Nephrology Dialysis Transplantation 2007 22(Supplement 7):vii194-vii244; doi:10.1093/ndt/gfm408
© The Author [2007]. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org
Appendix
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Appendix A—The Renal Registry Statement of Purpose
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- Executive summary
- Introduction
- Statement of intent
- Relationships of the Renal Registry
- The role of the Renal Registry for patients
- The role of the Renal Registry for nephrologists
- The role of the Renal Registry for Trust managers
- The role of the Renal Registry for commissioning agencies
- The role of the Renal Registry national quality assurance schemes
- References and websites
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A1 Executive summary
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- (1.1) The Renal Registry was established by the Renal Association to act as a resource in the development of patient care in renal disease.
- (1.2) The Registry acts as a source of comparative data for audit/benchmarking, planning, policy and research. The collection and analysis of sequential biochemical and haematological data is a unique feature of the Registry.
- (1.3) Agreements have been made with participating renal centres, which ensure a formal relationship with the Registry and safeguard confidentiality.
- (1.4) The essence of the agreement is the acceptance of the Renal Registry Data Set Specification (RRDSS) as the basis of data transfer and retention.
- (1.5) Data is collected quarterly to maintain unit-level quality assurance, with the results being published in an annual report.
- (1.6) Activity is funded from commissioning agencies by a capitation fee on renal patients.
- (1.7) The Registry is responsible, with the express agreement of participants, for providing data to Trusts, Primary Care Trusts (PCTs), commissioning authorities and the European Renal Association–European Dialysis and Transplant Association (ERA–EDTA) Registry.
- (1.8) The development of the Registry is open to influence from all interested parties, including clinicians, Trusts, commissioning authorities and patient groups.
- (1.9) The Registry is non-profit making and has a registered charitable status through the Renal Association.
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A2 Introduction
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- (2.1) Registry-based national specialty comparative audit is one of the cornerstones of NHS development. The Renal National Service Framework (NSF), published in two sections in 2004 and 2005, recommended the participation of all renal units in comparative audit through the Renal Registry, with co-temporaneous documents defining the necessary information strategies [1–4].
- (2.2) The shape of future national audit will be set not only by conventional medical criteria, but also by NSF recommendations, prompted through the Healthcare Commission. The necessary detail is currently the subject of a formal scoping project, in which the Registry is represented. The final relationship of the Registry to the Healthcare Commission has yet to be defined.
- (2.3) The Chief Executives of Trusts are responsible for clinical governance, and audit will be an essential part of that agenda [5].
- (2.4) Demographic information on patients receiving renal replacement therapy (RRT) throughout Europe was collected from 1965 in the Registry of the ERA–EDTA. This voluntary exercise was conducted on paper and by post, demanded considerable effort and time from participating units and eventually proved impossible to sustain. Latterly, the incompleteness of UK data returns to ERA–EDTA made it impossible to build a picture of the activity of RRT in the UK for planning and policy purposes. Subsequently, five ad hoc national data collections from England & Wales were solicited from renal centres in 1992, 1996, 1999, 2002 and 2004 to fill this gap. The Registry is well placed to put such surveys on a permanent and regular footing, and extend their remit, to chronic kidney disease (CKD), for example.
- (2.5) Together with the need to know the demographic and structural elements, the NHS has developed a need to underpin clinical activity more rigorously through the scientific evidence base (for example, the Cochrane Initiative) and by quality assurance activity through audit. These initiatives require comprehensive information about the structures, processes and outcomes of RRT, which go well beyond the detail previously compiled by the ERA–EDTA.
- (2.6) The Registry is recognized as one of the very few high-quality clinical databases available for general use [6]. The collection of data by download of electronic records from routine clinical databases is uncommon, has been highly successful, and is being imitated worldwide.
- (2.7) The Renal Association has made a start in the area of audit by publishing guidelines in ‘Renal Standards’ documents. It was apparent during the development of the Standards that many of the desirable criteria of clinical performance were uncertain or unknown, and that only the accumulated data of practising renal units could provide the evidence for advice on best practice and what might be achievable. A common data registration provides the simplest device for such an exercise.
- (2.8) The continuing emphasis on evidence-based practice is being supported by changes in research funding (Culyer Report and recent national statements), which lean towards collaborative projects and include both basic science and ‘health services research’ components. It is apparent that an RRT database is invaluable to a wide range of research studies.
- (2.9) It can be seen that the need for a Registry of RRT has developed for a variety of reasons: international comparisons, national planning, local Trust, Primary Care Trust (PCT) and health authority management, standard setting, audit and research. The opportunity for data gathering arises partly from improvements in information technology. Although it was possible to see the need for a national renal database 20 years ago, the circumstances have become ideal for the maintenance of a data repository, supported by the clinical users and resourced for national benchmarking as a routine part of RRT management.
- (2.10) The provisional expectations of earlier Annual Reports can now be replaced by confident assertions, built on the experience of 7 years of publication, about the role and potential of the Registry. The integration of the various elements of Renal Association strategy is being pursued through the recently established Clinical Affairs Board (CAB).
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A3 Statement of intent
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The Renal Registry provides a focus for the collection and analysis
of standardized data relating to the incidence, clinical management
and outcome of renal disease. Data will be accepted quarterly
according to the RRDSS by automatic downloading from renal centre
databases. There will be a core data set, with optional elements
of special interest that may be entered by agreement for defined
periods. A report will be published annually to allow a comparative
audit of facilities, patient demographics, quality of care and
outcome measures. Participation is mandated through the recommendation
in the Renal NSF. There will be an early concentration on RRT,
including transplantation, with an extension to other nephrological
activity at a later date. The Registry will provide an independent
source of data and analysis on national activity in renal disease.
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A4 Relationships of the Renal Registry
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- (4.1) The Registry is a registered charity through the Renal Association (No. 2229663). It was established by a committee of the Renal Association, with additional representation from the British Transplantation Society, the British Association for Paediatric Nephrology, the Scottish Renal Registry, Wales and Northern Ireland. There is cross-representation with both the Renal Association Standards and Clinical Trials Committees and the Clinical Affairs Board. The Registry has a Chairman and Honorary Secretary nominated by the Renal Association. The Registry has an observer from the Department of Health, a participant from the National Kidney Federation (NKF) (patients’ association) and a member representing the Health Care Commissioners.
- (4.2) A number of sub-committees have been instituted as the database and renal unit participation developed, particularly for data analysis and interpretation for the Annual Report. Further specialized panels may be developed for publications and the dissemination of Registry analyses.
- (4.3) The Scottish Renal Registry sends data to the Renal Registry for joint reporting and comparison.
- (4.4) The return of English, Welsh and Northern Ireland data to the ERA Registry will be through the Renal Registry. The Scottish Renal Registry already sends data directly to the ERA Registry.
- (4.5) A paediatric database has been developed in collaboration with the Renal Registry, and the two databases are compatible. These two databases are in the process of being integrated, which will allow long-term studies of renal cohorts over a wide range of age.
- (4.6) Close collaboration has been achieved with UK Transplant to the benefit of both organizations. Data aggregation and integration has led to joint presentations and publications. The description of the entire patient journey in RRT by this means is a source of continuing insight and usefulness.
- (4.7) The basis of participation for renal units nationally is an agreement to accept the RRDSS for the transmission and retention of data. This consists of a core data set of some 200 items and further optional elements, which will be returned on a special understanding with the unit for a defined period of reporting. The data set is a considerable part of a National Renal Dataset (England) being developed currently by a project team, which includes Registry representation.
- (4.8) The Registry is part of the team undertaking an investigation into the necessary scope of national audit for the Healthcare Commission, in the light of the NSF.
- (4.9) The retention of patient identifiable information, necessary in particular for the adequate tracing of patients, has been approved by the Patient Information Advisory Group (PIAG), under Section 60 of the Health and Social Care Act. This is pending the introduction of mechanisms that will preserve patient anonymity through encryption of a unique patient identifier.
- (4.10) It is anticipated that the Registry will receive data from the secondary users service (SUS) of the national IT programme, Connecting for Health, when it is fully instituted. The detail of data routing from renal unit clinical systems to the national database has yet to be established.
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A5 The role of the Renal Registry for patients
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- (5.1) The goal of the Registry is to improve care for patients with renal disease. The appropriate use of Registry information should improve equity of access to care, adequacy of facilities, availability of important but high-cost therapies such as erythrocyte-stimulating agents and the efficient use of resources. The continuing comparative audit of the quality of care should facilitate the improvement of care and outcomes of care. It is intended to identify and publish examples of good practice. In such ways, patients will be the ultimate beneficiaries of the exercise.
- (5.2) A leaflet has been provided, in collaboration with the NKF, by which patients may opt out of the collection of identifiable data by the Registry, if they wish.
- (5.3) Information from the Registry will complement the individual records available on ‘Renal Patient View’ where it is accessible.
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A6 The role of the Renal Registry for nephrologists
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- (6.1) The clinical community have become increasingly aware of the need to define and understand their activities, particularly in relation to national standards and in comparison with other renal units.
- (6.2) The Registry is run by a committee of the Renal Association and therefore by colleagues with similar concerns and experience.
- (6.3) The Renal Standards documents are designed to give a basis for unit structure and performance, as well as patient-based elements such as case mix and outcomes. It is anticipated that Standards will become increasingly based on research evidence and the Cochrane Collaboration has recently resourced reviews of renal topics, which will support this conversion.
- (6.4) The Registry data are available to allow the comparative review of many elements of renal unit practice. Centre data are presented to allow a contrast of individual unit activity and results against national aggregated data. Sophisticated analyses of patient survival, for example, are a unique resource to exclude any anomalies of performance and standardize for unit caseload, etc.
- (6.5) Reports of demographic and treatment variables are available to the participating centres for distribution to Trusts, PCTs, Strategic Health Authorities and Commissioners, as well as Renal networks, as required and agreed with the unit. Reports should facilitate discussion between clinicians, Trust officers and commissioners.
- (6.6) Customized data reports can be made available by agreement with the Registry Committee. A donation to cover any costs incurred may be requested.
- (6.7) The Registry is developing the publication of focused and extended synopses of chapters from the annual Report. These ‘dips’ will facilitate the appreciation and application of comparative data and will allow wider distribution.
- (6.8) The Registry Committee welcome suggestions for topics of national audit or research that colleagues feel are of sufficiently widespread interest for the Registry to undertake.
- (6.9) The database has been designed to provide research facilities for future participation in national and international trials. Members of the Renal Association and other interested parties are welcome to apply to the Registry committee to conduct local or national audit and research using the database. All such projects will need the agreement of the Registry Committee, and any costs involved will need to be met by the applicants.
- (6.10) These facilities will be sustainable only through cooperation between nephrologists and the Registry. There is a need for high quality and comprehensive data entry at source.
- (6.11) The sustaining of data collection, organization and transmission from peripheral sites is not centrally resourced. The lack of clear status for many informatics staff at unit level, the imminent inroads of the national IT programme Connecting for Health and the potential disruptions of Agenda for Change will be balanced by the development of formal informatics organizations (The UK Council for Health Informatics Professions (UK CHIP [7]), the NHS Faculty of Health Informatics [8] and the Association of ICT Professionals in Health and Social Care (ASSIST [9]).
- (6.12) Units will need to develop an ‘annual informatics plan’, to review the maintenance and improvement of data collection organization and return to the Registry. This will help maintain the accuracy, timeliness and completeness of clinical data and also in parallel, support the career development of informatics staff.
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A7 The role of the Renal Registry for Trust managers
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- (7.1) As the basis of the clinical governance initiative, the gathering and presentation of clinical data are regarded as essential parts of routine patient management in the health service.
- (7.2) One of the principles of health service informatics is that the best data are acquired from clinical information recorded at the point of health care delivery.
- (7.3) Renal services data entered on local systems by staff directly engaged with patients are likely to be of the highest quality and it is these that the Registry intends to capture.
- (7.4) The Registry provides a cost-effective source of detailed information on renal services.
- (7.5) The regular reports of the Registry supply details of patient demographics, treatment numbers, treatment quality and outcomes. Data are compared with both national standards and national performance, for benchmarking and quality assurance. The assessment of contract activity and service delivery is possible through these data returns, without the need for further costly Trust or commissioner administrative activity. These data should be particularly valuable to contracts managers and those responsible for clinical governance.
- (7.6) Data are available on unit case mix, infrastructure and facilities.
- (7.7) It is anticipated that data on patients with renal disease other than those requiring RRT will become available in time (CKD).
- (7.8) It is anticipated that Trust interests may be served through the participation of a national Trust representative on the Registry Committee.
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A8 The role of the Renal Registry for commissioners of health care
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- (8.1) The commissioners of health care include Regional Specialty Commissioning Groups, the networks or joint renal strategy groups supporting them and the Primary Care Trusts.
- (8.2) The use of information sources such as the Registry is advised in the National Renal Review [6] in order to promote benchmarking and quality assurance of renal programmes. The comprehensive tracking of relatively small but costly renal cohorts should be regarded as a routine part of speciality case management.
- (8.3) The Registry provides validated, comparative reports of renal unit activity on a regular basis to participating centres. These allow assessment of unit performance across a wide range of variables relating to structure, process and outcome measures.
- (8.4) There are economies of scale in the performance of audit through the Registry, since multiple local audits are not required.
- (8.5) The incidence of RRT treated locally, their mortality and renal transplant rates should also be of interest. The assessment of referral and treatment patterns of patients with established renal failure by postcode analysis indicates the geographical origin. This information also allows the expression of differences relating to geography, ethnicity and social deprivation. These data may also identify potential unmet need in the population and permit assessment on the equity of service provision. In the future, the Registry database should also provide information on nephrology and pre-dialysis patients (CKD). This will allow a prediction of the need for RRT facilities, as well as indicating the opportunities for beneficial intervention.
- (8.6) Registry data are used to track patient acceptance and prevalence rates over time, which allows the modelling of future demand and the validation of these predictions.
- (8.7) Information on the clinical diagnosis of new and existing RRT patients may help identify areas where possible preventive measures may have maximal effect.
- (8.8) The higher acceptance rates in the elderly, and the increasing demand from ethnic groups due to a high prevalence of renal, circulatory and diabetic disease, are measurable.
- (8.9) Comparative data are available in all categories for national and regional benchmarking.
- (8.10) The Registry offers independent expertise in the analysis of renal services data and their interpretation, a resource that is widely required but difficult to otherwise obtain.
- (8.11) The cost of supporting the Registry is £16 per registered patient per annum, which is less than 0.05% of the typical cost of a dialysis patient per annum. It is expected that this cost will need to be made explicit within the renal services contract.
- (8.12) The Registry Committee includes a representative from the health care commissioners. This allow an influence on the development of the Registry and the topics of interest in data collection and analysis.
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A9 The role of the Renal Registry for national quality assurance agencies
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- (9.1) The role of the Registry in the national quality assurance programme of the Healthcare Commission, will depend on the decisions on the role and responsibilities of that agency and their means to discharging them.
- (9.2) The demographic, diagnostic and outcomes data could support the investigation of clinical effectiveness.
- (9.3) The case mix information and comorbidity data that would allow better assessment of survival statistics remains incomplete. There is also some clinical scepticism whether ‘correction’ of outcome data would reflect the realities of clinical practice.
- (9.4) With the publication of renal unit survival data, consideration of this issue in particular would be welcome in nephrological circles, with correspondence to the Registry Committee.
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A10 References
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- http://www.kidney.org.uk/campaigns/Renal-nsf/pt1-nsf-content-report.pdf [Accessed 23 November 2005]
- http://www.kidney.org.uk/campaigns/Renal-nsf/nsf-pt2.pdf[Accessed 23 November 2005]
- RNSF IS 1 http://www.dh.gov.uk/assetRoot/04/07/79/25/04077925.pdf
- RNSF IS 2 http://www.dh.gov.uk/assetRoot/04/11/35/05/04113505.pdf
- Black N. Clinical governance: fine words or action? Br Med J 1998; 316: 297–298.
- Black N. High-quality clinical databases: breaking down barriers [Editorial]. Lancet 1999; 353: 1205–1206
- http://www.ukchip.org.uk/
- http://www.informatics.nhs.uk/cgi-bin/item.cgi?id=1506 [Accessed 23 November 2005]
- http://www.assist.org.uk/
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Appendix B—Definitions, statistical methodology and analysis criteria, B1 Definitions of analysis quarters
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| Quarter |
Dates |
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| 1 |
1 January–31 March |
| 2 |
1 April–30 June |
| 3 |
1 July–30 September |
| 4 |
1 October–31 December |
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The quarterly biochemistry data were extracted from renal unit systems as the last data item stored for that quarter. If the patient treatment modality was haemodialysis (HD), the software will try to select a pre-dialysis value.
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B2 Renal Registry modality definitions
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Home haemodialysis
Home HD patients cease to be classed as such if they need longer
than 2 weeks of hospital dialysis when not an in-patient.
Satellite dialysis unit
A renal satellite unit is defined as an HD facility that is linked to a main renal unit and not autonomous for medical decisions, and that provides chronic outpatient maintenance HD but with no acute or inpatient nephrology beds on site.
Treatment modality at 90 days
This is used by the United States Renal Data System (USRDS) and is the modality that the patient is on at day 90 regardless of any changes from the start. It is a general indicator of initial dialysis but could miss failed continuous ambulatory peritoneal dialysis (CAPD). This would also miss patients intended for home HD who were not home yet. This modality is calculated by the Registry, which allows the definition to be changed.
Start of established renal failure
Established renal failure (also known as end-stage renal failure/end-stage renal disease) was defined as the date of the first dialysis (or of pre-emptive transplant).
If a patient started as ‘acute’ renal failure and did not recover, the date of start of renal replacement should have been backdated to the start of acute dialysis.
If a patient was started on dialysis and dialysis was temporarily stopped for less than 90 days for any reason (including access failure and awaiting the formation of further access) except the recovery of renal function, the date of the start of renal replacement therapy (RRT) remained the date of first dialysis. If the patient had stopped for longer than 90 days, he or she was classed as ‘recovered’.
Change of modality from PD to HD
Sites are requested to log in their timeline changes from peritoneal dialysis (PD) to HD if the modality switch is for longer than 30 days.
In analyses that included PD technique survival, patients on PD who changed to HD for less than 31days before changing back to PD were classified as remaining on PD. Those remaining on HD for more than 30 days and then changing back to PD were classified as having changed to HD.
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B3 Analysis criteria
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Definition of the take-on population (Incidence)
The take-on population in a year included patients who later
recovered from ERF after 90 days from the start of treatment.
Patients newly transferred into a centre who were already on
RRT were
excluded from the take-on population for that centre.
Patients restarting dialysis after a failed transplant were
also excluded (unless they started RRT in that current year).
Since patients who restarted RRT after recovering from ERF were included in the take-on population, the following scenario can occur: a patient may start RRT in 2004, recover and then restart RRT in 2004. Such patients were counted twice in the analysis providing they had been receiving RRT for more than 90 days on each occasion.
Patients who started treatment at a centre and then transferred out soon after receiving treatment were counted at the original centre for all analyses of treatment on the 90th day.
Definition of the prevalent population
This was calculated as all patients who are alive on 31 December and included the incident cohort for that year alive on that date.
Confidence interval
The 95% confidence intervals have been calculated using the normal approximation of the Poisson.
Death rate calculation
The death rate per 100 patient years was calculated by counting the number of deaths and dividing by the person-years exposed. This includes all patients, including those who died within the first 3 months of therapy. The person-years at risk were calculated by adding up, for each patient, the number of days at risk (until they died or transferred out) and dividing by 365.
Odds ratio
The odds of dying was the:
The odds ratio was the:
Hazard function
The hazard function was the probability of dying in a short time interval considering survival to that interval.
Hazard ratio
The hazard ratio was the:
Relative hazard
Following the notation of Collett, D (2003)—Modelling Survival Data in Medical Research, Chapman & Hall, p57:
The relative hazard was the exp(ßxi) component in the general proportional hazards model with age, the variable of interest and it's square as covariates. The plots were done for exp(ßxi) for different values of the variable of interest only, in other words, age was taken as a constant value of zero.
Z-scores
The enquiry into the excess of paediatric cardiac deaths at the Bristol Royal Infirmary defined an outlier as lying beyond 3 SDs from the mean, using the statistical methodology of Shewhart's control theory. This analysis relied on the centre sizes and hence their SDs, being very similar. Renal units in the UK vary greatly in size, catchment populations varying from 300 000 to over 2 million. There was a consequent variation in the total patient number on RRT so the figure for the SDs will vary greatly between centres. The SDs for the total RRT population is not an appropriate number as this will be very small. Therefore, the Shewhart methodology cannot be applied. The Registry has used the accepted statistical technique of Z-scores to identify any outliers.
Definition
Z-scores are sometimes called ‘standard scores’. It is a measure of the distance in SDs of a sample from the mean.
The Z-score transformation is especially useful when seeking to compare the relative standings of items from distributions with different means and/or different SDs. The Z-score for an item indicates how far and in what direction, that item deviates from its distribution's mean, expressed in units of its distribution's SD.
The Z-score is therefore an adjustment for the size of the centre and when comparing the different Z-scores for all the centres, they should be normally distributed. The observed Z-value compared with the expected Z-value (see explanation subsequently) should be on a straight line.
Calculation of the expected Z-value
Suppose there is a normally distributed population from which random samples of some specific size, say 10 are repeatedly drawn. These 10 values from each such random sample are sorted into increasing order, smallest value to largest value. When the sample data is sorted in this way, the individual numbers are called order statistics. The smallest value will vary somewhat from one such sample to another, but over the long run, the smallest values should tend to cluster around some average smallest value and produce a mean or expected values of the order statistics. These data have been compiled into tables so that for every specific total number of ordered samples (e.g. 38 centres with Registry survival data) there is an expected Z-value for each ordered centre in that list.
Survival analyses of prevalent cohort
These analyses excluded the current year's incident cohort. Note some Renal Registries include these patients in the prevalent survival.
Criteria for analysis by treatment modality in a quarter
The following quarterly entries were included and excluded:
- Patients on haemodialysis with a treatment centre of ‘elsewhere’ were removed. It should be noted that there were some patients on transplant with a treatment centre of ‘Elsewhere’; these patients were included.
- Entries for which the hospital centre was not the primary treatment centre were removed from the analysis of data for that centre.
- Patients who had been on RRT for less than 90 days were removed (by definition of ERF).
There were however, a few exceptions to these rules:
- If a patient's initial entry on the treatment timeline contained a ‘transferred in’ code, the patient was assumed to have been on RRT for longer than 90 days since the patient must have started RRT earlier than this elsewhere. Therefore, patients with an initial entry on the treatment timeline with a ‘transferred in’ code were included for all quarters. A patient with an initial treatment modality of ‘transferred in’ on 1 March 2005 would, for example, be included for the quarter 1,2005 even though the number of days on RRT would be calculated as 30 days.
- For patients who recovered renal function for a period of time and then went into ERF, the length of time on RRT was calculated from the day on which the patient restarted RRT. For a patient with an initial treatment start date of 1 March 2005 who recovered on the 1 June 2005 and then resumed RRT again on 1 November 2005, for example, the number of days on RRT would be calculated from 1 November 2005. The patient would be excluded from the analysis for quarter 4/05 since on 31 December 2005, he or she would have been on RRT for only 90 days. The patient would be included in the analysis from quarter 1/06 onwards.
If recovery was for less than 90 days, the start of RRT renal replacement therapy was calculated from the date of the first episode and the recovery period ignored. Patients who had transferred out or stopped treatment without recovery of function before the end of the quarter were excluded.
Criteria for analysis of biochemistry in a quarter
The analysis used information from the quarterly treatment table. In addition to the treatment modality criteria listed above, patients with the following quarterly entries were also excluded:
- Patients who had ‘transferred in’ to the centre in that particular quarter were excluded. If, for example, a patient transferred in on 1 March 2005, the patient was excluded from that biochemistry analysis of the centre transferred to in that quarter.
- Patients who had changed treatment modality in that particular quarter were excluded.
Treatment modality on day 90 of starting RRT
This was obtained from the treatment modality of the take-on population after 90 days of being on RRT. For this reason, patients who started treatment between 1 October 2004 and 31 September 2005 were used in this analysis.
The sample used was that defined by the take-on population.
Patients were counted at their take-on hospital centre rather than at their hospital centre on day 90. This is important as some patients had transferred out of their initial hospital centre by day 90.
Patients who died before they reached 90 days were excluded.
One-year survival of the take-on population
The sample used was the same as that defined for the take-on population except for recovered renal function patients, who were excluded.
Patients who transferred out of their initial treatment centre were censored on the day they transferred out if there was no further information in the timeline.
Analysis of 1-year survival of prevalent patients
The death rate within the year was calculated separately for the patients established on dialysis and with a functioning transplant on 1 January 2005. As there is an increased death rate in the first 3 months following transplantation, patients were included in the analysis only if they had not received a transplant between 1 October 2004 and 31 December 2004. The sample criteria thus became:
- Patients who had been receiving RRT for more than 90 days on 1 January 2005.
- Patients who had a transplant between 1 October 2004 and 31 December 2004 were excluded.
- Patients who transferred into a Registry centre were excluded if information was not available to confirm that they had not received a transplant between 1 October 2004 and 31 December 2004.
- The few patients who recovered renal function in 2005 were excluded.
- Patients who transferred out of a Registry centre to a non-Registry centre were censored at that date.
- A transplant patient whose transplant failed was censored at the time of restarting dialysis and dialysis patients who received a transplant were censored at the time of transplantation.
- Patients who died, received a transplant, or transferred out on 1 January 2005 were included and were counted as being at risk for 1 day.
- Patients who died on the day of the transplant were censored on this day rather than counted as a dialysis death.
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Appendix C—Renal services described for non-physicians
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(Reproduced from the third edition of the Renal Association
Standards document, August 2002).
This appendix provides information on the issues discussed in this Report, background information on renal failure and discusses the services available for its treatment.
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Renal diseases
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- (1.1) Diseases of the kidney are not as common as cardiovascular conditions or cancers but are much more common than some well-known disorders such as multiple sclerosis or muscular dystrophy. Renal conditions account for about 7000 deaths per annum according to the Registrar General's figures, but these are probably an underestimate since about one-third of deaths of patients with renal failure are not recorded as such in mortality statistics. These figures exclude deaths from cancers of the kidney and associated organs of the urinary tract such as the bladder and prostate.
- (1.2) Over 100 different diseases affect the kidneys. These diseases may present early with features such as pain, the presence of blood or protein in the urine, or peripheral oedema (swelling of the legs), but much renal disease is self-limiting; it occurs and heals with few or no symptoms or sequelae. On the other hand, some kidney diseases start insidiously and progress but are undetected until renal failure develops.
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Acute renal failure
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- (1.3) Renal failure may be acute and reversible. It occurs in previously normal kidneys when their blood supply is compromised by a fall in blood pressure caused by crush injuries, major surgery, failure of the heart's pumping action, loss of blood, salt or water, or when they are damaged by poisons or overwhelming infection. Renal support is then needed for a few days or weeks before renal function returns. However, about half such patients die during these illnesses because of another condition, often the one which caused the renal failure.
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Chronic renal failure (CRF) and established renal failure (ERF)
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- (1.4) More common is irreversible CRF, in which the kidneys are slowly destroyed over months or years. To begin with there is little to see or find and this means that many patients present for medical help very late in their disease, or even in the terminal stages. Tiredness, anaemia, a feeling of being ‘run down’ are often the only symptoms. However, if high blood pressure develops, as often happens when the kidneys fail, or is the prime cause of the kidney disease, it may cause headache, breathlessness and perhaps angina. Ankle swelling may occur if there is a considerable loss of protein in the urine.
- (1.5) Progressive loss of kidney function is also called CRF. Early CRF is sometimes referred to as chronic renal impairment or insufficiency and ERF when it reaches its terminal stage. At this point, if nothing is done the patient will die. Two complementary forms of treatment—dialysis and renal transplantation are available and both are needed if ERF is to be treated.
- (1.6) The incidence of chronic renal disease and ERF rises steeply with advancing age. Consequently, an increasing proportion of patients treated for ERF in this country are elderly and the proportion is even higher in some other developed countries. Evidence from the US suggests that the relative risk of ERF in the Black population (predominantly of African origin) is two to four times higher than that for Whites. Data collected during the review of renal specialist services in London suggest that there is in the Thames regions a similar greater risk of renal failure in certain ethnic populations (Asian and African-Caribbean) than in Whites, this is supported by national mortality statistics. People from the Indian subcontinent have a higher prevalence of non-insulin-dependent diabetes and those with diabetes are more likely than Whites to develop renal failure. This partly explains the higher acceptance rate of Asians onto renal replacement programmes.
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Causes of renal failure
|
|---|
- (1.7) Most renal diseases that cause renal failure fall into six categories.
- (1) Systematic disease. Although many generalized diseases such as systematic lupus, vasculitis, amyloidosis and myelomatosis can cause kidney failure, by far the most important cause is diabetes mellitus (
20% of all renal disease in many countries). Progressive kidney damage may begin after some years of diabetes, particularly if the blood sugar and high blood pressure have been poorly controlled. Careful lifelong supervision of diabetes has a major impact in preventing kidney damage.
- (2) Autoimmune disease. ‘Glomerulonephritis’ or ‘nephritis’ describes a group of diseases in which the glomeruli (the filters that start the process of urine formation) are damaged by the body's immunological response to tissue changes or infections elsewhere. Together, all forms of nephritis account for 30% of renal failure in Britain. The most severe forms are therefore treated with medications that suppress response, but treatment makes only a small impact on the progress of this group of patients to ERF.
- (3) High blood pressure. Severe (‘accelerated’) hypertension damages the kidneys, but the damage can be halted and to some extent reversed by early detection and early treatment of high blood pressure. This is a common cause of renal failure in patients of African origin.
- (4) Obstruction. Anything that obstructs the free flow of urine can cause back-pressure on the kidneys. Much the commonest cause is enlargement of the prostate in elderly men.
- (5) Infection of the urine. Cystitis is a very common condition, affecting about half of all women at some time in their lives, but it rarely has serious consequences. However, infections of the urine in young children or patients with obstruction, kidney stones or other abnormalities of the urinary tract may result in scarring of the kidney and eventual kidney failure.
- (6) Genetic disease. One common disease, polycystic kidneys and many rare inherited diseases which affect the kidneys, account for about 8% of all kidney failure in Britain. Although present at birth, polycystic kidney disease often causes no symptoms until middle age or later. Understanding of its genetic basis is rapidly advancing and may lead to the development of effective treatment.
|
Prevention
|
|---|
- (1.8) Although many diseases causing CRF cannot be prevented or arrested at present, better control of diabetes and high blood pressure and relief of obstruction have much to offer, provided they are employed early in the course of the disease before much renal damage has occurred. It has also been shown that a group of antihypertensives called angiotensin-converting enzyme inhibitors (ACEI) delay the progression of renal failure. Screening for renal disease has not been widely practised because the relatively low incidence of cases renders population screening inefficient and costly. Urine tests for protein or blood, or blood tests for the level of some substances normally excreted by the kidney such as creatinine and urea, are potentially useful methods for screening, if populations at risk of renal failure can be identified, e.g. diabetics and the elderly.
|
Complications and comorbidity
|
|---|
- (1.9) Renal failure is often accompanied by other disease processes. Some are due to the primary disease, e.g. diabetes may cause blindness and diseases of the nerves and blood vessels. Others, such as anaemia, bone disease and heart failure, are consequences of the renal failure. Coincidental disease such as chronic bronchitis and arthritis are particularly common in older patients with renal failure. In addition, many patients with ERF have diseases affecting the heart and blood vessels (vascular) particularly ischaemic heart disease and peripheral vascular disease. All these conditions, collectively called comorbidity, can influence the choice of treatment for renal failure and may reduce its benefits. Expert assessment of the patient before ERF can reduce comorbidity and increase the benefit and cost-effectiveness of treatment. Thus, early detection and referral of patients at risk of renal failure is important.
|
Renal replacement therapy
|
|---|
- (1.10) The term renal replacement therapy (RRT) is used to describe treatments for established renal failure in which, in the absence of kidney function, the removal of waste products from the body is achieved by dialysis and other kidney functions are supplemented by drugs. The term also covers the complete replacement of all kidney functions by transplantation.
|
Therapeutic dialysis (‘renal dialysis’)
|
|---|
- (1.11) Dialysis involves the removal of waste products from the blood by allowing these products to diffuse across a thin membrane into dialysis fluid which is then discarded along with the toxic waste products. The fluid is chemically composed to draw or ‘attract’ excess salts and water from the blood to cross the membrane, without the blood itself being in contact with the fluid.
|
Haemodialysis
|
|---|
- (1.12) The method first used to achieve dialysis was the artificial kidney, or haemodialysis. This involves the attachment of the patient's circulation to a machine through which fluid is passed and exchange can take place. A disadvantage of this method is that some form of permanent access to the circulation must be produced to be used at every treatment. Each session lasts 4–5 h and is needed three times a week.
|
Peritoneal dialysis
|
|---|
- (1.13) The alternative is peritoneal dialysis, often carried out in the form of continuous ambulatory peritoneal dialysis (CAPD). In this technique, fluid is introduced into the peritoneal cavity (which lies around the bowel) for 6 h before withdrawal. The washing fluid must be sterile in order to avoid peritonitis (infection and inflammation of the peritoneum), which is the main complication of the treatment. A silastic tube must be implanted into the peritoneum and this may give problems such as kinking and malposition. Each fluid exchange lasts 30–40 min and is repeated three or four times daily. Neither form of dialysis corrects the loss of the hormones secreted by the normal kidney so replacement with synthetic erythropoietin and vitamin D is often necessary.
|
Renal transplantation
|
|---|
- (1.14) Renal transplantation replaces all the kidneys’ functions, so erythropoietin and vitamin D supplementation are unnecessary. A single kidney is placed, usually in the pelvis close to the bladder to which the ureter is connected. The kidney is attached to a nearby artery and vein. The immediate problem is the body's acute rejection of the foreign graft, which can largely be overcome during the first months using drugs such as steroids and cyclosporin. These drugs and others that can be used for that purpose, have many undesirable side effects, including the acceleration of vascular disease. This often means that myocardial infarcts and strokes are commoner in transplant patients than in age-matched controls. During subsequent years there is a steady loss of transplanted kidneys owing to a process of chronic rejection; treatment of this is quite unsatisfactory at the moment, so many patients require a second or even a third graft over several decades, with further periods of dialysis in between.
- (1.15) The main problem with expanding the transplantation service is the shortage of suitable kidneys to transplant. Although the situation can be improved, it is now clear that whatever social and medical structures are present and whatever legislation is adopted, there will inevitably be a shortage of kidneys from humans. This remains the case even if kidneys from the newly dead (cadaver kidneys) are retrieved with the maximum efficiency and living donors (usually, but not always from close blood relatives of the recipient) are used wherever appropriate. Hope for the future rests with solving the problems of xenotransplantation (which involves using animal kidneys), probably from pigs, although baboons have also been suggested and are closer to humans. Many problems remain unsolved and it is thought highly unlikely that xenotransplantation will become a reliable treatment for ERF within the next 10 years.
|
Nature of renal services
|
|---|
- (1.16) The work of a nephrologist includes the early detection and diagnosis of renal disease and the long-term management of its complications such as high blood pressure, anaemia and bone disease. The nephrologist may share the management with the general practitioner or local hospital physician and relies on them to refer patients early for initial diagnosis and specific treatment. At any one time, perhaps only 5% of patients under care are in-patients in wards, the remainder being treated in their homes with 20% of these attending the renal unit regularly for haemodialysis. However, in-patient nephrology and the care of patients receiving centre-based dialysis are specialized, complex and require experienced medical advice to be available on a 24 h basis. This implies sufficient staff to provide expert cover; cross-covering by inexperienced staff is inappropriate and to be condemned. The other 95% of renal work is sustained on an out-patient basis; this includes RRT by dialysis and the care of transplant patients.
- (1.17) There are five major components to renal medicine.
- (1) RRT: The most significant element of work relates to the preparation of patients in ERF for RRT and their medical supervision for the remainder of their lives. The patient population will present increasing challenges for renal staffing as more elderly and diabetic patients are accepted for treatment.
- (2) Emergency work: The emergency work associated with the speciality consists of:
- (i) Treatment of acute renal failure, often in volving multiple organ failure and acute-on-chronic renal failure. Close cooperation with other medical specialties, including intensive care, is therefore a vital component of this aspect of the service.
- (ii) Management of medical emergencies arising from an ERF programme. This workload is bound to expand rapidly as the number, age and comorbidity of patients starting RRT increases and this may interrupt the regular care of patients already on RRT, so increased resources may be required.
- (3) Routine nephrology: A substantial workload is associated with the immunological and metabolic nature of renal disease which requires investigative procedures in an in-patient setting. It is estimated that 10 in-patient beds per million of the population are required for this work.
- (4) Investigation and management of fluid and electrolyte disorders: this makes up a variable proportion of the nephrologists work, depending on the other expertise available in the hospital.
- (5) Out-patient work: the outpatient work in renal medicine consists of the majority of general nephrology together with clinics attended by dialysis and renal transplant patients.
|
Further reading
|
|---|
Further details of renal services for renal failure, written
for non-physicians, can be found in: Cameron JS.
Kidney Failure – the Facts. London: Oxford University Press, 1996.
|
Appendix D—Methodology of standardized acceptance rates calculation and administrative area geography in the UK and the analysis of data by PCT group for England
|
|---|
Chapter 3, on the incidence of new patients, includes an analysis
of standardized acceptance rates in England, Wales, Scotland
and Northern Ireland for areas covered by the Registry. The
methodology is subsequently described. This methodology is also
used in Chapter 4 and in this Appendix for analyses of prevalent
patients.
Only some of the boundaries of Primary Care Trusts (PCTs) and Local Authorities (LAs) in England are similar. The Office for National Statistics (ONS) is in the process of re-aligning the PCT boundaries with those of LAs and hopes to complete this process by 2007. The data in this Report uses the PCT and LA boundaries from the 2001 census as the ONS have not issued new population tables for any of the changed boundaries.
|
Patients
|
|---|
For acceptance rate analyses, all new cases recorded by the
Registry as accepted on to RRT in each year were included. Each
patient's postcode was matched to a 2001 Census output area.
The analyses use the patient postcode rather than the GP postcode.
|
Geography—Unitary Authorities, counties and other areas
|
|---|
In contrast to 2002, contiguous ‘county’ areas were
not derived by merging Unitary Authorities (UAs) with a bordering
county. For example, Southampton UA and Portsmouth UA were kept
separate from Hampshire county. The final areas used were Metropolitan
counties, Greater London districts, Welsh areas, Shire counties,
UAs, Scottish Council areas and Northern Ireland District Council
areas—these different types of area are collectively called
‘LA areas’ here.
Lists of areas as on 31 December 2000 were taken from http://www.statistics.gov.uk/geography/geographic_area_listings/administrative.asp
|
Administrative area geography in England and Wales
|
|---|
There are currently 46 UAs in England, 34 shire counties and
six metropolitan counties. Greater London forms a unique area
type. Shire counties and Metropolitan counties are subdivided
into districts; UAs are not subdivided. Greater London is subdivided
into the London Boroughs and the City of London.
Unitary Authorities
Table D1. Unitary Authorities
| Code |
UA name |
|
| 00EB |
Hartlepool |
| 00EC |
Middlesbrough |
| 00EE |
Redcar and Cleveland |
| 00EF |
Stockton-on-Tees |
| 00EH |
Darlington |
| 00ET |
Halton |
| 00EU |
Warrington |
| 00EX |
Blackburn with Darwen |
| 00EY |
Blackpool |
| 00FA |
Kingston upon Hull, City of |
| 00FB |
East Riding of Yorkshire |
| 00FC |
North East Lincolnshire |
| 00FD |
North Lincolnshire |
| 00FF |
York |
| 00FK |
Derby |
| 00FN |
Leicester |
| 00FP |
Rutland |
| 00FY |
Nottingham |
| 00GA |
Herefordshire, County of |
| 00GF |
Telford and Wrekin |
| 00GL |
Stoke-on-Trent |
| 00HA |
Bath and North East Somerset |
| 00HB |
Bristol, City of |
| 00HC |
North Somerset |
| 00HD |
South Gloucestershire |
| 00HG |
Plymouth |
| 00HH |
Torbay |
| 00HN |
Bournemouth |
| 00HP |
Poole |
| 00HX |
Swindon |
| 00JA |
Peterborough |
| 00KA |
Luton |
| 00KF |
Southend-on-Sea |
| 00KG |
Thurrock |
| 00LC |
Medway |
| 00MA |
Bracknell Forest |
| 00MB |
West Berkshire |
| 00MC |
Reading |
| 00MD |
Slough |
| 00ME |
Windsor and Maidenhead |
| 00MF |
Wokingham |
| 00MG |
Milton Keynes |
| 00ML |
Brighton and Hove |
| 00MR |
Portsmouth |
| 00MS |
Southampton |
| 00MW |
Isle of Wight |
|
Shire counties
There are 34 shire counties, subdivided into non-metropolitan districts.
Table D2. Shire counties
| Code |
County name |
|
| 09 |
Bedfordshire |
| 11 |
Buckinghamshire |
| 12 |
Cambridgeshire |
| 13 |
Cheshire |
| 15 |
Cornwall and Isles of Scilly |
| 16 |
Cumbria |
| 17 |
Derbyshire |
| 18 |
Devon |
| 19 |
Dorset |
| 20 |
Durham |
| 21 |
East Sussex |
| 22 |
Essex |
| 23 |
Gloucestershire |
| 24 |
Hampshire |
| 26 |
Hertfordshire |
| 29 |
Kent |
| 30 |
Lancashire |
| 31 |
Leicestershire |
| 32 |
Lincolnshire |
| 33 |
Norfolk |
| 34 |
Northamptonshire |
| 35 |
Northumberland |
| 36 |
North Yorkshire |
| 37 |
Nottinghamshire |
| 38 |
Oxfordshire |
| 39 |
Shropshire |
| 40 |
Somerset |
| 41 |
Staffordshire |
| 42 |
Suffolk |
| 43 |
Surrey |
| 44 |
Warwickshire |
| 45 |
West Sussex |
| 46 |
Wiltshire |
| 47 |
Worcestershire |
|
Metropolitan counties
There are six metropolitan counties, all in England and representing heavily built-up areas (other than Greater London). These are subdivided into metropolitan districts.
Table D3. Metropolitan counties
| Code |
Area name |
Metropolitan district |
|
| 00BL |
Greater Manchester |
Bolton |
| 00BM |
|
Bury |
| 00BN |
|
Manchester |
| 00BP |
|
Oldham |
| 00BQ |
|
Rochdale |
| 00BR |
|
Salford |
| 00BS |
|
Stockport |
| 00BT |
|
Tameside |
| 00BU |
|
Trafford |
| 00BW |
|
Wigan |
| 00BX |
Cheshire and Merseyside |
Knowsley |
| 00BY |
|
Liverpool |
| 00CA |
|
Sefton |
| 00BZ |
|
St Helens |
| 00CB |
|
Wirral |
| 00CC |
South Yorkshire |
Barnsley |
| 00CE |
|
Doncaster |
| 00CF |
|
Rotherham |
| 00CG |
|
Sheffield |
| 00CH |
Northumberland, Tyne and Wear |
Gateshead |
| 00CJ |
|
Newcastle upon Tyne |
| 00CK |
|
North Tyneside |
| 00CL |
|
South Tyneside |
| 00CM |
|
Sunderland |
| 00CN |
West Midlands |
Birmingham |
| 00CQ |
|
Coventry |
| 00CR |
|
Dudley |
| 00CS |
|
Sandwell |
| 00CT |
|
Solihull |
| 00CU |
|
Walsall |
| 00CW |
|
Wolverhampton |
| 00CX |
West Yorkshire |
Bradford |
| 00CY |
|
Calderdale |
| 00CZ |
|
Kirklees |
| 00DA |
|
Leeds |
| 00DB |
|
Wakefield |
|
Greater London
This is an administrative unit covering the London metropolis. There are 32 boroughs and also the City of London (a City Corporation).
Table D4. London boroughs
| Code |
Area name |
Borough name |
|
| 00AA |
Greater London |
City of London |
| 00AB |
|
Barking and Dagenham |
| 00AC |
|
Barnet |
| 00AD |
|
Bexley |
| 00AE |
|
Brent |
| 00AF |
|
Bromley |
| 00AG |
|
Camden |
| 00AH |
|
Croydon |
| 00AJ |
|
Ealing |
| 00AK |
|
Enfield |
| 00AL |
|
Greenwich |
| 00AM |
|
Hackney |
| 00AN |
|
Hammersmith and Fulham |
| 00AP |
|
Haringey |
| 00AQ |
|
Harrow |
| 00AR |
|
Havering |
| 00AS |
|
Hillingdon |
| 00AT |
|
Hounslow |
| 00AU |
|
Islington |
| 00AW |
|
Kensington and Chelsea |
| 00AX |
|
Kingston upon Thames |
| 00AY |
|
Lambeth |
| 00AZ |
|
Lewisham |
| 00BA |
|
Merton |
| 00BB |
|
Newham |
| 00BC |
|
Redbridge |
| 00BD |
|
Richmond upon Thames |
| 00BE |
|
Southwark |
| 00BF |
|
Sutton |
| 00BG |
|
Tower Hamlets |
| 00BH |
|
Waltham Forest |
| 00BJ |
|
Wandsworth |
| 00BK |
|
Westminster |
|
Welsh Unitary Authorities
Table D5. Welsh Unitary Authorities
| Code |
Area name |
UA name |
|
| 00PT |
Bro Taf |
Cardiff |
| 00PH |
|
Merthyr Tydfil |
| 00PF |
|
Rhondda; Cynon; Taff |
| 00PD |
|
The Vale of Glamorgan |
| 00NQ |
Dyfed Powys |
Ceredigion |
| 00NU |
|
Carmarthenshire |
| 00NS |
|
Pembrokeshire |
| 00NN |
|
Powys |
| 00PL |
Gwent |
Blaenau Gwent |
| 00PK |
|
Caerphilly |
| 00PP |
|
Monmouthshire |
| 00PR |
|
Newport |
| 00PM |
|
Torfaen |
| 00PB |
Morgannwg |
Bridgend |
| 00NZ |
|
Neath, Port Talbot |
| 00NX |
|
Swansea |
| 00NE |
North Wales |
Conwy |
| 00NG |
|
Denbighshire |
| 00NJ |
|
Flintshire |
| 00NC |
|
Gwynedd |
| 00NA |
|
Isle of Anglesey |
| 00NL |
|
Wrexham |
|
Scottish Council areas
Table D6. Scottish Council areas
| 00QA |
Aberdeen City |
| 00QB |
Aberdeenshire |
| 00QC |
Angus |
| 00QD |
Argyll and Bute |
| 00QE |
Scottish Borders |
| 00QF |
Clackmannanshire |
| 00QG |
West Dunbartonshire |
| 00QH |
Dumfries and Galloway |
| 00QJ |
Dundee City |
| 00QK |
East Ayrshire |
| 00QL |
East Dunbartonshire |
| 00QM |
East Lothian |
| 00QN |
East Renfrewshire |
| 00QP |
Edinburgh, City of |
| 00QQ |
Falkirk |
| 00QR |
Fife |
| 00QS |
Glasgow City |
| 00QT |
Highland |
| 00QU |
Inverclyde |
| 00QW |
Midlothian |
| 00QX |
Moray |
| 00QY |
North Ayrshire |
| 00QZ |
North Lanarkshire |
| 00RA |
Orkney Islands |
| 00RB |
Perth and Kinross |
| 00RC |
Renfrewshire |
| 00RD |
Shetland Islands |
| 00RE |
South Ayrshire |
| 00RF |
South Lanarkshire |
| 00RG |
Stirling |
| 00RH |
West Lothian |
| 00RJ |
Eilean Siar |
|
Northern Ireland District Council areas
Table D7. Northern Ireland District Council areas
| 95AA |
Antrim |
| 95BB |
Ards |
| 95CC |
Armagh |
| 95DD |
Ballymena |
| 95EE |
Ballymoney |
| 95FF |
Banbridge |
| 95GG |
Belfast |
| 95HH |
Carrickfergus |
| 95II |
Castlereagh |
| 95JJ |
Coleraine |
| 95KK |
Cookstown |
| 95LL |
Craigavon |
| 95MM |
Derry |
| 95NN |
Down |
| 95OO |
Dungannon |
| 95PP |
Fermanagh |
| 95QQ |
Larne |
| 95RR |
Limavady |
| 95SS |
Lisburn |
| 95TT |
Magherafelt |
| 95UU |
Moyle |
| 95VV |
Newry and Mourne |
| 95WW |
Newtownabbey |
| 95XX |
North Down |
| 95YY |
Omagh |
| 95ZZ |
Strabane |
|
|
Areas included in Registry ‘covered’ population
|
|---|
All parts of Wales, Scotland and Northern Ireland are covered
by the Registry but coverage is not yet complete for England.
The Registry identified all areas in England which they estimated
to have complete coverage and analysis was restricted to these
areas.
The right hand column indicates whether the area has been included in the analyses. This is dependent on whether the renal unit in the area is sending data to the Registry and that there are no overlapping areas with renal units not yet connected to the Registry.
Table D8. Renal Registry coverage of England
| UK area |
SHA |
Name |
Area type |
Code |
Covered in 2005? |
|
| North East |
County Durham and Tees Valley |
Darlington |
Unitary authority |
00EH |
 |
|
|
Durham |
Shire county |
20 |
|
|
|
Hartlepool |
Unitary authority |
00EB |
|
|
|
Middlesbrough |
Unitary authority |
00EC |
|
|
|
Redcar and Cleveland |
Unitary authority |
00EE |
|
|
|
Stockton-on-Tees |
Unitary authority |
00EF |
|
|
Northumberland, Tyne and Wear |
Gateshead |
Metropolitan district |
00CH |
|
|
|
Newcastle upon Tyne |
Metropolitan district |
00CJ |
|
|
|
North Tyneside |
Metropolitan district |
00CK |
|
|
|
Northumberland |
Shire county |
35 |
|
|
|
South Tyneside |
Metropolitan district |
00CL |
|
|
|
Sunderland |
Metropolitan district |
00CM |
|
| North West |
Cheshire and Merseyside |
Cheshire |
Shire county |
13 |
 |
|
|
Halton |
Unitary authority |
00ET |
|
|
|
Knowsley |
Metropolitan district |
00BX |
|
|
|
Liverpool |
Metropolitan district |
00BY |
|
|
|
Sefton |
Metropolitan district |
00CA |
|
|
|
St Helens |
Metropolitan district |
00BZ |
|
|
|
Warrington |
Unitary authority |
00EU |
|
|
|
Wirral |
Metropolitan district |
00CB |
|
|
Cumbria and Lancashire |
Blackburn with Darwen |
Unitary authority |
00EX |
|
|
|
Blackpool |
Unitary authority |
00EY |
|
|
|
Cumbria |
Shire county |
16 |
|
|
|
Lancashire |
Shire county |
30 |
|
|
Greater Manchester |
Bolton |
Metropolitan district |
00BL |
|
|
|
Bury |
Metropolitan district |
00BM |
|
|
|
Manchester |
Metropolitan district |
00BN |
|
|
|
Oldham |
Metropolitan district |
00BP |
|
|
|
Rochdale |
Metropolitan district |
00BQ |
|
|
|
Salford |
Metropolitan district |
00BR |
|
|
|
Stockport |
Metropolitan district |
00BS |
|
|
|
Tameside |
Metropolitan district |
00BT |
|
|
|
Trafford |
Metropolitan district |
00BU |
|
|
|
Wigan |
Metropolitan district |
00BW |
|
| Yorkshire and the Humber |
North and East Yorkshire and Northern Lincolnshire |
East Riding of Yorkshire |
Unitary authority |
00FB |
|
|
|
Kingston upon Hull, City of |
Unitary authority |
00FA |
|
|
|
North East Lincolnshire |
Unitary authority |
00FC |
|
|
|
North Lincolnshire |
Unitary authority |
00FD |
|
|
|
North Yorkshire |
Shire county |
36 |
|
|
|
York |
Unitary authority |
00FF |
|
|
South Yorkshire |
Barnsley |
Metropolitan district |
00CC |
|
|
|
Doncaster |
Metropolitan district |
00CE |
|
|
|
Rotherham |
Metropolitan district |
00CF |
|
|
|
Sheffield |
Metropolitan district |
00CG |
|
|
West Yorkshire |
Bradford |
Metropolitan district |
00CX |
|
|
|
Calderdale |
Metropolitan district |
00CY |
|
|
|
Kirklees |
Metropolitan district |
00CZ |
|
|
|
Leeds |
Metropolitan district |
00DA |
|
|
|
Wakefield |
Metropolitan district |
00DB |
|
| East Midlands |
Leicestershire, Northamptonshire and Rutland |
Leicester |
Unitary authority |
00FN |
|
|
|
Leicestershire |
Shire county |
31 |
|
|
|
Northamptonshire |
Shire county |
34 |
|
|
|
Rutland |
Unitary authority |
00FP |
|
|
Trent |
Derby |
Unitary authority |
00FK |
|
|
|
Derbyshire |
Shire county |
17 |
|
|
|
Lincolnshire |
Shire county |
32 |
|
|
|
Nottingham |
Unitary authority |
00FY |
|
|
|
Nottinghamshire |
Shire county |
37 |
|
| West Midlands |
Birmingham and the Black Country |
Birmingham |
Metropolitan district |
00CN |
|
|
|
Dudley |
Metropolitan district |
00CR |
|
|
|
Sandwell |
Metropolitan district |
00CS |
|
|
|
Solihull |
Metropolitan district |
00CT |
|
|
|
Walsall |
Metropolitan district |
00CU |
|
|
|
Wolverhampton |
Metropolitan district |
00CW |
|
|
Coventry, Warwickshire, Herefordshire and Worcestershire |
Coventry |
Metropolitan district |
00CQ |
|
|
|
Herefordshire, County of |
Unitary authority |
00GA |
|
|
|
Warwickshire |
Shire county |
44 |
|
|
|
Worcestershire |
Shire county |
47 |
|
|
Shropshire and Staffordshire |
Shropshire |
Shire county |
39 |
|
|
|
Staffordshire |
Shire county |
41 |
|
|
|
Stoke-on-Trent |
Unitary authority |
00GL |
|
|
|
Telford and Wrekin |
Unitary authority |
00GF |
|
| East of England |
Bedfordshire and Hertfordshire |
Bedfordshire |
Shire county |
9 |
|
|
|
Hertfordshire |
Shire county |
26 |
|
|
|
Luton |
Unitary authority |
00KA |
|
|
Essex |
Essex |
Shire county |
22 |
|
|
|
Southend-on-Sea |
Unitary authority |
00KF |
|
|
|
Thurrock |
Unitary authority |
00KG |
|
|
Norfolk, Suffolk and Cambridgeshire |
Cambridgeshire |
Shire county |
12 |
|
|
|
Norfolk |
Shire county |
33 |
|
|
|
Peterborough |
Unitary authority |
00JA |
|
|
|
Suffolk |
Shire county |
42 |
|
| London |
North Central London |
Barnet |
London borough |
00AC |
|
|
|
Camden |
London borough |
00AG |
|
|
|
Enfield |
London borough |
00AK |
|
|
|
Haringey |
London borough |
00AP |
|
|
|
Islington |
London borough |
00AU |
|
|
North East London |
Barking and Dagenham |
London borough |
00AB |
|
|
|
City of London |
London borough |
00AA |
|
|
|
Hackney |
London borough |
00AM |
|
|
|
Havering |
London borough |
00AR |
|
|
|
Newham |
London borough |
00BB |
|
|
|
Redbridge |
London borough |
00BC |
|
|
|
Tower Hamlets |
London borough |
00BG |
|
|
|
Waltham Forest |
London borough |
00BH |
|
|
North West London |
Brent |
London borough |
00AE |
|
|
|
Ealing |
London borough |
00AJ |
|
|
|
Hammersmith and Fulham |
London borough |
00AN |
|
|
|
Harrow |
London borough |
00AQ |
|
|
|
Hillingdon |
London borough |
00AS |
|
|
|
Hounslow |
London borough |
00AT |
|
|
|
Kensington and Chelsea |
London borough |
00AW |
|
|
|
Westminster |
London borough |
00BK |
|
|
South East London |
Bexley |
London borough |
00AD |
|
|
|
Bromley |
London borough |
00AF |
|
|
|
Greenwich |
London borough |
00AL |
|
|
|
Lambeth |
London borough |
00AY |
|
|
|
Lewisham |
London borough |
00AZ |
|
|
|
Southwark |
London borough |
00BE |
|
|
South West London |
Croydon |
London borough |
00AH |
|
|
|
Kingston upon Thames |
London borough |
00AX |
|
|
|
Merton |
London borough |
00BA |
|
|
|
Richmond upon Thames |
London borough |
00BD |
|
|
|
Sutton |
London borough |
00BF |
|
|
|
Wandsworth |
London borough |
00BJ |
|
| South East |
Hampshire and Isle of Wight |
Hampshire |
Shire county |
24 |
|
|
|
Isle of Wight |
Unitary authority |
00MW |
|
|
|
Portsmouth |
Unitary authority |
00MR |
|
|
|
Southampton |
Unitary authority |
00MS |
|
|
Kent and Medway |
Kent |
Shire county |
29 |
|
|
|
Medway |
Unitary authority |
00LC |
|
|
Surrey and Sussex |
Brighton and Hove |
Unitary authority |
00ML |
|
|
|
East Sussex |
Shire county |
21 |
|
|
|
Surrey |
Shire county |
43 |
|
|
|
West Sussex |
Shire county |
45 |
|
|
Thames Valley |
Bracknell Forest |
Unitary authority |
00MA |
|
|
|
Buckinghamshire |
Shire county |
11 |
|
|
|
Milton Keynes |
Unitary authority |
00MG |
|
|
|
Oxfordshire |
Shire county |
38 |
|
|
|
Reading |
Unitary authority |
00MC |
|
|
|
Slough |
Unitary authority |
00MD |
|
|
|
West Berkshire |
Unitary authority |
00MB |
|
|
|
Windsor and Maidenhead |
Unitary authority |
00ME |
|
|
|
Wokingham |
Unitary authority |
00MF |
|
| South West |
Avon, Gloucestershire and Wiltshire |
Bath and North East Somerset |
Unitary authority |
00HA |
|
|
|
Bristol, City of |
Unitary authority |
00HB |
|
|
|
Gloucestershire |
Shire county |
23 |
|
|
|
North Somerset |
Unitary authority |
00HC |
|
|
|
South Gloucestershire |
Unitary authority |
00HD |
|
|
|
Swindon |
Unitary authority |
00HX |
|
|
|
Wiltshire |
Shire county |
46 |
|
|
Dorset and Somerset |
Bournemouth |
Unitary authority |
00HN |
|
|
|
Dorset |
Shire county |
19 |
|
|
|
Poole |
Unitary authority |
00HP |
|
|
|
Somerset |
Shire county |
40 |
|
|
South West Peninsula |
Cornwall and Isles of Scilly |
Shire county |
15 |
|
|
|
Devon |
Shire county |
18 |
|
|
|
Plymouth |
Unitary authority |
00HG |
|
|
|
Torbay |
Unitary authority |
00HH |
|
|
|
Population
|
|---|
The populations and age/gender breakdown for the LA areas were
taken from Casweb. Casweb is a web interface to statistics and
related information from the UK Census of Population, developed
at Manchester University for academic use.
|
Calculation of acceptance rates
|
|---|
Crude rate
The crude rate of acceptance on to RRT was calculated for each
LA area for each year
Standardized acceptance rate ratio (SARR)
The age/gender standardized rate ratio of acceptance onto RRT was calculated for each LA area for each year:
Observed cases (Oi) were calculated by summing all cases in all age and gender bands for each LA area. Expected cases (Ei) for each LA area were calculated in the following way. For each age/gender band the observed acceptance rate over all LA areas (the standard population) was applied to the population of that LA in that age/gender band to determine the expected number of new cases. These expected numbers were summed over the age/gender bands to give an expected total number of cases in each LA area. The 95% confidence limits were calculated for each area.
A ratio of 1 indicates that the LA area's acceptance rate was as expected if the age/gender rates found in the total covered population applied to the LA area's population structure; a value above 1 indicates that the observed rate is greater than expected given the LA area's population structure, if the lower confidence limit was above 1 this is statistically significant at the 5% level. The converse applies to standardized rate ratios under one.
These rates have not been adjusted for ethnicity. Much higher rates are expected in populations with a high percentage of patients from South Asian and African Caribbean backgrounds.
A similar process was followed to give the prevalence rates by LA (in Chapter 4) and by Primary Care Trusts (PCT) (in this Appendix).
|
Analysis of prevalent patients by PCT
|
|---|
Table D9 gives information on the observed and expected numbers
of prevalent patients, the ratio of these (with confidence limits)
and the crude rates per million population, by PCT in England.
There are no PCTs in Scotland, Wales or Northern Ireland and
the analyses of their data by LA are to be found in Chapters
3 and 4.
Groups such as PCTs, which represent relatively small populations of 30 000 to 250 000, often wish to assess their performance. When assessing a relatively infrequent occurrence such as prevalence of RRT in such small populations there are wide confidence intervals for any observed frequency. To enable assessment of whether an observed prevalence is likely to be significantly different from the national average, Figure D1 has been included in the report. From these, for any size of population (X-axis) the upper and lower 95% confidence limits around the national average prevalence (dotted lines) can be read from the Y-axis. Any observed prevalence for renal failure must be outside these limits for the given population to be statistically significantly different from the national average. Thus, for a population of 50 000 the observed prevalence would have to be outside the limits of 448 per million population to 904 per million population. However, for a population of 350 000 these limits are from 590 per million population to 762 per million population.
Table D9. Prevalent RRT patients by PCT
| UK area |
SHA |
Name |
Code |
Tot exp |
Tot pop |
Tot obs |
O/E |
L 95% CL |
U 95% CL |
Crude rate pmp |
|
| North East |
County Durham and Tees Valley |
Darlington PCT |
5J9 |
67.37 |
97 849 |
61 |
0.91 |
0.70 |
1.16 |
623.4 |
|
|
Derwentside PCT |
5KA |
60.04 |
85 171 |
64 |
1.07 |
0.83 |
1.36 |
751.4 |
|
|
Durham and Chester-le -Street PCT |
5KC |
95.48 |
140 644 |
85 |
0.89 |
0.72 |
1.10 |
604.4 |
|
|
Durham Dales PCT |
5J8 |
61.71 |
85 531 |
60 |
0.97 |
0.75 |
1.25 |
701.5 |
|
|
Easington PCT |
5KD |
64.87 |
93 971 |
58 |
0.89 |
0.69 |
1.16 |
617.2 |
|
|
Hartlepool PCT |
5D9 |
59.81 |
88 711 |
56 |
0.94 |
0.72 |
1.22 |
631.3 |
|
|
Langbaurgh PCT |
5KN |
68.58 |
97 028 |
73 |
1.06 |
0.85 |
1.34 |
752.4 |
|
|
Middlesbrough PCT |
5KM |
114.30 |
176 806 |
110 |
0.96 |
0.80 |
1.16 |
622.1 |
|
|
North Tees PCT |
5E1 |
118.40 |
177 992 |
104 |
0.88 |
0.72 |
1.06 |
584.3 |
|
|
Sedgefield PCT |
5KE |
60.79 |
87 204 |
64 |
1.05 |
0.82 |
1.35 |
733.9 |
|
Northumberland, Tyne and Wear |
Gateshead PCT |
5KF |
133.52 |
191 133 |
131 |
0.98 |
0.83 |
1.16 |
685.4 |
|
|
Newcastle PCT |
5D7 |
167.02 |
259 470 |
157 |
0.94 |
0.80 |
1.10 |
605.1 |
|
|
North Tyneside PCT |
5D8 |
135.06 |
191 999 |
133 |
0.98 |
0.83 |
1.17 |
692.7 |
|
|
Northumberland Care Trust |
TAC |
222.28 |
305 536 |
197 |
0.89 |
0.77 |
1.02 |
644.8 |
|
|
South Tyneside PCT |
5KG |
106.00 |
152 785 |
96 |
0.91 |
0.74 |
1.11 |
628.3 |
|
|
Sunderland Teaching PCT |
5KL |
188.12 |
280 805 |
182 |
0.97 |
0.84 |
1.12 |
648.1 |
| North West |
Cheshire and Merseyside |
Bebington and West Wirral PCT |
5F8 |
87.82 |
118 951 |
81 |
0.92 |
0.74 |
1.15 |
681.0 |
|
|
Birkenhead and Wallasey PCT |
5H2 |
128.44 |
193 264 |
139 |
1.08 |
0.92 |
1.28 |
719.2 |
|
|
Central Cheshire PCT |
5H4 |
|
|
|
|
|
|
|
|
|
Central Liverpool PCT |
5HA |
148.29 |
237 680 |
154 |
1.04 |
0.89 |
1.22 |
647.9 |
|
|
Cheshire West PCT |
5H3 |
108.28 |
151 111 |
89 |
0.82 |
0.67 |
1.01 |
589.0 |
|
|
Eastern Cheshire PCT |
5H5 |
|
|
|
|
|
|
|
|
|
Ellesmere Port and Neston PCT |
5H6 |
56.21 |
81 580 |
60 |
1.07 |
0.83 |
1.37 |
735.5 |
|
|
Halton PCT |
5J1 |
76.39 |
118 185 |
77 |
1.01 |
0.81 |
1.26 |
651.5 |
|
|
Knowsley PCT |
5J4 |
96.12 |
150 494 |
109 |
1.13 |
0.94 |
1.37 |
724.3 |
|
|
North Liverpool PCT |
5G9 |
64.60 |
102 529 |
71 |
1.10 |
0.87 |
1.39 |
692.5 |
|
|
South Liverpool PCT |
5HC |
66.76 |
98 107 |
82 |
1.23 |
0.99 |
1.53 |
835.8 |
|
|
South Sefton PCT |
5M5 |
114.00 |
168 764 |
110 |
0.96 |
0.80 |
1.16 |
651.8 |
|
|
Southport and Formby PCT |
5F9 |
85.21 |
114 120 |
59 |
0.69 |
0.54 |
0.89 |
517.0 |
|
|
St Helens PCT |
5J3 |
120.17 |
176 810 |
98 |
0.82 |
0.67 |
0.99 |
554.3 |
|
|
Warrington PCT |
5J2 |
127.13 |
190 391 |
106 |
0.83 |
0.69 |
1.01 |
556.7 |
|
Cumbria and Lancashire |
Blackburn With Darwen PCT |
5CC |
82.59 |
137 556 |
90 |
1.09 |
0.89 |
1.34 |
654.3 |
|
|
Blackpool PCT |
5HP |
102.88 |
142 184 |
70 |
0.68 |
0.54 |
0.86 |
492.3 |
|
|
Burnley, Pendle and Rossendale PCT |
5G8 |
159.11 |
244 449 |
143 |
0.90 |
0.76 |
1.06 |
585.0 |
|
|
Carlisle and District PCT |
5D4 |
80.65 |
113 582 |
62 |
0.77 |
0.60 |
0.99 |
545.9 |
|
|
Chorley and South Ribble PCT |
5F2 |
139.53 |
203 189 |
82 |
0.59 |
0.47 |
0.73 |
403.6 |
|
|
Eden Valley PCT |
5D5 |
51.95 |
69 020 |
45 |
0.87 |
0.65 |
1.16 |
652.0 |
|
|
Fylde PCT |
5HE |
55.72 |
72 657 |
31 |
0.56 |
0.39 |
0.79 |
426.7 |
|
|
Hyndburn and Ribble Valley PCT |
5G7 |
84.08 |
124 672 |
75 |
0.89 |
0.71 |
1.12 |
601.6 |
|
|
Morecambe Bay PCT |
5DD |
217.73 |
308 189 |
137 |
0.63 |
0.53 |
0.74 |
444.5 |
|
|
Preston PCT |
5HD |
89.32 |
140 065 |
80 |
0.90 |
0.72 |
1.12 |
571.2 |
|
|
West Cumbria PCT |
5D6 |
92.86 |
130 409 |
83 |
0.89 |
0.72 |
1.11 |
636.5 |
|
|
West Lancashire PCT |
5F3 |
74.88 |
108 541 |
66 |
0.88 |
0.69 |
1.12 |
608.1 |
|
|
Wyre PCT |
5HF |
79.62 |
105 713 |
58 |
0.73 |
0.56 |
0.94 |
548.7 |
|
Greater Manchester |
Ashton, Leigh and Wigan PCT |
5HG |
202.20 |
301 207 |
134 |
0.66 |
0.56 |
0.78 |
444.9 |
|
|
Bolton PCT |
5HQ |
170.57 |
261 329 |
136 |
0.80 |
0.67 |
0.94 |
520.4 |
|
|
Bury PCT |
5JX |
119.41 |
180 637 |
54 |
0.45 |
0.35 |
0.59 |
298.9 |
|
|
Central Manchester PCT |
5CL |
|
|
|
|
|
|
|
|
|
Heywood and Middleton PCT |
5F4 |
|
|
|
|
|
|
|
|
|
North Manchester PCT |
5CR |
|
|
|
|
|
|
|
|
|
Oldham PCT |
5J5 |
138.84 |
217 456 |
69 |
0.50 |
0.39 |
0.63 |
317.3 |
|
|
Rochdale PCT |
5JY |
83.30 |
131 546 |
54 |
0.65 |
0.50 |
0.85 |
410.5 |
|
|
Salford PCT |
5F5 |
141.82 |
215 817 |
88 |
0.62 |
0.50 |
0.76 |
407.8 |
|
|
South Manchester PCT |
5AA |
|
|
|
|
|
|
|
|
|
Stockport PCT |
5F7 |
|
|
|
|
|
|
|
|
|
Tameside and Glossop PCT |
5LH |
|
|
|
|
|
|
|
|
|
Trafford North PCT |
5F6 |
|
|
|
|
|
|
|
|
|
Trafford South PCT |
5CX |
|
|
|
|
|
|
|
| Yorkshire and the Humber |
North and East Yorkshire and Northern Lincolnshire |
Craven, Harrogate and Rural District |
5KJ |
144.92 |
202 790 |
117 |
0.81 |
0.67 |
0.97 |
577.0 |
|
|
PCT |
|
|
|
|
|
|
|
|
|
|
East Yorkshire PCT |
5E3 |
121.68 |
169 845 |
101 |
0.83 |
0.68 |
1.01 |
594.7 |
|
|
Eastern Hull PCT |
5E5 |
72.01 |
113 309 |
74 |
1.03 |
0.82 |
1.29 |
653.1 |
|
|
Hambleton and Richmondshire PCT |
5KH |
78.87 |
108 030 |
60 |
0.76 |
0.59 |
0.98 |
555.4 |
|
|
North East Lincolnshire PCT |
5AN |
106.82 |
159 214 |
110 |
1.03 |
0.85 |
1.24 |
690.9 |
|
|
North Lincolnshire PCT |
5EF |
104.77 |
148 965 |
94 |
0.90 |
0.73 |
1.10 |
631.0 |
|
|
Scarborough, Whitby and Ryedale PCT |
5KK |
118.52 |
157 007 |
94 |
0.79 |
0.65 |
0.97 |
598.7 |
|
|
Selby and York PCT |
5E2 |
185.79 |
271 280 |
179 |
0.96 |
0.83 |
1.12 |
659.8 |
|
|
West Hull PCT |
5E6 |
82.80 |
129 614 |
92 |
1.11 |
0.91 |
1.36 |
709.8 |
|
|
Yorkshire Wolds and Coast PCT |
5E4 |
107.93 |
143 581 |
97 |
0.90 |
0.74 |
1.10 |
675.6 |
|
South Yorkshire |
Barnsley PCT |
5JE |
149.50 |
218 125 |
168 |
1.12 |
0.97 |
1.31 |
770.2 |
|
|
Doncaster Central PCT |
5CK |
47.55 |
70 401 |
58 |
1.22 |
0.94 |
1.58 |
823.8 |
|
|
Doncaster East PCT |
5EK |
77.27 |
110 122 |
66 |
0.85 |
0.67 |
1.09 |
599.3 |
|
|
Doncaster West PCT |
5EL |
70.78 |
104 970 |
70 |
0.99 |
0.78 |
1.25 |
666.9 |
|
|
North Sheffield PCT |
5EE |
75.45 |
117 114 |
101 |
1.34 |
1.10 |
1.63 |
862.4 |
|
|
Rotherham PCT |
5H8 |
168.10 |
248 352 |
197 |
1.17 |
1.02 |
1.35 |
793.2 |
|
|
Sheffield South West PCT |
5EP |
84.70 |
124 598 |
60 |
0.71 |
0.55 |
0.91 |
481.5 |
|
|
Sheffield West PCT |
5EN |
68.63 |
107 094 |
71 |
1.03 |
0.82 |
1.31 |
663.0 |
|
|
South East Sheffield PCT |
5EQ |
110.52 |
164 239 |
125 |
1.13 |
0.95 |
1.35 |
761.1 |
|
West Yorkshire |
Airedale PCT |
5AW |
79.56 |
116 192 |
79 |
0.99 |
0.80 |
1.24 |
679.9 |
|
|
Bradford City PCT |
5CF |
69.32 |
135 189 |
139 |
2.01 |
1.70 |
2.37 |
1028.2 |
|
|
Bradford South and West PCT |
5CG |
84.11 |
132 310 |
103 |
1.22 |
1.01 |
1.49 |
778.5 |
|
|
Calderdale PCT |
5J6 |
128.44 |
192 381 |
142 |
1.11 |
0.94 |
1.30 |
738.1 |
|
|
East Leeds PCT |
5HK |
105.71 |
162 757 |
114 |
1.08 |
0.90 |
1.30 |
700.4 |
|
|
Eastern Wakefield PCT |
5E7 |
115.54 |
171 976 |
99 |
0.86 |
0.70 |
1.04 |
575.7 |
|
|
Huddersfield Central PCT |
5LJ |
89.75 |
137 821 |
113 |
1.26 |
1.05 |
1.51 |
819.9 |
|
|
Leeds North East PCT |
5HJ |
76.49 |
111 524 |
97 |
1.27 |
1.04 |
1.55 |
869.8 |
|
|
Leeds North West PCT |
5HM |
112.99 |
185 393 |
92 |
0.81 |
0.66 |
1.00 |
496.2 |
|
|
Leeds West PCT |
5HH |
70.70 |
108 892 |
84 |
1.19 |
0.96 |
1.47 |
771.4 |
|
|
North Bradford PCT |
5CH |
56.59 |
84 257 |
62 |
1.10 |
0.85 |
1.41 |
735.8 |
|
|
North Kirklees PCT |
5J7 |
106.80 |
170 627 |
139 |
1.30 |
1.10 |
1.54 |
814.6 |
|
|
South Huddersfield PCT |
5LK |
54.93 |
80 460 |
45 |
0.82 |
0.61 |
1.10 |
559.3 |
|
|
South Leeds PCT |
5HL |
93.00 |
145 835 |
86 |
0.92 |
0.75 |
1.14 |
589.7 |
|
|
Wakefield West PCT |
5E8 |
96.97 |
142 712 |
88 |
0.91 |
0.74 |
1.12 |
616.6 |
| East Midlands |
Leicestershire, Northamptonshire and Rutland |
Charnwood and North West |
5JC |
155.60 |
230 214 |
149 |
0.96 |
0.82 |
1.12 |
647.2 |
|
|
Leicestershire PCT |
|
|
|
|
|
|
|
|
|
|
Daventry and South Northamptonshire |
5AC |
68.82 |
101 006 |
55 |
0.80 |
0.61 |
1.04 |
544.5 |
|
|
PCT |
|
|
|
|
|
|
|
|
|
|
Eastern Leicester PCT |
5EY |
103.41 |
173 316 |
206 |
1.99 |
1.74 |
2.28 |
1188.6 |
|
|
Hinckley and Bosworth PCT |
5JA |
80.08 |
115 004 |
77 |
0.96 |
0.77 |
1.20 |
669.5 |
|
|
Leicester City West PCT |
5EJ |
62.23 |
106 430 |
95 |
1.53 |
1.25 |
1.87 |
892.6 |
|
|
Melton, Rutland and Harborough PCT |
5EH |
98.21 |
137 726 |
93 |
0.95 |
0.77 |
1.16 |
675.3 |
|
|
Northampton PCT |
5LW |
133.19 |
208 645 |
131 |
0.98 |
0.83 |
1.17 |
627.9 |
|
|
Northamptonshire Heartlands PCT |
5LV |
189.77 |
283 758 |
168 |
0.89 |
0.76 |
1.03 |
592.1 |
|
|
South Leicestershire PCT |
5JD |
109.57 |
158 350 |
100 |
0.91 |
0.75 |
1.11 |
631.5 |
|
Trent |
Amber Valley PCT |
5ED |
82.29 |
116 564 |
81 |
0.98 |
0.79 |
1.22 |
694.9 |
|
|
Ashfield PCT |
5FA |
56.14 |
81 777 |
56 |
1.00 |
0.77 |
1.30 |
684.8 |
|
|
Bassetlaw PCT |
5ET |
75.31 |
107 327 |
66 |
0.88 |
0.69 |
1.12 |
614.9 |
|
|
Broxtowe and Hucknall PCT |
5EV |
95.15 |
136 951 |
98 |
1.03 |
0.84 |
1.26 |
715.6 |
|
|
Central Derby PCT |
5AL |
37.91 |
64 320 |
54 |
1.42 |
1.09 |
1.86 |
839.5 |
|
|
Chesterfield PCT |
5EA |
69.64 |
98 882 |
78 |
1.12 |
0.90 |
1.40 |
788.8 |
|
|
Derbyshire Dales and South Derbyshire PCT |
5H7 |
74.47 |
107 461 |
61 |
0.82 |
0.64 |
1.05 |
567.6 |
|
|
East Lincolnshire PCT |
5H9 |
205.57 |
265 403 |
173 |
0.84 |
0.73 |
0.98 |
651.8 |
|
|
Erewash PCT |
5ER |
74.81 |
110 123 |
65 |
0.87 |
0.68 |
1.11 |
590.2 |
|
|
Gedling PCT |
5EC |
79.19 |
111 795 |
82 |
1.04 |
0.83 |
1.29 |
733.5 |
|
|
Greater Derby PCT |
5EX |
106.84 |
157 342 |
116 |
1.09 |
0.91 |
1.30 |
737.2 |
|
|
High Peak and Dales PCT |
5HN |
73.23 |
100 153 |
21 |
0.29 |
0.19 |
0.44 |
209.7 |
|
|
Lincolnshire South West PCT |
5D3 |
113.02 |
160 683 |
85 |
0.75 |
0.61 |
0.93 |
529.0 |
|
|
Mansfield District PCT |
5AM |
67.21 |
97 993 |
70 |
1.04 |
0.82 |
1.32 |
714.3 |
|
|
Newark and Sherwood PCT |
5AP |
75.13 |
105 709 |
91 |
1.21 |
0.99 |
1.49 |
860.9 |
|
|
North Eastern Derbyshire PCT |
5EG |
121.98 |
168 767 |
111 |
0.91 |
0.76 |
1.10 |
657.7 |
|
|
Nottingham City PCT |
5EM |
160.53 |
266 780 |
203 |
1.26 |
1.10 |
1.45 |
760.9 |
|
|
Rushcliffe PCT |
5FC |
73.23 |
105 507 |
62 |
0.85 |
0.66 |
1.09 |
587.6 |
|
|
West Lincolnshire PCT |
5D2 |
151.61 |
217 042 |
141 |
0.93 |
0.79 |
1.10 |
649.6 |
| West Midlands |
Birmingham and The Black Country |
Dudley Beacon and Castle PCT |
5HV |
76.54 |
112 378 |
80 |
1.05 |
0.84 |
1.30 |
711.9 |
|
|
Dudley South PCT |
5HT |
136.04 |
192 702 |
123 |
0.90 |
0.76 |
1.08 |
638.3 |
|
|
Eastern Birmingham PCT |
5MY |
125.91 |
203 367 |
202 |
1.60 |
1.40 |
1.84 |
993.3 |
|
|
Heart of Birmingham PCT |
5MX |
146.06 |
274 656 |
351 |
2.40 |
2.16 |
2.67 |
1278.0 |
|
|
North Birmingham PCT |
5MW |
102.06 |
150 593 |
138 |
1.35 |
1.14 |
1.60 |
916.4 |
|
|
Oldbury and Smethwick PCT |
5MG |
58.39 |
91 896 |
106 |
1.82 |
1.50 |
2.20 |
1153.5 |
|
|
Rowley, Regis and Tipton PCT |
5MH |
56.06 |
86 429 |
65 |
1.16 |
0.91 |
1.48 |
752.1 |
|
|
Solihull PCT |
5D1 |
139.20 |
199 486 |
139 |
1.00 |
0.85 |
1.18 |
696.8 |
|
|
South Birmingham PCT |
5M1 |
217.48 |
347 594 |
309 |
1.42 |
1.27 |
1.59 |
889.0 |
|
|
Walsall PCT |
5M3 |
170.16 |
253 316 |
216 |
1.27 |
1.11 |
1.45 |
852.7 |
|
|
Wednesbury and West Bromwich PCT |
5MJ |
71.45 |
104 403 |
94 |
1.32 |
1.07 |
1.61 |
900.4 |
|
|
Wolverhampton City PCT |
5MV |
157.63 |
236 453 |
212 |
1.34 |
1.18 |
1.54 |
896.6 |
|
Coventry, Warwickshire, Herefordshire and Worcestershire |
Coventry PCT |
5MD |
190.63 |
300 667 |
231 |
1.21 |
1.07 |
1.38 |
768.3 |
|
|
Herefordshire PCT |
5CN |
128.06 |
174 133 |
113 |
0.88 |
0.73 |
1.06 |
648.9 |
|
|
North Warwickshire PCT |
5MP |
123.41 |
180 975 |
152 |
1.23 |
1.05 |
1.44 |
839.9 |
|
|
Redditch and Bromsgrove PCT |
5MR |
110.47 |
162 126 |
100 |
0.91 |
0.74 |
1.10 |
616.8 |
|
|
Rugby PCT |
5M9 |
60.40 |
87 253 |
72 |
1.19 |
0.95 |
1.50 |
825.2 |
|
|
South Warwickshire PCT |
5MQ |
169.52 |
237 509 |
163 |
0.96 |
0.82 |
1.12 |
686.3 |
|
|
South Worcestershire PCT |
5MT |
197.31 |
277 881 |
169 |
0.86 |
0.74 |
1.00 |
608.2 |
|
|
Wyre Forest PCT |
5DR |
72.35 |
101 100 |
63 |
0.87 |
0.68 |
1.11 |
623.1 |
|
Shropshire and Staffordshire |
Burntwood, Lichfield and Tamworth |
5DQ |
101.88 |
151 448 |
113 |
1.11 |
0.92 |
1.33 |
746.1 |
|
|
PCT |
|
|
|
|
|
|
|
|
|
|
Cannock Chase PCT |
5MM |
85.59 |
127 829 |
68 |
0.79 |
0.63 |
1.01 |
532.0 |
|
|
East Staffordshire PCT |
5ML |
76.79 |
112 718 |
71 |
0.92 |
0.73 |
1.17 |
629.9 |
|
|
Newcastle-Under-Lyme PCT |
5HW |
|
|
|
|
|
|
|
|
|
North Stoke PCT |
5ME |
|
|
|
|
|
|
|
|
|
Shropshire County PCT |
5M2 |
202.68 |
279 717 |
184 |
0.91 |
0.79 |
1.05 |
657.8 |
|
|
South Stoke PCT |
5MF |
|
|
|
|
|
|
|
|
|
South Western Staffordshire PCT |
5MN |
|
|
|
|
|
|
|
|
|
Staffordshire Moorlands PCT |
5HR |
|
|
|
|
|
|
|
|
|
Telford and Wrekin PCT |
5MK |
99.95 |
158 142 |
86 |
0.86 |
0.70 |
1.06 |
543.8 |
| East of England |
Bedfordshire and Hertfordshire |
Bedford PCT |
5GD |
96.96 |
147 829 |
94 |
0.97 |
0.79 |
1.19 |
635.9 |
|
|
Bedfordshire Heartlands PCT |
5GE |
154.80 |
232 867 |
137 |
0.89 |
0.75 |
1.05 |
588.3 |
|
|
Dacorum PCT |
5GW |
92.07 |
137 177 |
78 |
0.85 |
0.68 |
1.06 |
568.6 |
|
|
Hertsmere PCT |
5CP |
|
|
|
|
|
|
|
|
|
Luton PCT |
5GC |
110.41 |
184 294 |
144 |
1.30 |
1.11 |
1.54 |
781.4 |
|
|
North Hertfordshire and Stevenage PCT |
5GH |
118.07 |
179 745 |
123 |
1.04 |
0.87 |
1.24 |
684.3 |
|
|
Royston, Buntingford and Bishops Stortford PCT |
5GK |
39.95 |
61 985 |
27 |
0.68 |
0.46 |
0.99 |
435.6 |
|
|
South East Hertfordshire PCT |
5GJ |
114.95 |
171 365 |
107 |
0.93 |
0.77 |
1.13 |
624.4 |
|
|
St Albans and Harpenden PCT |
5GX |
86.86 |
129 128 |
54 |
0.62 |
0.48 |
0.81 |
418.2 |
|
|
Watford and Three Rivers PCT |
5GV |
106.06 |
161 527 |
27 |
0.25 |
0.17 |
0.37 |
167.2 |
|
|
Welwyn Hatfield PCT |
5GG |
65.78 |
97 551 |
54 |
0.82 |
0.63 |
1.07 |
553.6 |
|
Essex |
Basildon PCT |
5GR |
64.67 |
102 623 |
62 |
0.96 |
0.75 |
1.23 |
604.2 |
|
|
Billericay, Brentwood and Wickford PCT |
5GP |
93.15 |
131 718 |
78 |
0.84 |
0.67 |
1.05 |
592.2 |
|
|
Castle Point and Rochford PCT |
5JP |
118.62 |
165 218 |
99 |
0.83 |
0.69 |
1.02 |
599.2 |
|
|
Chelmsford PCT |
5JN |
90.92 |
133 719 |
71 |
0.78 |
0.62 |
0.99 |
531.0 |
|
|
Colchester PCT |
5GM |
102.34 |
155 376 |
76 |
0.74 |
0.59 |
0.93 |
489.1 |
|
|
Epping Forest PCT |
5AJ |
84.56 |
120 964 |
69 |
0.82 |
0.64 |
1.03 |
570.4 |
|
|
Harlow PCT |
5DC |
50.43 |
78 935 |
39 |
0.77 |
0.57 |
1.06 |
494.1 |
|
|
Maldon and South Chelmsford PCT |
5GL |
60.02 |
87 435 |
50 |
0.83 |
0.63 |
1.10 |
571.9 |
|
|
Southend On Sea PCT |
5AK |
109.82 |
160 344 |
113 |
1.03 |
0.86 |
1.24 |
704.7 |
|
|
Tendring PCT |
5AH |
108.08 |
136 487 |
85 |
0.79 |
0.64 |
0.97 |
622.8 |
|
|
Thurrock PCT |
5GQ |
90.01 |
143 212 |
92 |
1.02 |
0.83 |
1.25 |
642.4 |
|
|
Uttlesford PCT |
5GN |
49.61 |
70 928 |
41 |
0.83 |
0.61 |
1.12 |
578.0 |
|
|
Witham, Braintree and Halstead |
TAG |
83.89 |
125 628 |
72 |
0.86 |
0.68 |
1.08 |
573.1 |
|
Norfolk, Suffolk and Cambridgeshire |
Broadland PCT |
5JL |
88.22 |
118 302 |
92 |
1.04 |
0.85 |
1.28 |
777.7 |
|
|
Cambridge City PCT |
5JH |
64.29 |
108 466 |
71 |
1.10 |
0.88 |
1.39 |
654.6 |
|
|
Central Suffolk PCT |
5JT |
71.73 |
97 953 |
54 |
0.75 |
0.58 |
0.98 |
551.3 |
|
|
East Cambridgeshire and Fenland PCT |
5JK |
97.47 |
136 129 |
76 |
0.78 |
0.62 |
0.98 |
558.3 |
|
|
Great Yarmouth PCT |
5GT |
66.30 |
90 889 |
20 |
0.30 |
0.19 |
0.47 |
220.0 |
|
|
Huntingdonshire PCT |
5GF |
93.33 |
140 111 |
98 |
1.05 |
0.86 |
1.28 |
699.4 |
|
|
Ipswich PCT |
5JQ |
94.43 |
141 672 |
92 |
0.97 |
0.79 |
1.20 |
649.4 |
|
|
North Norfolk PCT |
5JM |
79.68 |
97 168 |
90 |
1.13 |
0.92 |
1.39 |
926.2 |
|
|
North Peterborough PCT |
5AF |
62.11 |
99 239 |
72 |
1.16 |
0.92 |
1.46 |
725.5 |
|
|
Norwich PCT |
5A2 |
78.30 |
121 145 |
71 |
0.91 |
0.72 |
1.14 |
586.1 |
|
|
South Cambridgeshire PCT |
5JJ |
89.55 |
129 562 |
73 |
0.82 |
0.65 |
1.03 |
563.4 |
|
|
South Peterborough PCT |
5AG |
58.00 |
86 912 |
65 |
1.12 |
0.88 |
1.43 |
747.9 |
|
|
Southern Norfolk PCT |
5G1 |
147.72 |
200 492 |
134 |
0.91 |
0.77 |
1.07 |
668.4 |
|
|
Suffolk Coastal PCT |
5JR |
72.92 |
98 237 |
60 |
0.82 |
0.64 |
1.06 |
610.8 |
|
|
Suffolk West PCT |
5JW |
142.41 |
195 747 |
122 |
0.86 |
0.72 |
1.02 |
623.3 |
|
|
Waveney PCT |
5JV |
90.36 |
121 238 |
38 |
0.42 |
0.31 |
0.58 |
313.4 |
|
|
West Norfolk PCT |
5CY |
119.64 |
154 724 |
98 |
0.82 |
0.67 |
1.00 |
633.4 |
| London |
North Central London |
Barnet PCT |
5A9 |
197.03 |
314 203 |
223 |
1.13 |
0.99 |
1.29 |
709.7 |
|
|
Camden PCT |
5K7 |
116.31 |
198 008 |
127 |
1.09 |
0.92 |
1.30 |
641.4 |
|
|
Enfield PCT |
5C1 |
171.53 |
274 330 |
258 |
1.50 |
1.33 |
1.70 |
940.5 |
|
|
Haringey PCT |
5C9 |
122.41 |
216 812 |
207 |
1.69 |
1.48 |
1.94 |
954.7 |
|
|
Islington PCT |
5K8 |
101.96 |
175 798 |
140 |
1.37 |
1.16 |
1.62 |
796.4 |
|
North East London |
Barking and Dagenham PCT |
5C2 |
99.24 |
164 344 |
102 |
1.03 |
0.85 |
1.25 |
620.6 |
|
|
Chingford, Wanstead and Woodford PCT |
5C7 |
|
|
|
|
|
|
|
|
|
City and Hackney PCT |
5C3 |
115.44 |
210 480 |
171 |
1.48 |
1.28 |
1.72 |
812.4 |
|
|
Havering PCT |
5A4 |
|
|
|
|
|
|
|
|
|
Newham PCT |
5C5 |
126.35 |
244 280 |
201 |
1.59 |
1.39 |
1.83 |
822.8 |
|
|
Redbridge PCT |
5C8 |
109.24 |
176 883 |
365 |
3.34 |
3.02 |
3.70 |
2 063.5 |
|
|
Tower Hamlets PCT |
5C4 |
102.24 |
196 567 |
130 |
1.27 |
1.07 |
1.51 |
661.4 |
|
|
Walthamstow, Leyton and Leytonstone PCT |
5C6 |
|
|
|
|
|
|
|
|
North West London |
Brent PCT |
5K5 |
|
|
|
|
|
|
|
|
|
Ealing PCT |
5HX |
182.26 |
301 433 |
273 |
1.50 |
1.33 |
1.69 |
905.7 |
|
|
Hammersmith and Fulham PCT |
5H1 |
96.60 |
165 058 |
136 |
1.41 |
1.19 |
1.67 |
824.0 |
|
|
Harrow PCT |
5K6 |
|
|
|
|
|
|
|
|
|
Hillingdon PCT |
5AT |
152.47 |
240 346 |
155 |
1.02 |
0.87 |
1.19 |
644.9 |
|
|
Hounslow PCT |
5HY |
127.74 |
212 397 |
209 |
1.64 |
1.43 |
1.87 |
984.0 |
|
|
Kensington and Chelsea PCT |
5LA |
|
|
|
|
|
|
|
|
|
Westminster PCT |
5LC |
|
|
|
|
|
|
|
|
South East London |
Bexley PCT |
TAK |
145.65 |
218 675 |
160 |
1.10 |
0.94 |
1.28 |
731.7 |
|
|
Bromley PCT |
5A7 |
201.27 |
295 865 |
188 |
0.93 |
0.81 |
1.08 |
635.4 |
|
|
Greenwich PCT |
5A8 |
127.90 |
214 597 |
147 |
1.15 |
0.98 |
1.35 |
685.0 |
|
|
Lambeth PCT |
5LD |
147.96 |
266 487 |
207 |
1.40 |
1.22 |
1.60 |
776.8 |
|
|
Lewisham PCT |
5LF |
143.89 |
249 428 |
252 |
1.75 |
1.55 |
1.98 |
1 010.3 |
|
|
Southwark PCT |
5LE |
139.50 |
245 357 |
243 |
1.74 |
1.54 |
1.98 |
990.4 |
|
South West London |
Croydon PCT |
5K9 |
206.21 |
331 406 |
252 |
1.22 |
1.08 |
1.38 |
760.4 |
|
|
Kingston PCT |
5A5 |
|
|
|
|
|
|
|
|
|
Richmond and Twickenham PCT |
5M6 |
|
|
|
|
|
|
|
|
|
Sutton and Merton PCT |
5M7 |
|
|
|
|
|
|
|
|
|
Wandsworth PCT |
5LG |
|
|
|
|
|
|
|
| South East |
Hampshire and Isle Of Wight |
East Hampshire PCT |
5FD |
120.90 |
168 691 |
100 |
0.83 |
0.68 |
1.01 |
592.8 |
|
|
Eastleigh and Test Valley South PCT |
5LY |
109.21 |
161 617 |
103 |
0.94 |
0.78 |
1.14 |
637.3 |
|
|
Fareham and Gosport PCT |
5LX |
124.88 |
180 116 |
113 |
0.90 |
0.75 |
1.09 |
627.4 |
|
|
Isle of Wight PCT |
5DG |
99.81 |
131 502 |
66 |
0.66 |
0.52 |
0.84 |
501.9 |
|
|
Mid-Hampshire PCT |
5E9 |
117.17 |
169 042 |
81 |
0.69 |
0.56 |
0.86 |
479.2 |
|
|
New Forest PCT |
5A1 |
129.35 |
168 914 |
83 |
0.64 |
0.52 |
0.80 |
491.4 |
|
|
North Hampshire PCT |
5DF |
135.61 |
206 226 |
104 |
0.77 |
0.63 |
0.93 |
504.3 |
|
|
Portsmouth City PCT |
5FE |
113.34 |
177 571 |
128 |
1.13 |
0.95 |
1.34 |
720.8 |
|
|
Blackwater Valley and Hart PCT |
5G6 |
107.65 |
168 106 |
63 |
0.59 |
0.46 |
0.75 |
374.8 |
|
|
Southampton City PCT |
5L1 |
133.88 |
217 329 |
119 |
0.89 |
0.74 |
1.06 |
547.6 |
|
Kent and Medway |
Ashford PCT |
5LL |
|
|
|
|
|
|
|
|
|
Canterbury and Coastal PCT |
5LM |
|
|
|
|
|
|
|
|
|
Dartford, Gravesham and Swanley PCT |
5CM |
|
|
|
|
|
|
|
|
|
East Kent Coastal PCT |
5LN |
|
|
|
|
|
|
|
|
|
Maidstone Weald PCT |
5L2 |
|
|
|
|
|
|
|
|
|
Medway PCT |
5L3 |
|
|
|
|
|
|
|
|
|
Shepway PCT |
5LP |
|
|
|
|
|
|
|
|
|
South West Kent PCT |
5FF |
|
|
|
|
|
|
|
|
|
Swale PCT |
5L4 |
|
|
|
|
|
|
|
|
Surrey and Sussex |
Adur, Arun and Worthing PCT |
5L8 |
159.47 |
216 387 |
135 |
0.85 |
0.72 |
1.00 |
623.9 |
|
|
Bexhill and Rother PCT |
5FH |
70.53 |
87 368 |
49 |
0.69 |
0.53 |
0.92 |
560.8 |
|
|
Brighton and Hove City PCT |
5LQ |
162.05 |
248 061 |
131 |
0.81 |
0.68 |
0.96 |
528.1 |
|
|
Crawley PCT |
5MA |
63.62 |
99 679 |
66 |
1.04 |
0.82 |
1.32 |
662.1 |
|
|
East Elmbridge and Mid Surrey PCT |
5KP |
184.63 |
260 806 |
143 |
0.77 |
0.66 |
0.91 |
548.3 |
|
|
East Surrey PCT |
5KQ |
109.23 |
159 808 |
78 |
0.71 |
0.57 |
0.89 |
488.1 |
|
|
Eastbourne Downs PCT |
5LR |
126.57 |
166 311 |
106 |
0.84 |
0.69 |
1.01 |
637.4 |
|
|
Guildford and Waverley PCT |
5L5 |
152.85 |
222 319 |
81 |
0.53 |
0.43 |
0.66 |
364.3 |
|
|
Hastings and St Leonards PCT |
5FJ |
57.58 |
85 325 |
52 |
0.90 |
0.69 |
1.19 |
609.4 |
|
|
Horsham and Chanctonbury PCT |
5MC |
69.37 |
100 790 |
45 |
0.65 |
0.48 |
0.87 |
446.5 |
|
|
Mid-Sussex PCT |
5FK |
90.29 |
130 195 |
56 |
0.62 |
0.48 |
0.81 |
430.1 |
|
|
North Surrey PCT |
5L6 |
139.23 |
199 554 |
139 |
1.00 |
0.85 |
1.18 |
696.6 |
|
|
Sussex Downs and Weald PCT |
5LT |
111.19 |
153 865 |
92 |
0.83 |
0.67 |
1.02 |
597.9 |
|
|
Western Sussex PCT |
5L9 |
157.37 |
206 581 |
109 |
0.69 |
0.57 |
0.84 |
527.6 |
|
|
Woking PCT |
5L7 |
134.13 |
199 939 |
121 |
0.90 |
0.75 |
1.08 |
605.2 |
|
Thames Valley |
Bracknell Forest PCT |
5G2 |
65.79 |
108 151 |
56 |
0.85 |
0.66 |
1.11 |
517.8 |
|
|
Cherwell Vale PCT |
5DV |
81.73 |
122 009 |
82 |
1.00 |
0.81 |
1.25 |
672.1 |
|
|
Chiltern and South Buckinghamshire PCT |
5G4 |
114.23 |
159 751 |
83 |
0.73 |
0.59 |
0.90 |
519.6 |
|
|
Milton Keynes PCT |
5CQ |
128.05 |
211 671 |
133 |
1.04 |
0.88 |
1.23 |
628.3 |
|
|
Newbury and Community PCT |
5DK |
61.44 |
93 090 |
59 |
0.96 |
0.74 |
1.24 |
633.8 |
|
|
North East Oxfordshire PCT |
5DT |
44.90 |
69 101 |
52 |
1.16 |
0.88 |
1.52 |
752.5 |
|
|
Oxford City PCT |
5DW |
93.50 |
154 597 |
96 |
1.03 |
0.84 |
1.25 |
621.0 |
|
|
Reading PCT |
5DL |
120.00 |
194 294 |
126 |
1.05 |
0.88 |
1.25 |
648.5 |
|
|
Slough PCT |
5DM |
70.38 |
119 059 |
118 |
1.68 |
1.40 |
2.01 |
991.1 |
|
|
South East Oxfordshire PCT |
5DX |
65.59 |
92 996 |
46 |
0.70 |
0.53 |
0.94 |
494.6 |
|
|
South West Oxfordshire PCT |
5DY |
128.12 |
190 520 |
147 |
1.15 |
0.98 |
1.35 |
771.6 |
|
|
Vale of Aylesbury PCT |
5DP |
115.92 |
176 322 |
150 |
1.29 |
1.10 |
1.52 |
850.7 |
|
|
Windsor, Ascot and Maidenhead PCT |
5G3 |
96.25 |
143 891 |
76 |
0.79 |
0.63 |
0.99 |
528.2 |
|
|
Wokingham PCT |
5DN |
97.23 |
148 789 |
89 |
0.92 |
0.74 |
1.13 |
598.2 |
|
|
Wycombe PCT |
5G5 |
86.79 |
134 621 |
86 |
0.99 |
0.80 |
1.22 |
638.8 |
| South West |
Avon, Gloucestershire and Wiltshire |
Bath and North East Somerset PCT |
5FL |
117.01 |
168 857 |
104 |
0.89 |
0.73 |
1.08 |
615.9 |
|
|
Bristol North PCT |
5JF |
132.73 |
210 325 |
195 |
1.47 |
1.28 |
1.69 |
927.1 |
|
|
Bristol South and West PCT |
5JG |
106.35 |
170 088 |
127 |
1.19 |
1.00 |
1.42 |
746.7 |
|
|
Cheltenham and Tewkesbury PCT |
5KW |
107.87 |
156 444 |
91 |
0.84 |
0.69 |
1.04 |
581.7 |
|
|
Cotswold and Vale PCT |
5KY |
136.38 |
187 831 |
100 |
0.73 |
0.60 |
0.89 |
532.4 |
|
|
North Somerset PCT |
5M8 |
137.95 |
188 787 |
148 |
1.07 |
0.91 |
1.26 |
784.0 |
|
|
Kennet and North Wiltshire PCT |
5K4 |
130.76 |
191 978 |
93 |
0.71 |
0.58 |
0.87 |
484.4 |
|
|
South Gloucestershire PCT |
5A3 |
164.41 |
244 909 |
181 |
1.10 |
0.95 |
1.27 |
739.1 |
|
|
South Wiltshire PCT |
5DJ |
79.42 |
111 984 |
50 |
0.63 |
0.48 |
0.83 |
446.5 |
|
|
Swindon PCT |
5K3 |
118.73 |
183 706 |
110 |
0.93 |
0.77 |
1.12 |
598.8 |
|
|
West Gloucestershire PCT |
5KX |
148.62 |
218 086 |
172 |
1.16 |
1.00 |
1.34 |
788.7 |
|
|
West Wiltshire PCT |
5DH |
81.60 |
116 612 |
71 |
0.87 |
0.69 |
1.10 |
608.9 |
|
Dorset and Somerset |
Bournemouth PCT |
5CE |
101.52 |
147 140 |
76 |
0.75 |
0.60 |
0.94 |
516.5 |
|
|
Mendip PCT |
5FX |
74.15 |
106 714 |
70 |
0.94 |
0.75 |
1.19 |
656.0 |
|
|
North Dorset PCT |
5CD |
62.93 |
84 882 |
50 |
0.79 |
0.60 |
1.05 |
589.1 |
|
|
Poole PCT |
5KV |
129.62 |
177 766 |
104 |
0.80 |
0.66 |
0.97 |
585.0 |
|
|
Somerset Coast PCT |
5FW |
105.59 |
141 121 |
92 |
0.87 |
0.71 |
1.07 |
651.9 |
|
|
South and East Dorset PCT |
5FN |
120.14 |
146 810 |
88 |
0.73 |
0.59 |
0.90 |
599.4 |
|
|
South Somerset PCT |
5K1 |
106.32 |
145 686 |
88 |
0.83 |
0.67 |
1.02 |
604.0 |
|
|
South West Dorset PCT |
5FP |
99.98 |
131 532 |
101 |
1.01 |
0.83 |
1.23 |
767.9 |
|
|
Taunton Deane PCT |
5K2 |
72.19 |
101 955 |
70 |
0.97 |
0.77 |
1.23 |
686.6 |
|
South West Peninsula |
Central Cornwall PCT |
5KT |
136.82 |
184 265 |
152 |
1.11 |
0.95 |
1.30 |
824.9 |
|
|
East Devon PCT |
5FT |
94.51 |
117 674 |
60 |
0.63 |
0.49 |
0.82 |
509.9 |
|
|
Exeter PCT |
5FR |
86.49 |
130 206 |
86 |
0.99 |
0.80 |
1.23 |
660.5 |
|
|
Mid Devon PCT |
5FV |
67.84 |
92 204 |
74 |
1.09 |
0.87 |
1.37 |
802.6 |
|
|
North and East Cornwall PCT |
5KR |
117.74 |
156 064 |
130 |
1.10 |
0.93 |
1.31 |
833.0 |
|
|
North Devon PCT |
5FQ |
109.92 |
146 216 |
89 |
0.81 |
0.66 |
1.00 |
608.7 |
|
|
Plymouth PCT |
5F1 |
156.29 |
234 266 |
164 |
1.05 |
0.90 |
1.22 |
700.1 |
|
|
South Hams and West Devon PCT |
5CV |
83.88 |
109 761 |
71 |
0.85 |
0.67 |
1.07 |
646.9 |
|
|
Teignbridge PCT |
5FY |
79.07 |
105 290 |
70 |
0.89 |
0.70 |
1.12 |
664.8 |
|
|
Torbay PCT |
5CW |
97.20 |
129 848 |
96 |
0.99 |
0.81 |
1.21 |
739.3 |
|
|
West of Cornwall PCT |
5FM |
117.01 |
156 156 |
113 |
0.97 |
0.80 |
1.16 |
723.6 |
| Wales |
Bro Taf |
Cardiff |
6A8 |
195.65 |
314 969 |
237 |
1.21 |
1.07 |
1.38 |
752.5 |
|
|
Merthyr Tydfil |
6B8 |
37.02 |
55 566 |
59 |
1.59 |
1.23 |
2.06 |
1061.8 |
|
|
Rhondda, Cynon, Taff |
6A9 |
149.52 |
223 693 |
203 |
1.36 |
1.18 |
1.56 |
907.5 |
|
|
Vale of Glamorgan |
6C3 |
80.37 |
116 751 |
73 |
0.91 |
0.72 |
1.14 |
625.3 |
|
Dyfed Powys |
Carmarthenshire |
6B7 |
126.36 |
172 960 |
141 |
1.12 |
0.95 |
1.32 |
815.2 |
|
|
Ceredigion |
6A4 |
51.82 |
73 544 |
48 |
0.93 |
0.70 |
1.23 |
652.7 |
|
|
Pembrokeshire |
6A3 |
84.83 |
115 618 |
80 |
0.94 |
0.76 |
1.17 |
691.9 |
|
|
Powys |
6C4 |
93.55 |
125 503 |
87 |
0.93 |
0.75 |
1.15 |
693.2 |
|
Gwent |
Blaenau Gwent |
6C2 |
46.66 |
68 272 |
57 |
1.22 |
0.94 |
1.58 |
834.9 |
|
|
Caerphilly |
6B2 |
113.34 |
170 390 |
128 |
1.13 |
0.95 |
1.34 |
751.2 |
|
|
Monmouthshire |
6A1 |
61.77 |
85 343 |
75 |
1.21 |
0.97 |
1.52 |
878.8 |
|
|
Newport |
6B9 |
92.34 |
138 497 |
110 |
1.19 |
0.99 |
1.44 |
794.2 |
|
|
Torfaen |
6B6 |
60.58 |
89 636 |
82 |
1.35 |
1.09 |
1.68 |
914.8 |
|
Morgannwg |
Bridgend |
6B3 |
88.95 |
128 145 |
104 |
1.17 |
0.96 |
1.42 |
811.6 |
|
|
Neath Port Talbot |
6A5 |
93.50 |
131 456 |
111 |
1.19 |
0.99 |
1.43 |
844.4 |
|
|
Swansea |
6A6 |
156.70 |
226 286 |
205 |
1.31 |
1.14 |
1.50 |
905.9 |
|
North Wales |
Conwy |
6A7 |
83.94 |
112 599 |
70 |
0.83 |
0.66 |
1.05 |
621.7 |
|
|
Denbighshire |
6C1 |
66.61 |
92 531 |
70 |
1.05 |
0.83 |
1.33 |
756.5 |
|
|
Flintshire |
6B5 |
101.30 |
148 393 |
108 |
1.07 |
0.88 |
1.29 |
727.8 |
|
|
Gwynedd |
6A2 |
81.68 |
116 068 |
88 |
1.08 |
0.87 |
1.33 |
758.2 |
|
|
Isle of Anglesey |
6B1 |
49.59 |
67 660 |
52 |
1.05 |
0.80 |
1.38 |
768.5 |
|
|
Wrexham |
6B4 |
85.16 |
125 346 |
107 |
1.26 |
1.04 |
1.52 |
853.6 |
|
These are crude prevalence rates which have not been adjusted for age, sex or ethnicity. Much higher rates are expected in populations with a high percentage of patients from South Asian and African-Caribbean backgrounds.
|
Appendix E—Data Tables
|
|---|
E1 Patients starting renal replacement in 2005
Table E1.1. Take on figures for new patients on dialysis
| Treatment centre |
Aged < 65
|
Aged > 65
|
|
% on HD |
% on PD |
% on HD |
% on PD |
|
| Abrdn |
57 |
43 |
92 |
8 |
| Airdrie |
71 |
29 |
94 |
6 |
| Antrim |
58 |
42 |
86 |
14 |
| B Heart |
78 |
22 |
89 |
11 |
| B QEH |
66 |
34 |
78 |
22 |
| Bangor |
50 |
50 |
82 |
18 |
| Basldn |
53 |
47 |
75 |
25 |
| Belfast |
76 |
24 |
81 |
19 |
| Bradfd |
70 |
30 |
88 |
12 |
| Brightn |
59 |
41 |
80 |
20 |
| Bristol |
68 |
32 |
90 |
10 |
| Camb |
76 |
24 |
81 |
19 |
| Cardff |
70 |
30 |
88 |
13 |
| Carlis |
69 |
31 |
92 |
8 |
| Carsh |
69 |
31 |
84 |
16 |
| Chelms |
67 |
33 |
86 |
14 |
| Clwyd |
86 |
14 |
79 |
21 |
| Covnt |
62 |
38 |
78 |
22 |
| D&Gall |
60 |
40 |
75 |
25 |
| Derby |
50 |
50 |
72 |
28 |
| Dorset |
50 |
50 |
30 |
70 |
| Dudley |
44 |
56 |
73 |
27 |
| Dundee |
48 |
52 |
69 |
31 |
| Dunfn |
55 |
45 |
81 |
19 |
| Edinb |
67 |
33 |
90 |
10 |
| Exeter |
44 |
56 |
77 |
23 |
| GlasRI |
80 |
20 |
93 |
7 |
| GlasWI |
48 |
52 |
94 |
6 |
| Glouc |
54 |
46 |
84 |
16 |
| Hull |
59 |
41 |
87 |
13 |
| Inverns |
56 |
44 |
50 |
50 |
| Ipswi |
36 |
64 |
62 |
38 |
| Klmarnk |
35 |
65 |
94 |
6 |
| L Barts |
60 |
40 |
65 |
35 |
| L Guys |
82 |
18 |
91 |
9 |
| L H&Cx |
|
Top
Appendix A--The Renal Registry...
A1 Executive summary
