The population of the United Kingdom in 2023 was estimated to be approximately 68.3 million in 2023, with almost 9.48 million people living in South East England. London had the next highest population, at over 8.9 million people, followed by the North West England at 7.6 million. With the UK's population generally concentrated in England, most English regions have larger populations than the constituent countries of Scotland, Wales, and Northern Ireland, which had populations of 5.5 million, 3.16 million, and 1.92 million respectively. English counties and cities The United Kingdom is a patchwork of various regional units, within England the largest of these are the regions shown here, which show how London, along with the rest of South East England had around 18 million people living there in this year. The next significant regional units in England are the 47 metropolitan and ceremonial counties. After London, the metropolitan counties of the West Midlands, Greater Manchester, and West Yorkshire were the biggest of these counties, due to covering the large urban areas of Birmingham, Manchester, and Leeds respectively. Regional divisions in Scotland, Wales and Northern Ireland The smaller countries that comprise the United Kingdom each have different local subdivisions. Within Scotland these are called council areas whereas in Wales the main regional units are called unitary authorities. Scotland's largest Council Area by population is that of Glasgow City at over 622,000, while in Wales, it was the Cardiff Unitary Authority at around 372,000. Northern Ireland, on the other hand, has eleven local government districts, the largest of which is Belfast with a population of around 348,000.

All diagnoses of first episode genital herpes among people accessing sexual health services* in England who are also residents in England, expressed as a rate per 100,000 population. Data is presented by area of patient residence and include those residents in England and those with an unknown residence (data for those residents outside of England is not included).*Sexual health services providing STI related care (Levels 2 and 3). Further details on the levels of sexual healthcare provision are provided in the https://www.bashh.org/about-bashh/publications/standards-for-the-management-of-stis/ .RationaleGenital herpes is the most common ulcerative sexually transmitted infection seen in England. Infections are frequently due to herpes simplex virus (HSV) type 2, although HSV-1 infection is also seen. Recurrent infections are common with patients returning for treatment.Definition of numeratorThe number of diagnoses of genital herpes (first episode) among people accessing sexual health services in England who are also residents in England.Episode Activity codes (SNOMED or Sexual Health and HIV Activity Property Types (SHHAPT)) relating to diagnosis of genital herpes (first episode) were used. The clinical criteria used to diagnose the conditions are given at https://www.bashh.org/guidelines .Data was de-duplicated to ensure that a patient received a diagnostic code only once for each episode. Patients cannot be tracked between services and therefore de-duplication relies on patient consultations at a single service.Definition of denominatorThe denominators for 2012 to 2022 are sourced from Office for National Statistics (ONS) population estimates based on the 2021 Census.Population estimates for 2023 were not available at the time of publication – therefore rates for 2023 are calculated using estimates from 2022 as a proxy.Further details on the ONS census are available from the https://www.ons.gov.uk/census .CaveatsEvery effort is made to ensure accuracy and completeness of GUMCAD data, including web-based reporting with integrated checks on data quality. However, responsibility for the accuracy and completeness of data lies with the reporting service.Data is updated on an annual basis due to clinic or laboratory resubmissions and improvements to data cleaning. Data may differ from previous publications.Figures reported in 2020 and 2021 are notably lower than previous years due to the disruption to SHSs during the national response to the COVID-19 pandemic.

Crude rate per 100,000 population: the number of fast food outlets is divided by the population of the area and multiplied by 100,000.

Rationale

The environment in which we live and work has positive and negative effects on our health and wellbeing. One component of the built-up environment is food outlets and the choices they provide. Meals eaten outside of the home tend to be associated with higher calories, and portion sizes tend to be bigger, which can make it more challenging to eat healthily [1,2]. The neighbourhood food environment is one important modifiable determinant of dietary behaviour and obesity [3].

The availability of fast food in our environment is one issue, within a complex system [4], which is associated with a range of negative health outcomes and contributes to the obesogenic nature of some of our neighbourhoods. Fast food is more abundantly available in the most deprived areas of England where obesity in children and adults and the associated health conditions, such as type 2 diabetes, hypertension, and heart disease are most prevalent [5,6].

This indicator is designed to help users understand the number of fast food outlets in an area taking the size of the population into account. It is intended to support national policy making and influence planning activities in local authorities [7] with the aim of reducing the availability of fast food, where this is deemed desirable, in order to improve health outcomes.

References

Sugar reduction programme: industry progress 2015 to 2020 - GOV.UK
Calorie reduction programme: industry progress 2017 to 2021 - GOV.UK
Dietary inequalities: What is the evidence for the effect of the neighbourhood food environment?
A foresight whole systems obesity classification for the English UK biobank cohort
The Association between Fast Food Outlets and Overweight in Adolescents Is Confounded by Neighbourhood Deprivation
The association between the presence of fast-food outlets and BMI
No new fast-food outlets allowed! Evaluating the effect of planning policy on the local food environment in the North East of England

Definition of numerator The numerator is a count, at a specific point in time, of fast food outlets in each geographic area. The inclusion criteria for counting fast food outlets is described in the methodology section below.

Definition of denominator Count of the population in each geographic area from Office for National Statistics (ONS) mid-year population estimates 2023.

Caveats

The Impact of Food Delivery Services In recent years there has been a large growth of food delivery services and meal delivery apps (MDAs). These companies allow customers to order food via mobile apps or websites for delivery to a chosen address. The availability of fast food through MDAs expands the geographic coverage of fast food outlets, increasing the likelihood that customers will order from outlets in neighbouring local authority areas, especially in urban settings. These apps extend the reach of fast food outlets beyond the immediate resident or visiting population.

Cross Local Authority Movements Some individuals may travel to neighbouring local authorities to access fast food outlets. Therefore, data showing fast food outlets within a specific area may underestimate actual exposure for the resident population. Users should consider data from neighbouring areas to gain a more comprehensive understanding of fast food exposure.

The Impact of Non-Resident Populations Movements for work, shopping, entertainment, or tourism also affect exposure. Local authorities with high numbers of fast food outlets per 100,000 residents may have large non-resident populations who are not included in the population denominator but are still exposed to these outlets.

Data Source and Methods The data may not fully capture all fast food outlets. Many businesses are multi-functional—offering dine-in, takeaway, and delivery—and may be categorized as restaurants or cafés, thus excluded from fast food counts. Inclusion based on business names helps mitigate this, but some outlets may still be missed. Conversely, some outlets categorized as ‘Takeaway/sandwich shop’ may not be considered fast food.

Data from the FSA FHRS is presumed accurate, but errors in collection, collation, and entry are possible. Categorization may vary between local authorities. For example, an outlet selling sandwiches and tea might be recorded as a Restaurant/Café/Canteen in one area and as a Takeaway/sandwich shop in another.

Different data sources use varying definitions and categorizations, so numbers may differ across datasets. The data here counts businesses identified as fast food outlets, not direct access for individuals, which is influenced by factors like opening hours, pricing, parking, and delivery options. It reflects premises use rather than individual access.

Crude rate of cost of admissions for alcohol-related conditions (Broad definition) per head of population.

Rationale Alcohol misuse across the UK is a significant public health problem with major health, social, and economic consequences. This indicator aims to highlight the impact of alcohol-related conditions on inpatient hospital services in England. High costs of alcohol-related admissions are indicative of poor population health and high alcohol consumption. This indicator highlights the resource implications of alcohol-related conditions and supports the arguments for local health promotion initiatives. Publication of this indicator will allow national and local cost estimates to be updated and consistently monitored going forward. This measure accounts for just one aspect of the cost of alcohol to society, but there are others such as primary care, crime, ambulatory services, and specialist treatment services as well as broader costs such as unemployment and loss of productivity.

The Government has said that everyone has a role to play in reducing the harmful use of alcohol. This indicator is one of the key contributions by the Government (and the Department of Health and Social Care) to promote measurable, evidence-based prevention activities at a local level, and supports the national ambitions to reduce harm set out in the Government's Alcohol Strategy. This ambition is part of the monitoring arrangements for the Responsibility Deal Alcohol Network. Alcohol-related admissions can be reduced through local interventions to reduce alcohol misuse and harm.

References: (1) PHE (2020) The Burden of Disease in England compared with 22 peer countries https://www.gov.uk/government/publications/global-burden-of-disease-for-england-international-comparisons/the-burden-of-disease-in-england-compared-with-22-peer-countries-executive-summary

Definition of numerator The total cost (£s) of alcohol-related admissions (Broad). Admissions to hospital where the primary diagnosis is an alcohol-related condition, or a secondary diagnosis is an alcohol-related external cause.

More specifically, hospital admissions records are identified where the admission is a finished episode [epistat = 3]; the admission is an ordinary admission, day case or maternity [classpat = 1, 2 or 5]; it is an admission episode [epiorder = 1]; the sex of the patient is valid [sex = 1 or 2]; there is a valid age at start of episode [startage between 0 and 150 or between 7001 and 7007]; the region of residence is one of the English regions, no fixed abode or unknown [resgor <= K or U or Y]; the episode end date [epiend] falls within the financial year, and an alcohol-attributable ICD10 code appears in the primary diagnosis field [diag_01] or an alcohol-related external cause code appears in any diagnosis field [diag_nn].

For each episode identified, an alcohol-attributable fraction is applied to the primary diagnosis field or an alcohol-attributable external cause code appears in one of the secondary codes based on the diagnostic codes, age group, and sex of the patient. Where there is more than one alcohol-related ICD10 code among the 20 possible diagnostic codes, the code with the largest alcohol-attributable fraction is selected; in the event of there being two or more codes with the same alcohol-attributable fraction within the same episode, the one from the lowest diagnostic position is selected. For a detailed list of all alcohol-attributable diseases, including ICD 10 codes and relative risks, see ‘Alcohol-attributable fractions for England: an update’ (2). Alcohol-related hospital admission episodes were extracted from HES according to the Broad definition and admissions flagged as either elective or non-elective based on the admission method field.

The cost of each admission episode was calculated using the National Cost Collection (published by NHS England) main schedule dataset for the corresponding financial year applied to elective and non-elective admission episodes. The healthcare resource group (HRG) was identified using the HES field SUSHRG [SUS Generated HRG], which is the SUS PbR derived HRG code at episode level. Healthcare Resource Groups (HRGs) are standard groupings of clinically similar treatments which use common levels of healthcare resource. The elective admissions were assigned an average of the elective and day-case costs. The non-electives were assigned an average of the non-elective long stay and non-elective short stay costs. Where the HRG was not available or did not match the National Reference Costs look-up table, an average elective or non-elective cost was imputed. This may result in the cost of these admissions being underestimated. For each record, the AAF was multiplied by the reference cost and the resulting values were aggregated by the required output geographies to provide numerators for the cost per capita indicator.

References: (2) PHE (2020) Alcohol-attributable fractions for England: an update https://www.gov.uk/government/publications/alcohol-attributable-fractions-for-england-an-update

Definition of denominator Mid-year population estimates.

Caveats Not all alcohol-related conditions require inpatient services, so this indicator is only one measure of the alcohol-related health problems in each local area. However, inpatient admissions are easily monitored, and this indicator provides local authorities with a routine method of monitoring the health impacts of alcohol in their local populations.

The Healthcare Resource Group cost assigned to each hospital admission is for the initial admission episode only and doesn’t include costs related to alcohol in any subsequent episodes in the hospital spell. Where the HRG was not available or did not match the National Reference Costs look-up table, an average elective or non-elective cost was imputed. This may result in the cost of these admissions being underestimated. It must be noted that the numerator is based on the financial year and the denominator on calendar mid-year population estimates, e.g., 2019/20 admission rates are constructed from admission counts for the 2019/20 financial year and mid-year population estimates for the 2020 calendar year. Data for England includes records with geography 'No fixed abode'. Alcohol-attributable fractions were not available for children. Conditions where low levels of alcohol consumption are protective (have a negative alcohol-attributable fraction) are not included in the calculation of the indicator. This does not include attendance at Accident and Emergency departments. Hospital Episode Statistics overall is well completed. However, year-on-year variations exist due to poor completion from a proportion of trusts.

Analysis has revealed significant differences across the country in the coding of cancer patients in the Hospital Episode Statistics. In particular, in some areas, regular attenders at hospital for treatments like chemotherapy and radiotherapy are being incorrectly recorded as ordinary or day-case admissions. Since cancer admissions form part of the overarching alcohol-related admission national indicators, the inconsistent recording across the country for cancer patients has some implication for these headline measures.

Cancer admissions make up approximately a quarter of the total number of alcohol-related admissions. Analysis suggests that, although most Local Authorities would remain within the same RAG group compared with the England average if cancer admissions were removed, the ranking of Local Authorities within RAG groups would be altered. We are continuing to monitor the impact of this issue and to consider ways of improving the consistency between areas. The COVID-19 pandemic had a large impact on hospital activity with a reduction in admissions in 2020 to 2021. Because of this, NHS Digital has been unable to analyse coverage (measured as the difference between expected and actual records submitted by NHS Trusts) in the normal way. There may have been issues around coverage in some areas which were not identified as a result.

London was by far the largest urban agglomeration in the United Kingdom in 2023, with an estimated population of 9.65 million people, more than three times as large as Manchester, the UK’s second-biggest urban agglomeration. The agglomerations of Birmingham and Leeds / Bradford had the third and fourth-largest populations respectively, while the biggest city in Scotland, Glasgow, was the fifth largest. Largest cities in Europe Two cities in Europe had larger urban areas than London, with the Russian capital Moscow having a population of almost 12.7 million. The city of Paris, located just over 200 miles away from London, was the second-largest city in Europe, with a population of more than 11.2 million people. Paris was followed by London in terms of population-size, and then by the Spanish cities of Madrid and Barcelona, at 6.75 million and 5.68 million people respectively. Russia's second-biggest city; St. Petersburg had a population of 5.56 million, followed by Rome at 4.3 million, and Berlin at 3.5 million. London’s population growth Throughout the 1980s, the population of London fluctuated from a high of 6.81 million people in 1981 to a low of 6.73 million inhabitants in 1988. During the 1990s, the population of London increased once again, growing from 6.8 million at the start of the decade to 7.15 million by 1999. London's population has continued to grow since the turn of the century, reaching a peak of 8.96 million people in 2019, and is forecast to reach 9.8 million by 2043.

Deaths from alcohol-related conditions, all ages, directly age-standardised rate per 100,000 population (standardised to the European standard population).

Rationale Alcohol consumption is a contributing factor to hospital admissions and deaths from a diverse range of conditions. Alcohol misuse is estimated to cost the NHS about £3.5 billion per year and society as a whole £21 billion annually.

The Government has said that everyone has a role to play in reducing the harmful use of alcohol - this indicator is one of the key contributions by the Government (and the Department of Health and Social Care) to promote measurable, evidence-based prevention activities at a local level, and supports the national ambitions to reduce harm set out in the Government's Alcohol Strategy. This ambition is part of the monitoring arrangements for the Responsibility Deal Alcohol Network. Alcohol-related deaths can be reduced through local interventions to reduce alcohol misuse and harm.

The proportion of disease attributable to alcohol (alcohol attributable fraction) is calculated using a relative risk (a fraction between 0 and 1) specific to each disease, age group, and sex combined with the prevalence of alcohol consumption in the population. All mortality records are extracted that contain an attributable disease and the age and sex-specific fraction applied. The results are summed into quinary age bands for the numerator and a directly standardised rate calculated using the European Standard Population. This revised indicator uses updated alcohol attributable fractions, based on new relative risks from ‘Alcohol-attributable fractions for England: an update’ (1) published by PHE in 2020. A detailed comparison between the 2013 and 2020 alcohol attributable fractions is available in Appendix 3 of the PHE report (2). A consultation was also undertaken with stakeholders where the impact of the new methodology on the LAPE indicators was quantified and explored (3).

The calculation that underlies all alcohol-related indicators has been updated to take account of the latest academic evidence and more recent alcohol-consumption figures. The result has been that the newly published mortality and admission rates are lower than those previously published. This is due to a change in methodology, mainly because alcohol consumption across the population has reduced since 2010. Therefore, the number of deaths and hospital admissions that we attribute to alcohol has reduced because in general people are drinking less today than they were when the original calculation was made.

Figures published previously did not misrepresent the burden of alcohol based on the previous evidence – the methodology used in this update is as close as sources and data allow to the original method. Though the number of deaths and admissions attributed to alcohol each year has reduced, the direction of trend and the key inequalities due to alcohol harm remain the same. Alcohol remains a significant burden on the health of the population and the harm alcohol causes to individuals remains unchanged.

References:

PHE (2020) Alcohol-attributable fractions for England: an update PHE (2020) Alcohol-attributable fractions for England: an update: Appendix 3 PHE (2021) Proposed changes for calculating alcohol-related mortality

Definition of numerator Deaths from alcohol-related conditions based on underlying cause of death, registered in the calendar year for all ages. Each alcohol-related death is assigned an alcohol attributable fraction based on underlying cause of death (and all cause of deaths fields for the conditions: ethanol poisoning, methanol poisoning, toxic effect of alcohol). Alcohol-attributable fractions were not available for children.

Mortality data includes all deaths registered in the calendar year where the local authority of usual residence of the deceased is one of the English geographies and an alcohol attributable diagnosis is given as the underlying cause of death. Counts of deaths for years up to and including 2019 have been adjusted where needed to take account of the MUSE ICD-10 coding change introduced in 2020. Detailed guidance on the MUSE implementation is available at: MUSE implementation guidance.

Counts of deaths for years up to and including 2013 have been double adjusted by applying comparability ratios from both the IRIS coding change and the MUSE coding change where needed to take account of both the MUSE ICD-10 coding change and the IRIS ICD-10 coding change introduced in 2014. The detailed guidance on the IRIS implementation is available at: IRIS implementation guidance.

Counts of deaths for years up to and including 2010 have been triple adjusted by applying comparability ratios from the 2011 coding change, the IRIS coding change, and the MUSE coding change where needed to take account of the MUSE ICD-10 coding change, the IRIS ICD-10 coding change, and the ICD-10 coding change introduced in 2011. The detailed guidance on the 2011 implementation is available at: 2011 implementation guidance.

Definition of denominator ONS mid-year population estimates aggregated into quinary age bands.

Caveats There is the potential for the underlying cause of death to be incorrectly attributed on the death certificate and the cause of death misclassified. Alcohol-attributable fractions were not available for children. Conditions where low levels of alcohol consumption are protective (have a negative alcohol-attributable fraction) are not included in the calculation of the indicator.

The confidence intervals do not take into account the uncertainty involved in the calculation of the AAFs – that is, the proportion of deaths that are caused by alcohol and the alcohol consumption prevalence that are included in the AAF formula are only an estimate and so include uncertainty. The confidence intervals published here are based only on the observed number of deaths and do not account for this uncertainty in the calculation of attributable fraction - as such the intervals may be too narrow.

In 2023, almost nine million people lived in Greater London, making it the most populated ceremonial county in England. The West Midlands Metropolitan County, which contains the large city of Birmingham, was the second-largest county at 2.98 million inhabitants, followed by Greater Manchester and then West Yorkshire with populations of 2.95 million and 2.4 million, respectively. Kent, Essex, and Hampshire were the three next-largest counties in terms of population, each with around 1.89 million people. A patchwork of regions England is just one of the four countries that compose the United Kingdom of Great Britain and Northern Ireland, with England, Scotland and Wales making up Great Britain. England is therefore not to be confused with Great Britain or the United Kingdom as a whole. Within England, the next subdivisions are the nine regions of England, containing various smaller units such as unitary authorities, metropolitan counties and non-metropolitan districts. The counties in this statistic, however, are based on the ceremonial counties of England as defined by the Lieutenancies Act of 1997. Regions of Scotland, Wales, and Northern Ireland Like England, the other countries of the United Kingdom have their own regional subdivisions, although with some different terminology. Scotland’s subdivisions are council areas, while Wales has unitary authorities, and Northern Ireland has local government districts. As of 2022, the most-populated Scottish council area was Glasgow City, with over 622,000 inhabitants. In Wales, Cardiff had the largest population among its unitary authorities, and in Northern Ireland, Belfast was the local government area with the most people living there.

Proportion of the population who, when surveyed, reported that they had eaten the recommended 5 portions of fruit and vegetables on a usual day. This is the weighted number of respondents aged 16 and over, with valid responses to the question 'How many portions of fruit and vegetables did you eat yesterday?', eating at least 5 portions of fruit and vegetables in the previous day.

All analyses for this indicator have been weighted to be representative of the population of England. These indicators use data from the Sport England Active Lives (AL) survey. These indicators were not intended to be, and should not be, compared directly with other sources of diet data. The AL questions are more simplistic than those used in other sources e.g., National Diet and Nutrition Survey (NDNS) or Health Survey for England (HSE). Estimates from the different surveys are not directly comparable as the data collection methodologies are different.

For the HSE, participants are asked numerous questions, including separate questions about fruits, vegetables, and pulses, and portion sizes. For the NDNS, data are collected using food diaries. Foods are then broken down to their component parts and fruit and vegetable portions are calculated. The method used in AL enables responses from a very large sample to be collected which means we can present data for each local authority which cannot be done using other sources.

The main purpose of the data set used for the PHOF indicators is to enable comparisons between areas and to measure progress. Latest update presents data from Active Lives for the period mid-November to mid-November. The current estimates (2020 to 2021 onwards) are not comparable with the previous estimates (between 2015 to 2016 and 2019 to 2020) as the current estimates are consistently around 20 percentage points lower than the previous estimates. Although the estimates of those meeting the ‘5-a-day’ fruit and vegetable consumption recommendations are significantly lower from the single question, the ranking order across local authorities or inequality groups is similar.

Data is Powered by LG Inform Plus and automatically checked for new data on the 3rd of each month.

As of 2023, the population density in London was by far the highest number of people per square km in the UK, at *****. Of the other regions and countries which constitute the United Kingdom, North West England was the next most densely populated area at *** people per square kilometer. Scotland, by contrast, is the most sparsely populated country or region in the United Kingdom, with only ** people per square kilometer. Countries, regions, and cities According to the official mid-year population estimate, the population of the United Kingdom was just almost **** million in 2022. Most of the population lived in England, where an estimated **** million people resided, followed by Scotland at **** million, Wales at **** million and finally Northern Ireland at just over *** million. Within England, the South East was the region with the highest population at almost **** million, followed by the London region at around *** million. In terms of urban areas, Greater London is the largest city in the United Kingdom, followed by Greater Manchester and Birmingham in the North West and West Midlands regions of England. London calling London's huge size in relation to other UK cities is also reflected by its economic performance. In 2021, London's GDP was approximately *** billion British pounds, almost a quarter of UK GDP overall. In terms of GDP per capita, Londoners had a GDP per head of ****** pounds, compared with an average of ****** for the country as a whole. Productivity, expressed as by output per hour worked, was also far higher in London than the rest of the country. In 2021, London was around **** percent more productive than the rest of the country, with South East England the only other region where productivity was higher than the national average.

The population of London was approximately *** million in 2023, an increase of over *** million people when compared with the early 1980s. Throughout the 1980s, the population of the United Kingdom's capital grew at a relatively slow rate, before accelerating to a much faster rate in the 1990s. London is by far the largest city / urban agglomeration in the United Kingdom, more than three times larger than the next largest cities of Manchester and Birmingham. London’s forecasted population is expected to continue growing at much the same pace it has been growing since the mid-1990s and reach almost *** million by 2042. London boroughs As of 2022, the London borough with the highest population was Croydon, at approximately *******, followed by Barnet at *******. Overall, London is divided into 33 different boroughs, with London's historic center, the City of London, having by far the smallest population, at just ******. Residents of the City of London, however, have the highest average median weekly earnings among all of London's boroughs, at ***** pounds per week, compared with just *** pounds per week in Redbridge, the lowest average weekly earnings among London boroughs. While the overall unemployment rate for London was *** percent in early 2023, this ranged from *** percent in Brent, to just *** percent in Kingston upon Thames.
Economic imbalance Aside from being the UK's largest city in terms of population, London is also undoubtedly the UK's cultural, political and economic center. As of 2021, the GDP of Greater London was approximately ***** billion British pounds, just over ** percent of the UK's overall GDP. In the same year, GDP per person in London was ****** pounds compared with the UK average of ****** pounds. Additionally, productivity in London is far higher than the UK average. As measured by output per hour worked, London was **** percent more productive than the rest of the UK.

People aged 15 to 59 years seen at HIV services in the UK, expressed as a rate per 1,000 population.Data is presented by area of residence, and exclude people diagnosed with HIV in England who are resident in Wales, Scotland, Northern Ireland or abroad.RationaleThe geographical distribution of people seen for HIV care and treatment is not uniform across or within regions in England. Knowledge of local diagnosed HIV prevalence and identification of local risk groups can be used to help direct resources for HIV prevention and treatment.In 2008, http://www.bhiva.org/HIV-testing-guidelines.aspx recommended that Local Authority and NHS bodies consider implementing routine HIV testing for all general medical admissions as well as new registrants in primary care where the diagnosed HIV prevalence exceeds 2 in 1,000 population aged 15 to 59 years.In 2017, guidelines were updated by https://www.nice.org.uk/guidance/NG60 which is co-badged with Public Health England. This guidance continues to define high HIV prevalence local authorities as those with a diagnosed HIV prevalence of between 2 and 5 per 1,000 and extremely high prevalence local authorities as those with a diagnosed HIV prevalence of 5 or more per 1,000 people aged 15 to 59 years.When this is applied to national late HIV diagnosis data, it shows that two-thirds of late HIV diagnoses occur in high-prevalence and extremely-high-prevalence local authorities. This means that if this recommendation is successfully applied in high and extremely-high-prevalence areas, it could potentially affect two-thirds of late diagnoses nationally.Local authorities should find out their diagnosed prevalence published in UKHSA's http://fingertips.phe.org.uk/profile/sexualhealth , as well as that of surrounding areas and adapt their strategy for HIV testing using the national guidelines.Commissioners can use these data to plan and ensure access to comprehensive and specialist local HIV care and treatment for HIV diagnosed individuals according to the http://www.medfash.org.uk/uploads/files/p17abl6hvc4p71ovpkr81ugsh60v.pdf and http://www.bhiva.org/monitoring-guidelines.aspx .Definition of numeratorThe number of people (aged 15 to 59 years) living with a diagnosed HIV infection and accessing HIV care at an NHS service in the UK and who are resident in England.Definition of denominatorResident population aged 15 to 59.The denominators for 2011 to 2023 are taken from the respective 2011 to 2023 Office for National Statistics (ONS) revised population estimates from the 2021 Census.Further details on the ONS census are available from the https://www.ons.gov.uk/census .CaveatsData is presented by geographical area of residence. Where data on residence were unavailable, residence have been assigned to the local health area of care.Every effort is made to ensure accuracy and completeness of the data, including web-based reporting with integrated checks on data quality. The overall data quality is high as the dataset is used for commissioning purposes and for the national allocation of funding. However, responsibility for the accuracy and completeness of data lies with the reporting service.Data is as reported but rely on ‘record linkage’ to integrate data and ‘de-duplication’ to prevent double counting of the same individual. The data may not be representative in areas where residence information is not known for a significant proportion of people accessing HIV care.Data supplied for previous years are updated on an annual basis due to clinic or laboratory resubmissions and improvements to data cleaning. Data may therefore differ from previous publications.Values are benchmarked against set thresholds and categorised into the following groups: <2 (low), 2 to 5 (high) and≥5 (extremely high). These have been determined by developments in national testing guidelines.The data reported in 2020 and 2021 is impacted by the reconfiguration of sexual health services during the national response to COVID-19.

By 2047 the population of London is expected to reach 9.97 million people, an increase of almost 699,500 when compared with 2025. While there has been quite a steep rise in its population in recent years, London’s population growth was relatively stagnant throughout the 1980s and even decreased slightly towards the end of that decade. After peaking at 8.89 million in 2019, the population of London has fallen slightly, to 8.8 million by 2021. UK population forecast Like London, the population of the United Kingdom is forecast to continue to grow well into the middle of the century. By 2046, the population of the UK is estimated to be over 76.3 million people, an increase of over 20 million people when compared with the population figures for 1976. Additionally, the average age of the population is predicted to increase from 39.5 years in 2020 to 44.5 years by the mid-2040s, and continue to increase towards the end of the century. London looms large In the UK, London is by far the largest urban agglomeration in the country, dwarfing the UK's next largest cities of Birmingham, Manchester, and Leeds. London also has a dominant economic position in the UK, with the city accounting for around a quarter of the total GDP in the country. The UK capital also has a far higher GDP per head than the rest of the county, at over ****** pounds in 2023, compared with the UK average of ****** pounds.

All new STI diagnoses among people accessing sexual health services* in England. Data represent STI diagnoses among people who are resident in England. Data is presented by area of patient residence and include those residents in England and those with an unknown residence (data for those residents outside of England is not included). Data is expressed as a rate per 100,000 population.*Sexual health services providing STI related care (Levels 1, 2 or 3). Further details on the levels of sexual healthcare provision are provided in the Standards for the Management of STIs.

Rationale A summary figure of all new STI diagnoses.

Definition of numerator The number of new STI diagnoses among people accessing sexual health services in England who are also residents in England.STI data excluding chlamydia is sourced from the GUMCAD STI Surveillance System (Levels 2 and 3). GUMCAD data is reported by SHSs providing STI related care (Levels 2 or 3). Chlamydia data is sourced from GUMCAD (Level 3) and CTAD Chlamydia Surveillance System (Levels 1 and 2), UKHSA. CTAD data is reported by laboratories conducting testing for any service (Levels 1, 2 or 3) providing chlamydia testing.The Episode Activity codes (SNOMED or Sexual Health and HIV Activity Property Types (SHHAPT)) relating to diagnosis of: chancroid, Lymphogranuloma venereum (LGV), donovanosis, chlamydia, gonorrhoea, first episode anogenital herpes, new HIV diagnosis, molluscum contagiosum, non-specific genital infection (NSGI), pelvic inflammatory disease (PID) and epididymitis: non-specific, scabies and pediculosis pubis, syphilis (primary, secondary and early latent), trichomoniasis, first episode genital warts were used.In 2015, the new STI diagnoses group was expanded to include new codes that were not previously reported via GUMCADv2. The new codes include: Mycoplasma genitalium (C16); Shigella: flexneri, sonnei and unspecified (SG1, SG2, SG3).The clinical criteria used to diagnose the conditions are given at https://www.bashh.org/guidelines .Data was de-duplicated to ensure that a patient received a diagnostic code only once for each episode. Patients cannot be tracked between services and therefore de-duplication relies on patient consultations at a single service.

Definition of denominator The denominators for 2012 to 2022 are sourced from Office for National Statistics (ONS) population estimates based on the 2021 Census.Population estimates for 2023 were not available at the time of publication – therefore rates for 2023 are calculated using estimates from 2022 as a proxy.Further details on the ONS census are available from the https://www.ons.gov.uk/census .Caveats Every effort is made to ensure accuracy and completeness of GUMCAD data, including web-based reporting with integrated checks on data quality. However, responsibility for the accuracy and completeness of data lies with the reporting service.Data is updated on an annual basis due to clinic or laboratory resubmissions and improvements to data cleaning. Data may differ from previous publications.Figures reported in 2020 and 2021 are notably lower than previous years due to the disruption to SHSs during the national response to the COVID-19 pandemic.

All diagnoses of first episode genital warts among people accessing sexual health services* in England who are also residents in England, expressed as a rate per 100,000 population. Data is presented by area of patient residence and include those residents in England and those with an unknown residence (data for those residents outside of England is not included).RationaleGenital warts are the third most commonly diagnosed sexually transmitted infection (STI) in the UK and are caused by infection with specific subtypes of human papillomavirus (HPV). Recurrent infections are common with patients returning for treatment.Definition of numeratorThe number of diagnoses of first episode genital warts among people accessing sexual health services in England who are also residents in England.

Episode Activity codes (SNOMED or Sexual Health and HIV Activity Property Types (SHHAPT)) relating to diagnosis of first episode of genital warts were used. The clinical criteria used to diagnose the condition are given at BASHH guidelines.

Data was de-duplicated to ensure that a patient only received a diagnostic code once for each episode. Patients cannot be tracked between services and therefore de-duplication relies on patient consultations at a single service.Definition of denominatorThe denominators for 2012 to 2022 are sourced from Office for National Statistics (ONS) population estimates based on the 2021 Census.

Population estimates for 2023 were not available at the time of publication – therefore rates for 2023 are calculated using estimates from 2022 as a proxy.

Further details on the ONS census are available from the ONS website.CaveatsEvery effort is made to ensure accuracy and completeness of GUMCAD data, including web-based reporting with integrated checks on data quality. However, responsibility for the accuracy and completeness of data lies with the reporting service.Data is updated on an annual basis due to clinic or laboratory resubmissions and improvements to data cleaning. Data may differ from previous publications.Figures reported in 2020 and 2021 are notably lower than previous years due to the disruption to SHSs during the national response to the COVID-19 pandemic.

All gonorrhoea diagnoses among people accessing sexual health services* in England who are also residents in England, expressed as a rate per 100,000 population. Data is presented by area of patient residence and include those residents in England and those with an unknown residence (data for those residents outside of England is not included).*Sexual health services providing STI related care (Levels 2 and 3). Further details on the levels of sexual healthcare provision are provided in the https://www.bashh.org/about-bashh/publications/standards-for-the-management-of-stis/ .RationaleGonorrhoea causes avoidable sexual and reproductive ill-health. Gonorrhoea is used as a marker for rates of unsafe sexual activity. This is because the majority of cases are diagnosed in sexual health clinics, and consequently the number of cases may be a measure of access to sexually transmitted infection (STI) treatment. Infections with gonorrhoea are also more likely than chlamydia to result in symptoms.Definition of numeratorThe number of gonorrhoea diagnoses among people accessing sexual health services in England who are also residents in England.Episode Activity codes (SNOMED or Sexual Health and HIV Activity Property Types (SHHAPT)) relating to diagnosis of gonorrhoea were used. The clinical criteria used to diagnose the conditions are given at https://www.bashh.org/guidelines .Data was de-duplicated to ensure that a patient received a diagnostic code only once for each episode. Patients cannot be tracked between services and therefore de-duplication relies on patient consultations at a single service.Definition of denominatorThe denominators for 2012 to 2022 are sourced from Office for National Statistics (ONS) population estimates based on the 2021 Census.Population estimates for 2023 were not available at the time of publication – therefore rates for 2023 are calculated using estimates from 2022 as a proxy.Further details on the ONS census are available from the https://www.ons.gov.uk/census .CaveatsEvery effort is made to ensure accuracy and completeness of GUMCAD data, including web-based reporting with integrated checks on data quality. However, responsibility for the accuracy and completeness of data lies with the reporting service.Data is updated on an annual basis due to clinic or laboratory resubmissions and improvements to data cleaning. Data may differ from previous publications.Figures reported in 2020 and 2021 are notably lower than previous years due to the disruption to SHSs during the national response to the COVID-19 pandemic.