Select Committee on Health Memoranda

5.  ACTIVITY, PERFORMANCE AND EFFICIENCY

5.1  In-Patient Activity and Waiting

  5.1.1  How many admissions, removals and decisions to admit were there in each year since 1988-89? What was non-emergency and emergency activity in each year? What was the waiting list, and how many suspensions and self-deferrals were outstanding, at the end of each year? (Q63)

  ANSWER

  The information requested is given in Table 63a to Table 63c.

Table 63a NUMBERS OF DECISIONS TO ADMIT, ADMISSIONS AND REMOVALS

England	Ordinary and Day Case Admissions
12 months to:	Decision to Admit	Admitted	Removed
March 1989	2,783,298	2,632,085	200,677
March 1990	2,943,658	2,768,482	260,503
March 1991	2,964,836	2,761,005	306,899
March 1992	3,257,615	2,993,532	387,980
March 1993	3,480,268	3,111,627	412,299
March 1994	3,501,715	3,110,477	451,559
March 1995	3,765,407	3,376,016	521,320
March 1996	3,968,825	3,500,353	547,863
March 1997	4,111,511	3,549,074	551,999
March 1998	4,192,037	3,543,634	558,242
March 1999	4,189,323	3,826,507	672,432
March 2000	4,159,078	3,682,180	622,787
March 2001	3,935,930	3,467,338	613,931
March 2002	3,781,437	3,244,185	581,534
March 2003	3,778,390	3,330,981	601,353
March 2004	3,802,744	3,391,644	621,345
March 2005	3,787,713	3,390,694	612,004
March 2006	4,031,519	3,577,104	613,626

  Source: KH06 NHS Trust-based figures.

  Notes:

1.  In the year 1997-98, information was collected annually only.

Table 63b IN-PATIENT WAITING LIST AND NUMBER OF SELF DEFERRALS AND SUSPENSIONS

England Number at:	No of patients waiting for admission	Self Deferrals	Suspensions
March 1989	922,676	45,867	not collected
March 1990	958,976	46,176	not collected
March 1991	948,243	48,113	not collected
March 1992	917,717	44,116	not collected
March 1993	994,974	54,895	not collected
March 1994	1,064,369	64,374	not collected
March 1995	1,044,051	79,340	not collected
March 1996	1,048,029	90,020	52,544
March 1997	1,158,004	95,412	66,832
March 1998	1,297,662	121,160	77,635
March 1999	1,072,860	90,765	81,086
March 2000	1,037,066	81,041	74,993
March 2001	1,006,727	75,474	76,734
March 2002	1,035,365	71,663	71,030
March 2003	992,075	68,916	72,823
March 2004	905,753	65,875	78,813
March 2005	821,722	62,811	73,359
March 2006	784,554	64,995	71,897
June 2006	784,523	66,603	75,277

  Source: KH07A NHS Trust-based figures.

  Footnotes:

1.  In the year 1997-98, information was collected annually only.

Table 63c

EMERGENCY AND NON-EMERGENCY GENERAL &

ACUTE ADMISSIONS(1), (2), (3)

England Year	Non-Elective Admissions	Elective Admissions(4)
	(Emergency)	(Non-Emergency)
1996-97	3,603,712	4,364,224
1997-98	3,735,690	4,450,266
1998-99	3,854,980	4,868,981
1999-2000	3,893,223	4,933,617
2000-01	3,949,302	5,044,678
2001-02(5)	3,967,554	5,080,176
2002-03(5)	4,013,674	5,307,871
2003-04	4,281,536	5,492,033
2004-05	4,504,295	5,606,534
2005-06(6)	4,677,746	5,691,325

  Source: Health Authority Quarterly Monitoring, Monthly Monitoring Returns.

  Footnotes:

1.  These figures are for admissions purchased by the NHS (commissioner-based).

2.  Figures for years prior to 2005-06 have been rebased to allow direct comparison.

3.  General & Acute specialities do not include mental health, learning difficulties or maternity services.

4.  Elective activity includes waiting list, booked and planned admissions.

5.  Earlier figures are from Health Authorities. With the abolition of Health Authorities, figures for 2001-02 and 2002-03 are based on returns from NHS Trusts.

6.  Figures are subject to revision when final outturn figures are received.

  5.1.2  What were (a) mean and (b) median waiting times for inpatient admission in each year since 1988-89? Could these data be shown in tabular and graphical form? (Q64)

  ANSWER

  1.  The information requested is given in Table 64 and Figure 64.

Table 64

ESTIMATED MEAN AND MEDIAN INPATIENT WAITING TIMES (IN WEEKS)

Qtr Ending	Mean	Median
March 1988	40.0	21.7
March 1989	40.4	22.2
March 1990	37.4	20.5
March 1991	32.8	19.2
March 1992	22.2	13.9
March 1993	19.6	13.8
March 1994	20.0	14.0
March 1995	17.4	12.3
March 1996	15.9	11.8
March 1997	18.1	13.2
March 1998	20.0	14.8
March 1999	18.6	12.8
March 2000	18.7	12.9
March 2001	18.1	12.6
March 2002	17.4	12.7
March 2003	15.6	11.9
March 2004	12.4	10.2
March 2005	10.6	8.5
March 2006	8.7	7.3
June 2006	8.6	7.1

  Source: QF01 commissioner-based.

  5.1.3  Could the Department detail (a) numbers of First Finished Consultant Episodes (FFCEs), broken down into ordinary and day cases (b) admissions by type of admission and (c) episode/spell ratios by Strategic Health Authority in the past three years for which data are available? Could the Department comment on the use of FFCEs rather than Finished Consultant Episodes (FCEs)? (Q65)

  ANSWER

  1.  The available information is given in Table 65.

  2.  From 30 June 1998, the Department's admissions data has been collected as First Finished Consultant Episodes (FFCEs) rather than Finished Consultant Episodes (FCEs). The reason for this change is that FFCEs are a better indicator of new demand (ie patients entering the system for a new episode of care), as for every single FFCE there can be a number of FCEs, meaning FCEs generally overstate demand.

  3.  Furthermore, it can be noted that "spell" based activity counts are based on completed episodes of care (ie the sum of the completed FCEs equals one "spell") and are thus similar in number to FFCE counts of activity. Essentially, spells are a count of discharges whereas FFCEs is a count of admissions, hence the two giving similar counts over any given period.

  4.  Note that the Department's data collections on ordinary and day-case admissions are not further subdivided by admission type. Also note that the Department does not collect data episode or spell which is available from the Information Centre's HES return (though this is not directly comparable with the Department's information as supplied).

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Prepared 21 November 2006