Secondary Care (Hospitals)

Introduction

Admissions to Hospitals – Hospital Episode Statistics

Hospital Episode Statistics (HES) are record level patient data collected by the Department of Health from every NHS hospital in England and Wales. Each year approximately 15 million HES records for inpatients and day cases are generated, containing individual patient details such as age, sex, dates of admission and discharge, diagnoses, treatments and operations, NHS number and postcode.

HES data provides a comprehensive picture of inpatient care that can support public health analysis, planning and resource allocation, benchmarking, clinical audit, monitoring and performance management and research. It can offer a longitudinal picture of particular conditions or procedures. It can support local NHS analysis of activity and allows comparisons between Trusts, PCTs, SHAs, LAs, etc. In addition it also provides data for the construction of a large percentage of the NHS Performance Indicators which summarise quality and performance in the NHS.

Uses identified for HES data by the Department of Health include: - to develop, monitor and evaluate departmental policies

  • to assess the effective delivery of care

  • to identify public health issues

  • to monitor improvements in public health

  • to determine fair access to health care

  • to improve the patient/carer experience

  • to examine health outcomes

  • for public and parliamentary accountability

  • for central and local NHS management

  • in resource acquisition and distribution

  • for general medical research and statistical functions.

HES is not a live system and it usually takes between 9 and 12 months for a full financial year to be available through on-line HES or the safe haven extract. So, for example, complete 2007/08 data would not be available until December 2008 or thereabouts.

A recent development from IC and Northgate who manage the HES dataset is to produce a HES Outpatient dataset, years 2002/03 to 2004/05 are considered to be experimental but 2005/06 and the 2006/07 datasets can be used to examine number of outpatient appointments and attendances by provider and by specialty.

Payment by Results

Payment by Results is the government policy which introduces a fixed price payment for completion of inpatient treatment for patients within a specified condition. Tariffs are set for each Healthcare Resource Group (HRG). HRGs are standard groupings of clinically similar treatments, which use common levels of healthcare resource. They may be considered as ‘units of currency’ within the health service, allowing for costing across services.

Performance comparators

NHS Comparators provides comparative data to enable commissioners and providers to investigate aspects of local activity, costs and outcomes.

This includes activity and costed data through the payment by results (PbR) tariff from the Secondary Uses Service (SUS), together with quality and outcomes framework (QOF) information, GP practice demographic population profile data and now prescribing data.

Commissioners use NHS Comparators to identify and investigate differences in referral and access rates to secondary care in terms of costs and activity.

NHS Choices

You can compare the performance of Providers on a number of measures by visiting the NHS Choices website. It is an interactive website that allows you to compare hospitals by various criteria such as car parking, facilities, treatments offered or availability of A&E departments. If you and your GP agree that you need to see a specialist you can then book your appointment online.