1: Boundaries and Populations

Contacts

Preface

Contents

List of Tables
List of Figures

Abbreviations

Main Body

1: Boundaries and Populations
2: Inequalities and Deprivation
3: Ethnicity and Health
4: Environmental Hazards
5: Health related behaviour
    of young people
6: Accidents
7: Cancer
8: Teeth and fluoridation
9: Coronary Heart Disease
10: Communicable diseases

Appendices

1.1    Health Authorities and Local Authorities In The West Midlands

The maps in this section act as reference material for information presented in the following chapters.

Figure 1.1 Health Authorities in the West Midlands

Figure 1.2 West Midlands Local Authorities

1.2    The Geography of Primary Care Groups (PCGs) in the West Midlands

Defining a resident population for PCGs.

Primary Care Groups are based around natural geographical communities of around 100,000 population. Within the area covered by the NHS Executive West Midlands Regional Office there are 61 PCGs with vastly varying list sizes. By mapping primary care groups by practices (Figures 1.3 and 1.4) it is possible to visualise the general area each PCG covers in terms of where the bulk of its responsible population lives. As with individual practices, a PCG's responsible population will be spread over a wide area with total catchment areas overlapping to form a complex pattern of patient flows. This causes difficulties when defining boundaries to represent PCGs by discrete areas. Fixing PCGs by a measurable area is needed for the purposes of allocating unregistered patients to PCGs, mapping health and social indicators and analysing information not linked to GP codes and therefore not directly attributable to a PCG.

The Geographic Information System (GIS) Service based in the West Midlands Cancer Intelligence Unit has been used to collate PCG boundaries from around the West Midlands Regional Office area in an attempt to produce a regional picture. In many cases, defining PCG boundaries has been a difficult task. The PCG boundaries displayed in Figure 1.5 are all developed from the aggregation of existing administrative areas (usually wards). Population figures from the 1991 census have also been aggregated to provide denominator data for PCGs. The differences in PCG boundary construction is due to the variety of methods used by Health Authorities and reflect the huge variation in list sizes and geographical areas.

The purpose of the PCG maps in this publication is to inform PCGs, Health Authorities and other interested parties of the regional configuration. Also by defining boundaries by aggregation of known areas, resident populations can be calculated and used as denominators for information provision and health needs assessment. As the PCGs move towards Primary Care Trusts and the Governments Information Strategy for the NHS is realised, the need for accurate PCG definition and information provision will become

The GIS Service is fully aware of the inadequacies and problems associated with defining discrete boundaries for PCGs, but would argue that until health information is integrated (Electronic Patient Record), a pragmatic approach must be taken when dealing with PCG populations. Defining PCGs by a resident population has provided an important means of displaying data (e.g. cancer incidence), that would otherwise not be linked to a responsible PCG population. Pragmatism is also needed if we are to relate PCGs to other social variables, now and after the information is released from the 2001 census. The task of defining PCG areas is an ongoing process and these maps are very much the first draft of a regional configuration. Comments and discussion of this configuration are welcomed so as to continue to develop an understanding and workable approach to these issues.

Figure 1.3 GPs by Primary Care Group

Figure 1.4 GPs by Primary Care Group in the West Midland County

Figure 1.5 Primary Care Group Areas

1.3    Populations

To give an idea of population sizes in the geographical areas used in this report, age specific population counts for Health Authorities, Local Authorities and Primary Care Groups have been included.

The populations for health and local authorities are based on mid-year estimates, whereas the populations for PCGs are based on the 1991 census count. (See discussion above in PCG section).

Table 1.1 1998 Population for Health Authorities

Table 1.2 1998 Population for Local Authorities

Table 1.3 1991 Population for Primary Care Groups (resident population)

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