Annual Mid-year Population Estimates for Health Geographies: Mid-2012

• Clinical commissioning groups (CCGs) are responsible for deciding how NHS funds are spent in their local area and replaced primary care organisations (PCOs) in April 2013

• CCG areas exist only in England and are formed from groups of lower layer Super Output Areas (LSOAs)

• There are 211 CCGs in England with a median population size of 221,000 in mid-2012

• Population size ranges from 63,100 in NHS Corby to 869,400 in NHS North, East, West Devon

• Eight of the ten CCGs with the largest population increases in the year to mid-2012 are in London

• In mid-2012 the lowest median age in a CCG was 27.0 in NHS Bradford City. The highest median age in mid-2012 was 49.5 in NHS North Norfolk

• CCG population estimates are of particular interest to the Department of Health, NHS organisations and researchers

This bulletin presents the 2012 mid-year population estimates for the clinical commissioning groups (CCGs) in England. The Health and Social Care Act 2012 introduced a new structure for NHS organisation which replaced primary care organisations (PCOs) with CCGs from 1 April 2013. This bulletin also describes population estimates for the former PCO areas.

CCG areas are formed from groups of lower layer Super Output Areas (LSOAs), which are a level of geography designed specifically for the reporting of small area statistics. CCG population estimates for mid-2012 are therefore formed by directly aggregating mid-2012 LSOA estimates, which are rolled forward from mid-2011 to mid-2012 using a ratio change methodology. CCG estimates are a new product and are part of a wider suite of small area population estimates.

In general, small area population estimates are used by both central government departments and local authorities for a range of purposes including planning and monitoring of services; as denominators for the calculation of various rates and indicators and as a base for population projections and forecasts. Additionally, CCG population estimates are of particular interest to the Department of Health and NHS organisations.

Mid-year population estimates for 2012 for England, including estimates for regions and local authorities within England were published on 26 June 2013. The estimates refer to the usually resident population as at 30 June of the reference year and are published annually.

Mid-year population estimates for clinical commissioning groups (CCGs) within England also refer to the usually resident population as at 30 June of the reference year. These are the second CCG population estimates to be published (estimates for mid-2011 were published in August 2013) and are initially being made available as experimental statistics. Further publications will be annual, approximately three months after the publication of national, regional and local authority level estimates.

There are 211 CCGs within England whose function is to commission healthcare services for their communities. CCGs are the lowest level of the new health administration system in England, reporting to 25 NHS area teams which themselves form four commissioning regions.

Small area population estimates

These CCG estimates for mid-2012 have been published in response to user demand for statistics for the new health geographies for England introduced in April 2013. They are published as part of the suite of small area population estimates for England and Wales, which are produced annually, usually approximately three months after the publication of the national, regional and local authority level estimates.

There are two main types of small area population estimates:

• Super Output Area (SOA) estimates – National Statistics including estimates for middle and lower layer SOAs. Mid-2012 estimates for SOAs were published on 17 October 2013

• Estimates for other geographies – Experimental Statistics including estimates for parliamentary constituencies and wards. Mid-2012 estimates for wards and parliamentary constituencies are provisionally due to be published in November/December 2013

The mid-2012 CCG population estimates, referred to in this bulletin, are aggregations of mid-2012 lower layer Super Output Area (LSOA) estimates. LSOAs were rolled forward from mid-2011 to mid-2012 using a ratio change methodology and are consistent with population estimates for higher levels of geography including local authorities and the national total for England.

Clinical commissioning group (CCG) population estimates are produced using lower level Super Output Areas (LSOAs) as building blocks. The population of each CCG is the sum of the population of the LSOAs which fall within the geographic boundaries of the area.

Mid-2012 population estimates for LSOAs were published 17 October 2013. Full descriptions of the methods used to calculate mid-2012 small area population estimates are available from the ONS website.

For further information on the quality and use of these statistics, please see the Quality and Methodology Information for Small Area Population Estimates.

Clinical commissioning groups (CCGs) are responsible for deciding how NHS funds are spent in their local area and replace primary care organisations (PCOs) as the lowest level of health geography in England. There are 211 CCGs and the current boundaries were introduced in April 2013. They are formed from groups of lower layer Super Output Areas (LSOAs) as defined for the 2011 Census.

At mid-2012, the median population of CCGs was 221,000 with population sizes ranging from 63,100 in NHS Corby to 869,400 in NHS North, East, West Devon.

Figure 1 above shows the distribution of CCGs by total population size. The majority (72%) of the CCGs have populations of between 100,000 and 300,000. The 10 CCGs with the largest populations (in table 1 below) are either county areas or inner city areas outside London and are also the 10 CCGs formed from the largest number of LSOAs.

Table 2 shows the 10 CCGs with the smallest populations. These are also the 10 CCGs formed from the smallest number of LSOAs.

Annual population change

In mid-2012 the population of England was 53,493,700, an increase of 386,600 (0.7%) since mid-2011.

Table 3 shows the 10 CCGs with the largest percentage increases in population, eight of which are in London. The CCG with largest percentage increase in population between mid-2011 and mid-2012 was NHS Tower Hamlets at 2.7%.

In total, 14 CCGs (7%) had a population decrease between mid-2011 and mid-2012, with the greatest percentage decrease in population being 1.4% in NHS Hammersmith and Fulham. The decreases in the remaining CCGs were all less than 0.7%.

The age distribution of the resident population in a clinical commissioning group (CCG) is likely to impact on both the overall level of demand for health services, and the type of health services required.

The median age of the population of England in mid-2012 was 39.5 years of age. However, the median age of populations in CCGs varies between different areas.

Map 1: Distribution of clinical commissioning groups by median age, mid-2012

In mid-2012 the lowest median age in a CCG was 27.0 in NHS Bradford City. The highest median age in mid-2012 was 49.5 in NHS North Norfolk. Table 4 below shows the 10 CCGs with the lowest median age in mid-2012.

The CCGs with the lowest median ages are city areas. All 10 CCGs with the highest median age, as shown in table 5 below, include coastal areas of England which are known for their large populations of people of retirement age.

The percentage of the population who are older may also impact on requirements for health service provision. In mid-2012, 7.9% of the population of England were aged 75 or over. By comparison over 13% of the population in NHS Eastbourne, Hailsham and Seaford were aged 75 or over, as shown in table 6 below.

The percentage of the population who are children may also impact on requirements for health service provision. In mid-2012, 18.9% of the population of England were aged 0 to 15. By comparison, 28% of the population in NHS Bradford City CCG were aged 0 to 15, as shown in table 7 below.

Similarly to the areas with the lowest median ages, the CCGs with the largest proportions of children are in city areas.

The four NHS commissioning regions are North of England, Midlands and East of England, London, and South of England. These are the highest layer of health geography in England.

NHS area teams are the middle-layer of health geography for England. There are 25 in total, across the four commissioning regions. The London NHS area team is distinct in that it covers the same area as the London commissioning region, being the sole area team within that region. Therefore it is the NHS area team with the largest population; 8,308,400 compared to the median population of 1,744,200 across all NHS area teams. The NHS area teams are all formed from whole clinical commissioning groups (CCGs).

From 1 April 2013, primary care organisations (PCOs) were replaced with CCGs as the lowest level of health geography in England. For comparison and analysis purposes and in response to user requirements, mid-2012 estimates for PCO areas have been produced and published alongside mid-2012 CCG estimates.

• There are 151 former PCO areas. In mid-2012, the median population size of former PCOs was 292,600

• The population sizes, in mid-2012, of former PCOs ranged from 92,200 in Hartlepool to 1,330,200 in Hampshire, a greater population range than for CCGs

The constituent countries of the UK have different arrangements for the management of their health services and therefore population statistics are produced for health geographies that are relevant to each individual country.

Population estimates for the seven Welsh Local Health Boards, which consist of one or more unitary authorities, are created using a cohort component based method and published on the Welsh Government website. The estimates for mid-2012 were published on 10 October 2013.

National Records of Scotland (NRS) produce population estimates for Scottish NHS Boards. NRS use a cohort component based method to produce estimates for the 14 NHS Board areas in Scotland. Further information on this methodology and the mid-2012 estimates are available on their website.

The Northern Ireland Statistics and Research Agency (NISRA) publish population estimates for the Health and Social Services Board and the five Health and Social Care Trusts in Northern Ireland. These are also produced using a cohort component based method. Further information on this methodology and the mid-2012 estimates can be found on the NISRA website.

The list below shows the other small area population estimates products which are planned for publication in 2013. The majority of the dates given below are provisional. Final confirmed dates will be available on the UK National Statistics Publication Hub release calendar at least four weeks before publication.

• Small area population estimates for wards and parliamentary constituencies, mid-2012: November/December 2013

• Super Output Area (SOA) population estimates, mid-2002 to mid-2010 revised: November/December 2013

• Small area population estimates for wards and parliamentary constituencies, mid-2002 to mid-2010 revised: November/December 2013

Further research work on small area population is planned to be completed following the publication of the products listed above. This is likely to include:

• Detailed assessment of the difference between 2011 Census SOA population estimates and the estimates for mid-2011 based on the 2001 Census

• Review of the methods used to produce small area population estimates in the light of the results of the 2011 Census