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Related to: PharmaciesMedicines Management and Optimisation, Ill Health and Disability, Mental Health and Illness, Physical and Mobility Impairments, Population

Key Facts:

  • Bath and North East Somerset operates using a model of 5 GP practice clusters, each with a population of 30,000 to 50,000.
  • The B&NES CCG GP registered population of 199,660 in March 2014, was slightly higher than the resident population (180,097 as at mid-2013).
  • One of the most notable demographic characteristic is Bath Central GP cluster’s large population of young people aged 15-24 registered with a GP.
  • Chew/Keynsham GP cluster has the greatest concentration of older people (65 years and over). 
  • People registered with GP practices in the Norton Radstock GP cluster report significantly higher rates of long-standing health conditions and health related problems in daily life compared to those registered with all GPs in B&NES.
  • The Chew/Keynsham GP cluster had the greatest proportion of patients with cardio-vascular disease, coronary heart disease, hypertension, stroke, and diabetes. These significantly higher rates are likely to be due to an older population.
  • During 2010/11 Bath West GP cluster had significantly higher rates of emergency hospital admissions compared to B&NES CCG as a whole.  This could partly be due to Bath West GP cluster having the highest number and proportion of people aged 85 and over.
  • According to the 2015 Indices of Multiple Deprivation scores, the overall deprivation level experienced by patients in B&NES CCG (IMD score 12.1) is lower than that of the England average (IMD score 21.8).

The CCG and GP Practice Clusters

Clinical Commissioning Groups (CCGs) were created following the Health and Social Care Act in 2012, and replaced Primary Care Trusts on 1 April 2013. CCGs are clinically-led statutory NHS bodies responsible for the planning and commissioning of health care services for their local area. They are membership bodies with local GP practices as the members and governed by an elected body of GPs, clinicians and lay members. 

B&NES operates using a model of 5 GP practice clusters, each with a population of 30,000 to 50,000. These clusters are essentially groups of GP practices and are used by the CCG in their working arrangements, as shown in the map below.

B&NES CCP GP Clusters

GP Cluster Map

Figure 1: B&NES CCP GP Clusters

B&NES CCG GP Registered Population

GP registered population table

Table 1: B&NES GP registered population by age and GP practice cluster, March 2014

The B&NES CCG GP registered population – 199,660 as at March 2014 is slightly higher than the resident population (180,097 as at mid-2013).1 The GP registered population is greater than the residential population as a result of the fact that residents do not have to register with GPs in their local authority area.


Figure 2: B&NES GP registered population by age proportions and GP practice cluster, March 2014

  • One of the most notable demographic characteristic is Bath Central GP cluster’s large population of young people aged 15-24 registered with a GP (12,260) – nearly a third (30.9 per cent) of the total GP registered population in the Bath Central GP Cluster
  • Norton Radstock GP cluster has the highest number (8,620) and proportion (17.4 per cent) of 0-14 year olds registered with a GP
  • Chew/Keynsham GP cluster has the greatest concentration of older people (19.9% are aged 65-84 and a further 3.3% are aged 85 and over)
  • Bath West GP cluster has the highest number (1,483) and proportion (3.5 per cent) of GP registered people aged 85 and over

B&NES CCG GP Registered Population by Cluster, Age and Gender

Cluster 1 – Norton Radstock GP cluster

Figure 3: Norton Radstock GP cluster - GP registered population by age and gender

The Norton Radstock GP cluster has a notably lower proportion of young 15-25 year old population registered with GPs compared to the CCG overall distribution, for both genders.  The Norton Radstock GP cluster as also has a slightly greater proportion of those aged over 35 and up to 80.

Cluster 2 – Chew/Keynsham GP cluster

Figure 4: Chew/Keynsham GP cluster - GP registered population by age and gender

The Chew/Keynsham GP cluster has a similar profile compared to the Norton Radstock GP cluster profile, with a lower proportion of those aged 15-25, for both genders compared to B&NES CCG and a greater proportion of those aged over 40, particularly 65-69.

Cluster 3 – Bath East GP cluster

Figure 5: Bath East GP cluster - GP registered population by age and gender

The Bath East GP cluster very closely follows the overall B&NES CCG population profile, with the exception of a slightly larger proportion of females aged 15-24 and slightly lower proportion of males of the same age.

Cluster 4 – Bath West GP cluster

Figure 6: Bath West GP cluster - GP registered population by age and gender

The Bath West GP cluster demonstrates a ‘flatter’ population distribution compared B&NES CCG, with lower proportions of males and females aged 15 – 25, and a small but notable increase in the proportion of people aged 80 and over, particularly females.

Cluster 5 – Bath Central GP cluster

Figure 7: Bath Central GP cluster  - GP registered population by age and gender

The population breakdown for the Bath Central GP cluster differs greatly from its neighbours with a significantly greater proportion of people aged between 15 and 29, for both genders. This is likely due to the high student population registered with GP practices in the Bath Central GP cluster.

Locally Identified Health Needs (B&NES CCG GP Registered Population)

This section presents a selection of ten GP cluster aggregated indicators from the national GP Practice Profile.  These indicators are grouped into two categories: (i) disabilities and long-term health conditions; and (ii) emergency hospital admissions.

Disability and Long-Term Health Conditions 2

Table 2: Locally Identified Health Needs, GP Clusters, Disability/Long-Term Conditions 3

Notes: GP cluster figures are highlighted for statistical significance against overall B&NES CCG GP practice population: where (H) indicates significantly higher than B&NES CCG and (L) indicates significantly lower than B&NES CCG (at the 95 per cent level of significance). More  detailed definitions can be found in the source as referenced.

Caution: Due to probable bias, these figures are not necessarily representative of the whole of the B&NES CCG GP registered population.  A more reliable indication of the ‘true’ prevalence of people with long-term health conditions and disability in B&NES is likely to be from the national 2011 Census.

People registered with GP practices in the Norton Radstock GP cluster report significantly higher rates of long-standing health conditions and health related problems in daily life compared to those registered with all GPs in B&NES. This suggests that they have the greatest level of health needs.

Table 3: Locally Identified Health Needs, GP Clusters, Disability/Long-Term Conditions 4

Notes: CVD – Cardio-Vascular Disease; CHD – Coronary Heart Disease; COPD - Chronic Obstructive Pulmonary Disease.  The Quality and Outcomes Framework (QOF) is a voluntary annual reward and incentive programme for all GP surgeries in England, detailing practice achievement results. GP cluster figures are shaded for statistical significance against overall B&NES CCG GP practice population: where (H) indicates significantly higher than B&NES CCG and (L) indicates significantly lower than B&NES CCG (at the 95 per cent level of significance). More detailed definitions can be found in the source as referenced.

Overall, people registered at GP practices in Chew/Keynsham GP cluster appear to have the most significant long-term health needs (in terms of the conditions outlined in Table 3). However, these significantly higher rates are likely to be due to an older population profile and are an indication of the likely higher demand for health services.

Adults registered at GP practices in Norton Radstock GP cluster are estimated to have the highest prevalence of diabetes – 5.7 per cent (significantly higher than the B&NES CCG rate of 4.6 per cent).

People registered at GP practices in Bath Central GP cluster appear to have significantly lower prevalence rates of long-term health conditions.  However, these significantly lower rates are likely to be due to a younger population profile. It is likely that inclusion of the University Medical Centre in Bath Central GP practice cluster is masking some of the health needs of this most deprived population.

The most common long-term health condition among B&NES GP registered patients is hypertension (high blood pressure) – 25,395 patients having been diagnosed as at 2012/13.

Emergency Hospital Admissions 5

Table 4:Locally Identified Health Needs, GP Clusters, Emergency Admissions 6

Notes: GP cluster figures are shaded for statistical significance against overall B&NES CCG GP practice population: where (H) indicates significantly higher than B&NES CCG and (L) indicates significantly lower than B&NES CCG (at the 95 per cent level of significance). More detailed definitions can be found in the source as referenced.

During 2010/11 people registered at GP practices in Bath West GP cluster had significantly higher rates of emergency hospital admissions when compared to the overall comparable rate of emergency hospital admissions across B&NES CCG.  This could partly be due to Bath West GP cluster having the highest number and proportion of people aged 85 and over.  This older age group is more likely to have complex co-morbidities that place greater demands on acute health services (as well as primary care).

During 2010/11 people registered at GP practices in Norton Radstock and Bath West GP clusters had highest rates of emergency hospital admissions for chronic conditions (although neither rate is significantly different from the overall comparable B&NES rate).

B&NES CCG GP Practices by Deprivation Levels of Patients 7

According to the 2015 Indices of Multiple Deprivation (IMD) scores, the overall deprivation level experienced by patients in B&NES (IMD score 12.1) is lower than that of the England average (IMD score 21.8).

The only GP practice in B&NES where the overall deprivation level experienced by its patients is higher than that of the England average (IMD score 21.8) is St Michael’s GP Surgery (IMD score 29.3). However, it is important to note that while St Michael's can be considered an outlier in terms of the higher level of deprivation experienced by its patients many GP practices in B&NES will have some patients experiencing high levels of deprivation. 

Figure 8: B&NES CCG GP Practices by Deprivation Levels of Patients (2015 Indices of Multiple Deprivation (IMD) scores) 8