This topic covers outputs that are used to directly measure the provision of services to patients and clients. It includes Hospital Episode Statistics (HES), results from the Quality and Outcomes Framework (QOF) for Primary Care and self-reported patient experience data.
Publications
Monthly data on delayed transfers of care
Critical care periods taking place in a predominately adult unit, in England ending between April 2008 and March 2009
Critical care periods taking place in a predominately adult unit, in England ending between April 2008 and March 2009
Alcohol-related discharges from general acute and psychiatric hospitals and provides an update on data presented in the Alcohol Statistics Scotland publications.
Clinical outcomes from ambulance services.
Information on the quality of care delivered by ambulance services, including the response times of ambulance crews, and the re-contact and call abandonment rates of patients
An initial number of indicators to support Health and Wellbeing Boards and Clinical Commissioning Groups in their planning for 2013/14. This will include detail on a number of the NHS Outcome Framework indicators at local level. These indicators may be considered when agreeing local service priorities and quality requirements for commissioning.
Progress made by NHS Boards in the first year against implementing the HEAT H3 target on child healthy weight interventions
Annual statistics on childhood hospital admissions. Also included are statistics on childhood mortality, from previously published death registration data collected by the General Register Office for Scotland.
Information collected by HSC Trusts agencies and legacy health and social services boards on all clinical / social care negligence cases in Northern Ireland
Clinical Outcome Indicators (Web based)
This statistical release summarises information collected on complaint issues received by the 6 HSC Trusts in Northern Ireland, including the Northern Ireland Ambulance Service.
This Statistical Release presents data on the arrangements for transfer of patients to a more appropriate care setting in Wales
Analysis of length of stay (LOS), day case rates, and emergency readmissions for in-patients in England with a diabetes diagnosis compared to those without.
The Survey of Domiciliary Care Providers Northern Ireland, is based on the findings from a self-completed postal survey of 154 providers of domiciliary care across the statutory, voluntary and independent sectors in Northern Ireland. The survey elicited providers views on; domiciliary practices and procedures, the extent to which the views of users informed providers decisions and providers views of the degree to which they considered they were meeting regulations and minimum standards of domiciliary care.
This statistical bulletin presents information on the number of clients receiving domiciliary care services from the statutory and independent sectors during a survey week. It provides information on the number of domiciliary care contact hours provided, the number of client visits and the number of clients receiving domiciliary care during this survey week.
Effectiveness of child and adolescent mental health services
Covers the latest trends in the UK's health and contains commentary on the latest health findings, topical articles illustrated with colour charts and diagrams, and regularly updated statistical graphs and tables.
This statistical bulletin presents information on hearing aid assessments and re-assessments by audiologists in Northern Ireland. Information has been derived from the quarterly collection AUD1 and monitors information on both adults and children fitted and assessed for hearing aids during the quarter, complaints received, and cost of hearing aids issued. In addition, the collection monitors complete and incomplete waits for assessment during the quarter and the length of time patients were waiting or had waited following referral to an audiologist (specified time bands).
Monthly activity data relating to elective and non-elective inpatient admissions (or first finished consultant episodes FFCEs) and outpatient referrals and attendances for first consultant outpatient appointments.
A data warehouse containing records of all patients admitted to NHS hospitals in England. Contains details of around 16 million episodes of patient care (finished consultant episodes) per year.
A 10 year time series for indicators of: deaths within 30 days of a hospital procedure; deaths within 30 days of emergency admission to hospital.
Emergency admissions to any hospital in England occurring within 28 days of the last, previous discharge from hospital after admission for: fractured proximal femur; hysterectomy; primary hip replacement surgery; stroke and all conditions. Data provided at: England; GOR; ONS area; SHA; County; LA; PCO; NHS provider Trust; inner and outer London; provider cluster and deprivation group.
Publication of individual level data for all outpatient appointments in NHS, England.
Quarterly release of the Hospital Standardised Mortality Ratios (HSMR's) of all hospitals participating in the Scottish Patient Safety Programme
National report on incidence of healthcare associated infections within ICUs in Scotland. As from 26 October 2010 this publication is no longer released by ISD but by Health Protection Scotland instead.
Addressing ethnic inequalities in health requires accurate and complete information to support monitoring and health improvement. This publication relates to the quality and completeness of information on ethnicity in hospital discharge and new outpatient appointment data.
First annual update of the set of headline indicators recommended in the Equally Well report of the ministerial task force on health inequalities.
Quarterly data on new cases taken on in the year by Early Intervention (EI) in psychosis services, number of patients on Care Programme Approach (CPA) followed up within 7 days of discharge from psychiatric inpatient care, and gate keeping inpatient admissions by Crisis Resolution Home Treatment (CRHT) teams.
Number of breaches of the policy on Mixed Sex Accommodation in relation to sleeping accomodation for the month, broken down by provider and commissioner.
Monthly statistics on access to, volume and quality of NHS 111 calls. It covers information on the price of the NHS 111 service, its impact on activity across the urgent and emergency care system. It will include figures on user experience every six months.
This publication includes monthly statistics on access to, volume and quality of NHS 111 calls. It covers information on the price of the NHS 111 service, its impact on activity across the urgent and emergency care system. It will include figures on user experience every six months.
This Statistical Release shows information on NHS Direct Wales which is a 24 hour information line offering advice about illness, health and the NHS.
This Statistical Release is a monthly series that presents the number of GP referrals received by Welsh Trusts for a first out patient consultant appointment.
Headline tables showing number of admissions to hospital due to alcohol. Using alcohol attributable fractions, these admissions will include wholly attributable diagnoses (such as alcoholic liver disease) as well as a proportion of partially attributable diagnoses (such as hypertension or haemorrhagic stoke)
Provides data on the uptake of immunisation, primarily in childhood, for Wales.
A set of indicators across the five NHS Outcomes Framework domains, presented at national level.
Report of annual survey of Primary 1 / Primary 7 children's dental health, which gathers information to inform children (and parents) of their dental/oral health status through anonymised, combined data; and advise the Scottish Govenment, NHS Boards and other organisations concerned with children's health of the oral disease prevalence in their area.
Monitors patient awareness of choice and recall of having been offered a choice of hospital for their first outputpatient appointment.
Quarterly New Cancer Waiting Times statistics for the 62-day target: patients urgently referred with a suspicion of cancer to first cancer treatment; and for the 31-day target: all patients regardless of the route of referral from date decision to treat to first cancer treatment by NHS Board, Cancer Network and Cancer Type.
This report presents trends in cancer incidence and survival updated with incidence and mortality.
Consolidates results from surveys in the National Patient Survey Programme to give overall experience scores (out of 100) for the NHS against 5 broad headings.
Patient experience.
Statistics on Accident and Emergency Quality Indicators for England.
Provisional information from the latest monthly Hospital Episode Statistics data. Including number of finished consultant episodes, admissions, outpatient appointments and A&E attendances
Percentage of last 6 months of life spent at home or in a community setting. These data are shown by financial year at Scotland, Health Board, Council Area and Community Health Partnership level.
Summary statistics for Consultants and NHS Boards performing joint replacement operations.
Annual report from the Scottish Intensive Care Society Audit Group (SICSAG) looking at activity and outcomes of care in Scottish intensive care and high dependency units.
Statistics on clients in contact with Substitute Prescribing treatment services during the year broken down by Health and Social Services Board in Northern Ireland.
Indicator reporting mortality at hospital trust level across the NHS.
The surgical profiles project aims to lead to improvements in patient care by making better use of existing Scotland-wide data sources. The surgical profile comprises clinical indicators about the surgical care provided by an NHS Board and its hospitals (data are not presented for individual clinicians or patients). It is a tool designed to be interpreted and used locally by those providing surgical care to stimulate reflection on surgical services.
Report describing second cycle of surgical profiles project, including summary of how NHS Boards are using the data in the profile to support improvements in patient care. This is accompanied by the charts included in the profile, presenting data at NHS Board and hospital level.
Provides a reference for the comparison of key figures between the constituent countries, and between the UK as a whole and other nation states.
Provider level information on the number and proportion of admitted adult patients who have been risk assessed for Venous thromboembolism (VTE)
Overview
Hospital Episode Statistics (HES) is the data source for a wide range of healthcare analysis for the NHS, government and many other organisations and individuals. HES is the national statistical data warehouse that contains information about hospital admissions and outpatient attendances in England.
The HES team processes approximately 15 million records for admitted patients and 55 million records for outpatients each financial year. The data in HES come from the Secondary Uses Service, which collects data that passed between healthcare providers and commissioners.
The Quality and Outcomes Framework began as part of the new General Medical Services contract in 2004. It aims to improve the quality of patient care by rewarding practices against a set of 135 clinical and organisational indicators. Clinical indicators cover a range of chronic disease areas. Practices scored points on the basis of achievement against each indicator.
The Public Services Agreement scores for patient experience provide a measure of the effectiveness of services, as reported by the patients themselves. Results are derived from one of largest survey programmes in the world, covering a wide range of subject areas. Scores are combined using a methodology agreed with the Healthcare Commission to give results out of 100 in five broad domains: access & waiting, better information more choice, building close relationships, safe, high quality coordinated care and clean, comfortable, friendly place to be.
Technical Data
Hospital Episode Statistics (HES) is a data warehouse containing details of all admissions to NHS hospitals in England. It includes private patients treated in NHS hospitals, patients who were resident outside of England and care delivered by treatment centres (including those in the independent sector) funded by the NHS. HES also contains details of all NHS outpatient appointments in England.
Each HES record can contain more than 50 pieces of information, collected directly by hospital providers or derived by the HES team. HES is a records-based system that covers all NHS trusts in England, including acute hospitals, primary care trusts and mental health trusts. HES records also include care provided to NHS patients by the independent sector, including that taking place in treatment centres, and care given to private patients in NHS hospitals. 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
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clinical details of diagnoses/treatments
The HESonline website gives you the opportunity to view a range of HES data, either as downloadable tables or in personalised, online tables.
The Quality and Outcomes Framework (QOF) information published by the NHS-IC is derived from the Quality Management Analysis System (QMAS), a national system developed by NHS Connecting for Health.
QOF has four domains; each has a set of indicators against which practices score points on the basis of achievement against each indicator, up to a maximum of 1,000 points.
The Clinical Domain has 80 indicators across 19 clinical areas, worth up to 655 points. The Organisational Domain has 43 indicators across five organisational areas, worth up to 181 points. The Patient Experience Domain has four indicators relating to length of consultations and patient surveys, worth up to 108 points. The Additional Services Domain has eight indicators across four areas, worth up to 36 points. QOF rewards practices with a holistic care payment, based on clinical achievement, worth up to 20 points.
QOF achievement for 2007/08 is presented for 8,294 general practices in England. Clinical prevalence information for 2007/08 shows numbers on disease registers as a proportion of practice lists.
Practices may exception-report patients from QOF achievement; patients can be excluded from indicators if a patient is unsuitable for treatment, newly registered, newly diagnosed, or because of informed dissent.
In 2002, the Department of Health agreed a target for the measurement of trends in patient experience as part of its Public Services Agreement (PSA) with HM Treasury. This was rolled forward in a slightly amended form in 2004:
Secure sustained annual national improvements in NHS patient experience by 2008, as measured by independently validated surveys, ensuring that individuals are fully involved in decisions about their healthcare, including choice of provider.
It was rolled forward again in the same form, as one of the indicators in the 2008-11 PSA delivery agreement 19: ’ensure better care for all’.
The Healthcare Commission’s national patient survey programme provides the data to assess progress against this indicator. Each survey consists of responses from individual respondents. Each respondent answers around 50 questions about their experience per survey.
To report on the indicator, questions have been identified in advance to represent findings against each of five domains of patient experience. Responses to these questions are converted into scores out of 100 using a scoring schema, and results are standardised by age and gender (and in the case of inpatient data, by admission method too). Scores are aggregated to form five domain scores:
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access & waiting
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safe, high quality, coordinated care
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better information, more choice
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building closer relationships
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clean, comfortable, friendly place to be
Glossary
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Finished Admission Episode
A finished admission episode is the first period of inpatient care under one consultant within one healthcare provider. Finished admission episodes are counted against the year in which the admission episode finishes. Please note that admissions do not represent the number of inpatients, as a person may have more than one admission within the year.
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Finished Consultant Episode (FCE)
An 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. Figures do not represent the number of patients, as a person may have more than one episode of care within the year.
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General Medical Services (GMS)
A GMS practice is one that has a standard, nationally negotiated contract. Within this, there is some local flexibility for GPs to 'opt out' of certain services or 'opt in' to the provision of other services.
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Inpatients
Inpatients are defined as patients who are admitted to hospital and occupy a bed, including both admissions where an overnight stay is planned and day cases.
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Outpatient Data Quality
Outpatient Hospital Episode Statistics (HES) data were collected for the first time in 2003/04. It is not mandatory to code procedures on outpatient records and therefore only around 2 per cent of records have completed clinical codes. We have no reliable existing data source to validate these data against, as Department of Health aggregate returns data have never collected clinical codes, and therefore it is not clear how representative it is. The data represent a sample of outpatient attendances and statistics (such as median and 90th percentile waiting times for main operations) are unreliable until it is possible to assess the extent of dummy coding.
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Primary Care
Primary care includes medical, dental, ophthalmic and pharmaceutical services, and also NHS Direct and NHS walk-in centres. In the UK, all these services are managed at a local level by Primary Care Organisations (for example, Primary Care Trusts in England). They are responsible for ensuring that the Primary Care services available meet the needs of the patients.
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Public Service Agreement (PSA)
The aim of the Department's Public Service Agreement is to transform the health and social care system so that it produces faster, fairer services that deliver better health and tackle health inequalities.
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QMAS
The Quality Management Analysis System (QMAS) is a national system developed by NHS Connecting for Health. QMAS uses data from general practices to calculate individual practices’ QOF achievement.
Contact Details
For statistical enquiries about this topic, please contact:
NHS Information Centre
Email: enquiries@ic.nhs.uk
Telephone: +44 (0) 845 300 6016
The NHS Information Centre 1 Trevelyan Square Boar Lane Leeds LS1 6AE
