Select Committee on Health Memoranda


Memorandum by the Department of Health

PUBLIC EXPENDITURE QUESTIONNAIRE 2001

Table 4.14.7

AVERAGE DAILY NUMBER OF AVAILABLE AND OCCUPIED BEDS1 AND THROUGHPUT,2 BY SECTOR, NHS TRUSTS IN LONDON



  Footnotes:
  (1)  Number of bed days in the year divided by the number of days in the year. The return was revised in 1996-97 to specifically include the separate collection of beds in paediatric intensive care wards, and NHS managed beds in residential care.
  (2)  Number of finished consultant episodes for ordinary admissions per available bed. Figures exclude well babies.
  (3)  General and acute is defined as acute plus geriatric (excluding well babies).
  (4)  1996-97 is the first year for the collection of Bed Occupancy figures.
  (5)  "." denotes not applicable and ".." denotes not available.
  (6)   Source: KH03, KP70 & HES.
  (7)  1998-99* & 1999-2000* data are derived from ungrossed Hospital Episode Statistics. From 1998-99 HES data are used to report hospital inpatient activity levels,because HES data are now more timely and more accurate. HES based data for 1997-98 differ from KP70 data because HES data consisently report activity according to the speciality of the consultant involved. Some Trusts report KP70 data for some specialties according to the specialty treatment.
  (8)  2000-01 Throughput figures are unavailable as HES figures are awaiting to be finalised.


Table 4.14.8

AVERAGE DAILY NUMBER OF AVAILABLE AND OCCUPIED BEDS1 AND THROUGHPUT,2 BY SECTOR, NHS TRUSTS IN SOUTH EAST



  Footnotes:
  (1)  Number of bed days in the year divided by the number of days in the year. The return was revised in 1996-97 to specifically include the separate collection of beds in paediatric intensive care wards, and NHS managed beds in residential care.
  (2)  Number of finished consultant episodes for ordinary admissions per available bed. Figures exclude well babies.
  (3)  General and acute is defined as acute plus geriatric (excluding well babies).
  (4)  1996-97 is the first year for the collection of Bed Occupancy figures.
  (5)  "." denotes not applicable and ".." denotes not available.
  (6)   Source: KH03, KP70 & HES.
  (7)  1998-99* & 1999-2000* data are derived from ungrossed Hospital Episode Statistics. From 1998-99 HES data are used to report hospital inpatient activity levels,because HES data are now more timely and more accurate. HES based data for 1997-98 differ from KP70 data because HES data consisently report activity according to the speciality of the consultant involved. Some Trusts report KP70 data for some specialties according to the specialty treatment.
  (8)  2000-01 Throughput figures are unavailable as HES figures are awaiting to be finalised.


Table 4.14.9

AVERAGE DAILY NUMBER OF AVAILABLE AND OCCUPIED BEDS1 AND THROUGHPUT,2 BY SECTOR, NHS TRUSTS IN SOUTH WEST



  Footnotes:
  (1)  Number of bed days in the year divided by the number of days in the year. The return was revised in 1996-97 to specifically include the separate collection of beds in paediatric intensive care wards, and NHS managed beds in residential care.
  (2)  Number of finished consultant episodes for ordinary admissions per available bed. Figures exclude well babies.
  (3)  General and acute is defined as acute plus geriatric (excluding well babies).
  (4)  1996-97 is the first year for the collection of Bed Occupancy figures.
  (5)  "." denotes not applicable and ".." denotes not available.
  (6)   Source: KH03, KP70 & HES.
  (7)  1998-99* & 1999-2000* data are derived from ungrossed Hospital Episode Statistics. From 1998-99 HES data are used to report hospital inpatient activity levels,because HES data are now more timely and more accurate. HES based data for 1997-98 differ from KP70 data because HES data consisently report activity according to the speciality of the consultant involved. Some Trusts report KP70 data for some specialties according to the specialty treatment.
  (8)  2000-01 Throughput figures are unavailable as HES figures are awaiting to be finalised.


  4.14b  Could the Department provide figures for the number of delayed discharges of patients from acute settings and a commentary on how these delays are being addressed?

  2.  The information requested is contained in the attached table below.

Table 4.14.10

PATIENTS AGED 75 AND OVER WITH DELAYED DISCHARGE



  Source:   Figures before 1996-97 were collected by survey. Figures from 1996-97 onwards are taken from the Department of Health Quarterly Monitoring Returns.

  Notes:  Information is reported by health authorities to the NHS Executive.

  Null returns are seen as questionable data and have been removed from the England calculations

4.15  Maternity Hospital Episode System

  4.15a  How many maternities were registered in each NHS region in 1999-2000 and how many records in the Maternity Hospital Episode System had (i) maternity tails and, (ii) maternity tails containing data? Could the Department also update the information given in Tables 4.14.3—4.14.7?

  4.15b  Could the Department provide a commentary on, and show evidence of, the progress Trusts and Regions are making in improving data quality and on the steps the Department has taken to ensure improvement?

  1.  The data requested are contained in tables 4.15.1 to 4.15.7. In each table the Regional Office area tabulated is that in which the delivery took place.

  2.  HES data quality has been improving over the last few years and the Department continues to take action to improve it. In fulfilling the aims set out in the "National Framework for Assessing Performance", the Data Quality Indicator (DQI), which includes Maternity HES information and guidance for assessing Maternity HES data quality, was introduced by the Department in August 1999. The DQI is now in it's second year of running. We anticipate an improvement in data quality as a result of the inclusion of the DQI within traffic lights. This has been piloted this year and is expected to become a first element component of traffic lights next year. Coverage and completeness of Maternity data are key components of the DQI.

  3.  Examinations for the National Clinical Coding Qualification (UK) have been established to provide clinical coders with a recognised professional qualification. The next level of the qualification is now being worked towards. An optional module within the Professional Awards in IM&T (Health) at certificate level will be part of this.

  4.  Initiatives will also be taken over the next year to further develop and enhance measurements for the quality of clinical coding on HES. These will be developed as part of the continued development agenda for the DQI.

  5.  In addition to the DQI the annual Chief Executive sign up now requires a Board level member to be nominated as responsible for data quality, in line with the guidelines for the Audit Commission "Light Touch" Review. This involves trust chief executives committing themselves in writing to assure the quality of their data, or explaining shortfalls in data standards.

  6.  The Department is also pursuing with the NHS-wide Clearing Service and hospital maternity software providers various options for facilitating the submission of maternity clinical details.

  7.  A second statistical bulletin on NHS Maternity Services in England for 1996-97 to 1997-98 was published in June 2001; a third bulletin covering 1998-99 to 2000-01 is planned for summer 2002.

Table 4.15.1

NHS HOSPITAL MATERNITIES REGISTERED BY REGION OF OCCURRENCE 1999-2000



  Footnote:
  1.   Source: ONS, aggregated from unit level by DH SD2B.


Table 4.15.2

NUMBER OF NHS HOSPITAL DELIVERY RECORDS AND ESTIMATED TAILS WITH DATA IN MATERNITY HOSPITAL EPISODE STATISTICS 1999-2000



  Footnote:
  1.   Source: Hospital Episode Statistics (Maternity), produced by DH SD2B.
  2.  Records containing data are those with a valid method of delivery in the maternity tail.


Table 4.15.3

NHS HOSPITAL DELIVERIES: PLACE OF DELIVERY BY REGION 1999-2000



  Footnote:

  1.   Source:   Hospital Episode Statistics (Maternity), produced by DH SD2B.

Table 4.15.4

METHOD OF DELIVERY BY REGION 1999-2000



  Footnote:
  1.  Source:   Hospital Episodes Statistics (Maternity), produced by DH SD2B.


Table 4.15.5

METHOD OF ONSET OF LABOUR BY REGION 1999-2000



  Footnote:
  1.  Source:   Hospital Episodes Statistics (Maternity), produced by DH SD2B.


Table 4.15.6

PERSON CONDUCTING DELIVERY BY REGION 1999-2000


  Footnote:
  1.  Source:   Hospital Episodes Statistics (Maternity), produced by DH SD2B.


Table 4.15.7

DURATION OF POSTNATAL STAY BY REGION 1999-2000



  Footnote:
  1.  Source:   Hospital Episodes Statistics (Maternity), produced by DH SD2B.

4.16  Waiting Lists and Times

  4.16a  Could the Department provide information about waiting lists, both distribution by waiting time as well as mean and median average time, on a district of residence basis and on a provider unit basis? Could the Department show graphically changes in mean and median waiting times since March 1988 and include a table of figures?

  4.16b  Could the Department provide an update of Tables 4.15.4 to 4.15.8 on outpatient waiting times?

  4.16c  Could the Department provide figures on how many people were removed from waiting lists for day case treatment and for in-patient treatment (i) because of admission for treatment and (ii) for reasons other than treatment? How many people were self-deferred in each six-month period since September 1988? What rules apply to ensure consistent interpretation of these figures? Has the Department made any assessment of the extent to which people removed for reasons other than treatment in that hospital had either been admitted, died, treated in another hospital, or no longer required treatment?

  4.16.d  Could the Department provide charts and figures showing how trends in emergency and waiting list, booked and planned activity have moved with waiting lists sizes since June 1991? Could the Department provide both indices and actual numbers in each case?

  4.16.e  Can the Department provide a comparison of total numbers of people waiting for outpatient appointments for each year for which figures are available, separately identifying trends in the average wait for an outpatient appointment?

  4.16.f  Can the Department estimate the number of people at each access point of the elective care system broken down to show:

    (b)  numbers of referrals to specialist outpatient clinics

    (c)  numbers of attendances at specialist outpatient clinics

    (d)  numbers of placements on waiting lists (differentiated by (i) "waiting list", (ii) "booked" and (iii) "planned", and(e) numbers of elective episodes of care, for each year since 1991-92

  Would the Department provide a commentary on changes over time in numbers waiting at each stage, and the conversion rates between each stage?

  4.16.g  What additional mechanisms have been put in place since last year's response to deal with waiting lists? How is the success of each of these measured? What assessment have you made of the effectiveness of each? What has been the cost of each of these?

  4.16a  Could the Department provide information about waiting lists, both distribution by waiting time as well as mean and median average time, on a district of residence basis and on a provider unit basis? Could the Department show graphically changes in mean and median waiting times since March 1988 and include a table of figures?

  1.  Table 4.16.1 shows the most recent NHS Trust-based figures for waiting lists and times for ordinary inpatients and day cases by region. Resident and responsible population figures are shown in table 4.16.2. Mean and median times on the list are included in these tables. It should be noted that these figures show patients waiting on the list at the time of the last count, ie they are the average lengths of time waited by patients still on a waiting list.

  2.  Figure 4.16.1 shows mean and median waiting times from March 1988 to March 2000. Table 4.16.3 shows the underlying data.


 
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