The document discusses cervical cancer screening coverage in England at the clinical commissioning group (CCG) level and its relationship to deprivation. It finds that CCGs with higher average deprivation scores based on the English Index of Multiple Deprivation generally have lower cervical cancer screening coverage rates. Coverage is also lower in more urban areas compared to rural areas. The document provides data on screening coverage and deprivation scores for the most and least deprived CCGs.

1. Cervical screening coverage and
deprivation
Please send questions to phe.screeninghelpdesk@nhs.net quoting the title of this
presentation
Public Health England leads the NHS Screening Programmes

2. Notes
Coverage is calculated as the number of eligible women having an adequate screening
result within the last 3.5 years (for 25 to 49 age group) or last 5.5 years (for 50 to 64 age
group).
Eligible women are those within the age group and not ceased from screening for clinical
reasons.
Coverage at CCG (clinical commissioning group) level is currently available 6 months in
arrears, so at the end of March 2017 the figures for September 2016 became available.
Sources of data:
Coverage data - National Health Application and Infrastructure Services (NHAIS) systems
accessed using Open Exeter: https://nww.openexeter.nhs.uk/nhsia
Indices of deprivation - Department for Communities and Local Government:
https://www.gov.uk/government/statistics/english-indices-of-deprivation-2015
Rural urban classification (2011) of CCGs in England – Office of National Statistics:
http://geoportal.statistics.gov.uk/datasets/d247bded1f4f45ab8c61e05be4303934_0
2 IMD Score vs. Cervical coverage September 2016

3. Notes
Clinical commissioning groups (CCG) are NHS organisations set up by the Health and
Social Care Act 2012 to organise the delivery of NHS services in England. They are
clinically led groups that include all of the general practice groups in their geographical
area.
In September 2016, there were 209 Clinical Commissioning Groups (CCGs) in England,
with varying sizes of eligible female population.
Eligible (female) CCG populations at end of September 2016
Median : (ages 25 to 49) 41,269 over 33 practices
(ages 50 to 64 ) 19,136 over 33 practices
Smallest : (ages 25 to 49) Corby = 13,400 over 5 practices
(ages 50 to 64) Bradford City = 5,421 over 28 practices
Largest : (ages 25 to 49) Cambs .& Peterborough = 162,432 over 107 practices
(ages 50 to 64) Northern, Eastern & Western Devon = 79,386 over 120
practices
3 IMD Score vs. Cervical coverage September 2016

4. Notes
Deprivation
The English Index of Multiple Deprivation (IMD) 2015 is the official measure of relative
deprivation for small areas using 7 domains of deprivation, which are:-
Employment / Health / Education / Crime / Barriers to housing & services /
Living environment.
The deprivation for each CCG is calculated by averaging the scores for the Lower-Layer
Super Output Areas (LSOAs) that make up that CCG
Rural urban classification
The 2011 rural-urban classification (RUC) of clinical commissioning groups (CCG) in
England is based on the 2011 RUC of output areas published in August 2013. The
classification was produced by the University of Sheffield and was sponsored by a cross-
Government working group comprising Department for Environment, Food and Rural
Affairs, Department of the Communities and Local Government and Office for National
Statistics)
4 IMD Score vs. Cervical coverage September 2016

5. 5 IMD Score vs. Cervical coverage September 2016
Cervical coverage by CCG vs. deprivation (IMD
Score 2015) for least & most deprived CCGs
Green shading
indicates national
coverage standard of
at least 80% is met
Source for IMD Scores:
Department for
Communities and Local
Government
Source for coverage
data: National Health
Application and
Infrastructure Services
(NHAIS) systems
accessed using Open
Exeter. Data for
September 2016
Clinical
Commissioning
Group Code
Clinical Commissioning Group Name
IMD - Avg
rank
IMD -
Rank of
avg rank
IMD -
Average
score
% with
adequate
test in
previous
3.5 years:
ages 25 to
49
% with
adequate
test in
previous
5.5 years:
ages 50 to
64
E38000209 NHS Wokingham CCG 3648.02 209 5.652 74.26 80.95
E38000142 NHS Rushcliffe CCG 5872.34 208 7.702 81.38 84.64
E38000177 NHS Surrey Downs CCG 5991.03 207 7.985 70.08 76.20
E38000214 NHS Guildford and Waverley CCG 6254.01 206 8.253 70.79 77.65
E38000083 NHS Horsham and Mid Sussex CCG 6451.87 205 8.278 75.53 79.50
E38000178 NHS Surrey Heath CCG 6831.59 204 8.85 71.39 77.09
E38000033 NHS Chiltern CCG 7307.74 203 9.069 71.18 79.62
E38000207 NHS Windsor, Ascot and Maidenhead CCG 7645.09 202 9.489 69.94 78.71
E38000017 NHS Bracknell and Ascot CCG 7917.9 200 9.679 74.15 80.18
E38000118 NHS North East Hampshire and Farnham CCG 7732.95 201 9.855 73.64 79.41
E38000132 NHS Nottingham City CCG 25061.02 14 36.927 69.78 79.30
E38000013 NHS Birmingham South and Central CCG 25065.52 13 37.245 61.43 74.89
E38000144 NHS Sandwell and West Birmingham CCG 25896.01 5 37.77 62.78 75.27
E38000032 NHS Central Manchester CCG 26658.22 3 39.666 58.54 73.79
E38000101 NHS Liverpool CCG 25461.22 10 41.126 65.73 71.85
E38000085 NHS Hull CCG 25310.26 12 41.235 72.31 77.78
E38000091 NHS Knowsley CCG 25599.37 8 41.387 69.54 74.59
E38000015 NHS Blackpool CCG 25692.67 6 41.997 68.20 72.47
E38000123 NHS North Manchester CCG 28303.3 2 46.747 63.30 72.95
E38000018 NHS Bradford City CCG 30140.52 1 51.549 57.26 75.82

6. Deprivation
(IMD 2015)
Map of IMD scores
6 IMD Score vs. Cervical coverage September 2016
Source for IMD scores:
Department for Communities and
Local Government
The IMD score for each CCG is the
average of the Lower-Layer Super
Output Areas (LSOAs) that make up
that CCG

7. Cervical coverage by CCG vs. deprivation (IMD
2015)
7 IMD Score vs. Cervical coverage September 2016
50
55
60
65
70
75
80
85
90
0 10 20 30 40 50
Coverage
(%w/adequatescreen)in3.5(25-49)or5.5(50-64)
years
IMD Score 2015
Ages
50to64
Ages
25to49
Linear
(Ages
50to64
)
Linear
(Ages
25to49
)
Source for IMD score:
Department for
Communities and
Local Government
Source for coverage
data: National Health
Application and
Infrastructure Services
(NHAIS) systems
accessed using Open
Exeter.
Data for September
2016
Green line indicates
national coverage
standard of at least
80%
NB Linear trend
lines are guides
only and may not
be statistically
significant.

8. Urban with Major Conurbation Purple
Urban with Minor Conurbation Blue
Urban with City and Town Green
Urban with Significant Rural (rural including hub towns 26-49%) Yellow
Largely Rural (rural including hub towns 50-79%) Orange
Mainly Rural (rural including hub towns >=80%) Grey
Grouping into area types
8 IMD Score vs. Cervical coverage September 2016
Source: Office of National Statistics
http://geoportal.statistics.gov.uk/datasets/d247bded1f4f45ab8c61e05be4303934_0

9. Map of area types
showing rural / urban mix
9 IMD Score vs. Cervical coverage September 2016
Source for rural urban mix:
Office of National Statistics
The RUC11 classification was produced by
the University of Sheffield and sponsored
by a cross-Government working group

10. 50
55
60
65
70
75
80
85
90
0 10 20 30 40 50
Coverage(%withadequatetestwithin5.5years)
IMD Score 2015
Urban with Major
Conurbation
Urban with Minor
Conurbation
Urban with City and
Town
Urban with Significant
Rural (rural incl. hub
towns 26-49%)
Largely Rural (rural
incl. hub towns 50-
79%)
Mainly Rural (rural incl.
hub towns >=80%)
IMD score vs. cervical coverage for ages 50 to 64
grouped by area type
10 IMD Score vs. Cervical coverage September 2016
Source for IMD score:
Department for
Communities and
Local Government
Source for coverage
data: NHAIS systems
accessed using Open
Exeter.
Data for September
2016
Green line indicates
national coverage
standard of at least
80%

11. 50
55
60
65
70
75
80
85
90
0 10 20 30 40 50
Coverage(%withadequatetestwithin3.5years)
IMD Score 2015
Urban with Major
Conurbation
Urban with Minor
Conurbation
Urban with City and
Town
Urban with Significant
Rural (rural incl. hub
towns 26-49%)
Largely Rural (rural
incl. hub towns 50-
79%)
Mainly Rural (rural incl.
hub towns >=80%)
IMD score vs. cervical coverage for ages 25 to 49
grouped by area type
11 IMD Score vs. Cervical coverage September 2016
Source for IMD score:
Department for
Communities and
Local Government
Source for coverage
data: NHAIS systems
accessed using Open
Exeter.
Data for September
2016
Green line indicates
national coverage
standard of at least
80%

12. Cervical coverage for ages 50 to 64: top & bottom
CCGs grouped by area type
12 IMD Score vs. Cervical coverage September 2016
Source for rural urban mix: Office of National Statistics
Source for coverage data: NHAIS systems accessed using Open Exeter. Data for September 2016
Urban with
Major Conurbation
Urban with
Minor Conurbation
Urban with
City and Town
Urban with
Significant Rural
(rural incl. hub towns 26-
49%)
Largely Rural
(rural incl. hub towns 50-
79%)
Mainly Rural
(rural incl. hub towns
>=80%)
Greater Huddersfield
(82.1%)
Nottingham North and East
(82.41%)
South Gloucestershire
(81.4%)
North Derbyshire (81.71%) Rushcliffe (84.64%)
Hambleton, Richmondshire
and Whitby (80.63%)
Calderdale (80.63%) Nottingham West (81.75%) Wokingham (80.95%)
Harrogate and Rural District
(80.75%)
South Lincolnshire (81.29%) South Norfolk (78.73%)
Leeds West (79.77%) Erewash (80.6%)
North East Lincolnshire
(80.94%)
Lincolnshire West (80.58%) Aylesbury Vale (80.99%) West Suffolk (78.47%)
Hammersmith and Fulham
(68.89%)
Nottingham City (79.3%) Halton (74.67%) Morecambe Bay (76.63%) Herefordshire (77.48%) Lincolnshire East (77.59%)
West London (66.03%) Doncaster (78.91%) Southampton (74.66%)
Great Yarmouth and
Waveney (76.62%)
High Weald Lewes Havens
(77.24%)
Kernow (77.59%)
Central London
(Westminster) (63.93%)
Sheffield (78.5%) Blackpool (72.47%) Cannock Chase (76.37%) West Norfolk (76.4%) Isle of Wight (74.53%)
of 73 CCGs of 8 CCGs of 52 CCGs of 43 CCGs of 26 CCGs of 7 CCGs

13. Cervical coverage for ages 25 to 49: top & bottom
CCGs grouped by area type
13 IMD Score vs. Cervical coverage September 2016
Source for rural urban mix: Office of National Statistics
Source for coverage data: NHAIS systems accessed using Open Exeter. Data for September 2016
Urban with
Major Conurbation
Urban with
Minor Conurbation
Urban with
City and Town
Urban with
Significant Rural
(rural incl. hub towns 26-
49%)
Largely Rural
(rural incl. hub towns 50-
79%)
Mainly Rural
(rural incl. hub towns
>=80%)
North Tyneside (76.68%)
Nottingham North and East
(78.68%)
South Gloucestershire
(76.98%)
North Derbyshire (78.38%) Rushcliffe (81.38%)
Hambleton, Richmondshire
and Whitby (76.98%)
Calderdale (76.02%) Nottingham West (77.3%)
Castle Point and Rochford
(76.39%)
West Kent (76.62%)
East Riding of Yorkshire
(77.55%)
North Norfolk (76.84%)
Greater Huddersfield
(75.32%)
Erewash (77.03%)
Horsham and Mid Sussex
(75.53%)
Ashford (75.95%) Northumberland (77.43%) South Norfolk (74.74%)
West London (53.19%) Doncaster (72.57%) Leicester City (62.33%) North Hampshire (70.58%)
Guildford and Waverley
(70.79%)
West Suffolk (73.07%)
Camden (52.32%) Sheffield (71.63%) South Reading (62.17%) Morecambe Bay (70.13%)
Cambridgeshire and
Peterborough (68.74%)
Isle of Wight (71.48%)
Central London
(Westminster) (52.06%)
Nottingham City (69.78%) Slough (61.63%) East Staffordshire (69.82%) Oxfordshire (68.73%) Lincolnshire East (70.66%)
of 73 CCGs of 8 CCGs of 52 CCGs of 43 CCGs of 26 CCGs of 7 CCGs