Health Survey for England - Health, social care and lifestyles

The Health Survey for England (HSE) is an important annual survey looking at changes in the health and lifestyles of people all over the country.

Around 8,000 adults and 2,000 children take part in the survey each year. Information is collected through an interview and, if participants agree, a visit from a specially trained nurse.

The surveys, which have been carried out since 1991, provide regular information that cannot be obtained from other sources.

Find out more on the NatCen website.

The Health and Social Care Statistics Leadership Forum have commissioned a joint public consultation of health and social care statistical outputs produced by the Department of Health and Social Care (DHSC), Office for National Statistics (ONS), United Kingdom Health Security Agency (UKHSA), NHS Business Services Authority (NHSBSA) and NHS England (NHSE). 

As part of the consultation NHS England are proposing to either change the mode of the Health Survey for England and/or the frequency of the Survey. As users of the Survey we would welcome your views on these changes. The consultation is currently open and will close on Tuesday 5 March 2024.

The Health Survey for England publication series includes links to the latest report and all previous HSE reports published by NHS England.

As well as the standard survey publications we have also published the following: 

Health Survey England Additional Analyses, Ethnicity and Health, 2011-2019 Experimental statistics

Health Survey England Additional Analyses - Health and health-related behaviours of Lesbian, Gay and Bisexual adults

Health Survey for England predicting height, weight and body mass index from self-reported data

The Health Survey for England 2020/2021 Feasibility Study. This report examines the suitability of transferring key HSE content from face-to-face interviewing to self-completion modes. It reports on the key findings and response rates achieved and considers the data quality and the accuracy of survey estimates.

Find out out more any methodology changes implemented within HSE. 

The Health Survey England dashboard uses data from HSE to monitor the interesting changes and trends in England’s health since the 1990’s. 

The dashboard shows how the rate of smoking have steadily declined over time, and the prevalence of both obesity and overweight has increased.

Other graphs show the changing proportion of people eating their ‘5-a day’, shifts in the rate of a longstanding illness, and the rise in doctor-diagnosed diabetes, and several other indicators, that help us track our changing health.

The HSE provides vital information, which is used by central government (the Department of Health & Social Care and Public Health England) and local government for a range of different purposes, including:

• monitoring changes in health and lifestyles
• monitoring the prevalence of specific health conditions
• planning services
• policy development
• monitoring and evaluating policy

Local authorities also use the survey to compare local indicators with national figures. Other organisations include NHS England, other NHS bodies, charities and voluntary organisations. The survey is also widely used by academics and researchers from different universities in the UK.

Examples of how information from the HSE has been used include:

• it found that lots of older people weren't aware that they had kidney disease and that levels of undiagnosed kidney disease are significantly higher than the official diagnosed levels - this issue inspired action to tackle the problem
• HSE is used to measure how many people are reaching the 5-a-day government target on fruit and vegetable consumption
• HSE found that many people didn't know they had high blood pressure, which can cause serious health problems - doctors now check blood pressure more regularly
• data from the survey is used as a component in the formula allocating public health grants from the Department of Health and Social Care to local authorities

The current survey is being carried out by NatCen Social Research on behalf of NHS England. 

The HSE surveys are reviewed yearly by an independent group of people called a Research Ethics Committee, to protect the safety, rights, wellbeing and dignity of those taking part.

The 2021 survey was reviewed by the East Midlands - Nottingham 2 Research Ethics Committee and given a favourable outcome (REC reference:15/EM/0254).

Addresses are chosen at random, meaning every address in England has an equal chance of being included. This ensures that we get a truly representative picture of people living in private households in England.

If you've received a letter asking you to take part, one of NatCen's interviewers will soon call at your home to arrange an interview at a time that suits you. You can say no if you don’t want to take part, but the interview itself is relaxed and there's nothing to prepare. You can skip any questions you don't want to answer.

Due to the COVID-19 pandemic we have changed how we collect the survey for 2021. An interviewer will call at your home, but will remain on the doorstep, they will provide you with more information about the survey and answer any questions you may have. If you would like to take part they will offer you an interview by telephone for a time that is convenient to you.

You will be offered a telephone interview until we are safely able to return to face to face interviewing. Your interviewer will ask you about a range of topics including your health and aspects of your lifestyle that can affect it.  Again you do not have to answer any questions you don’t want to, you can just skip on to the next one.

During the interview we will also ask your permission for a nurse to visit, however this visit will not take place until current government restrictions allow. Nurse visits will re-commence in October 2021. You can find out more information about what’s involved on the NatCen taking Part webpage.

The Health Survey for England content page includes information about which topics were included each year of the survey from 1993 to 2019.

There are core topics for which data is collected regularly including:

• physical health asthma 
• mental health and wellbeing 
• lifestyle behaviours such as: smoking, drinking, dietary habits 
• social care
• physical measures such as height, weight, and blood pressure (carried out by nurse visit)

Additional topics can also be included in specific survey years by organisations such as central government, charities, and researchers, subject to funding and space. 

In addition, organisations may choose to fund population boosts whereby a larger sample of a particular sub-group are interviewed. This leads to more statistically robust data for that group. Previous boosts include children, ethnic minorities, or certain geographical locations.

The answers

The answers from the questionnaire are put together with the answers collected from thousands of other people across England and the survey findings are published on our webpage, see the  Health Survey for England publication series for the latest report. The findings will not identify anyone who took part in the survey. 

If you’ve taken part in the survey and you change your mind you can ask for your details to be removed from the survey records. Please contact  [email protected] and ask for the Surveys Team to remove your details from the Health Survey for England dataset. We will remove your survey details from the dataset and will no longer process your data however we won’t be able to change any publications that have already happened. 

The survey data

The data will not be presented in a form that can reveal any personal information that could be used to identify individuals. An anonymised dataset will be made available on the UK Data Service Catalogue. The data will be used by researchers within central and local government and academia for not-for-profit research to help improve health and social care services. The UK Data Service is home to the UK's largest collection of digital social and economic research data. The anonymised dataset made available by the UK Data Service has been carefully created following Government Statistical Service disclosure control guidance and removing any information that might identify individuals.

We may also share  more detailed data with specifically approved researchers and analysts under a Data Sharing Agreement. This would only be after following our independent scrutiny process for external data releases. NHS England will carefully review any requests (see the Data Access Request Service) and applicants will need to meet strict data governance standards. This information will be used for statistical, policy and research purposes only and again individuals will not be directly identified.

The anonymised Health Survey for England datasets can be accessed via the UK Data Service. Strict measures are in place regarding who can access the data and users will need to agree to the licence conditions about use. Researchers interested in accessing the datasets will need to register with UK Data Service in the first instance.

The dataset is available to researchers in the UK, EEA or those from a country with a suitable adequacy agreement. Requests from researchers from other countries will be reviewed on a case-by-case basis. 

Data is available for 1993 to 2019. The data items available will vary each year depending on what questions were asked that year and also disclosure control measures applied to the dataset to protect individuals' rights. The Health Survey for England Content page provides at a glance what topics were included each survey year. More specific information about which data items are available for each survey dataset can be found on the UK Data Service website under the HSE survey year of interest.

The latest HSE dataset available is 2019 which is available on the UK Data Service website: Health Survey for England 2019. 

To find out more about the methods of accessing this data set, visit the DARS Population health surveys page.

The Health Survey for England has a steering group which has directed the design, development, implementation and delivery of the survey. 

The role includes:

• providing direction and recommendations on priorities relating to the Health Survey for England
• considering representations in relation to the needs of data users
• considering, agreeing and approving changes in data to be collected, methodology, questionnaires, sample design, processing and presentation of results

Find out more about the steering group.

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If you have any enquiries please contact [email protected] and ask for the Surveys Team.