This is a report on admitted patient care activity in English NHS hospitals and English NHS-commissioned activity in the independent sector. This annual publication covers the financial year ending March 2020. It contains final data and replaces the provisional data that are released each month. The data are taken from the Hospital Episodes Statistics (HES) data warehouse. HES contains records of all admissions, appointments and attendances for patients at NHS hospitals in England. The HES data used in this publication are called 'Finished Consultant Episodes', and each episode relates to a period of care for a patient under a single consultant at a single hospital. Therefore this report counts the number of episodes of care for admitted patients rather than the number of patients. This publication shows the number of episodes during the period, with a number of breakdowns including by patient's age, gender, diagnosis, procedure involved and by provider. Hospital Adult Critical Care (ACC) data are now included within this report, following the discontinuation of the 'Hospital Adult Critical Care Activity' publication. The ACC data tables are not a designated National Statistic and they remain separate from the APC data tables. The ACC data used in this publication draws on records submitted by providers as an attachment to the admitted patient care record. These data show the number of adult critical care records during the period, with a number of breakdowns including admission details, discharge details, patient demographics and clinical information. The purpose of this publication is to inform and support strategic and policy-led processes for the benefit of patient care. This document will also be of interest to researchers, journalists and members of the public interested in NHS hospital activity in England. Supplementary analysis has been produced, by NHS Digital, containing experimental statistics using the Paediatric Critical Care Minimum Data Set (PCCMDS) data, collected by NHS Digital, against activity published in NHS Reference Costs. This analysis seeks to assist users of the data in understanding the data quality of reported paediatric critical care data. Also included within this release, is supplementary analysis that has been produced in addition to the Retrospective Review of Surgery for Urogynaecological Prolapse and Stress Urinary Incontinence using Tape or Mesh: Hospital Episode Statistics (HES), Experimental Statistics, April 2008 - March 2017. It contains a count of Finished Consultant Episodes (FCEs) where a procedure for urogynaecological prolapse or stress urinary incontinence using tape or mesh has been recorded during the April 2019 to March 2020 period.

This guide is to be used across NHS England FHIR Release 4 Application Programming Interfaces (APIs) when implementing Medicines.

This report shows monthly numbers of NHS Hospital and Community Health Services (HCHS) staff working in NHS Trusts and CCGs in England (excluding primary care staff). Data are available as headcount and full-time equivalents and for all months from 30 September 2009 onwards. These data are an accurate summary of the validated data extracted from the NHS HR and Payroll system. Additional statistics on staff in NHS Trusts and CCGs and information for NHS Support Organisations and Central Bodies are published each: September (showing June statistics) December/January (showing September statistics) March (showing December statistics) June (showing March statistics) Quarterly NHS Staff Earnings, monthly NHS Staff Sickness Absence reports, and data relating to the General Practice workforce and the Independent Healthcare Provider workforce are also available via the Related Links below. Following feedback from data users, there is a change to the HCHS doctor grades of 'Associate Specialist' and 'Specialty Doctor' in relevant tables in this release. Two new specialty doctor and specialist grades were introduced in April 2021 and both were reported in NHS Digital tables within the 'Specialty Doctor' grade. However, the new specialist grade is more appropriately classified within the 'Associate Specialist' category. Therefore, from March 2022 these are included within the 'Associate Specialist' category and have been removed from the 'Specialty Doctor' category. The March 2022 data in this publication reflects this new approach, and the time series back to April 2021 has also been revised in relevant tables. An issue has been identified with the provisional data for April 2022, whereby records for a few thousand staff have not been joined correctly in the ESR database. This does not appear to be having a noticeable effect on the data presented in this publication. Further information will be included in the full April 2022 publication, if the issue is not resolved. We welcome feedback on the methodology and tables within this publication. Please email us with your comments and suggestions, clearly stating Monthly HCHS Workforce as the subject heading, via enquiries@nhsdigital.nhs.uk or 0300 303 5678.

The DID is a monthly collection of information about diagnostic imaging tests carried out on NHS patients in England which enables analysis of demographic and geographic variation in access to different test types and providers. The dataset, collected at patient level, includes patient identifiers to enable linkage to other datasets, most notably cancer registration data. Information from the DID may inform the accreditation processes for imaging departments through the UK Imaging Services Accreditation Scheme and the assessment of imaging services by the Care Quality Commission. The dataset provides information on the utilisation of high value imaging equipment such as MRI scanners. Information about diagnostic testing is being linked to cancer patient’s records held in Cancer Registries, expanding the understanding we have of their treatment pathway. Further information can be found on the NHS Digital DID website. Release Date - Aggregated data at Trust level is published the last Thursday of the month by NHS England on the DID webpage iView - DID data is available to the DID user community and the DHSC via Community View in iView. This data resource has been designed for professionals working with health and social care data on a regular basis. Access to iView can be requested by contacting NHS Digital on 0300 303 5678 or enquiries@nhsdigital.nhs.uk

Context

Mental Health Services Monthly Statistics

This publication provides the most timely picture available of people using NHS funded secondary mental health, learning disabilities and autism services in England. These are experimental statistics which are undergoing development and evaluation. This information will be of use to people needing access to information quickly for operational decision making and other purposes. More detailed information on the quality and completeness of these statistics is made available later in our Mental Health Bulletin: Annual Report publication series.

• COVID-19 and the production of statistics

Due to the coronavirus illness (COVID-19) disruption, it would seem that this is now starting to affect the quality and coverage of some of our statistics, such as an increase in non-submissions for some datasets. We are also starting to see some different patterns in the submitted data. For example, fewer patients are being referred to hospital and more appointments being carried out via phone/telemedicine/email. Therefore, data should be interpreted with care over the COVID-19 period.

Content

Time period covered Feb 1, 2020 - April 31, 2020

Area covered England

Acknowledgements

reference: Mental Health Services Monthly Statistics

Author: Community and Mental Health Team, NHS Digital
Responsible Statistician: Tom Poupart, Principal Information Analyst
Public Enquiries: Telephone: 0300 303 5678
Email: enquiries@nhsdigital.nhs.uk
Press enquiries should be made to: Media Relations Manager: Telephone: 0300 303 3888

Published by NHS Digital part of the Government Statistical Service Copyright © 2020 Health and Social Care Information Centre. The Health and Social Care Information Centre is a non-departmental body created by statute, also known as NHS Digital.

You may re-use this document/publication (not including logos) free of charge in any format or medium, under the terms of the Open Government Licence v3.0.
To view this licence visit To view this licence visit www.nationalarchives.gov.uk/doc/open-government-licence www.nationalarchives.gov.uk/doc/open-government-licence or write to the Information Policy Team, The National Archives, or write to the Information Policy Team, The National Archives, Kew, Richmond, Surrey, TW9 4DU Kew, Richmond, Surrey, TW9 4DU; or email: psi@nationalarchives.gsi.gov.uk or email: psi@nationalarchives.gsi.gov.uk

Cover by-

Inspiration

This dataset is to solve the challenge- UNCOVER COVID-19 Challenge, United Network for COVID Data Exploration and Research. This data is scraped in hopes of solving the task - Mental health impact and support services.

Task Details Can we predict changes in demand for mental health services and how can we ensure access? (by region, social/economic/demographic factors, etc). Are there signs of shifts in mental health challenges across demographies, whether improvements or declines, as a result of COVID-19 and the various measures implement to contain the pandemic?

Publication changes: Please read the section on 'Notes on changes to publications' within the PDF report as this highlights changes to data currently published and potentially the frequency of future reports. This report shows monthly numbers of NHS Hospital and Community Health Service (HCHS) staff groups working in Trusts and CCGs in England (excluding primary care staff). Data is available as headcount and full-time equivalents. This data is an accurate summary of the validated data extracted from the NHS's HR and Payroll system. In addition to the regular monthly reports there are a series of quarterly reports (first published on 26 July 2016 looking at the data for March 2016) which include statistics on staff in Trusts and CCGs and information for NHS Support Organisations and Central Bodies. The quarterly analysis will be published each; September (showing June statistics) December (showing September statistics) March (showing December statistics) June (showing March statistics). Due to their size CSV data are only available for each respective month however data from September 2009 to March 2016 are all available within the March 2016 web page. This is accessible from the 'previous versions of the publication' link within the 'Related Links' section below. Additional healthcare workforce data relating to GPs and Independent Sector workforce are also available; links to this data are available below. We welcome feedback on the methodology and tables within this publication. Please email us with your comments and suggestions, clearly stating Monthly HCHS Workforce as the subject heading, via enquiries@nhsdigital.nhs.uk or 0300 303 5678

A provisional view of GPs by type working in General Practice .

The general practice data records numbers and details of GPs in England. Time series data is available within the excel tables together with more detailed information for December 2016 data for England, by NHS England Regions, NHS England Region Local Offices, Clinical Commissioning Groups and practice.

This report is one of several publications presenting details of staff numbers within the NHS workforce. Links to these publications are at the bottom of the page.

Note: This publication only includes information on GPs, other practice staff groups including Nurses are not included.

Given the classification of ‘Provisional Experimental statistics’ NHS Digital invited comments and feedback on the methodology applied which were reviewed over the summer and incorporated in revisions as part of this publication. Feedback is welcomed via email.

Please email us with your comments and suggestions, clearly stating NHS Workforce as the subject heading, via enquiries@nhsdigital.nhs.uk or 0300 303 5678.

For more details see: http://www.content.digital.nhs.uk/article/2021/Website-Search?productid=...

Context

Deaths occurring in hospital and after discharge between 0 and 29 days (inclusive) of an emergency admission to hospital with a stroke. This indicator is available for males, females and persons at the following breakdowns: England/Region of residence/Local authority of residence/County of residence/London authority of residence/Provider

https://digital.nhs.uk/data-and-information/publications/clinical-indicators/compendium-of-population-health-indicators/compendium-hospital-care/current/deaths-within-30-days/deaths-within-30-days-of-emergency-admission-to-hospital-stroke-indirectly-standardised-rate-all-ages-annual-trend-f-m-p#

General Enquiries: enquiries@nhsdigital.nhs.uk

Freedom of Information (FOI) requests : FOI Enquiries enquiries@nhsdigital.nhs.uk https://digital.nhs.uk/about-nhs-digital/contact-us/freedom-of-information

Content

Some people with stroke die before they can be admitted to hospital. There are variations in death rates among those who survive long enough to be admitted, and some of these deaths may potentially be preventable. The National Service Framework for older people cites evidence that people who have strokes are more likely to survive if admitted promptly to a hospital-based stroke unit with treatment and care provided by a specialist coordinated stroke team within an integrated service. The National Health Service (NHS) may be helped to prevent some of these deaths by seeing comparative figures and learning lessons from follow-up investigations.

Legacy unique identifier: P02167

Acknowledgements

digital.nhs.uk

Photo by K. Mitch Hodge on Unsplash

Inspiration

Stroke cases among Covid-19 patients outside the risk group that puzzle American doctors. Studies attempt to unravel the relationship between strokes and younger people infected with coronavirus

Coronavirus (COVID-19) has led to increased demand on general practices, including an increasing number of requests to provide patient data to inform planning and support vital research on the cause, effects, treatments and outcomes for patients of the virus. To support the response to the coronavirus outbreak, NHS Digital has been legally directed to collect and analyse healthcare information about patients, including from their GP record, for the duration of the coronavirus emergency period, under the COVID-19 Public Health Directions 2020 (COVID-19 Direction). All GP practices in England are legally required to share data with NHS Digital for this purpose under the Health and Social Care Act 2012. More information about this requirement is contained in the Data Provision Notice issued by NHS Digital to GP practices.

This collection will reduce burden on general practices, allowing them to focus on patient care and support the coronavirus response.

Timescales for dissemination of agreed data can be found under 'Our Service Levels' at the following link: https://digital.nhs.uk/services/data-access-request-service-dars/data-access-request-service-dars-process

Data forming the COVID-19 SARI-Watch data set relate to demographic, risk factor, treatment, and outcome information for patients admitted to hospital with a confirmed COVID-19 diagnosis, as recorded in the PHE COVID-19 SARI-Watch Surveillance System.

SARI-Watch data are to be collected for the purposes of direct care, service monitoring, planning and research in response to the spread of COVID-19, including for the following purposes identified in the COVID-19 Directions (see below): •understanding information about patient access to health services and adult social care services as a direct or indirect result of COVID-19 and the availability and capacity of those services •monitoring and managing the response to COVID-19 by health and social care bodies and the Government, including providing information to the public about COVID-19 and its effectiveness, and information about capacity, medicines, equipment, supplies, services and the workforce within the health services and adult social care services •research and planning in relation to COVID-19, such as providing COVID-19 diagnosis.

Timescales for dissemination can be found under 'Our Service Levels' at the following link: https://digital.nhs.uk/services/data-access-request-service-dars/data-access-request-service-dars-process Standard wording

NHS Digital will only disseminate SARI-Watch data collected from PHE where the information is linked to other information controlled by NHS Digital.

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 SUS data set. SUS data covers all NHS Clinical Commissioning Groups (CCGs) in England including: 1. private patients treated in NHS hospitals 2. patients resident outside of England 3. care delivered by treatment centres (including those in the independent sector) funded by the NHS

Each SUS record contains a wide range of information about an individual patient admitted to an NHS hospital including: 1. clinical information about diagnoses and operations 2. patient information such as age group gender and ethnicity 3. administrative information such as dates and methods of admission and discharge 4. geographical information such as where patients are treated and the area where they live

NHS Digital apply a strict statistical disclosure control in accordance with the NHS Digital protocol to all published SUS data. This suppresses small numbers to stop people identifying themselves and others to ensure that patient confidentiality is maintained.

Who SUS is for SUS provides data for the purpose of healthcare analysis to the NHS government and others including:

The Secondary Users Service (SUS) database is made up of many data items relating to A&E care delivered by NHS hospitals in England. Many of these items form part of the national Commissioning Data Set (CDS) and are generated by the patient administration systems within each hospital. 1. national bodies and regulators such as the Department of Health NHS England Public Health England NHS Improvement and the CQC 2. local Clinical Commissioning Groups (CCGs) 3. provider organisations 4. government departments 5. researchers and commercial healthcare bodies 6. National Institute for Clinical Excellence (NICE) 7. patients service users and carers 8. the media

Uses of the statistics The statistics are known to be used for: 1. national policy making 2. benchmarking performance against other hospital providers or CCGs 3. academic research 4. analysing service usage and planning change 5. providing advice to ministers and answering a wide range of parliamentary questions 6. national and local press articles 7. international comparison

PHE supply cancer registration data to NHS Digital. For linkage with other NHS Digital data to provide notifications on cancer status, be available to support research studies and to identify potential research participants for clinical trials.

Hospital Episode Statistics (HES) is a database containing details of all admissions, A and E 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 data covers all NHS Clinical Commissioning Groups (CCGs) in England, including:

• private patients treated in NHS hospitals
• 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

We apply a strict statistical disclosure control in accordance with the NHS Digital protocol, to all published HES data. This suppresses small numbers to stop people identifying themselves and others, to ensure that patient confidentiality is maintained.

Timescales for dissemination can be found under 'Our Service Levels' at the following link: https://digital.nhs.uk/services/data-access-request-service-dars/data-access-request-service-dars-process

• to provide annual data about the nation’s health;
• to estimate the proportion of people in England with specified health conditions;
• to estimate the prevalence of certain risk factors associated with these conditions;
• to examine differences between population subgroups in their likelihood of having specific conditions or risk factors;
• to assess the frequency with which particular combinations of risk factors are found, and which groups these combinations most commonly occur;
• to monitor progress towards selected health targets
• since 1995, to measure the height of children at different ages, replacing the National Study of Health and Growth;
• since 1995, monitor the prevalence of overweight and obesity in children.

The survey includes a number of core questions every year but also focuses on different health issues at each wave. Topics are revisited at appropriate intervals in order to monitor change.

Further information about the series may be found on the NHS Digital Health Survey for England; health, social care and lifestyles webpage, the NatCen Social Research NatCen Health Survey for England webpage and the University College London Health and Social Surveys Research Group UCL Health Survey for England webpage.

Changes to the HSE from 2015:
Users should note that from 2015 survey onwards, only the individual data file is available under standard End User Licence (EUL). The household data file is now only included in the Special Licence (SL) version, released from 2015 onwards. In addition, the SL individual file contains all the variables included in the HSE EUL dataset, plus others, including variables removed from the EUL version after the NHS Digital disclosure review. The SL HSE is subject to more restrictive access conditions than the EUL version (see Access information). Users are advised to obtain the EUL version to see if it meets their needs before considering an application for the SL version.

COVID-19 and the HSE:
Due to the COVID-19 pandemic, the HSE 2020 survey was stopped in March 2020 and never re-started. There was no publication that year. The survey resumed in 2021, albeit with an amended methodology. The full HSE resumed in 2022, with an extended fieldwork period. Due to this, the decision was taken not to progress with the 2023 survey, to maximise the 2022 survey response and enable more robust reporting of data. See the NHS Digital Health Survey for England - Health, social care and lifestyles webpage for more details.

For the fourth edition (April 2010), three new children's Body Mass Index (BMI) variables have been added to the general population and ethnic boost data files (bmicat1, bmicat2, bmicat3). Further information is available in the documentation and on the Information Centre for Health and Social Care Health Survey for England web page.

SUMMARYTo be viewed in combination with the ‘Levels of obesity, inactivity and associated illnesses: Summary (England)’ dataset.This dataset shows where there was no data* relating to one of more of the following factors:Obesity/inactivity-related illnesses (recorded at the GP practice catchment area level*)Adult obesity (recorded at the GP practice catchment area level*)Inactivity in children (recorded at the district level)Excess weight in children (recorded at the Middle Layer Super Output Area level)* GPs do not have catchments that are mutually exclusive from each other: they overlap, with some geographic areas being covered by 30+ practices.GP data for the financial year 1st April 2018 – 31st March 2019 was used in preference to data for the financial year 1st April 2019 – 31st March 2020, as the onset of the COVID19 pandemic during the latter year could have affected the reporting of medical statistics by GPs. However, for 53 GPs (out of 7670) that did not submit data in 2018/19, data from 2019/20 was used instead. This dataset identifies areas where data from 2019/20 was used, where one or more GPs did not submit data in either year (this could be because there are rural areas that aren’t officially covered by any GP practices), or where there were large discrepancies between the 2018/19 and 2019/20 data (differences in statistics that were > mean +/- 1 St.Dev.), which suggests erroneous data in one of those years (it was not feasible for this study to investigate this further), and thus where data should be interpreted with caution.Results of the ‘Levels of obesity, inactivity and associated illnesses: Summary (England)’ analysis in these areas should be interpreted with caution, particularly if the levels of obesity, inactivity and associated illnesses appear to be significantly lower than in their immediate surrounding areas.Really small areas with ‘missing’ data were deleted, where it was deemed that missing data will not have impacted the overall analysis (i.e. where GP data was missing from really small countryside areas where no people live).See also Health and wellbeing statistics (GP-level, England): Missing data and potential outliers dataDATA SOURCESThis dataset was produced using:- Quality and Outcomes Framework data: Copyright © 2020, Health and Social Care Information Centre. The Health and Social Care Information Centre is a non-departmental body created by statute, also known as NHS Digital.- National Child Measurement Programme: Copyright © 2020, Health and Social Care Information Centre. The Health and Social Care Information Centre is a non-departmental body created by statute, also known as NHS Digital. - Active Lives Survey 2019: Sport and Physical Activity Levels amongst children and young people in school years 1-11 (aged 5-16). © Sport England 2020.- Active Lives Survey 2019: Sport and Physical Activity Levels amongst adults aged 16+. © Sport England 2020.- GP Catchment Outlines. Copyright © 2020, Health and Social Care Information Centre. The Health and Social Care Information Centre is a non-departmental body created by statute, also known as NHS Digital. Data was cleaned by Ribble Rivers Trust before use.- Administrative boundaries: Boundary-LineTM: Contains Ordnance Survey data © Crown copyright and database right 2021. Contains public sector information licensed under the Open Government Licence v3.0.- MSOA boundaries: © Office for National Statistics licensed under the Open Government Licence v3.0. Contains OS data © Crown copyright and database right 2021.COPYRIGHT NOTICEThe reproduction of this data must be accompanied by the following statement:© Ribble Rivers Trust 2021. Analysis carried out using data that is: Copyright © 2020, Health and Social Care Information Centre. The Health and Social Care Information Centre is a non-departmental body created by statute, also known as NHS Digital; © Sport England 2020; © Office for National Statistics licensed under the Open Government Licence v3.0. Contains Ordnance Survey data © Crown copyright and database right 2021. Contains public sector information licensed under the Open Government Licence v3.0.CaBA HEALTH & WELLBEING EVIDENCE BASEThis dataset forms part of the wider CaBA Health and Wellbeing Evidence Base.

Prescription Cost Analysis (PCA) provides details of the number of items and the net ingredient cost of all prescriptions dispensed in the community in England. The drugs dispensed are listed by British National Formulary (BNF) therapeutic class.