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Intro:\ud This report adds qualitative understanding to an earlier report of health and social data for Maryport (Maryport – A left behind community? Health and Social Data Dive).\ud Methods:\ud Qualitative interviews with residents (n=8) and stakeholders (n=7) undertaken from November 2020 to May 2021\ud Findings:\ud This report has focussed on access to resources and services for people living in Maryport; it has shown Maryport to be an underserved community and revealed a range of interconnected challenges relating to education, employment, and connectivity. Many of the points raised by informants resonate with the findings in the CMO’s annual report (DHSC, 2021 ) and the OCSI’s work on ‘Left behind communities’ (2019). \ud Conclusions:\ud Maryport can be seen as a typical, left behind, coastal town. Furthermore, the difficulties faced by Maryport residents can be conceptualised as the wider determinants of their health.

Intro:\ud The purpose of this report is to present a ‘Deep Dive’ of publicly available health and social data for the town of Maryport. The OCSI (2019) report on left behind communities was used to guide the analysis.\ud Methods:\ud Presentation of health and social data for the town of Maryport accessed via a range of public data sources.\ud Findings:\ud The data examined suggests that Maryport faces numerous socio-economic challenges. Such challenges relate to Income, employment, health, education and training as well as connectedness to key services and civic, educational and cultural assets – ‘facilities that provide things to do often, at no or little cost’ (OCSI, 2019). Moreover, the Index of Multiple Deprivation (table 56 above) places six of the seven Maryport LSOAs within the 40% most deprived in England; this indicates that Maryport residents are generally lacking access to the resources required to meet their needs; resources that are perceived as customary to the rest of society. These challenges are most pressing for the neighbourhoods covered by the adjacent LSOAs Allerdale 005A (Ellenborough: South) and Allerdale 005B (Ewanrigg: North), and the MSOA Allerdale 005.\ud Conclusions:\ud Despite there being no Maryport wards identified as ‘left behind’ by OCSI (2019) this is largely due to the configuration of ward boundaries there wherein the two most deprived LSOAs are allocated to different wards. Had this not been the case, and had a ward been constituted that included both Allerdale 005A and 005B, then that ward would certainly have been identified as Left Behind.

Intro:\ud A presentation of data from the Indices of Deprivation for the North Cumbria Area\ud Methods:\ud Secondary analysis of the Indices of Deprivation\ud Findings:\ud Examination of higher-level data (i.e. county and district) illustrated how analyses across larger areas can obscure the existence of deprivation at the local level. As such, data for Cumbria County Council suggests it to be a relatively comfortable area with only moderate levels of deprivation. Analysis of lower-level (LSOA) data revealed a range of deprivation levels in North Cumbria and suggested some polarisation between and within LSOAs. This was apparent on the main domains for income and employment. Two domains stood out from the others due to the distribution of rankings being skewed towards most deprived; these are the domains for education, training and skills, and health deprivation and disability.\ud Conclusions:\ud The Indices of Deprivation reveal concentrations of deprivation in North Cumbria. However, more localised, pocket deprivation is remains hidden due geographically large and polarised LSOAs.

Antenatal care involves the screening, diagnosis and monitoring of the “at-risk” fetus using ultrasound. When a problem is detected by an ultra-sonographer (e.g. a fetal anomaly or small sized baby), the mother is referred to a local specialist or the regional FM centre in Newcastle for confirmation of the diagnosis, counselling and management. At present, three consultant-led maternity units in Cumbria refer FM cases to Newcastle. This means that patients travel for 6 hours at their own expense. Telemedicine could help in reducing travel and improving access to consultants. This new service is aimed at establishing a videoconferencing infrastructure between the obstetric ultrasound department at West Cumberland Hospital and the Fetal Medicine (FM) centre in Newcastle. It is currently in its implementation stage.

Teleswallowing:-\ud • Is an innovation designed by Blackpool Speech and Language Therapy Department to enable remote swallowing assessment of dysphagic patients resident in nursing homes\ud • It is a response to the growing demand on Speech and Language Therapy departments for swallowing assessments\ud • Was initially piloted in three nursing homes between August 2013 and March 2014, and was evaluated as successful in April 2014\ud • Was expanded to five further nursing homes in October 2014 to test findings on a larger scale and to enrich the clinical case for service transformation.