Hospital Episode Statistics (HES) maternity data are a subset of HES inpatient data. Maternity data involves standard HES inpatient data well as maternity specific information. This includes details such as gestation, onset of labour, method of delivery, anaesthetics and birth weight.
Publications
Statistics on abortions.
The Abortion update contains information on notifications, to the Chief Medical Officer for Scotland, of terminations of pregnancy under the Abortion Act 1967. The release includes numbers and rates for Scotland, NHS Boards and Local Council Areas.
Child Health Profiles provide a snapshot of child health and well-being for each local authority in England using key health indicators, which enable comparison locally, regionally and nationally
Summary of findings of a national data quality assessment of maternity data held by ISD, giving detailed findings about the maternity dataset, involvement of midwives, and quality of clinical coding.
The indicators on breastfeeding and the smoking status of pregnant women at the time of delivery are being published as two separate releases, commencing from the publication relating to the quarter ending December 2011, released on 16 February. The information on breastfeeding initiation and the prevalence of breastfeeding at 6 to 8 weeks will continue to be published by the Department of Health. Smoking at Delivery information will be published by the NHS Information Centre.
Monitors how PCTs perform against measures in the following areas: CHD-Diabetic retinopathy; CHD-NHS Health Checks; Older people-Delayed Discharge; Health Improvement-Maternity; Health Improvement-Stroke
Provides summary data on community contraceptive services provided by clinics in Wales.
Hospital Episode Statistics contains a wide range of maternity information.
To collect information from the perspective of women using maternity care.
Provides statistics on teenage conceptions including data for England and Wales.
This annual updates includes statistical information on teenage pregnancies based on age at conception. The release includes data by NHS Board of residence and Local Council Area for age groups.
Overview
Hospital Episode Statistics (HES) maternity data are a subset of HES inpatient data. Maternity data involves standard HES inpatient data well as maternity specific information. This includes details such as:
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onset of labour
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method of delivery (including caesareans)
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anaesthetics
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ectopic pregnancies
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birth weight
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gestation
Hospital Episode Statistics (HES) is a data warehouse containing details of all admissions to National Health Service (NHS) hospitals in England. It includes:
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private patients treated in NHS hospitals
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patients who were resident outside of England
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care delivered by treatment centres (including those in the independent sector) funded by the NHS
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details of all NHS outpatient appointments in England
HES is a records-based system that covers all NHS trusts in England, including acute hospitals, primary care trusts and mental health trusts.
Each HES record can contain more than 50 pieces of information, collected directly by hospital providers or derived by the HES team.
The type of information collected for each record includes:
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personal information about the patient treated
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details of where the patient was treated, such as the NHS trust or Primary Care Trust (PCT)
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clinical details of diagnoses and treatments
Technical Data
Hospital Episode Statistics (HES) contains a wide range of maternity information which has been published annually since 2000-01.
HES maternity data is currently published alongside other HES data on HES Online. It was produced separately from other HES data prior to 2006-07.
Between 2001 to 2006, coverage of hospital maternity deliveries were 72.6 per cent on average, while home deliveries were 13.6 per cent on average. In addition to this, a number of NHS Trusts persistently submit poor quality data. Some of the issues associated with the coverage and data quality problems are listed below:
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Trusts submitting a significantly higher number of delivery episodes compared to birth episodes
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Trusts failing to submit data on the number of birth episodes where they record a high number of delivery episodes (see glossary for definitions)
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Trusts failing to submit delivery records – the reason for this is that approximately 20 trusts have a stand alone maternity system which is not linked to the Patient Administration System, this is the computer system used by the hospital to record patient information. The transfer of maternity information between systems leaves scope for errors and shortfalls within the data
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Trusts identifying a high number of maternity beds available, but not recording any information about deliveries or birth
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Trusts identifying that they have no maternity beds available, but recording a high number of birth and delivery episodes
As a result, maternity data has previously undergone additional manually intensive validation, including comparisons with data on registered births from Office for National Statistics (ONS). These validation processes were intended to provide a realistic estimate of maternity related activity within the NHS, because of the known shortfalls in the data.
The NHS Information Centre for Health and Social Care (NHS IC) began a complete review of the NHS Maternity Statistics publication in December 2007. Due to this consultation exercise, a number of revisions were made to NHS Maternity Statistics 2006-07. Full details of which can be found on the NHS IC website.
The NHS IC will continue to monitor data quality and is currently developing a maternity data quality dashboard which will encourage NHS trusts to quality assure their data. The maternity data quality dashboard is a downloadable tool designed to highlight the quality of aspects of maternity data submitted to the Secondary Uses Service (SUS).
Data Providers can review and benchmark the quality of their data against all other providers of NHS funded healthcare in England. In this way, the tool aims to improve the quality of maternity data held in SUS and downstream systems – for example Hospital Episode Statistics
Glossary
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Anaesthetic given during labour or delivery
This field defines the anaesthetic or analgesic administered before and during labour and delivery. General anaesthetic (the administration by a doctor of an agent intended to produce unconsciousness); epidural or caudal anaesthetic (the injection of a local anaesthetic agent into the epidural space); spinal anaesthetic (the injection of a local anaesthetic agent into the subarachnoid space); general anaesthetic and epidural or caudal anaesthetic; general anaesthetic and spinal anaesthetic; epidural or caudal and spinal anaesthetic; and any other not listed: not applicable (no analgesic or anaesthetic administered), or not known.
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Antenatal days of stay
This derived field contains the number of days between the start of the episode and the date of delivery of the first baby.
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Birth Weight
This field contains the weight of the baby in grams immediately after birth. This item appears for each baby on multiple birth delivery records.
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Change of delivery place reason
This field defines the reason for changing the delivery place type. Decision made during pregnancy because of change of address; decision made during pregnancy for clinical reasons; decision made during pregnancy for other reasons; decision made during labour for clinical reasons; decision made during labour for other reasons; occurred unintentionally during labour (not present in 2002-03 HES data); other; not applicable; or not known.
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Delivery place (actual)
This field defines the actual type of delivery place. This item appears for each baby on multiple birth delivery records. Either at a domestic address; in NHS hospital – delivery facilities associated with consultant ward; in NHS hospital – GMP ward; in NHS hospital – midwife ward; in NHS hospital – joint consultant/GMP/midwife ward; in private hospital; in other hospital or institution; in NHS hospital – ward or unit without delivery facilities; other (none of the above); not known.
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Delivery place (intended)
This field defines the intended type of delivery place. The initial intention is designated by the General Medical Practitioner (GMP) and midwife, or by the GMP and hospital staff. The decision is normally made when the mother is assessed for delivery: At a domestic address; in NHS hospital – delivery facilities associated with consultant ward; in NHS hospital – GMP ward; in NHS hospital – midwife ward; in NHS hospital – joint consultant / GMP / midwife ward; in private hospital; in other hospital or institution; in NHS hospital – ward or unit without delivery facilities; other (none of the above); or not known.
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Episode duration
This field contains the difference in days between the episode start date and the episode end date. If the episode is unfinished, the episode duration is calculated from episode start date and the end of the data year.
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Finished Consultant Delivery Episode (FCE)
A finished consultant episode (FCE) is defined as a period of admitted patient care under one consultant within one healthcare provider. FCEs are counted against the year in which the FCE finishes. The main Episode types used in the Maternity publication are Delivery Episode and Other delivery event as well as Birth Episode and Other birth event. Delivery episode: Episode in which the delivery takes place. Other delivery event: This applies to all delivery events other than those resulting in delivery or birth episodes under NHS funding or in any other facility supplied under a service agreement with the NHS. The data in these records come from birth notification records and require only a limited data set to be completed. Maternity events, taking place in either NHS hospitals or in non-NHS hospitals funded by the NHS, will be recorded as ordinary Delivery and Birth episodes.
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First antenatal assessment date
This field contains the date when a pregnant woman was first assessed and arrangements were made for antenatal care. This is not necessarily the date when delivery arrangements were made.
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Gestation period in weeks at first antenatal assessment
This field shows the gestation period in weeks at the date of the first antenatal assessment. It is calculated from First antenatal assessment date, length of gestation and the date of birth of baby and is usually recorded once the delivery has taken place.
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Length of gestation
This field contains the number of completed weeks of gestation according to the World Health Organization definition, which specifies time from the first day of the last menstrual period. If this date is not reliable, an estimate is provided. This item appears for each baby on multiple birth delivery records. Gestation lengths less than 20 weeks have been grouped together into the under 20 week’s group, gestation lengths greater than 48 have been grouped together into a 48 and over group.
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Live or still birth
This field contains a code which indicates whether the baby was born alive or dead (still birth). A still birth is a birth after a gestation period of 24 weeks (168 days) where the baby shows no sign of life when delivered. This item appears for each baby on multiple birth delivery records.
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Method of delivery
The method used to deliver a baby that is a registrable birth; which is a baby born live at any time or a still birth, that is a birth after a gestation of 24 weeks (168 days), or more, where a baby shows no identifiable signs of life at delivery. Spontaneous vertex (normal vaginal delivery, occipitoanterior); spontaneous other cephalic (cephalic vaginal delivery with abnormal presentation of head at delivery, without instruments, with or without manipulation); low forceps, not breech (e.g. forceps, low application, without manipulation. Includes forceps delivery not otherwise specified); other forceps, not breech (for example, forceps with manipulation. Includes high forceps and mid forceps); ventouse, vacuum extraction; breech (spontaneous delivery assisted or unspecified. Includes partial breech extraction); breech extraction (not otherwise specified. Includes total breech extraction and version with breech extraction); elective caesarean section (caesarean section before, or at onset of, labour); emergency caesarean section; other than those specified above (for example, application of weight to leg in breech delivery. Includes destructive operation to facilitate delivery and other surgical or instrumental delivery).
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Method of onset of labour
This field defines the method used to induce (initiate) labour, rather than to accelerate it. Spontaneous; the onset of regular contractions whether or not preceded by spontaneous rupture of the membranes; any caesarean section carried out before the onset of labour; or a planned elective caesarean section carried out immediately following the onset of labour, when the decision was made before labour; surgical induction; by amniotomy (artificial rupture of the amniotic sac); medical induction; including the administration of agents either orally, intravenously or intravaginally with the intention of initiating labour; combination of surgical induction and medical induction; not applicable; or not known.
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Normal delivery
A normal delivery is one without induction, without the use of instruments, not by Caesarean section and without general, spinal or epidural anaesthetic before or during delivery. Excluded are any other procedures not relating to an unassisted delivery except repair of laceration.
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Number of babies
This field contains the number of babies delivered at the end of a single pregnancy. Both live and stillborn babies are counted. Until 2002-03, a maximum of six babies could be recorded in HES.
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Postnatal days of stay
This field contains the number of days between the baby's birth and the end of the finished episode. It is calculated from episode end date and the first baby's date of birth.
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Status of person conducting delivery
This field normally provides the status of the person conducting the delivery. When a student delivers the baby, the code of the supervisor is given. This item appears for each baby on multiple birth delivery records: Hospital doctor; general practitioner; midwife; other than above; not known.
Contact Details
For statistical enquiries about this topic, please contact:
The NHS Information Centre
Email: enquiries@ic.nhs.uk
Telephone: +44 (0) 845 300 6016
1 Trevelyan Square Boar Lane Leeds LS1 6AE
