Long-term Conditions & Prevention
England — National — are we finding and managing disease?
Figures are your practice where published; otherwise the nearest available area, marked ○.
England
EnglandCondition cards — found vs expected, and how well managed
One card per major condition. The number is recorded QOF prevalence; the sub-line compares it to the modelled expected prevalence (where held) plus the QOF achievement for that clinical area.
Dementia — recorded register & care planning
Recorded dementia register prevalence among the registered 65+ (registration-based, vs the nearest-parent benchmark), and how much of the register has a care plan and a medication review. The official modelled diagnosis-rate-vs-expected is shown for context — it is published only at sub-ICB and above.
498,122 people aged 65+ on the dementia register. Official modelled 65+ estimated diagnosis rate 66.3% at National grain (ENGLAND). This is the recorded register vs the registered list — not the modelled diagnosis-rate-vs-expected.
Severe Mental Illness — physical health checks
The percentage of the SMI register who received all six annual physical-health checks (vs the nearest-parent benchmark), and coverage of each of the six elements. Experimental NHS statistic (PHSMI) over a rolling 12-month window — sub-ICB submission completeness varies, so practices that did not submit are absent.
484,420 people on the SMI register. 4.7% received none of the six checks. Every coverage figure is the recorded count ÷ the SMI register — best-effort over submitted practices.
Prescribing tie-in — antibacterial stewardship
Antibacterial items (BNF chapter 5.1) as a share of all prescribed items, against the nearest-parent benchmark. A stewardship lens — lower is better.
A statins-vs-CVD-register scatter (in the design mockup) is omitted — drug-level reads beyond the antibacterial share are not held.
Register composition
The mix of long-term conditions by recorded prevalence — a quick read of the case-mix this team manages.
Practice comparison
One sortable row per practice — finding and managing disease. Click a heading to re-sort; your practice is highlighted.
Wider area context
Wider area contextNot specific to your practice — nearest available area, marked ○.
Case-finding gap (expected − recorded)
How many more people we'd expect to have each condition than are on the register. Longer orange bars = more people likely living undiagnosed. The expected prevalence is a Fingertips MODELLED estimate published at ICB / England grain, not your practice's own count.
Recorded vs expected prevalence
Two bars per condition: what's on the register (blue) against what we'd expect (orange). The bigger the orange overhang, the bigger the find opportunity. The expected is the Fingertips modelled (ICB / England) figure, not practice-level.
Risk factors vs nearest parent
The upstream drivers of long-term conditions, compared with the nearest-parent benchmark. Higher bars mean this population carries more of that risk.
LD health-check coverage
Learning-disability annual health checks as a share of the LD register, with last year for context.
Derived checks ÷ register ratio at England grain (the dataset's published grain — not the official 14+ AHC coverage). Up 1.4pp year-on-year. SMI physical-health-check coverage is not held.
Seasonal flu vaccine uptake
Flu vaccine coverage among the eligible GP cohorts — aged 65+ (the headline), under-65 in a clinical at-risk group, and pregnant women — against the nearest-parent benchmark. UKHSA publishes this at ICB grain (not GP practice), so figures are shown at the scope's nearest published grain; in-season figures are provisional.
Shown for England (England). Season 2025 to 2026, final end-of-season data. Coverage is vaccinated ÷ eligible — additive ICB → Region → National.
Prevalence vs deprivation gradient
Each dot is a practice: its patients' deprivation (x) against recorded diabetes prevalence (y). A rising line means disease concentrates in more-deprived areas.
Across England’s 6,125 practices, more-deprived practices have a higher recorded diabetes prevalence — a weak positive relationship (r = 0.37, n = 6125).