specific qualification level. For example, 10% of people in England are qualified up to level 1 only, 17% are qualified up to level 2 only, 19 % are qualified up to level 3 only, etc.

The different levels of qualifications are defined as:

  • Level 1: 1+ O level passes, 1+ CSE/GCSE any grades, NVQ level 1, Foundation GNVQ.
  • Level 2: 5+ O level passes, 5+ CSEs (grade 1's), 5+ GCSEs (grades A-C), School Certificate, 1+ A levels/AS levels, NVQ level 2, Intermediate GNVQ.
  • Level 3: 2+ A levels, 4+ AS levels, Higher School Certificate, NVQ level 3, Advanced GNVQ, ONC, OND, BTEC National etc.
  • Level 4 and above: First degree, Higher degree, NVQ levels 4 and 5, HNC, HND, Professional qualifications (for example teaching, nursing, accountancy).
  • Other qualifications: Vocational/Work-related Qualifications, Foreign Qualifications, includes any qualifications not mentioned above.

Crime

  • Hastings has higher rates of total crime (excluding fraud) and violence against the person compared to the average for England.
  • East Sussex has a lower rate for both of these indicators, compared with England.

Chart 11 Total recorded crime and violence against the person, 2022

Loneliness & isolation

  • Those who answered the survey question saying they ‘often or some of the time felt lonely living in your local area’ were slightly higher in Hastings and Eastbourne compared to the other areas.
  • The response to this question across all areas when looking at how people answered the survey in previous years is broadly the same with no discernible trend.

Chart 12 Community Survey – Responses to the question “do you ever feel lonely living in your local area?", 2015 - 2019

Environment

  • Domestic carbon dioxide (CO2) emissions were the largest of the three sectors in 2005 but these emissions have fallen by 41% in 2020.

  • The industrial and commercial sector emissions have continued to fall with a 58% decrease in 2020 compared to 2005.

  • The transport sector of CO2 emissions has had a reduction over the period with a decline of 29% which is the least compared to the other sectors.

Chart 13 CO2 Emissions by sector 2005 - 2020 in East Sussex

  • The reduction of CO2 has been consistent across all districts and boroughs through the years 2005-2020 with a 50% reduction for East Sussex.

Chart 14 Emissions of carbon dioxide per person in East Sussex by district and borough, 2005-2020.

Access to healthy spaces

Natural England have produced an online map that shows where all the green spaces are within the UK. To access the tool go to Natural England’s Green Infrastructure Map. The mapping tool provides many different layers that can be selected in order to provide a map view of resources of the local area.

Map 10 shows the green and blue spaces in East Sussex, produced using the mapping tool.

Map 10 An extract from Natural England’s mapping tool showing some of the green & blue infrastructure areas in East Sussex

Blue spaces are outdoor environments, either natural or built, that prominently feature water such as streams, ponds, canals and other water bodies.


Life expectancy

Life expectancy

  • Life Expectancy (LE) at birth is higher at an East Sussex level compared to England and higher for females than males. LE was increasing in East Sussex up to around 2012-2014 when it began to plateau. The latest data (2018-2020) estimates that life expectancy for females in East Sussex is 84.1 years and for males 80.4 years.
  • At a lower tier level, for males in 2018-2020 it ranges from 78.0 years in Hastings to 81.6 years in Wealden. For females is ranges from 81.8 in Hastings to 85.0 in Wealden.
  • For females, all district and boroughs except Hastings have a higher LE than nationally. This is also generally the case for males although in recent years (and also around 2008-2012) LE for males in Eastbourne has dropped below the England rate.
  • There was a noticeable drop in LE for males in Hastings from 2012-14 to 2015-17.
  • At an East Sussex level, in 2018-2020 LE fell very slightly in males but increased in females compared to the previous period (2017-2019). This is different to the England picture where a more noticeable drop can be seen for the latest period.
  • At a small area level (MSOA, latest data 2015-2019) Crowborough North East has the highest LE for both males (85.3 years) and females (88.8 years). For males it is lowest in Pier (73.7 years) and for females it is lowest in Central St Leonards (79.1 years). At a MSOA-level this means the gap is 11.6 years for males and 9.7 years for females.

Chart 15 Life expectancy between 2001 to 2003 and 2018 to 2020, East Sussex and England

Chart 16 Life expectancy for males: between 2001 to 2003 and 2018 to 2020 by district and borough

Chart 17 Life expectancy for females: between 2001 to 2003 and 2018 to 2020 by district and borough

Middle Layer Super Output Areas (MSOAs) are a geographic hierarchy designed to improve the reporting of small area statistics in England and Wales. MSOAs are built from groups of LSOAs. In East Sussex there are 69 MSOAs, each containing on average 8,000 residents.

Map 11 Life expectancy for males, MSOAs 2015-2019

Map showing Life expectancy for males, MSOAs 2015-2019

Map 12 Life expectancy for females, MSOAs 2015-2019

Map of East Sussex showing Life expectancy for females, MSOAs 2015-2019

Gap in life expectancy

  • Circulatory conditions contribute the most to the gap in LE between the most and least deprived areas in East Sussex (27-28%). This is followed by cancer and then respiratory conditions, with these 3 disease groups together contributing to around two-thirds of the gap for males and three-quarters of the gap for females.
  • External causes contribute to the gap more for males than females.

Chart 18 Breakdown of the LE gap (within area) between most and least deprived areas in East Sussex, 2017-2019

Healthy life expectancy

  • In the latest time period (2018-2020) healthy life expectancy for males (63.1 years) is the same as for England. However, for females in East Sussex (63.3) it is lower than nationally (63.9) but has increased from a drop in 2017-19 which was the lowest it had been in the last 10 years.

Chart 19 Healthy Life Expectancy at birth, East Sussex and England, between 2009 to 2011 and 2018 to 2020

Leading causes of death

  • Across all ages dementia is the leading cause of death in East Sussex followed by ischaemic heart disease and then stroke.

  • From a premature mortality perspective (deaths in the under 75s), the leading cause of death is ischaemic heart disease followed by lung cancer and then chronic lower respiratory diseases.

Table 5 All ages, leading cause of death (numbers of deaths shown, with cancers broken down), 2022

Table 6 Under 75s, leading cause of death (numbers of deaths shown, with cancers broken down), 2022

Premature mortality (deaths under 75s)

  • Premature mortality is highest in Hastings and Lowest in Wealden.

  • All areas had a decrease in premature mortality in 2022 compared to the previous year.

  • Premature mortality is highest in the most deprived quintile.

  • All quintiles saw a reduction in premature mortality in 2022 compared to the previous year. For quintiles 1, 2 and 4 this decrease was significantly different from the previous year.

Chart 20 Premature mortality (under 75s) from all causes, by district and borough, 2019 – 2022

Chart 20 Premature mortality (under 75s) from all causes, by district and borough, 2019 – 2021

Chart 21 Premature mortality (under 75s) from all causes, rates by national deprivation quintile, 2019 - 2022

Chart 21 Premature mortality (under 75s) from all causes, rates by national deprivation quintile, 2019 - 2021


Disease & poor health

Disability

  • In the 2011 Census East Sussex had 107,145 people with a Limited long-term illness. This is projected to increase to 146,482 an increase of 37% by 2034.
  • The projected overall disability in 2019 was 95,621. This is projected to increase to 121,273 an increase of 27%.
  • These increases are across all district and boroughs, the projections suggest that Wealden will have the highest increases both in terms of numbers and percentage.
  • The highest number of Disability Living Allowance (DLA) and Personal Independence Payments (PIP) are in Hastings and Eastbourne, which have higher levels of deprivation compared to the other areas.

Please note: Disability living allowance (DLA) & Personal Independence Payments (PIP) - all claimants, May 2021.

Table 7 Data on disability for 2020 and the projected numbers for 2035
Illness / Disability East Sussex Eastbourne Hastings Lewes Rother  Wealden
Limited Long-Term illness - 2021 110,553 21,919 20,525 20,342 20,138 27,629
Projected LLTI - 2020 118,510 22,906 21,434 21,084 22,481 30,604
Projected LLTI - 2035 147,795 27,019 25,048 26,073 28,057 41,598
Projected overall disability - 2020 96,597 18,697 17,398 17,184 18,436 24,881
Projected overall disability - 2035 122,427 22,462 20,698 21,578 23,360 34,330
Disability Living Allowance (DLA) and Personal Independence Payments (PIP) (All claimants, August 2022) 35,227 7,682 8,213 6,122 6,020 7,196

Source: East Sussex in Figures. Limited Long-Term illness – 2011 ; Projected LLTI ; Projected overall disability ; Disability Living Allowance (DLA) and Personal Independence Payments (PIP)

Quality & outcomes framework

Table 8 shows extracts from the Quality and Outcomes Framework (QOF) for 2022, 2023. 

Data within the QOF is not aged standardised and so some areas of high or low prevalence may in some part be a result of the age demographics of the area. It is important to understand more about the demography when interpreting this data. Public Health England have produced some National General Practice area profiles for PCNs, which include a “Data View” of the population.

This data can be access via PHEs National General Practice Profiles online Fingertips tool

  • In Table 8 Bexhill and Seaford PCNs, have significantly higher prevalence's across most conditions. This is likely to reflect the older age profiles in their populations

Table 8 GP reported disease prevalence for each Primary Care Network in East Sussex, 2022, 2023

Table 8 GP reported disease prevalence for each Primary Care Network in East Sussex, 2019/20

View table 8 as a larger table pdf 106kb

To see what geographical footprints the Primary Care Networks cover see Map 4 in the “Primary Care Network” section of this document.

Obesity

  • East Sussex has a lower percentage of children with excess weight compared to England and is significantly better than England for those aged 10-11 years.

  • East Sussex and most districts and boroughs have a significantly lower percentage of children aged 10-11 years with excess weight, however Hastings has a similar percentage compared to England.

  • East Sussex and most districts and boroughs have similar percentages of overweight or obese adults compared to England, but Wealden is significantly worse than England.

Table 9 Excess weight and obesity in young people and adults, 2019 - 2022

Table 9 Excess weight and obesity in young people and adults, 2017 - 2020


Health related behaviours

Smoking

  • East Sussex has a significantly better smoking prevalence compared to England. Within the county, Hastings as a significantly worse, and Wealden has a significantly better smoking prevalence compared to England.

  • East Sussex has a significantly worse percentage of women smoking at the time of delivery compared to England.

  • East Sussex has a significantly better smoking quit rates at four weeks compared to England.

Table 11 Smoking prevalence and quit rates, 2019 - 2021

Table 11 Smoking prevalence and quit rates, 2019 - 2021

Alcohol

  • East Sussex has a similar alcohol related admissions compared to England, except for those relating to women, which are significantly worse for East Sussex and most districts and boroughs (except Lewes which is significantly better and Wealden which is similar).

  • Hastings and Eastbourne have significantly worse rates of alcohol-related admissions, and Hastings also has higher rates of alcohol-specific mortality (though not significantly) compared to England.

Table 12 Alcohol, 2017 - 2022

Table 12 Alcohol, 2017 - 2020

Physical activity & healthy eating

  • East Sussex is significantly better for the percentages of physically active adults and those meeting the recommended "5 a day", compared to England. Most districts and boroughs are also higher, or similar compared to England, except Hastings which is significantly worse for the proportion of the population meeting their recommended "5 a day".

Table 13 Physical activity and healthy eating, 2019 - 2022

Table 13 Physical activity and healthy eating, 2019 - 2021

No Data: Value missing due to small sample size

Sexual health

  • New STI diagnoses (which exclude chlamydia in under 25 year olds) in East Sussex are significantly better than England.

  • Compared to England, the chlamydia detection rates in people aged 15 to 24 years is significantly worse for East Sussex. 

  • Compared to a target goal, East Sussex has a significantly better HIV diagnosis prevalence rate per 1,000.

Table 14 Sexual health, 2020 -2022

Table 14 Sexual health, 2020

Drug & Alcohol treatment

  • Eastbourne and Hastings have significantly higher rates of adults in drug and/or alcohol treatment and for young people in drug or alcohol treatment, and Rother and Wealden have significantly lower rates.

Table 15 Drug and alcohol treatment, 2020 - 2022

Screening & immunisation

  • Data for childhood immunisation is only presented at East Sussex County level. For all childhood immunisations East Sussex is below the 95% goal for vaccination and significantly below the goal for DTap and IPV booster in 5 year olds.

  • A significantly higher percentage of 65+ year olds received their seasonal flu vaccination in East Sussex compared to the 75% goal for vaccination cover.

Table 16a Immunisations, 2019 - 2022

Table 16 Screening and immunisations, 2019 - 2021

Table 16b Screening, 2021-2022

Table 16 Screening and immunisations, 2019 - 2021

View table 16b as a larger table

  • East Sussex Sub ICS has significantly lower eligible 50-64 year olds screened for cervical cancer compared to England. Bexhill and Hastings and St Leonards PCN were also significantly lower and the Hastings and St Leonards PCN has the lowest of all East Sussex PCNs.
  • Victora PCN has a significantly lower percentage of 50-70 year olds screened for breast cancer and is the lowest PCN in the whole of East Sussex.

Health & social care services

Maternity

  • East Sussex is significantly better for the percentage of mothers breastfeeding at 6-8 weeks, compared to England.
  • Deliveries to teenage mothers are similar or significantly better for East Sussex and all district and boroughs, except for Hastings which are significantly worse than England.

Table 17 Pregnancy and birth, 2017 - 2021

Table 17 Pregnancy and birth, 2017 - 2021

Hospital attendance

  • As the main provider of acute services in East Sussex, East Sussex Healthcare Trust (ESHT) provide at least half of all emergency and elective admissions, A&E and outpatient attendances for East Sussex residents. They are the main provider of services to residents in Eastbourne, Hastings and Rother.
  • University Hospitals Sussex NHS Foundation Trust are the main providers of services for Lewes district residents.
  • Residents in Wealden do use ESHT the most, but also are more likely than the rest of East Sussex to use Maidstone and Tunbridge Wells NHS (MTW)Trust as well as elsewhere.
Table 18 Emergency admissions by hospital Trust admitted to, 2022/23
NHS Trust East Sussex Eastbourne Hastings Lewes Rother Wealden
East Sussex Healthcare Trust 70% 93% 94% 26% 87% 52%
University Hospitals Sussex  15% 3% 2% 69% 2% 13%
Maidstone and Tunbridge Wells 10% 0% 1% 0% 7% 29%
Elsewhere 4% 4% 3% 4% 4% 6%
 Percent Total 100% 100% 100% 100% 100% 100%
Table 19 Elective admissions by hospital Trust admitted to, 2022/23
NHS Trust East Sussex Eastbourne Hastings Lewes Rother Wealden
East Sussex Healthcare Trust 59% 82% 84% 20% 79% 46%
University Hospitals Sussex  19% 6% 5% 63% 4% 14%
Maidstone and Tunbridge Wells 5% 0% 0% 0% 4% 15%
Elsewhere 17% 12% 11% 17% 13% 24%
 Percent total 100% 100% 100% 100% 100% 100%
Table 20 First outpatient attendances, 2022/23
NHS Trust East Sussex Eastbourne Hastings Lewes Rother Wealden
East Sussex Healthcare Trust 60% 82% 89% 20% 82% 44%
University Hospitals Sussex  16% 4% 3% 61% 3% 10%
Maidstone and Tunbridge Wells 8% 0% 0% 0% 5% 22%
Elsewhere 16% 14% 8% 19% 10% 23%
 Percent total 100% 100% 100% 100% 100% 100%
Table 21 A&E attendances, 2022/23
NHS Trust East Sussex Eastbourne Hastings Lewes Rother Wealden
East Sussex Healthcare Trust 61% 94% 96% 14% 87% 40%
University Hospitals Sussex  15% 2% 1% 52% 1% 11%
Sussex Community Foundation Trust 15% 1% 0% 31% 2% 28%
Elsewhere 9% 2% 2% 2% 9% 21%
 Percent total 100% 100% 100% 100% 100% 100%

Hospital activity

  • Over the last 12 years Wealden district has had the highest numbers of emergency and elective admissions as well as outpatient attendances.
  • Numbers of elective admissions are lowest in Hastings and numbers of emergency admissions are lowest in Lewes.
  • Numbers of A&E attendances (which includes attendances at Urgent Treatment Centres and Minor Injury Units) are highest in Wealden and lowest in Rother.

Chart 26 Number of emergency admissions, 12-year trends, for East Sussex districts/boroughs, 2011/12 – 2022/23

Chart 27 Number of elective admissions, 12-year trend for East Sussex districts/boroughs, 2011/12 – 2022/23

Chart 28 Number of first outpatient attendances, 12-year trend for East Sussex districts/boroughs, 2011/12 – 2022/23

Chart 29 Number of A&E attendances, East Sussex districts/boroughs, 2018/19 - 2022/23

Hospital activity - age specific rates & by deprivation

  • In terms of children and young people, rates of emergency admissions and outpatient and A&E attendances are highest in the under 5s and then drop for 5-9 years olds who tend to have the lowest rates across all age bands.
  • Rates are highest across all activity types in older people. For electives and outpatient attendances rates begin to decrease round the age of 80 years, which is generally not the case for urgent care.

Chart 30 Age-specific rates of emergency admissions, 2022/23

Chart 31 Age-specific rates of elective admissions, 2022/23

Chart 32 Age-specific rates of first outpatient attendances, 2022/23

Chart 33 Age-specific rates of A&E attendances, 2022/23

  • There is a clear association of higher emergency admissions with increasing levels of deprivation and a widening of the gap in admission rates between the most and least deprived areas. Historically this was the case with elective admissions and outpatient attendances, although in more recent years this has not necessarily been the case and in 2022/23 all areas experienced similar rates.
  • A&E attendance rates are highest in the most derived quintile followed by the second most deprived quintile, with the rest of East Sussex experiencing similar rates.

Chart 34 Age-standardised rates of emergency admissions by deprivation, 2011/12 – 2022/23

Chart 35 Age-standardised rates of elective admissions by deprivation, 2011/12 – 2022/23


Chart 36 Age-standardised rates of 1st outpatient attendances by deprivation, 2012/13 – 2022/23


Chart 37 Age-standardised rates of A&E attendances by deprivation, 2018/19 – 2022/23

Leading cause of admissions

  • There are differences in the main causes of emergency admissions by age group.
  • Respiratory conditions are the leading cause of emergency admissions in under 5s followed by infectious and parasitic diseases.
  • In children and young people aged 5-19 years and adults the leading cause of emergency admissions is signs, symptoms and abnormal clinical/laboratory findings.  
Table 22 East Sussex, 0-4 year olds (top 5 causes account for 80% of emergency admissions 2022, 2023)
Top 5 disease/injury causes of emergency admissions Number Percentage
Diseases of the respiratory system 1498 33%
Certain infectious and parasitic diseases 835 19%
Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified 688 15%
Injury, poisoning and certain other consequences of external causes 287 6%
Certain conditions originating in the perinatal period 272 6%
Total emergency admissions for all causes 4489  
Table 23 East Sussex, 5-19 year olds (top 5 causes account for 74% of emergency admissions 2022, 2023)
Top 5 disease/injury causes of emergency admissions Number Percentage
Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified 1097 24%
Injury, poisoning and certain other consequences of external causes 977 22%
Diseases of the respiratory system 595 13%
Certain infectious and parasitic diseases 359 8%
Diseases of the digestive system 322 7%
Total emergency admissions for all causes 4517  
Table 24 East Sussex, 20-64 year olds (top 5 causes account for 64% of emergency admissions 2022, 2023)
Top 5 disease/injury causes of emergency admissions Number Percentage
Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified 4661 22%
Injury, poisoning and certain other consequences of external causes 2873 13%
Diseases of the digestive system 2803 13%
Diseases of the respiratory system 1856 9%
Diseases of the circulatory system 1574 7%
Total emergency admissions for all causes 21419  
Table 25 East Sussex, 65+ year olds (top 5 causes account for 67% of emergency admissions 2022, 2023)
Top 5 disease/injury causes of emergency admissions Number Percentage
Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified 5496 17%
Injury, poisoning and certain other consequences of external causes 4933 15%
Diseases of the circulatory system 4836 15%
Diseases of the respiratory system 3811 12%
Diseases of the digestive system 2890 9%
Total emergency admissions for all causes 32845  

Adult social care caseload

  • Hastings has the highest number of new contacts with Adult Social Care for both adults (18-64) and older people (65+) age groups.

  • Wealden district have the lowest rates.

Chart 38 - Total number of new contacts as a rate per 100,000, 2021/22

  • All areas for older people (65+) have a similar percentage of those 'new care' contacts progressing to a Social Care Assessment.

  • Hastings has the highest (21%) progressing to a Social Care Assessment for adults.

Chart 39 - 'New care' contacts from the community that have progressed to a Social Care Assessment, 2021/22

  • All areas have a similar percentage of Social Care Assessment that resulted in Support Plans except Hastings which has the lowest (78%).
  • Rother has the highest percentage for adults.

Chart 40 - Social Care Assessment that resulted in Support Plans, 2021/22

  • Wealden had the lowest rate of people with a least one activity in a 12-month period.

Chart 41 – Number of people with at least one activity in a 12-month period as a rate per 100,000 population, 2021/22

Activity relates to contacts, assessments, reviews, appearance of needs tools, other statutory work, and safeguarding episodes.

Note: East Sussex data also includes clients that were unable to be allocated to a specific district/borough.

  • Hastings has the highest rate of persons receiving Long Term Support during 2021-22 for both adults and older people.

Chart 42 – Persons receiving Long Term Support rate per 1,000 population, 2021/22

CSC caseload / Looked after children

  • Hastings has the highest rate of looked after children and child protection plans but only has the second highest referrals to Children’s social care with Eastbourne having the highest with 53 per 1,000 children with Hastings having 47 per 1,000 children.

Chart 43 Children's social care - Locked after Children, Child Protection plans rate per 1,000 as at 31st March 2023 and referrals, 2022/23