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In 2015, the UK government plans to widen patient choice of general practitioner (GP) to improve access through the voluntary removal of practice boundaries in the English NHS. This follows a 12-month pilot in four areas where volunteer GP practices accepted patients from outside their boundaries. Using evidence from the pilot evaluation, we discuss the likely impact of this policy change on patient experience, responsiveness and equity of access. Patients reported positive experiences but in a brief pilot in four areas, it was not possible to assess potential demand, the impact on quality of care or health outcomes. In the rollout, policymakers and commissioners will need to balance the access needs of local residents against the demands of those coming into the area. The rollout should include full information for prospective patients; monitoring and understanding patterns of patient movement between practices and impact on practice capacity; and ensuring the timely transfer of clinical information between providers. This policy has the potential to improve choice and convenience for a sub-group of the population at lower marginal costs than new provision. However, there are simpler, less costly, ways of improving convenience, such as extending opening hours or offering alternatives to face-to-face consultation.

Abstract Background There is a need for local level health data for local government and health bodies, for health surveillance and planning and monitoring of policies and interventions. The Health Survey for England (HSE) is a nationally-representative survey of the English population living in private households, but sub-national analyses can be performed only at a regional level because of sample size. A boost of the HSE was commissioned to address the need for local level data in London but a different mode of data collection was used to maximise participant numbers for a given cost. This study examines the effects on survey and item response of the different survey modes. Methods Household and individual level data are collected in HSE primarily through interviews plus individual measures through a nurse visit. For the London Boost, brief household level data were collected through interviews and individual level data through a longer self-completion questionnaire left by the interviewer and collected later. Sampling and recruitment methods were identical, and both surveys were conducted by the same organisation. There was no nurse visit in the London Boost. Data were analysed to assess the effects of differential response rates, item non-response, and characteristics of respondents. Results Household response rates were higher in the 'Boost' (61%) than 'Core' (HSE participants in London) sample (58%), but the individual response rate was considerably higher in the Core (85%) than Boost (65%). There were few differences in participant characteristics between the Core and Boost samples, with the exception of ethnicity and educational qualifications. Item non-response was similar for both samples, except for educational level. Differences in ethnicity were corrected with non-response weights, but differences in educational qualifications persisted after non-response weights were applied. When item non-response was added to those reporting no qualification, participants' educational levels were similar in the two samples. Conclusion Although household response rates were similar, individual response rates were lower using the London Boost method. This may be due to features of London that are particularly associated with lower response rates for the self-completion element of the Boost method, such as the multi-lingual population. Nevertheless, statistical adjustments can overcome most of the demographic differences for analysis. Care must be taken when designing self-completion questionnaires to minimise item non-response.

BACKGROUND: There is a need for local level health data for local government and health bodies, for health surveillance and planning and monitoring of policies and interventions. The Health Survey for England (HSE) is a nationally-representative survey of the English population living in private households, but sub-national analyses can be performed only at a regional level because of sample size. A boost of the HSE was commissioned to address the need for local level data in London but a different mode of data collection was used to maximise participant numbers for a given cost. This study examines the effects on survey and item response of the different survey modes. METHODS: Household and individual level data are collected in HSE primarily through interviews plus individual measures through a nurse visit. For the London Boost, brief household level data were collected through interviews and individual level data through a longer self-completion questionnaire left by the interviewer and collected later. Sampling and recruitment methods were identical, and both surveys were conducted by the same organisation. There was no nurse visit in the London Boost. Data were analysed to assess the effects of differential response rates, item non-response, and characteristics of respondents. RESULTS: Household response rates were higher in the 'Boost' (61%) than 'Core' (HSE participants in London) sample (58%), but the individual response rate was considerably higher in the Core (85%) than Boost (65%). There were few differences in participant characteristics between the Core and Boost samples, with the exception of ethnicity and educational qualifications. Item non-response was similar for both samples, except for educational level. Differences in ethnicity were corrected with non-response weights, but differences in educational qualifications persisted after non-response weights were applied. When item non-response was added to those reporting no qualification, participants' educational levels were similar in the two samples. CONCLUSION: Although household response rates were similar, individual response rates were lower using the London Boost method. This may be due to features of London that are particularly associated with lower response rates for the self-completion element of the Boost method, such as the multi-lingual population. Nevertheless, statistical adjustments can overcome most of the demographic differences for analysis. Care must be taken when designing self-completion questionnaires to minimise item non-response.

The findings of the UK prevalence study of abuse and neglect among older people provide unique opportunities for adult protection systems to consider possible changes to their priorities, activities, services and publicity. This article reports first on the contribution of adult protection coordinators to the design and execution of the research. It then sets out potential uses for the evidence provided by the study by the adult protection community in the UK. The article outlines some of the media reactions to the study that adult protection workers will also have to understand and navigate. It concludes with some suggestions for future research and service development in the UK context.

The article outlines the background to the recently commissioned UK national study of the prevalence of elder abuse and explains the methodology adopted in Stages 1 and 2 of the research. This is being funded by Comic Relief with co‐funding from the Department of Health and carried out by a team of researchers at King's College London and the National Centre for Social Research. Stage 1, the development work, was completed in autumn 2005. Stage 2, which began in March 2006, is a national survey of the private residential population of the United Kingdom.

Introduction: Hard-to-reach and minority groups are often at higher risk for adverse sexual health outcomes. While such groups are therefore of
interest to sexual health researchers, it can be difficult to locate and recruit sufficient sample sizes using probability sampling methods. This study
aims to establish whether web-panel surveys can provide a viable less resource intensive means of boosting sample sizes of two hard-to-reach
groups (people of Black African ethnicity, and gay men) for a sexual health survey, and the extent of any bias.
Methods: Results from a national probability sample survey (Natsal-3, administered using a computer-assisted personal interview (CAPI) and selfinterview
(CASI) with 15,162 participants), which included 211 black African participants and 83 gay men, were compared with results from a webpanel
survey (using identical questions) of 529 black Africans and 592 gay men. Web-panel survey results for socio-demographics were
compared with external benchmarks, and for sexual behaviours and attitudes reported in Natsal-3. Odds ratios (ORs) were used to examine
differences between variables and the average absolute OR, along with the number of estimates for which the web-panel survey differed
significantly from the benchmarks, were used to summarise survey performance.
Results: At least 18% of estimates differed significantly between surveys for gay and black African men, and 28% for black African women. For
black African women average absolute ORs were: 1.6 for attitudinal questions asked in CAPI, 1.5 for attitudinal CASI questions, 3.2 for behaviour
questions asked in CAPI and for 1.7 for behaviour CASI. For black African men average absolute ORs were: 1.5 for attitudinal questions asked in
CAPI, 1.8 for attitudinal CASI questions, 2.5 for behavioural questions asked in CAPI and 1.6 for behavioural questions asked in CASI=1.6. For
gay men, average absolute ORs were: 2.2 for attitudinal questions asked in CAPI, 2.8 for attitudinal CASI questions, 1.8 for behavioural questions
asked in CAPI to 1.6 for behavioural questions asked in CASI.
Discussion: Web-panel surveys may be able to sample hard-to-reach groups but may not be able to replace probability-sample surveys where
accurate population-level estimates of sensitive sexual behaviours are required. Differences between web and CASI responses, where mode
effects may be similar, suggest web-panel survey selection bias.

BACKGROUND: Sexual orientation encompasses three dimensions: sexual identity, attraction and behaviour. There is increasing demand for data on sexual orientation to meet equality legislation, monitor potential inequalities and address public health needs. We present estimates of all three dimensions and their overlap in British men and women, and consider the implications for health services, research and the development and evaluation of public health interventions. METHODS: Analyses of data from Britain's third National Survey of Sexual Attitudes and Lifestyles, a probability sample survey (15,162 people aged 16-74 years) undertaken in 2010-2012. FINDINGS: A lesbian, gay or bisexual (LGB) identity was reported by 2·5% of men and 2·4% of women, whilst 6·5% of men and 11·5% of women reported any same-sex attraction and 5·5% of men and 6·1% of women reported ever experience of same-sex sex. This equates to approximately 547,000 men and 546,000 women aged 16-74 in Britain self-identifying as LGB and 1,204,000 men and 1,389,000 women ever having experience of same-sex sex. Of those reporting same-sex sex in the past 5 years, 28% of men and 45% of women identified as heterosexual. INTERPRETATION: There is large variation in the size of sexual minority populations depending on the dimension applied, with implications for the design of epidemiological studies, targeting and monitoring of public health interventions and estimating population-based denominators. There is also substantial diversity on an individual level between identity, behaviour and attraction, adding to the complexity of delivering appropriate services and interventions.

Background: Sexual orientation encompasses three dimensions: sexual identity, attraction and behaviour. There is increasing demand for data on sexual orientation to meet equality legislation, monitor potential inequalities and address public health needs. We present estimates of all three dimensions and their overlap in British men and women, and consider the implications for health services, research and the development and evaluation of public health interventions. Methods: Analyses of data from Britain's third National Survey of Sexual Attitudes and Lifestyles, a probability sample survey (15,162 people aged 16–74 years) undertaken in 2010–2012. Findings: A lesbian, gay or bisexual (LGB) identity was reported by 2·5% of men and 2·4% of women, whilst 6·5% of men and 11·5% of women reported any same-sex attraction and 5·5% of men and 6·1% of women reported ever experience of same-sex sex. This equates to approximately 547,000 men and 546,000 women aged 16–74 in Britain self-identifying as LGB and 1,204,000 men and 1,389,000 women ever having experience of same-sex sex. Of those reporting same-sex sex in the past 5 years, 28% of men and 45% of women identified as heterosexual. Interpretation: There is large variation in the size of sexual minority populations depending on the dimension applied, with implications for the design of epidemiological studies, targeting and monitoring of public health interventions and estimating population-based denominators. There is also substantial diversity on an individual level between identity, behaviour and attraction, adding to the complexity of delivering appropriate services and interventions.