comparison between nhscr and community health index … · 2008-06-17 · 1855 1862 1869 1876 1883...

General Register Officefor

S C O T L A N Dinformation about Scotland's people

Comparison between NHSCR and Community Health Index

sources of migration

Cecilia Macintyre General Register Office for Scotland



Overview of Presentation

• Description of trends in Scotland • Overview of methodology for mid-year

estimates• Comparison of NHSCR and CHI

estimates• Future work



General Register Office for Scotland

• “Information about Scotland’s people”• Vital events statistics• Census• Population estimates and projections• Household estimates and projections• Other statistics (eg drug deaths, dwellings)• NHS Central Register• General demographic advice



Estimated population

•5,094,800 at 30 June 2005•16,400 up during the year•Increase for the third year running•2002, 5,054,800•Change in previous trend of slow decline



Scotland's Population 1855-2005

0.0

1.0

2.0

3.0

4.0

5.0

6.0

1855 1862 1869 1876 1883 1890 1897 1904 1911 1918 1925 1932 1939 1946 1953 1960 1967 1974 1981 1988 1995 2002

Year

Popu

latio

n (M

illio

ns)

Fastest % increase 1876

& 1878

Passes 3m

1856/7

Passes 4m

1889/90

Largest & sharpest fall

1924

Passes 5m 1938/39

Highest-ever level 1974

Largest & fastest post

WW2 fall 1988

Largest & fastest

post WW2 rise 1971Largest rise

1900

First recorded fall 1912



Natural change and net migration, 1951-2005

-50

-40

-30

-20

-10

0

10

20

30

40

50

1951 1956 1961 1966 1971 1976 1981 1986 1991 1996 2001 2005Year

Pers

ons

('000

s)

Natural Change (births-deaths) Net M igration



Migration



Scottish migration

2002/3 2003/4 2004/5• Rest of UK (from NHSCR)

– In 54,300 61,900 57,300– Out 47,300 46,400 44,800

• Overseas migration– In 30,500 36,300 35,400– Out 26,400 24,600 28,100



Mid-Year Estimates Process

Census

End April –1st year of decade

Mid Census Year

Mid Census Year+1

…….Mid Census Year+9

Census

End April –1st year of decade



Migration (and other adjustments)

• Proxy Indicators– NHSCR (NHS Central Register)– CHI (Community Health Index)

• Surveys– IPS (International Passenger Survey)

• Other Information– Armed Forces– Home Office (Asylum Seekers)



NHSCR and CHI

• NHSCR Movements are recorded between Health Board Areas

• CHI movements allow migration to be measured below health board area



NHSCR

• Originally set up in 1939 for purpose of call-up for military service and food rationing

• Function - to maintain a register of all NHS patients on lists of general practitioners in Scotland

• To supply info to organisations in health service and for medical research



NHSCR

• Currently holds records for every patient registered, now or in the past with a Scottish GP

• Everyone born in Scotland since 1985 who have not been registered with a Scottish GP

• Patients formerly registered with a Scottish GP, who died after 1992



NHSCR dataset

• Unique NHS number• Unique Community Health Index

number• Names• Date of birth• Current and previous registrations with

UK health authority• Medical flags



Community Health Index

• All patients registered with a GP in Scotland, or those in contact with health service allocated CHI number

• Since 1997 there has been a unique CHI number allocated

• Aim to use throughout health service for identification



CHI extract

• Information includes– Identifiers (CHI & NHS)– Current status– Age/sex– Health board of residence + Postcode– Area codes + transfer in/out dates– Immigrant code



NHSCR (Dumfries)

• NHSCR (Dumfries) – monthly file with details or all ‘postings’ – Moves between health board areas– Cross-border England, Wales and

Northern Ireland– Immigrants and embarkations



ONS Migration Stats

• ONS Migration statistics supply details on all migrants to England & Wales quarterly sourced from NHSCR (Southport)



Northern Ireland

• Total number of migrants to NI from Northern Ireland Health and Social Services



Community Health Index

• Annual extracts

• Compared to identify changes of address and all moves across health board boundaries



Current context

• Recent changes in health board boundaries

• Increased interest in international migration

• Checking assumptions in methodology after 4 years



Data flows for in migrants

• New patient informs GP with details of previous location

• Registered on CHI with new information and old area recorded if within UK

• Request records to be transferred from old area

• NHSCR updated • For new patients, NHS no allocated



Data flows for out migrants

• Patient informs GP in other UK area of details of previous location in Scotland

• NHSCR(Southport) or NIHSS updated• Change information passed to NHSCR(D)• Reports of transfer out sent to CHI for

updating• Records transferred to new area• Embarkation – another story



Moves to E&W

• Number of migrants to England & Wales reported by NHSCR(Southport) – 42400

• Number of transfers out to E&W on CHI– 26000



Comparison of NHSCR-derived and CHI Flows to E&W 2001-0222

13

5497

3537

3146

1008

5

1473 21

53

3505

8309

2882

2612

1888

158

199

192

1467

3514

2375

2035

7252

1045 14

94

2539

5389

2027

1621

1453

104

162

125

0

2000

4000

6000

8000

10000

12000H

ighl

and

Gra

mpi

an

Tays

ide

Fife

Loth

ian

Bord

ers

Forth

Val

ley

Argy

ll &

Cly

de

Gre

ater

Gla

sgow

Lana

rksh

ire

Ayrs

hire

& A

rran

Dum

fries

&G

allo

way

Ork

ney

Shet

land

Wes

tern

Isle

s

Health Board

Mig

rant

s

NHSCR-derived CHI



CHI and NHSCR-deribed flows to E&W by age

0

500

1000

1500

2000

2500

0 10 20 30 40 50 60 70 80 90

Age

Mig

rant

s

NHSCR-derived CHI



Percentage age distribution of CHI and NHSCR-derived flows to E&W

0%

1%

2%

3%

4%

5%

6%

0 10 20 30 40 50 60 70 80 90

Age

% M

igra

nts

NHSCR-derived CHI



Moves to E&W –Possible explanations

• Flow of information from NHSCR(Dumfries) to Practitioner services

• Impact of patients who are untraced or lost



Further work

• Case studies of sample of patients

• Transfers in from overseas

• Northern Ireland flows - was there a black hole in the Irish Sea?



Thank you

Questions?

comparison between nhscr and community health index … · 2008-06-17 · 1855 1862 1869 1876 1883...

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