Health statistics for South Norfolk

Population counted: Eligible women (denominator) is the number of women aged 53 to 70 years resident in the area (determined by postcode of residence) who are eligible for breast screening at a given point in time, excluding those whose recall has been ceased for clinical reasons (for example, due to previous bilateral mastectomy).

Method: Count is divided by denominator and multiplied by 100. England figures have been aggregated from local authority data and exclude women resident in Wales or of unknown local authority

This indicator presents screening coverage by local authority of residence. This is not the same as the indicator based on population registered with primary care organisations which include patients wherever they live. This is likely to result in different England totals depending on selected (registered or resident) population footprint. The Breast screening coverage: aged 53 to 70 years old indicator is available from the Cancer Services Fingertips profile and presents screening data at GP, sub-ICB, ICB and PCN geographies. The indicator excludes women outside the target age range for the screening programme who may self refer for screening. Please be aware that the April 2019 to March 2020, April 2020 to March 2021 and April 2021 to March 2022 data covers the time period affected by the COVID19 pandemic and therefore data for this period should be interpreted with caution. Standards say "Women who are ineligible for screening due to having had a bilateral mastectomy, women who are ceased from the programme based on a ‘best interests’ decision under the Mental Capacity Act 2005 or women who make an informed choice to remove themselves from the screening programme will be removed from the numerator and denominator. There are a number of categories of women in the eligible age range who are not registered with a GP and subsequently not called for screening as they are not on the Breast Screening Select (BS Select) database. Screening units have a responsibility to maximise coverage of eligible women in their target population and should therefore be accessible to women in this category through self referral and GP referral.

Source: NHS England, Breast Screening Programme. Reporting cycle: Financial year end point.

Population counted: Total number of children whose second birthday falls within the time period.

Method: Crude percentage: numerator is divided by denominator and then multiplied by 100.

ICB data GP-level coverage data is collected by the NHS Digital strategic data collection service, as provided by Child Health Information Service (CHIS) providers. Completeness of practices and data quality may vary, and so validations may need to be made if using this data for analyses. Full GP postcodes are used to aggregate data to ICB published by NHS Digital. These may not be consistent with the local authority geographies used by the CHIS providers in the local authority level report. Unregistered children are allocated to a ICB based on residence. ICB data do not form part of the core annual COVER programme official statistics because we do not have full assurance that they meet the quality pillar of the Code of Practice for Statistics. Caution should be exercised when comparing coverage figures over time due to occasional data quality issues reported by some data suppliers. Apparent trends could reflect changes in the quality of data reported as well as real changes in vaccination coverage. While this issue will be more apparent at the local level it may also have an impact on national figures. Similarly, some caution should also be exercised when comparing coverage between different areas where data quality issues have been reported. For data quality notes please see: Cover of vaccination evaluated rapidly (COVER) programme: quality and methodology information

Source: UK Health Security Agency, Coverage of Vaccinations Evaluated Rapidly Programme. Reporting cycle: Financial.

Population counted: Denominator is the GP registered population on the date of extraction including patients who have been offered the vaccine but refused it, as the uptake rate is measured against the overall eligible population. For more detailed information please see the user guide, available to view and download from https://www.gov.uk/government/collections/vaccine-uptake#seasonal-flu-vaccine-uptake

Method: Vaccine uptake data are collected via the ImmForm website on cumulative vaccinations administered from the beginning of October to the end of February inclusive. All data is cumulative (i.e., total vaccinations administered from beginning of October to the end of the month or week in question). 1. Data is final and represents a percentage of all GP practices in England responding to the final survey. Where a total for England is quoted (for example a sum of number of patients registered and number vaccinated) this is taken from the GP practice sample and is therefore not an extrapolated figure. 2. . For definitions of clinical at risk groups for those aged 6 months to under 65 years, see annual flu letter published at https://www.gov.uk/government/collections/annual-flu-programme 3. The age under 65 clinical at risk group data includes pregnant women with other risk factors but excludes otherwise 'healthy' pregnant women and carers. 4. All figures are derived from data as extracted from records on GP systems or as submitted by GP practices or other responsible NHS organisations Data source: ImmForm website: registered patient GP practice data Influenza Immunisation Vaccine Uptake Monitoring Programme. The data collection is comprised of those aged 65 years and older % vaccine uptake is a percentage: numerator is divided by denominator and then multiplied by 100. Therefore, the data is NOT extrapolated. (GP practice response rates vary each year however response tends to be over 95 percent with the 2021 to 2022 season response rate being 97.1 percent). GP practices are asked to provide vaccine uptake data on the number of patients registered on the date of data extraction that fall within each defined eligible group (the denominator), and the number of those vaccinated within each group (the numerator). This means denominator fluctuations will occur as patients join and leave the practice or die during the data collection campaign. It will be assumed that vaccinations given in other settings by other healthcare providers (e.g. pharmacies, special clinics such as antenatal care, residential homes and private or occupational health vaccinations) will be recorded onto GP systems in a timely manner. This is essential for maintaining the individual's clinical record but also ensures a clear auditable trail to the original source of any data and will avoid double counting for the vaccine uptake survey. It may be that for some vaccinations where recording onto a GP system is difficult or slow, for example, vaccinations of travelling communities or homeless or where patients are not registered, recording of these vaccinations may be missed by the survey, although this is undesirable. Patients who are vaccinated but have not had their electronic patient record updated by the time of data extraction, will be excluded. For more information, see data collection guidance on GOV.UK [ARCHIVED CONTENT] Appendix I: data collection GOV.UK (nationalarchives.gov.uk) Data prior to 2013 to 2014 were collected at a PCT level and converted to LA level.

Read codes are primarily used for data collection purposes to extract vaccine uptake data for patients who fall into one or more of the designated clinical risk groups. The codes identify individuals at risk, and therefore eligible for flu vaccination. However, it is important to note that there may be some individuals with conditions not specified in the recommended risk groups for vaccination, who may be offered influenza vaccine by their GP based on clinical judgement and according to advice contained in the flu letter and Green Book, and thus are likely to fall outside the listed Read codes. Therefore, this data should not be used for GP payment purposes.

Source: NHS England. Reporting cycle: Financial.

Population counted: ONS mid year population estimates for the respective calendar years Population estimates for 2025 come from 2022-based population projections (migration category variant on 2023 local authority geographies edition of the dataset), provided by the ONS.

Method: Abridged life tables (based on five year age groups) were constructed using standard methods.i,ii Separate tables were constructed for males and females using numbers of deaths registered in calendar years and annual mid year population estimates. A life table template which illustrates the method used to calculate life expectancy (and 95 percent confidence intervals) can be found on the ONS website: https://www.ons.gov.uk/file?uri=/peoplepopulationandcommunity/healthandsocialcare/healthandlifeexpectancies/datasets/healthstatelifeexpectancytemplate/current/healthstatelifeexpectanciestemplate.xls i Shyrock HS and Siegel JS (1976) The Methods and Materials of Demography (abridged edition), Academic Press: New York. ii Newell C (1994) Methods and Models in Demography, John Wiley & Sons: Chichester LSOA-based deprivation data are calculated by Office for Health Improvements and Disparities using mortality data and mid year population estimates from the Office for National Statistics, and Index of Multiple Deprivation 2010, 2015, 2019 and 2025 (IMD 2010, IMD 2015, IMD 2019 and IMD 2025) scores from the Ministry of Housing, Communities and Local Government (MHCLG). Lower Super Output Areas (LSOAs) in each area (England, region, local authority) were ranked in order of deprivation using overall IMD scores from the appropriate version of IMD. They were then divided into ten categories or 'deprivation deciles' with approximately equal numbers of LSOAs in each. LSOA level mortality data and population estimates were aggregated to these deprivation deciles. Life expectancy at birth was then calculated for each of the ten deprivation deciles in each area, for males and females separately. Index of Multiple Deprivation (IMD) 2010 has been used to define deprivation deciles for the time periods 2001 to 2003 through to 2009 to 2011 (available at England level only). IMD 2015 has been used to define deprivation deciles for the time periods 2011 to 2013 through to 2015 to 2017. IMD 2019 has been used to define deprivation deciles for the time periods 2016 to 2018 through to 2021 to 2023. IMD 2025 has been used to define deprivation deciles for the time period 2022 to 2024. Data are not available for 2010 to 2012 due to lack of consistent population estimates. Provisional data for 2021 to 2023 have been provided for LSOA deprivation deciles, using mid-2023 LSOA population estimates calculated by OHID. These are based on mid-year estimates for LSOAs for 2022, published by ONS. These have been aged on a year and then constrained to mid-year population estimates for 2023 local authorities, published by ONS.

Source: Office for National Statistics. Reporting cycle: Calendar.

Population counted: Eligible population (denominator) is the number of men and women aged 60 to 74 years resident in the area (determined by postcode of residence) who are eligible for bowel cancer screening at a given point in time, excluding those whose recall has been ceased for clinical reasons (e.g. no functioning colon) or if they opt out of the programme.

Method: Count is divided by denominator and multiplied by 100. England figures have been aggregated from local authority data and exclude participants who are resident outside England or of unknown local authority.

This indicator presents screening coverage by local authority of residence. This is not the same as the indicator based on population registered with primary care organisations which include patients wherever they live. This is likely to result in different England totals depending on selected (registered or resident) population footprint. The Bowel cancer screening coverage: aged 60 to 74 years old indicator is available from the Cancer Services Fingertips profile and presents screening data at GP, sub-ICB, ICB and PCN geographies. Please be aware that the April 2019 to March 2020, April 2020 to March 2021 and April 2021 to March 2022 data covers the time period affected by the COVID19 pandemic and therefore data for this period should be interpreted with caution.

Source: NHS England, Bowel Cancer Screening Programme. Reporting cycle: Financial year end point.

Population counted: Total number of respondents (with valid recorded smoking status) aged 18+and over from the Annual Population Survey. The number of respondents has been weighted in order to improve representativeness of the sample. The weights take into account survey design and non-response.

Method: The prevalence is calculated by dividing the weighted number of self-reported smokers aged 18 and over by total number of respondents (with a valid smoking status) aged 18 and over, expressed as a percentage.

Each eligible participant (18 years and over) in the Annual Population Survey (APS) was asked two smoking related questions; From 2016: 1. Have you ever smoked cigarettes regularly? (yes/no) 2. And do you smoke cigarettes at all nowadays? (yes/no) Prior to 2016: 1. Have you ever smoked a cigarette, cigar or pipe? (yes/no) 2. Do you smoke cigarettes at all nowadays? (yes/no) From this smoking status was derived as “current”, “ex-smoker” or “non-smoker”. Self-reported smoking status may be prone to respondent bias. For further details please see here These data have not been age-standardised and, therefore, variation between area values may be a result of differences in population structure. The numerator and denominator counts (which have been weighted to improve representativeness) are based on a sample of the population and, as such, are not true counts. Where the estimate is based on a sample size of less than 10 no figure is calculated and a data quality note applied. Where the estimate is based on a sample size less than 30 there is uncertainty in the figure and a data quality note applied. In July 2018 the confidence interval method has been modified and new confidence intervals have been applied to the entire time series. See here for further details.

Source: OHID, based on Office for National Statistics data. Reporting cycle: Calendar.

Population counted: Eligible women (denominator) is the number of women aged 25 to 49 years resident in the area (determined by postcode of residence) who are eligible for cervical screening at a given point in time, excluding those without a cervix.

Method: Count is divided by denominator and multiplied by 100. England figures have been aggregated from local authority data and exclude women resident in Wales or of unknown local authority

This indicator presents screening coverage by local authority of residence. This is not the same as the indicator based on population registered with primary care organisations which include patients wherever they live. This is likely to result in different England totals depending on selected (registered or resident) population footprint. The Cervical screening coverage: aged 25 to 49 years old indicator is available from the Cancer Services Fingertips profile and presents screening data at GP, sub-ICB, ICB and PCN geographies. The indicator excludes women outside the target age range for the screening programme who may self refer for screening. Please be aware that the April 2019 to March 2020, April 2020 to March 2021 and April 2021 to March 2022 data covers the time period affected by the COVID19 pandemic and therefore data for this period should be interpreted with caution.

Source: NHS England, Cervical Screening Programme. Reporting cycle: Financial year end point.

Population counted: Eligible women (denominator) is the number of women aged 50 to 64 years resident in the area (determined by postcode of residence) who are eligible for cervical screening at a given point in time, excluding those without a cervix.

Method: Count is divided by denominator and multiplied by 100. England figures have been aggregated from local authority data and exclude women resident in Wales or of unknown local authority

This indicator presents screening coverage by local authority of residence. This is not the same as the indicator based on population registered with primary care organisations which include patients wherever they live. This is likely to result in different England totals depending on selected (registered or resident) population footprint. The Cervical screening coverage: aged 50 to 64 years old indicator is available from the Cancer Services Fingertips profile and presents screening data at GP, sub-ICB, ICB and PCN geographies. The indicator excludes women outside the target age range for the screening programme who may self refer for screening. Please be aware that the April 2019 to March 2020, April 2020 to March 2021 and April 2021 to March 2022 data covers the time period affected by the COVID19 pandemic and therefore data for this period should be interpreted with caution.

Source: NHS England, Cervical Screening Programme. Reporting cycle: Financial year end point.

Population counted: The estimated number of households in the corresponding geographical area (modelled)

Method: Numerator/Denominator, multiplied by 100 Under the "Low Income Low Energy Efficiency" measure, a household is considered to be fuel poor if: • it is living in a property with an energy efficiency rating of band D, E, F or G as determined by the most up-to-date Fuel Poverty Energy Efficiency Rating (FPEER) methodology AND • its disposable income (after housing costs and energy needs) would be below the poverty line There are 3 important elements in determining whether a household is fuel poor: • household income • household energy requirements • fuel prices More detailed information on the methodology used to model fuel poverty rates is available at: https://www.gov.uk/government/publications/fuel-poverty-sub-regional-methodology-and-documentation

ICB data from 2019 to 2022 are estimated from local authority data. In most cases ICBs are coterminous with local authorities, so the ICB figures are precise. In cases where local authorities cross ICB boundaries, the local authority data are proportionally split between ICBs, based on population located in each ICB. The affected ICBs are: Bath and North East Somerset, Swindon and Wiltshire; Bedfordshire, Luton and Milton Keynes; Buckinghamshire, Oxfordshire and Berkshire West; Cambridgeshire and Peterborough; Frimley; Hampshire and Isle of Wight; Hertfordshire and West Essex; Humber and North Yorkshire; Lancashire and South Cumbria; Norfolk and Waveney; North East and North Cumbria; Suffolk and North East Essex; Surrey Heartlands; Sussex; West Yorkshire ICB data for 2023 was aggregated to ICB from LSOA data avaliable from: Sub regional fuel poverty data 2025 (2023 data)

Source: Department for Energy Security and Net Zero. Reporting cycle: Calendar.

Population counted: Calculation does not involve a denominator

Method: An increase of 10 µg/m 3 in population-weighted annual average background concentration of PM 2.5 * is assumed to increase all cause mortality rates by 8% - a relative risk (RR) of 1.08 per 10 µg/m 3 (COMEAP, 2022). For a population weighted modelled annual average background PM 2.5 concentration x, RR is calculated as (1.08) (x/10) (as explained in PHE, 2014). The fraction of deaths attributable to PM 2.5 is expressed as a percentage, calculated as 100*(RR-1)/RR. For example for the the year 2021 England air pollution was 7.4 µg/m 3 To calculate the RR for England you use the following formula: RR = 1.08^(7.4/10) RR = 1.059 To calculate the attributable fraction: AF = (1.059 - 1)/1.059 * 100 AF = 5.54% Population weighted annual average concentrations of PM 2.5 were provided by Ricardo for all lower tier and unitary local authorities within England, as well as combined at upper tier, regional and national level along with NHS regions . Attributable fractions can be calculated at all these scales.

There is no accepted way of fully quantifying the uncertainty associated with modelled concentrations of PM 2.5 . The modelling used in calculating the indicator meets the requirements of the Air Quality Standards Regulation 2010 on Ambient Air Quality that the uncertainty in modelled annual average PM 2.5 concentrations should be no more than 50 percent in the region of the Limit Value (20 µg/m 3 ). Caution is needed when considering apparent trends over time. Trend data should not be overinterpreted for a number of reasons: • Concentrations of PM 2.5 vary from year to year due to the weather. This variation due to weather is generally greater than the year to year variation from changes in emissions. • The methods and data inputs for the pollution modelling are continually updated and improved.

Source: Department for Environment, Food and Rural Affairs. Reporting cycle: Calendar.

Method: For more information, please see the Technical Report for 2025 IMD publication. For GP deprivation scores, the population weighting is based on NHS Digital, Patients Registered at a GP Practice - October 2025: LSOA file (persons). By knowing how many patients live in which LSOAs (proportions of the accounted-for total list size) a weighted average of the LSOA IMD scores can be built as GP IMD score. GP IMD score = (No of patients in LSOA1)* IMD(LSOA1)/No of patients (LSOA1 +....+ LSOAx) + ..... + (No of patients in LSOAx)* IMD(LSOAx)/No of patients (LSOA1 +....+ LSOAx)

The Indices of Deprivation 2025 are relative measures of deprivation. This means it can tell you if one area is more deprived than another, but not by how much. The Indices of Deprivation 2025 is not a measure of affluence; all of the indicators used in the index are designed to identify aspects of deprivation, not affluence. Therefore the area ranked as the least deprived is not necessarily the most affluent.

Source: Ministry of Housing, Communities and Local Government. Reporting cycle: Calendar.

Population counted: ONS mid-year population estimates (for construction of life tables) and Census 2021 resident populations (to derive health prevalence estimates).

Method: Healthy life expectancy was calculated by ONS using the Sullivan method . For these MSOA estimates, health prevalence is derived from Census 2021 self-reported general health data. Individuals reporting their health as "Very good" or "Good" are classified as being in good health, while those reporting "Fair", "Bad" or "Very bad" health are classified as not being in good health. Mortality rates are based on deaths registered during 2019 to 2023 and corresponding mid-year population estimates. Life expectancy estimates are period-based estimates derived from abridged life tables with a final age group of 90 years and over. Male and female estimates were produced separately. Further details of the methodology are available from the ONS publication Health state life expectancy estimates for Middle layer Super Output Areas, England and Wales.

Estimates for small geographic areas are subject to greater uncertainty than national estimates and should be interpreted alongside their 95% confidence intervals. Healthy life expectancy estimates in this indicator should only be compared with other estimates published within the same indicator, including the higher-level geographies presented alongside the MSOA estimates. Comparisons with healthy life expectancy estimates published in other indicator series or publications are not appropriate, as differences in methodology, data sources and reference periods can result in systematically different values. Estimates should not be compared directly with the previous small-area health expectancy estimates published by ONS in 2015, because the current methodology uses a final age group of 90 years and over, whereas the earlier release used a final age group of 85 years and over. To improve the robustness of estimates for small populations, mortality data are aggregated over a five-year period and some mortality rates, population estimates, and health prevalence values have been imputed where insufficient data was available. MSOAs where imputation was required are identified in the ONS dataset. Areas where ONS identified implausible life expectancy estimates were classified as unreliable and no healthy life expectancy estimate was calculated for those areas.

Source: OHID Fingertips. Reporting cycle: Calendar.