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Article History

Received: 7 June 2024

Accepted: 11 December 2024

First Online: 27 January 2025

Declarations

:

: This work used anonymised (i.e. de-identified) data for secondary analysis, from routinely collected administrative records, so individual consent was not required, according to national regulations by the NHS Health Research Authority, in England, UK [] and as clarified in the NHS England De-Identified Data Analytics and Publication Directions 2023 []. The secondary analysis of anonymised data provided in a public health activity designed to investigate the health and care issues in a population to improve service development and population health is not classified as research and thus it does not require ethics committee review (see the document produced by the UK NHS Health Research Authority:) and according to the standard defined in Section 251(10) and 251(11) of the National Health Service Act 2006. The project was approved by C&M Health and Care Partnership Combined Intelligence for Population Health Action (CIPHA) Data Access Approval Group (DAAG): (DSR079_DARF). The cohort of patients analysed excluded patients whose primary care practice did not have a data sharing agreement for population health management purposes with C&M NHS Integrated Care Board. The project was approved by the Caldicott Guardian on 17/08/21 and by CIPHA DAAG on 05/10/21. Data was extracted through CIPHA secure data environment (SDE).

: Not applicable.

: RP, BB, and KD report no conflict of interest in this project. AA is employed by NHS Cheshire and Merseyside Integrated Care Board, who is the commissioner of health services in Cheshire and Merseyside. WB and IB are employed, and JR was formerly employed by NHS Mersey Care Foundation Trust, which is one of the providers of community and mental health services in Cheshire and Merseyside. AA, WB, and JR were involved in providing information about general service provision in Cheshire and Merseyside, facilitating access to data, as well as providing contextual information for the interpretation of the results, and reviewing drafts of the manuscript. They had no role in the analysis or presentation of the results. The views expressed in this article are those of the authors and do not represent the views of Mersey Care NHS Foundation Trust. There are no other relationships or activities that could appear to have influenced the submitted work.