Bariatric surgical procedures, 2021/22 (provisional)– National Obesity Audit [Management Information]

This initial release contains data from Hospital Episode Statistics (HES). Other data sources will be used in future releases. 

Hospital Episode Statistics (HES) is a database containing details of all admissions, Accident and Emergency attendances and outpatient appointments at NHS hospitals in England. 

Initially this data is collected during a patient's time at hospital as part of the Commissioning Data Set (CDS). This is submitted to NHS Digital for processing and is returned to healthcare providers as the Secondary Uses Service (SUS) data set and includes information relating to payment for activity undertaken. It allows hospitals to be paid for the care they deliver.  

This same data can also be processed and used for non-clinical purposes, such as research and planning health services. Because these uses are not to do with direct patient care, they are called 'secondary uses'. This is the HES data set. HES is collected and published monthly as provisional official statistics data with final annual data published at the end of the year as national statistics.  Annual admitted patient care data is available for every financial year from 1989-90 onwards.  

HES data covers: 

• private patients treated in NHS hospitals (However this data is not included in the NOA) 

• patients resident outside of England 

• care delivered by treatment centres (including those in the independent sector) funded by the NHS 

Each HES record contains a wide range of information about an individual patient admitted to an NHS hospital, including: 

• clinical information about diagnoses and operations 

• patient information, such as age group, gender and ethnicity 

• administrative information, such as dates and methods of admission and discharge 

• geographical information such as where patients are treated and the area where they live 

The Hospital Episode Statistics (HES) webpages provide further information. 

Mid-year estimates of the usual resident population for clinical commissioning groups in England from the Office for National Statistics have been mapped to Integrated Care Boards (ICBs) and then used to calculate the rates per 100,000 population.  

The Clinical commissioning group population estimates webpages provide further information. 

England total and provider level breakdown includes data for persons not resident in England, or of no fixed abode/ unknown residence. All other sub-national breakdowns include data only for patients resident in England.  

The term ‘bariatric surgery’ is often used to define a group of procedures that can be performed to facilitate weight loss although these procedures can be performed for conditions other than weight loss. We have used primary diagnosis of obesity using the tenth revision of the International Classification of diseases (ICD10 code E66), to limit the bariatric procedures to those related to obesity. There is a small possibility that people undergoing bariatric surgical procedures for cancer may be counted. 

Here is a list of the OPCS codes (Office for Population, Censuses and Surveys: Classification of Intervention and Procedures, 4th Revision (OPCS4)) used for each type of procedure where we counted each patient where there has been at least one instance of each type of procedure. For revisions, in some cases evidence of previous bariatric procedure in the preceding 10 financial years has also been looked at. 

Primary procedure: G281, G282, G283, G284, G285, G301, G302, G303, G304, G312, G321, G331, G716. 

Revision procedure: G305, G315, G316, G322, G323, G324, G325, G332, G387, G717 

Gastric balloons and bubbles: G481, G485. 

Further details are in the metadata. 

Disclosure control has been applied to minimise the risk of patient identification.  

Counts 

National level data 

No disclosure control for small numbers.  

Breakdowns below national level 

The following steps have been applied to reduce the risk of identifying individuals from small numbers. 

1) If the national total is between 1 and 7 (inclusive), no sub-national breakdown will be displayed. 

2) If the national total is greater than or equal to 8 

• Sub-national counts between 1 and 7 (inclusive) will be displayed as ’*’.  

• For the under 18 and over 75 years age groups no sub national breakdowns have been included. 

• Zeroes will be unchanged. 

• All other counts will be rounded to the nearest 5. 

Percentages 

National level data 

No disclosure control required for small numerator or denominator.  

Breakdowns below national level 

The following should be applied when calculating percentages at sub-national level: 

1) Where the numerator or denominator is between 1 and 7 (inclusive), no percentage or rate is calculated, and a ’*’ will be displayed. 

2) Where the numerator is zero, the percentage will be 0%. 

3) Where the unrounded numerator and denominator are greater than or equal to 8, a percentage or rate is calculated using the rounded numerator or denominator. 

Numerators and denominators are the 2 numbers that make up a fraction. The numerator is the number that sits at the top. It represents how many equal parts of the whole are present. The denominator is the number at the bottom. It tells us how many equal parts the whole is divided into. 

Comments on this report would be welcomed. Any questions concerning any data in this publication, or requests for further information, should be addressed to:  

The Contact Centre, NHS Digital 7 and 8 Wellington Place, Leeds, West Yorkshire, LS1 4AP. 

Telephone: 0300 303 5678 

Email: [email protected]  
  
Press enquiries should be made to: 

Media Relations Manager 

Telephone: 0300 303 5678 

Email: [email protected]  
  

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Published by NHS Digital Part of the Government Statistical Service 

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