BackgroundPrimary Care Networks (PCNs) were established in England in 2019 and will play a key role in providing care at a neighbourhood level within Integrated Care Systems (ICSs).AimTo identify PCN ‘catchment’ areas and compare the overlap between registered and resident populations of PCNs.Design & settingObservational study using publicly available data on the number of people within each Lower Layer Super Output Area (LSOA) registered to each General Practice (GP) in England in April 2021.MethodLSOAs were assigned to the PCN to which the majority of residents were registered. The PCN catchment population was defined as the total number of people resident in all LSOAs assigned to that PCN. We compared PCN catchment populations to the population of people registered to a GP practice in each PCN.ResultsIn April 2021, 6,506 GP practices were part of 1,251 PCNs. 56.1% of PCNs had between 30,000 and 50,000 registered patients. There was a strong correlation (0.91) between the total registered population size and catchment population size. We found significant variation in the percentage of residents in each LSOA registered to a GP practice within the same PCN catchment, and strong associations with both urban-rural status and socioeconomic deprivation.ConclusionThere exists significant variation across England in the overlap between registered and resident (catchment) populations in PCNs which may impact on integration of care in some areas. There was less overlap in urban and more deprived areas which could exacerbate existing health inequalities.

Objectives To examine the impact of COVID-19 vaccination on hospital admissions in England in 2021. Design Observational study of emergency admissions for COVID-19 by vaccination status in people 16 years and over in England. Setting Hospitals in England. Participants A total of 48.1 million people registered with an English GP, aged ≥16 years with a recent NHS contact. Main outcome measures Emergency hospital admissions with a primary diagnosis of COVID-19 between 1 January and 31 December 2021. Monthly admission rates were directly standardised for age, sex, risk category and vaccination dose to estimate vaccine effectiveness (VE) over time, between vaccine doses, age groups and risk groups. Results A total of 192,047 hospital admissions were included. The unvaccinated admission rate was higher in December 2021 (6.1 admissions per 100,000 person-days; 95% CI: 5.9 to 6.3) than January 2021 (4.9; 95% CI: 4.9 to 5.0). Vaccinated admission rates were ≤1 per 100,000 from February to December. Doses 1 and 2 VE waned over time, particularly in older and clinically vulnerable groups (although this may reflect that they were vaccinated earlier). Dose 3 VE remained above 93%. Conclusions COVID-19 hospitalisations were consistently highest in the unvaccinated. Despite high case rates at the end of 2021, overall admission rates remained stable, driven by low admission rates among vaccinated people. There is population-level waning in VE, recovering after subsequent doses, potentially more marked in older and at-risk groups. The findings support JCVI (Joint Committee on Vaccination and Immunisation) guidance for an ongoing booster programme, especially in older people and higher clinical risk groups.

Background Erectile dysfunction (ED) is the most common sexual dysfunction in men. Some types of ED are amenable to treatment using lifestyle medicine approaches with or without pharmacotherapy. Aim Investigate self-reported efficacy of lifestyle medicine approaches to tackle ED. Methods A cross-sectional online survey of 1177 community dwelling adults explored the prevalence and methods used to tackle ED in the community setting. We examined differences between participants with and without ED. Variables associated with ED in univariable analyses were included in a multivariable logistic regression to identify variables independently associated with the condition. Outcomes Self-reported measure: perceived effectiveness of lifestyle medicine interventions to tackle ED. Results Most respondents (76.5%) had experienced ED, and this was associated with having a long-term condition, taking anti-hypertensive medication, hypercholesterolaemia and obesity. Medication was the most common management strategy overall (65.9%), followed by stress management (43.5%) and weight loss (40.4%). Over half (53.9%) did not use any lifestyle modification strategies to tackle ED. Only 7.0% of ED sufferers received a mental health assessment and 29.2% received other tests (e.g., blood test, medical imaging) by GPs. Cardiovascular training was identified as the best rated strategy by its users (37.8%). Supplements (35.1%) and weight training/physical activity (32.6%) were also positively rated. Clinical implications Structured education to general practitioners and community dwelling adults about the impact of lifestyle behaviour modification and how this could influence the appearance or trajectory of ED could help improve personal choice when tackling ED. Strengths and limitations To our knowledge, this is the first study to collect eSurvey responses from community dwelling adults to gauge their reliance and perceived effectiveness of lifestyle medicine approaches to tackle ED. The principal limitation was the lack of follow-up, and not recording other information including lifestyle factors such as nutrition, smoking, and the use of alcohol and recreational drugs, which may have enabled a fuller exploration of the factors that could influence the primary outcome measures examined. Conclusion Despite the high prevalence of ED, there is not enough awareness in the community setting about effective and low-cost lifestyle medicine strategies, including cardiovascular training and the use of supplements and weight training, to help tackle this common condition.