armley primary care network introduction

Summary of report

The Index of Multiple Deprivation 2019 (IMD2019) is used in this report to relate differences in health data to variations in patient environments. Each PCN has a calculated deprivation score which is created using the July 2015 practice population size and locations, PCNs are ranked by their deprivation score in many charts to investigate relationships with deprivation. July 2015 population data is used because it matches the denominators used by the IMD2019 itself.

Note that PCN registered populations can live far from their GP practice and experience a wide variety of deprivation conditions.

This report uses GP recorded data for groups of practices called Primary care networks (PCNs).Most of the data in this report represents the combined registered populations of the practices making up the PCN. Collating and producing data for this report was concluded in early 2020 when the PCN memberships had been stable for some time. The following practices were aggregated to create PCN data for this profile:

Armley Primary Care Network introduction

Deprivation in this report

B86003 Armley Medical Centre, B86024 Priory View, B86060 Thornton Medical Centre

Practices in this PCN when this report data was made

Armley PCN has an age structure very like Leeds, and the majority of these patients are living in the most deprived parts of the city. The ethnic make-up of the PCN is close to that of Leeds.

GP recorded conditions are all very high, significantly above city rates. The exceptions are cancer and common mental health issues. Cancer rates tend to be higher in less deprived populations, this is thought to be due to earlier presentation and improved survival rates. Frailty rates are low for a PCN with such a deprived population, however under 75 mortality rates are significantly above Leeds and respiratory mortality in particular is rising quickly.

Life expectancy is significantly below the city but better than some PCNs with similar levels of deprivation.

PCN footprints: Some data - Life Expectancy for instance - cannot be made by registered populations and instead is produced for the area that the PCN covers which is called its footprint. A PCN footprint is the area of Leeds where the PCN has more registered patients than eny other PCN. Data reported by footprints represents all patients living in the area regardless of which PCN they are registered to. PCN footprints do not overlap and cover the entirety of Leeds.

PCN footprints

Health and wellbeing profile of 24 22/06/2020

Armley PCN

Introduction 1Contents 2About the charts in this report 3

Demographics Age structure 4Black and Minority Ethnic patients (BAME) 5Population change over time 6

Health Asthma 7Child obesity (NCMP)* 8Smoking 9Obesity 10Obese smokers 11Diabetes 12Coronary Heart Disease (CHD) 13Chronic Obstructive Pulmonary Disorder (COPD) 14Cancer 15Common mental health 16Severe mental health 17Frailty 18

Mortality All cause mortality (under 75s)* 19Cancer mortality (under 75s)* 20Circulatory mortality (under 75s)* 21Respiratory mortality (under 75s)* 22Life expectancy* 23

Map of PCN footprints Map of PCN footprints* 24

Armley Primary Care Network

* Some datasets cannot be grouped by practice and are shown by PCN footprint area instead. See Introduction page for more details.


Armley PCN

76 plus yrs

56 to 75 yrs

36 to 55 yrs

16 to 35 yrsLeeds is shown as dark grey bars and dotted lines, the chosen PCN is highlighted in blue and the ageband with the highest prevalence in the PCN is labelled with prevalence percentage.

% of agebands with condition example

About the charts used in this profile

Time series chart example

Comparing rates, PCNs ranked by deprivation example

Charts use consistent colours throughout this profile, and text about the PCN will be in blue. Colours have been chosen to work with the most common forms of colour blindness.

The proportion of each ageband with this condition. In this example more deprived PCN populations have larger rates in all agebands but the rate is quite steady for over 75s in all PCNS.

In this chart PCNs are shown in order of deprivation with the most deprived on the left. Middleton & Hunslet PCN is orange because it is significantly higher than Leeds, Central PCN is significantly lower than Leeds and therefore blue.

The dotted line is a best fit through all PCN rates and in this case slopes downward because less deprived PCN populations have lower rates.

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Deprived Leeds

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Armley PCN

PCN registered

95+ Females Males90 - 94 85 - 89 80 - 84 75 - 79 70 - 74 65 - 69 60 - 6455 - 59 50 - 54 45 - 4940 - 44 35 - 39 30 - 34 25 - 29 20 - 24 15 - 19 10 - 1405 - 0900 - 04

Most deprived 5th

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2nd least deprived

Least deprived fifth

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greater than or equal to 30%greater than or equal to 20%greater than or equal to 15%greater than or equal to 11%

January 2020 population data collected from practices quarterly and therefore only contains records where patients are presenting and have been questioned. Certain population groups are known to visit their GP rarely.

Lees deprived PCNs have older populations

Deprivation in this PCN population

Age structure of this PCN, compared to Leeds in grey The age and genders proportions of this PCN are shown as shaded areas. The colours correspond to deprivation levels in Leeds as in the chart below.

Leeds can be divided into five groups, from most to least deprived.

In this PCN the population are almost entirely within the two most deprived fifths of Leeds.

Armley Primary Care Network is similar to Leeds with fewer young adults, and slightly fewer aged 70 or more.

This table shows the agebands that dominate PCN populations. The least deprived PCNs have populations that are less diverse in age.

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Age structure and deprivation compared to Leeds

PCNs in deprivation order, most deprived to the left, least deprived on the right

The 30-39 ageband is the largest in this PCN.

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Armley PCN

PCN registered

PCN BAME change over time

Armley Leeds overall

Unknown, not recordedWhite BritishBAME

Unknown, not recordedWhite BritishBAME

PCN ethnicity change over time

The PCN shows a steady rise of BAME proportion, is almost identical to Leeds, and has a very high rate of recording.

In 2020 this PCN has a similar proportion of BAME patients than Leeds. 30% compared to 29%

Ethnicity is recorded in very high detail by Leeds GPs, when aggregated it can provide a simple picture of the population changing over time.

How these details are grouped to make Black and minority ethnic (BAME) can effect the outcome. These charts compare the "White British" group with all remaining ethnic types combined into BAME. The third category shows patients with no recorded ethnicity, this has steadily improved in Leeds helping to reveal the true picture.

Leeds BAME change over time29% of the Leeds registered population falls into the BAME category in 2020.

Improvements in recording have resulted in increases for both the "White British" and "BAME" categories.

21% 21% 22% 22% 22% 26%30% 30%

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Armley PCN

PCN registered

PCN population age change over time

10-69 years

Population change over time - the very young, and the elderly

0-9 years

Armley Leeds overall

0-9 years

In 2020 this PCN has a similar proportion of young patients to Leeds, 13% compared to 12%

In terms of the older population, 10% of the PCN are aged 70 or more - smaller than Leeds at 11%

Leeds population age change over time

70 years and older 70 years and older

Leeds registered patients are remarkably stable in terms of the overall proportions of the youngest and oldest agebands.

The over 70s group has only increased from 10% to 10.6% in the chart below but that is a change in number of people from 80,465 to 92,065.

10-69 years

13% 13% 13% 13% 13% 13% 13% 13%

77% 77% 77% 77% 77% 77% 78% 78%

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Armley PCN

PCN registered

This data is collected from practices quarterly and therefore only contains records where patients are presenting and have been questioned. Certain population groups are known to visit their GP rarely.

This PCN has been rising slowly for the past years, and is not significantly different to the overall Leeds rate since 2017. However it is now very close to

Deprived Leeds is barely different to Leeds overall, and falling at the same speed.

This PCN has average asthma rates for older patients, and below average for others.

The ageband with the highest asthma rate in this PCN is 16 to 35 years, with a rate of 11%

Asthma in children

In a time series we can see that generally rates have been falling for many years.

Change of asthma rates over time (under 16s)

Asthma is more common in less deprived populations (January 2020)

Under 16s rates compared (January 2020) - ranked by deprivation Overall, in January 2020, rates of asthma in children don’t display a relationship with deprivation - the grey dotted line is virtually horizontal.

The proportion of each ageband who have asthma. In general it is more prevalent in middle aged groups in less deprived PCN populations.

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Armley PCN

PCN footprintsChild obesity in Reception and Year 6

PCN NCMP data shows the students resident inside the PCN footprint, regardless of where their school is located. NCMP data is collected annually and sent to NHS Digital for national collation. NHS Digital return the processed data to local authorities and this is presented here.

Obesity % - Reception over time Obesity % - Year 6 over time

Obesity % - PCNs reception in 2018-2019 Obesity % - PCNs Year 6 in 2018-2019

Leeds has hovered around 10% obesity in Reception classes for years. Deprived areas are higher and rising steadily, while the PCNs are slowly diverging.This PCN is above Leeds but not significantly so, the rate is more or less static in recent years and very close to Deprived rates.

Year 6 obesity rates in this PCN are high but not significantly above Leeds. They may be falling slowly and this is despite deprived areas and Leeds both increasing in recent data.

The Year 6 data has a much stronger relationship with deprivation - the dashed line slopes steeply, and around half of PCNs have a higher Year 6 rate than the highest Reception rate.

Reception rates of obesity are higher for more deprived PCNs and lower for less deprived - the chart generally slopes from left to right. The relationship is clear but not that strong.

Leeds has risen a little from around 19% to 21% in the chart below, and rates in deprived areas are much higher.

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Armley PCN

PCN registered

76 plus yrs

56 to 75 yrs

36 to 55 yrs

16 to 35 yrs


This PCN has high smoking rates in all agebands.

The ageband with the highest smoking rate is 36 to 55 years, with a rate of 32%

Smoking (adults)

Adult rates compared (January 2020) - ranked by deprivation Overall, in January 2020, rates of smoking display an extremely strong relationship with deprivation - the grey dotted line slopes sharply.

Smoking is more common in all age groups as deprivation increases

Deprived Leeds is very different to Leeds overall with much higher rates of smoking, however it is falling more quickly than Leeds overall.

The proportion of each ageband who smoke. More deprived PCN populations generally have larger smoking rates in all agebands.

Change of smoking rates over time (adults) In a time series we can see that rates have been falling steadily for many years.

This PCN has been falling slowly for the past several years, but more slowly than Leeds. It is significantly above the overall Leeds rate.

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Armley PCN

PCN registered

76 plus yrs

56 to 75 yrs

36 to 55 yrs

16 to 35 yrs


Adult rates compared (January 2020) - ranked by deprivation Overall, in January 2020, rates of adult obesity display a reasonably strong relationship with deprivation - the grey dotted line is sloped but there is variation.

Obesity is more common in middle age as deprivation increases The proportion of each ageband who are obese. More deprived PCN populations generally have larger obesity rates in all agebands. Older agebands tend to be more obese.This PCN has well above average obesity rates for all but the oldest patients which are average.

The ageband with the highest Obesity rate is 56 to 75 years, with a rate of 36%

Change of obesity rates over time (adults) In a time series we can see that rates have been rising slowly for many years.

This PCN has been rising more quickly than Leeds for several years. It has always been significantly above the overall Leeds rate.

Deprived Leeds is much higher than Leeds overall, and rising at the same speed.

Obesity (adults where BMI>30)

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Armley PCN

PCN registered

Females Males

Females Males

greater than or equal to 30%greater than or equal to 25%greater than or equal to 20%greater than or equal to 10%

Obese smokers (where both records were updated within 12 months)

Obese smokers, counts in this PCN by gender and deprivation

Obese smokers are older in less deprived PCNs

In this PCN…

This table shows the agebands within each PCN that contribute the most to the PCN total of obese smokers.

For instance, the 50-59 ageband contains between 25% and 30% of the obese smoker population for most PCNs.

These charts show the number of obese smokers in this PCN, by gender and deprivation.

In this PCN the peak in 2018 is likely to be a data error. There are more female obese smokers than male, and the rates for both overall are rising.

Interestingly, counts appear to be increasing in all parts of the PCN.

Obese smokers in Leeds, counts by gender and deprivation In January 2020 there were 10,252 Leeds registered and resident patients recorded as being obese and current smokers.

56% of these patients are female.

These charts show the numbers gradually rising since 2014, and the most deprived 5th of Leeds (dark orange) has always had the most patients.

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Armley PCN

PCN registered

Change of diabetes rates over time In a time series we can see that rates have been rising steadily for many years.

This PCN has been rising more quickly than Leeds for several years. It has always been significantly above the overall Leeds rate.

Deprived Leeds is much higher than Leeds overall, and rising more quickly.

Diabetes (all ages)


Rates compared (January 2020) - ranked by deprivation Overall, in January 2020, rates of adult diabetes display a very strong relationship with deprivation - the grey dotted line is clearly sloped.

Diabetes in older age is more common as deprivation increases The proportion of each ageband recorded with diabetes. In general it is more prevalent in older age groups in more deprived PCN populations.

This PCN has slightly above average diabetes rates for most agebands.

The ageband with the highest diabetes rate is 76 plus years, with a rate of 22%

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Armley PCN

PCN registered


Rates compared (January 2020) - ranked by deprivation Overall, in January 2020, rates of CHD display a clear relationship with deprivation - the grey dotted line is clearly sloping.

CHD in older age is slightly more common as deprivation increases The proportion of each ageband recorded with CHD. It is very prevalent in the oldest age groups, slightly more so in more deprived PCN populations.

This PCN has slightly above average CHD rates for most agebands.

The ageband with the highest CHD rate is 76 plus years, with a rate of 22%

Change of CHD rates over time In a time series we can see that rates have been falling slowly for many years.

This PCN has been rising more quickly than Leeds for several years. It has almost always been significantly above the overall Leeds rate.

Deprived Leeds is much higher than Leeds overall, and falling slightly more quickly.

Coronary heart disease (CHD) all ages

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Armley PCN

PCN registered

Change of COPD rates over time In a time series we can see that rates have been very slowly increasing for many years.

This PCN has been rising more quickly than Leeds for several years. It has almost always been significantly above the overall Leeds rate.

Deprived Leeds is much higher than Leeds overall, and rising while Leeds is almost static.

Chronic obstructive pulmonary disorder (COPD) all ages


Rates compared (January 2020) - ranked by deprivation Overall, in January 2020, rates of COPD display a very strong relationship with deprivation - the grey dotted line is clearly sloping.

COPD is more common in older more deprived populations The proportion of each ageband recorded with COPD. It is very prevalent in the oldest age groups, less so in the least deprived PCN populations.

This PCN has well above average COPD rates for older agebands.

The ageband with the highest COPD rate is 76 plus years, with a rate of 13%

0

1,000

2,000

3,000

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6,00020

13

2014

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age

stan

dard

ised

rate

per

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0

1,000

2,000

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Bees

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76 plus yrs

56 to 75 yrs

36 to 55 yrs

under 16s

16 to 35 yrs


Armley PCN

PCN registered


Rates compared (January 2020) - ranked by deprivation

Cancer is more common in older less deprived populations

Overall, in January 2020, rates of cancer display a weak inverted relationship with deprivation - the grey dotted line is sloped slightly showing lower rates in more deprived PCN populations.

The proportion of each ageband recorded with cancer. It is very prevalent in the oldest age groups, more so in the least deprived PCN populations.

This PCN has well below average cancer rates for older agebands.

The ageband in this PCN with the highest Cancer rate is 76 plus years, with a rate of 16%

Change of Cancer rates over time In a time series we can see that rates have been climbing steadily for many years.

This PCN has been rising at the same speed as Leeds for several years. It has always been significantly below the overall Leeds rate. Deprived Leeds is lower than Leeds overall, this is thought to be due to higher cancer mortality, possibly a result of late diagnosis.

Cancer (all ages)

1,0001,5002,0002,5003,0003,5004,0004,5005,000

2013

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1,0001,5002,0002,5003,0003,5004,0004,5005,000

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16%

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76 plus yrs

56 to 75 yrs

36 to 55 yrs

under 16s

16 to 35 yrs


Armley PCN

PCN registered


Deprived Leeds is higher than Leeds overall and increasing at the same rate.

Rates compared (January 2020) - ranked by deprivation Overall, in January 2020, rates of common mental health don’t really display a relationship with deprivation - the grey dotted line barely slopes and PCN rates vary a lot. This may indicate low recording or presentations in some areas.

CMH does not vary much by age group or deprivation The proportion of each ageband recorded with common mental health issues. It is very prevalent in most age groups.

This PCN has average CMH rates for all agebands.

The ageband in this PCN with the highest rate of recorded common mental health issues is 56 to 75 years, with a rate of 31%

Change of common mental health rates over time In a time series we can see that rates have been climbing steadily for many years.

This PCN has been rising slightly more quickly than Leeds for several years. It is no longer significantly below the overall Leeds rate.

Common mental health issues (CMH) all ages

10,000

15,000

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17

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2020

age

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31%

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76 plus yrs

56 to 75 yrs

36 to 55 yrs

under 16s

16 to 35 yrs


Armley PCN

PCN registered


Rates compared (January 2020) - ranked by deprivation Overall, in January 2020, rates of severe mental health display a very strong relationship with deprivation - the grey dotted line slopes steeply.

SMH is more common in older more deprived populations The proportion of each ageband recorded with serious mental health issues. It is prevalent in the older age groups, more so in the most deprived PCN populations.This PCN has well above average SMH rates for all agebands.

The ageband in this PCN with the highest rate of recorded severe mental health issues is 56 to 75 years, with a rate of 2%

In a time series we can see that rates have been climbing very slowly for many years.

This PCN has been falling slowly for several years and is still significantly above the overall Leeds rate.

Deprived Leeds is much higher than Leeds overall and increasing at the same slow rate.

Change of severe mental health rates over time (18+)

Severe mental health issues (SMH) ages 18+

0

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36 to 55 yrs

under 16s

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Armley PCN

PCN registeredFrailty - moderate and severe, March 2019

Source: Leeds Data model March 2019

Severe frailty, age standardised rates per 1,000

Moderate frailty, age standardised rates per 1,000 Moderate frailty rates per 1,000 show a strong relationship with deprivation.

Despite outliers the picture is of higher rates in more deprived PCN populations, and lower rates in less deprived PCNs.

'LSMP & The Light' PCN has a very low rate and a very wide range of confidence, the population contains few elderly patients hence the wide range.

Wetherby PCN however has an average rate of frailty despite its position as least deprived PCN population in the city.

Severe frailty also has a strong relationship with deprivation, and again Wetherby PCN stands out as having a rate well above average.

Age standardisation of this data has removed age as a factor in differences so there is another reason for this. It could perhaps be improved recording or presentation by patients.

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Armley PCN

PCN footprints

Females Males

Source: ONS, GP registered populations

Female and male rates over time

Rates compared (2014-18) - ranked by deprivation Overall mortality rates are shown here for all PCNs, there is a strong and consistent link with deprivation where less deprived PCN populations have lower mortality rates.

Only one PCN (Middleton & Hunslet) has a rate higher than this PCN, and twelve are lower.

All cause mortality (under 75s)

An overall mortality rate often hides very different rates for the different sexes. Here are the separate female and male rates.

Male and female rates are very different but both are always significantly above the city and falling at a similar rate.

Change in overall mortality rate over time In a time series we can see that rates have been dropping very slowly for many years.

This PCN has always had a very high mortality rate, but it is falling more or less at the same rate as Leeds.

Deprived Leeds is much higher than Leeds overall and decreasing at the same slow rate.

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0100200300400500600700

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Armley PCN

PCN footprints

Females Males

Change in overall mortality rate over time In a time series we can see that rates have been falling very slowly for many years.

This PCN has been higher than Leeds for many years, but in recent data it is perhaps falling closer to average.

Cancer mortality (under 75s)

Female and male rates over time An overall mortality rate often hides very different rates for the different sexes. Here are the separate female and male rates.

Female rates are falling more slowly than Leeds, but male rates were previously highest in Leeds. They have since fallen to around average.


Rates compared (2014-18) - ranked by deprivation Overall mortality rates are shown here for all PCNs, there is a clear and consistent link with deprivation where less deprived PCN populations have lower mortality rates.

This PCN has a rate significantly higher than four of the least deprived PCNs.


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Armley PCN

PCN footprints

Females Males

Change in overall mortality rate over time In a time series we can see that rates have been falling very slowly for many years.

This PCN has always been significantly above the Leeds rate, but in recent years has been static while Leeds falls.

Circulatory disease mortality (under 75s)


Female rates have fallen steadily over many years and are now the same as Leeds. However male rates have increased steadily and are now around the highest in the city.


Rates compared (2014-18) - ranked by deprivation Overall mortality rates are shown here for all PCNs, there is a clear and consistent link with deprivation where less deprived PCN populations have lower mortality rates.

This PCN has a rate significantly higher than eleven less deprived PCNs.


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021426384

105126147168189

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Armley PCN

PCN footprints

Females Males

Change in overall mortality rate over time In a time series we can see that the Leeds rate has been rising very slowly for many years.

This PCN has always been above the Leeds rate, but in recent years has increased sustantially to become highest in the city.

Deprived Leeds is much higher than Leeds overall and increasing much more quickly.

Respiratory disease mortality (under 75s)

There is a clear and strong link between deprivation and mortality. This PCN has the highest rate in Leeds, and is signifcantly higher than more deprived PCN Burmantofts, Harehills and Richmond Hill.



Increases for this PCN are almost entirely driven by female mortality rates. Male rates are increasing more slowly.

Rates compared (2014-18) - ranked by deprivation Overall mortality rates are shown here for all PCNs, there is a relatively consistent link with deprivation where less deprived PCN populations have lower mortality rates.

01020304050607080

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Armley PCN

PCN footprints

Females Males

Females Males

Change in life expectancy over timeIn a time series we can see that rates have been climbing slowly for many years. Male figures are improving more quickly but still generally lower than females.

Female life expectancy in this PCN footprint changed greatly around 2010, male LE has been very low but increasing steadily until the recent drop.

Life expectancy

Bars in this chart encompass 95% confidence intervals, Leeds and deprived Leeds have very narrow confidence intervals and can be illustrated with a line. Source: ONS deaths extract, GP registered populations.

Deprived Leeds is much lower than Leeds overall and more or less static while Leeds slowly improves.

Female and male life expectancy in 2016-18, all PCNsLife expectancy 95% confidence interval ranges are shown here. PCNs are ranked by footprint deprivation scores and those with lower deprivation have much higher life expectancy.

The link to deprivation is especially clear for males.

In 2016-18 the life expectancy for both sexes are very different.

This PCN has life expectancy figures which are significantly higher than some similar PCNs such as York Road.

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Armley PCN

armley primary care network introduction

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