Provisional Monthly Hospital Episode Statistics for Admitted Patient Care, Outpatients and Accident and Emergency Data - April 2012 to February 2013

Monthly HES data for Inpatients
In the year from March 2012 to February 2013 there were:

• 17.6 million finished consultant episodes (FCEs), 59.8 per cent (10.5 million) of which included at least one procedure or intervention, and 6.0 million of which were day cases.
• 15.0 million finished admission episodes (FAEs), of which 5.3 million were emergency admissions.

Monthly HES - Inpatient Clinical coding coverage
The shortfall between the most recent month's data is more pronounced when considering clinical (procedures and diagnoses) coverage. More procedures and N/A more diagnoses were coded in the HES data submitted to SUS by 19/4/2013 (Month 12), which was the extract used for this publication, compared to the HES data submitted to SUS by 14/3/2013 (Month 11), which was used for 14th May 2013 publication.  We accordingly recommend extra caution using clinical codes for the most recent months data.

Monthly HES for Outpatients
In the year from March 2012 to February 2013 there were:

• 93.5 million outpatient appointments made, with 74.9 million (80.1 per cent) of these attended by the patient.
• 6.9 million outpatient appointments not attended by the patient, representing 7.3 per cent of all appointments.

Provisional Monthly HES data for Accident and Emergency (Experimental Data)
In the year from March 2012 to February 2013 there were:

• 18.3 million A&E attendances recorded in A&E HES. Of these 3.8 million (20.7 percent) resulted in admission to hospital for inpatient treatment, 3.7 million (20.0 per cent) resulted in a GP follow up, and 7.2 million (39.0 per cent) were discharged with no follow up.

TOI: Falls

• There were 410,377 admissions for falls over this period; a 13.4 per cent decrease in admissions from the same period a year earlier (473,642). This decrease was mostly seen for 'unspecified falls' (decrease of 23 per cent; from 193,524 to 148,308) with the next biggest decrease for 'other fall on same level' (decrease of 7 per cent; from 55,853 to 51,963) and then 'fall involving bed' (decrease of 15 per cent; from 22,817 to 19,304).
• Admissions for falls were highest in older ages, especially for females - 73.0 per cent (176,539) of female admissions were aged 65 or over compared to 49.3 per cent (83,110) of male admissions aged 65 or over. The population rate demonstrates that females 60 and over experience higher rates of admissions for falls than males.
• Many admissions for falls were categorised as 'unspecified' (36.1 per cent; 148,308) but the next largest recorded types of fall were 'falls on the same level through slipping, tripping and stumbling' (21.8 per cent; 89,488) and 'other fall on same level' (12.7 per cent; 51,963). 'Falls involving snow and ice' only represented 1.5 per cent (6,178) of falls.
• Standardised admission rates for falls were highest in the North East region (89.9 per 10,000 population; 23,682 admissions) followed by the North West region (88.6 per 10,000; 62,203 admissions). The England average admission rate was 76.4 per 10,000 (405,713 admissions).
• The top three primary diagnoses for admissions for falls were 'fracture of femur' (60,987; 14.9 per cent), 'fracture of forearm' (37,424; 9.1 per cent) and 'open wound of head' (34,801; 8.5 per cent).
• For the age groups 15-64, 65-79 and 80+ there was a higher percentage of deaths in hospital after being admitted for a fall than for all admissions - with overall 3.7 per cent (15,389) of admissions for falls ending in a hospital death compared to 1.4 per cent of all admissions. For older age groups there was a higher percentage of male admissions compared to female admissions resulting in a hospital death - 9.4 per cent (4,668) of males aged 80+ compared to 5.7 per cent of females aged 80+ (7,049).

TOI - Accident & Emergency

• Attendances at A&E have been increasing over the last decade. A&E HES data has been collected since 2007-08 and data coverage of the official WSitAE data is now over 80 per cent of A&E attendances.
• The pattern of A&E arrival times has remained very similar since A&E HES data was first collected in 2007-08 . Although the number of A&E attendances recorded in HES each year is increasing, the percentage of attendances at each hour of the day has remained very similar. For 2012-13 (to the end of February) 58.5 per cent of attendances arrived at A&E between 9am and 6pm. This figure has remained between 56.8 per cent and 58.5 per cent since 2007-08.
• In 2012-13 (to the end of February) 20.7 per cent of attendances led to admission to hospital, 20.0 per cent were discharged requiring a GP follow up and 39.0 per cent were discharged with no follow up. In 2007-08 these figures were 20.7 per cent, 17.0 per cent and 41.2 per cent respectively.
• In 2012-13 (to the end of February) the most deprived 10 per cent of society accounted for more than double the number of attendances (14.4 per cent, or 2.4 million) compared to the least deprived 10 per cent (6.7 per cent, or 1.1 million). This compares to 15.7 per cent and 6.4 per cent respectively in 2007-08.
• Between 2002 and 2012 the number of full time equivalent NHS Hospital & Community Health Service (HCHS) Doctors with an A&E specialty increased by 70.8 per cent from 3,183 to 5,437 (an average annual increase of 5.5 per cent). The number of full time equivalent GPs (excluding Registrars and Retainers) increased by 17.7 per cent from 26,833 to 31,578 over the same period (an average annual increase of 1.6 per cent).
• Between 2002 and 2011 the population of England increased by 6.9 per cent from 49.7 million to 53.1 million.