5. ACTIVITY AND PERFORMANCE
5.1.1 How many admissions, removals and decisions
to admit were there in each year from 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? (Q40)
Answer
1. The available information is given in
tables 40a to 40c.
2. Data are sourced from the Quarterly Activity
Return (QAR), formerly KH06 and KH07a quarterly aggregate returns.
These are national statistics and are therefore reliable, although
figures were only collected on an annual basis in 1997-98. This
shows a very high figure of 121,000 self deferrals in March 1998,
which is a questionable figure in the context of the time series.
3. Elective and non-elective activity data
are sourced from health authority quarterly and PCT monthly aggregate
returns. The data are generally reliable.
4. The total number of patients admitted
to hospital for treatment is now some 68% higher than in 1989.
Fewer patients are required to stay in hospital and more patients
are receiving the treatment they need in outpatients.
5. The In-patient Waiting List has increased
by 6.5% since 2008, but is down 39% on 1989.
6. The NHS is seeing more patients with
3.6 million more non-emergency admissions and emergency admissions
since 1996-97. This is an increase of some 44%.
Admissions, decisions to admit and removals
7. The total number of admissions in the year
ended March 2009 was 4,418,000, up 375,000 on the year ended March
2008 and up 1,786,000 on the year ended March 1989. The admissions
figures provided include those patients that were booked and those
given fixed dates to attend. Both these categories of patient
are on the elective waiting list until admitted. The figures exclude
planned admissions.
8. The number of removals has seen a steady
rise since 1988, with the total number of removals increasing
from 201,000 in the year ended March 1989 to 648,000 in the year
ended March 2009. The peak number of removals was 672,000 in March
1999.
9. Removals consist of patients taken off
the waiting list for:
— Patients removing themselves from list.
— Patient admitted as an emergency.
— Patient no longer needs the procedure.
— Patient removed from one trust's waiting
list to enable transfer to another.
10. The number of decisions to admit increased
from 2,783,000 in the year ended March 1989 to 4,980,000 for March
2009. This represents a peak in the number of decisions to admit
and is linked to increased activity as the NHS implements the
18-week operational standard.
11. Decisions to admit include those patients
put on the waiting list as a result of consultants' decisions
at outpatient appointments and in A&E departments.
Self deferrals and suspensions
12. Self deferrals increased from 46,000
as at March 1989 to a peak of 121,000 in March 1998. Since that
date self deferrals have followed a downward pattern and in March
2009 there were 46,000 such deferrals.
13. Figures on the number of suspensions
were first collected in March 1996. Latest figures show the number
of suspensions was around 41,000 in March 2009. This is down from
a peak of 81,000 in March 1999.
14 Self deferrals and suspensions are collected
as a stock figure at the end of each quarter.
Elective and non-elective activity
15. There has been an annual average increase
of 2.8% for emergency admissions and 3.4% for non-emergency admissions
since 1996-97. This gives an overall annual average increase of
3.1% since 1996-97.
16. The admissions figures given in table
40a do not include planned admissions, and are therefore not comparable
with the figures given in table 40c.
Table 40a
NUMBERS OF DECISIONS TO ADMIT, ADMISSIONS
AND REMOVALS
|
| England | Ordinary and day case admissions (FFCEs)
|
| 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
|
| March 2007 | 4,154,486
| 3,746,666 | 613,886
|
| March 2008 | 4,355,950
| 4,043,307 | 646,394
|
| March 2009 | 4,979,682
| 4,418,090 | 647,550
|
|
| Source: |
| Knowledge and Intelligence, DH |
| KH06 (1989-2006), KH067A (2007) and QAR (Q3 2007-08 onwards) NHS trust-based figures:
|
http://www.dh.gov.uk/en/Publicationsandstatistics/Statistics/Performancedataandstatistics/HospitalActivi tyStatistics/DH_087982
|
| Footnotes: |
| 1. In the year 1997-98, information was collected annually only.
|
| 2. These figures are national statistics.
|
Table 40b
IN-PATIENT WAITING LIST AND NUMBER OF SELF DEFERRALS AND
SUSPENSIONS
|
| |
| |
| |
| England |
|
| |
| |
| Annual percentage change
|
| Number at: | Number of
patients waiting
for admission
| Self
deferrals
| Suspensions | Number of
patients waiting
for admission
| Self
deferrals
| Suspensions |
|
| March 1989 | 922,676
| 45,867 | not collected
| |
| |
| March 1990 | 958,976
| 46,176 | not collected
| 3.9% | 0.7%
| |
| March 1991 | 948,243
| 48,113 | not collected
| -1.1% | 4.2%
| |
| March 1992 | 917,717
| 44,116 | not collected
| -3.2% | -8.3%
| |
| March 1993 | 994,974
| 54,895 | not collected
| 8.4% | 24.4%
| |
| March 1994 | 1,065,369
| 64,374 | not collected
| 7.1% | 17.3%
| |
| March 1995 | 1,044,051
| 79,340 | not collected
| -2.0% | 23.2%
| |
| March 1996 | 1,048,029
| 90,020 | 52,544
| 0.4% | 13.5%
| |
| March 1997 | 1,158,004
| 95,412 | 66,832
| 10.5% | 6.0%
| 27.2% |
| March 1998 | 1,297,662
| 121,160 | 77,635
| 12.1% | 27.0%
| 16.2% |
| March 1999 | 1,072,860
| 90,765 | 81,086
| -17.3% | -25.1%
| 4.4% |
| March 2000 | 1,037,066
| 81,041 | 74,993
| -3.3% | -10.7%
| -7.5% |
| March 2001 | 1,006,727
| 75,474 | 76,734
| -2.9% | -6.9%
| 2.3% |
| March 2002 | 1,035,365
| 71,663 | 71,030
| 2.8% | -5.0%
| -7.4% |
| March 2003 | 992,075
| 68,916 | 72,823
| -4.2% | -3.8%
| 2.5% |
| March 2004 | 905,753
| 65,875 | 78,813
| -8.7% | -4.4%
| 8.2% |
| March 2005 | 821,722
| 62,811 | 73,359
| -9.3% | -4.7%
| -6.9% |
| March 2006 | 784,572
| 64,995 | 71,897
| -4.5% | 3.5%
| -2.0% |
| March 2007 | 700,624
| 65,638 | 75,129
| -10.7% | 1.0%
| 4.5% |
| March 2008 | 531,520
| 53,675 | 43,548
| -24.1% | -18.2%
| -42.0% |
| March 2009 | 565,954
| 45,532 | 41,413
| 6.5% | -15.2%
| -4.9% |
|
| Source: |
| Knowledge and Intelligence, DH |
KH07A (1989-2006), KH067A (2007) and QAR (Q3 2007-08 onwards) NHS trust-based figures
http://www.dh.gov.uk/en/Publicationsandstatistics/Statistics/Performancedataandstatistics/HospitalActivityStatistics/DH_087982
|
Footnotes:
|
| 1. In the year 1997-98, information was collected annually only.
|
Table 40c
EMERGENCY AND NON-EMERGENCY GENERAL AND ACUTE ADMISSIONS
(1) (2) (3)
|
| |
| | Annual percentage change
|
| Year | Non-elective admissions
(emergency) FFCEs
| Elective admissions (4)
(non-emergency) FFCEs
| Non-elective admissions
(emergency) FFCEs
| Elective admissions (4)
(non-emergency) FFCEs
|
|
| 1996-97 | 3,641,889
| 4,441,113 |
| |
| 1997-98 | 3,775,265
| 4,528,670 | 3.7%
| 2.0% |
| 1998-99 | 3,895,818
| 4,954,763 | 3.2%
| 9.4% |
| 1999-2000 | 3,934,467
| 5,020,537 | 1.0%
| 1.3% |
| 2000-01 | 3,991,140
| 5,133,554 | 1.4%
| 2.3% |
| 2001-02 (5) | 4,009,584
| 5,169,678 | 0.5%
| 0.7% |
| 2002-03 (5) | 4,056,193
| 5,401,385 | 1.2%
| 4.5% |
| 2003-04 | 4,326,893
| 5,588,791 | 6.7%
| 3.5% |
| 2004-05 | 4,552,012
| 5,705,309 | 5.2%
| 2.1% |
| 2005-06 | 4,749,617
| 5,832,792 | 4.3%
| 2.2% |
| 2006-07 | 4,777,037
| 5,917,141 | 0.6%
| 1.4% |
| 2007-08 | 4,795,153
| 6,236,082 | 0.4%
| 5.4% |
| 2008-09 | 5,053,889
| 6,621,810 | 5.4%
| 6.2% |
|
| Source: |
| Knowledge and Intelligence, DH |
| 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 2006-07 have been rebased to allow direct comparison.
|
| 3. General and 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 200-03 are based on returns from NHS trusts. Figures for 2003-04 onwards are for PCTs.
|
|
