This bulletin presents the main messages from the publication of the 2010 mid-year population estimates for Primary Care Organisations (PCOs) in England. It also describes changes that have taken place since 2001 and the age distribution of the population within these areas.
Mid-year population estimates for 2010 for England, including estimates for regions and local authorities within England were published on 30 June 2011. The estimates refer to the usually resident population as at 30 June of the reference year and are published annually.
Primary Care Organisation population estimates
Mid-year population estimates for Primary Care Organisations (PCOs) within England also refer to the usually resident population as at 30 June of the reference year and are published annually, approximately three months after the publication of national, regional and local authority level estimates.
PCOs are the lower level of the current health administration in England, reporting to Strategic Health Authorities (SHAs).
In mid-2010 there were 151 Primary Care Organisations within England consisting of 145 Primary Care Trusts and 6 Care Trusts. Care Trusts have similar duties to Primary Care Trusts, except that Care Trusts have responsibilities for social care as well as health care.
Quality and Use
PCO population estimates are used by both central government departments and local authorities for a range of purposes including planning and monitoring of services, as denominators for the calculation of various rates and indicators, and in the production of population projections and forecasts.
These estimates are currently classified as experimental statistics as they have not yet been assessed against the standards required for National Statistics. For further information on the quality of population estimates please see the Summary Quality Reports available from:
The structure of NHS management is under review following the introduction of the Health and Social Care Bill (2011) into Parliament on 19 January 2011. In future PCO population estimates may be replaced by population estimates for areas more relevant to any new NHS management structure. Key users of these statistics will be consulted before any changes are made to the range of population estimates available for health geographies within England. Further information on the Health and Social Care Bill (2011) can be found at:
In mid-2010 the population of England was 52,234,000, an increase of 0.8 per cent on mid-2009 and 5.6 per cent on mid-2001.
In mid-2010 the median population size of PCOs was 284,000 compared to 282,000 in mid-2009, a 0.8 per cent increase. In mid-2010 PCOs varied widely in population size with the smallest PCO, Hartlepool, having a population of 91,000, and the largest, Hampshire, a population of 1,297,000. The majority of PCOs (81 per cent) have a population of between 100,000 and 500,000 persons.
|Population||Count of PCOs||Percentage of PCOs|
|less than 100,000||1||0.7|
|100,000 to 199,999||29||19.2|
|200,000 to 299,999||57||37.7|
|300,000 to 399,999||21||13.9|
|400,000 to 499,999||15||9.9|
|500,000 to 599,999||9||6.0|
|600,000 to 699,999||8||5.3|
|700,000 to 799,999||7||4.6|
|800,000 to 899,999||1||0.7|
|900,000 to 999,999||0||0.0|
|1,000,000 and greater||3||2.0|
PCOs with populations greater than 500,000 in mid-2010 are mainly those representing county areas, for example Hampshire, Surrey and Hertfordshire. However, three PCOs covering areas including the cities of Leeds, Sheffield and Bradford also have populations greater than 500,000.
The majority of PCOs (90 per cent) with populations of less than 200,000 in mid-2010 are areas equivalent to a single local authority district.
Change between mid-2001 and mid-2010
In total, 77 PCOs (51 per cent) had a population increase of over 5 per cent over the nine year period from mid-2001 to mid-2010, including 17 PCOs (11 per cent) where the increase was over 10 per cent.
|Population (thousands)||Percentage Change|
|Rank||Primary Care Organisation||Mid-2001||Mid-2010||Mid-01 to Mid-10|
The greatest percentage increase in population between mid-2001 and mid-2010 was 24.5 per cent in Westminster PCO. Four other London PCOs were included in the top ten areas with the greatest percentage increase in population along with four PCOs covering large cities or towns.
In total, 11 PCOs (7 per cent) had a population decrease over the nine year period from mid-2001 to mid-2010, including 1 PCO where the decrease was over 4 per cent.
|Population (thousands)||Percentage Change|
|Rank||Primary Care Organisation||Mid-2001||Mid-2010||Mid-01 to Mid-10|
|7||Redcar and Cleveland||139||137||-1.3|
|8||Heywood, Middleton and Rochdale||206||205||-0.6|
|10||North East Lincolnshire||159||159||-0.4|
The greatest percentage decrease in population between mid-2001 and mid-2010 was 4.8 per cent in Brent Teaching PCO. The majority of areas where the population has decreased over the nine year period since mid-2001 are in the North West or North East of England.
The age distribution of a PCO area is likely to impact on both the overall level of demand for health services, and the type of health services required.
The median age of the population of England in mid-2010 was 39.5, up by 1.7 years since mid-2001. However, the median age of populations in PCOs varies between different areas. In mid-2010 the lowest median age in a PCO was 28.3 in Heart of Birmingham Teaching. The highest median age in mid-2010 was 48.3 in Dorset. This compares to a range of 29.1 to 45.1 in mid-2001.
The percentage of the population aged 65 and over in England in mid-2010 was 16.5 per cent, an increase of 0.6 percentage points over the nine year period since mid-2001. In mid-2010, at PCO level, the percentage of the population aged 65 and over varied from 6.8 per cent in Tower Hamlets to 25.6 per cent in Dorset.
The change in the proportion of the older population also varied more widely at PCO level as can be seen in table 4 below.
|Change in population aged 65 and over (percentage points)||Count of PCOs|
|3.1 to 4.0||2|
|2.1 to 3.0||20|
|1.1 to 2.0||40|
|0.0 to 1.0||36|
|-0.1 to -1.0||29|
|-1.1 to -2.0||17|
|-2.1 to -3.0||6|
|-3.1 to -4.0||1|
Over the nine year period from mid-2001 to mid-2010, 62 PCOs had an increase of more than one percentage point in the population aged 65 and over and 22 PCOs had an increase of more than two percentage points. PCOs with the largest increases in the percentage of population aged 65 and over are areas which include more rural districts such as South Staffordshire, Shropshire County and Herefordshire.
In total 53 PCOs had a smaller percentage of older population in mid-2010 than in mid-2001. In 24 PCOs the decrease was greater than 1 percentage point. PCOs with the largest decreases in their percentage of population aged 65 and over are more likely to be urban areas. These include the London boroughs of Barking and Dagenham and Tower Hamlets and PCOs covering the cities of Manchester, Nottingham and Bristol.
The percentage of the population aged 0 to 15 in England in mid-2010 was 18.7 per cent, a decrease of 1.3 percentage points since mid-2001. In mid-2010, at PCO level, the percentage of the population aged 0 to 15 varied from 13.1 per cent in Westminster to 25.1 per cent in Newham.
|Change in population aged 0 to 15 (percentage points)||Count of PCOs|
|1.1 to 2.0||5|
|0.0 to 1.0||7|
|-0.1 to -1.0||41|
|-1.1 to -2.0||68|
|-2.1 to -3.0||25|
|-3.1 to -4.0||5|
Over the nine year period from mid-2001 to mid-2010, 11 PCOs (7 per cent) had an increase in the percentage of population aged 0 to 15, and of these only 5 had an increase of more than one percentage point. All PCOs with increases in the percentage of population aged 0 to 15 between mid-2001 and mid-2010 are in London.
The majority of PCOs (92 per cent) had a decrease in the population aged 0 to 15 between mid-2001 and mid-2010. 65 per cent had a decrease of more than one percentage point and 20 per cent had a decrease of more than 2 percentage points. The majority of those PCOs with the largest decreases in percentage of population aged 0 to 15 are in the north of England.
The mid-2010 Primary Care Organisation population estimates are provided for the boundaries that came into force on 1 April 2010. PCO population estimates for previous years, from mid-2001 to mid-2009, are available on the PCO boundaries that came into force on 1 October 2006. This boundary set consisted of 152 PCOs.
Further information on PCO boundary changes and reorganisation can be found at:
The PCO estimates are created using a combination of mid-year population estimates for local authorities and lower layer Super Output Areas (LSOAs). The majority of PCOs (85 per cent) are composed of one or more complete local authority areas. Therefore, for these areas the PCO population estimates are identical to the mid-year population estimates for the relevant local authority or aggregation of local authorities.
The boundaries of a further 16 PCOs (11 per cent) do not match with local authority boundaries but can be created by aggregating LSOA areas. Mid-year population estimates for these PCOs are calculated by aggregating the relevant LSOA population estimates.
The remaining 6 PCOs (in Birmingham and Lincolnshire) do not completely match either LSOA or LA boundaries as a small number of LSOAs are split between PCO areas (5.6 per cent of LSOAs in Birmingham are split and 0.3 per cent of those in Lincolnshire). For these areas the population estimates have been created by aggregating LSOA population estimates and making minor adjustments to account for these splits. The adjustments apportion the population of any split LSOAs to the appropriate PCO using the latest available data on the geographic distribution of the population in these LSOAs.
More detail on the methodology used to create both the local authority and LSOA Mid-Year Population Estimates can be found at:
The constituent countries of the UK have different arrangements for the management of their health services and therefore population statistics are produced for health geographies that are relevant to each individual country.
Population estimates for the seven Welsh Local Health Boards, which consist of one or more unitary authorities, are published alongside the mid-year population estimates for the UK and created using a cohort component based method. The latest estimates for mid-2010 were published on 30 June 2011 and can be found at:
National Records of Scotland (NRS) produce population estimates for Scottish NHS Boards. NRS use a cohort component based method to produce estimates for the 14 NHS Board areas in Scotland. Further information on this methodology and the latest estimates (for mid-2010) can be found at:
The Northern Ireland Statistics and Research Agency (NISRA) publish population estimates for the Health and Social Services Board and the 5 Health and Social Care Trusts in Northern Ireland. These are also produced using a cohort component based method. Further information on this methodology and the latest estimates (for mid-2010) can be found at:
In May 2010 a package of improvements for mid-year population estimates for England and Wales was introduced as part of a cross-government programme to improve migration statistics. These improvements led to revisions to the mid-2002 to mid-2008 local authority population estimates for England and Wales. The improved methods have also been used to calculate mid-2009 and mid-2010 population estimates. Details of this improvements package can be found at:
PCO population estimates for mid-2002 to mid-2007 were also revised to maintain consistency with local authority estimates; estimates for mid-2008 and mid-2009 were originally published using the improved methods.
Further improvements to the population estimates methodology have been developed. More information on these improvements is expected to be published in November 2011. These have been made as the result of user feedback and improved access to, and understanding of, a range of administrative sources.
Mid-2010 population estimates for Primary Care Organisations in England can be found at:www.ons.gov.uk/ons/taxonomy/index.html?nscl=Population+Estimates+by+Age+and+Sex
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