This publication looks at Accident and Emergency activity in England for the financial year 2023-24. It describes NHS accident and emergency activity and performance in hospitals in England. The data sources for this publication are the Emergency Care Data Set (ECDS) and Emergency Admissions Monthly Situation Reports (MSitAE) relating to A&E attendances in NHS hospitals, minor injury units and walk-in centres. The report includes analysis by patient demographics, time spent in A&E, distributions by time of arrival and day of week, arriving by ambulance, performance times, waits for admission and reattendances to A&E within 7 days. The purpose of this publication is to inform and support strategic and policy-led processes for the benefit of patient care and may also be of interest to researchers, journalists and members of the public interested in NHS hospital activity in England. Note: the MSitAE figures presented in the 'MSitAE Report Tables' file account for revisions to historic data and may therefore differ slightly from those shown in the 'Quality Indicators (CQI) Open Data' file, which is based on data published at fixed points in the year. The MSitAE data referenced throughout this report are published monthly by NHS England on the separate 'NHS England MSitAE Home Page', as linked to in the Related Links section below. This publication includes the total number of attendances for all A&E types, including Urgent Treatment Centres, Minor Injury Units and Walk-in Centres, and of these, the number discharged, admitted or transferred within four hours of arrival. Also included are the number of Emergency Admissions, and any waits of over four hours for admission following decision to admit. Contact details Author: Secondary Care Open Data and Publications; Activity Capacity & Planning, NHS England Responsible Statistician: Karl Eichler Email: enquiries@nhsdigital.nhs.uk Press enquiries should be made to: Media Relations Manager: telephone 0300 303 3888

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: • 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 SUS 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 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. • national bodies and regulators, such as the Department of Health, NHS England, Public Health England, NHS Improvement and the CQC • local Clinical Commissioning Groups (CCGs) • provider organisations • government departments • researchers and commercial healthcare bodies • National Institute for Clinical Excellence (NICE) • patients, service users and carers • the media

Uses of the statistics The statistics are known to be used for: • national policy making • benchmarking performance against other hospital providers or CCGs
• academic research • analysing service usage and planning change • providing advice to ministers and answering a wide range of parliamentary questions • national and local press articles • international comparison More information can be found at https://digital.nhs.uk/data-and-information/data-tools-and-services/data-services/hospital-episode-statistics https://digital.nhs.uk/data-and-information/publications/statistical/hospital-accident--emergency-activity"

Abstract copyright UK Data Service and data collection copyright owner.The National Patient Survey Programme is one of the largest patient survey programmes in the world. It provides an opportunity to monitor experiences of health and provides data to assist with registration of trusts and monitoring on-going compliance. Understanding what people think about the care and treatment they receive is crucial to improving the quality of care being delivered by healthcare organisations. One way of doing this is by asking people who have recently used the health service to tell the Care Quality Commission (CQC) about their experiences. The CQC will use the results from the surveys in the regulation, monitoring and inspection of NHS acute trusts (or, for community mental health service user surveys, providers of mental health services) in England. Data are used in CQC Insight, an intelligence tool which identifies potential changes in quality of care and then supports deciding on the right regulatory response. Survey data will also be used to support CQC inspections. Each survey has a different focus. These include patients' experiences in outpatient and accident and emergency departments in Acute Trusts, and the experiences of people using mental health services in the community. History of the programme The National Patient Survey Programme began in 2002, and was then conducted by the Commission for Health Improvement (CHI), along with the Commission for Healthcare Audit and Inspection (CHAI). Administration of the programme was taken over by the Healthcare Commission in time for the 2004 series. On 1 April 2009, the CQC was formed, which replaced the Healthcare Commission. Further information about the National Patient Survey Programme may be found on the CQC Patient Survey Programme web pages. The Emergency Department Survey, 2016 is the sixth iteration in a series of surveys focusing on patient experiences of emergency services. This survey involved 137 acute and specialist NHS trusts with a Type 1 accident and emergency department (major, consultant led Accident and Emergency Department with full resuscitation facilities operating 24 hours a day, 7 days a week). 49 of these trusts also had direct responsibility for running a Type 3 department (Accident and Emergency /minor injury unit with designated accommodation for the reception of accident and emergency patients) and patients from these departments were included within the survey for the first time in 2016. Responses were received from 45,597people. Further information is available on the CQC Emergency Department Survey 2016 and NHS Surveys webpages. Although surveys of Emergency Departments have been carried out previously (in 2003 (SN 5092) 2004/5 (SN 5092) 2008 (SN 6329) 2012 (SN 7406) and 2014 (SN 8138)) results from the 2016 survey are not comparable with these because of changes made to the sampling and analysis strategy. For more information please see Statistical Release and Quality and Methodology reports. Main Topics: The survey covers issues that affect the quality of care that patients receive and were identified by patients as important to them. Topics covered included: arriving at the Emergency Department, waiting, doctors and nurses, care and treatment, tests, pain, hospital environment and facilities and discharge. Multi-stage stratified random sample The sampling methodology used in ED16 was different from that used in previous iterations of the survey, and included a number of steps, more detailed information on this can be found in the documentation.

In April 2011 a new set of clinical quality indicators was introduced to replace the previous four hour waiting time standard, and measure the quality of care delivered in A&E departments in England. Further details on the background and management of the quality indicators are available from the Department of Health (DH) website. This is the ninth publication of data on the Accident and Emergency (A&E) clinical quality indicators, drawn from A&E data within provisional Hospital Episode Statistics (HES). These data relate to A&E attendances in December 2011 and draw on 1.36 million detailed records of attendances at major A&E departments, single speciality A&E departments (e.g. dental A&Es), minor injury units and walk-in centres in England. This report sets out data coverage, data quality and performance information for the following five A&E indicators: Left department before being seen for treatment rate Re-attendance rate Time to initial assessment Time to treatment Total time in A&E Publishing these data will help share information on the quality of care of A&E services to stimulate the discussion and debate between patients, clinicians, providers and commissioners, which is needed in a culture of continuous improvement. These A&E HES data are published as experimental statistics to note the shortfalls in the quality and coverage of records submitted via the A&E commissioning data set. The data used in these reports are sourced from Provisional A&E HES data, and as such these data may differ to information extracted directly from Secondary Uses Service (SUS) data, or data extracted directly from local patient administration systems. Provisional HES data may be revised throughout the year (for example, activity data for April 2011 may differ depending on whether they are extracted in August 2011, or later in the year). Indicator data published for earlier months have not been revised using updated HES data extracted in subsequent months. The data presented here represent the output of the existing A&E Commissioning Dataset (CDS V6 Type 010). It must be recognised that these data will not exactly match the data definitions for the A&E clinical quality indicators set out in the guidance document A&E clinical quality indicators: Implementation guidance and data definitions (external link). The DH is currently working with Information Standards Board to amend the existing CDS Type 10 Accident and Emergency to collect the data required to monitor the A&E indicators. A&E HES data are collected and published by the NHS Information Centre for Health and Social Care. The data in this report are secondary analyses of HES data produced by the Urgent & Emergency Care team, Department of Health. A&E HES data are published as experimental statistics to note the known shortfalls in the quality of some A&E HES data elements. The published information sets out where data quality for the indicators may be improved by, for example, reducing the number of unknown values (e.g. unknown times to initial assessment) and default values (e.g. the number of attendances that are automatically given a time to initial assessment of midnight 00:00). The quality and coverage of A&E HES data have considerably improved over the years, and the Department and the NHS Information Centre are working with NHS Performance and Information directors to further improve the data. Note: This information is secondary analysis of HES data that have been produced by the Urgent & Emergency Care team in the Department of Health. Questions should be forward to the mailbox of the Urgent & Emergency Care team at the Department of Health urgent&emergencycare@dh.gsi.gov.uk . Revisions Policy: Please note, Provisional HES data may be revised throughout the year (for example data will differ depending on the time at which they were extracted). Indicator data published for earlier months will not be revised using updated HES data extracted in subsequent months.

The National Child Development Study (NCDS) is a continuing longitudinal study that seeks to follow the lives of all those living in Great Britain who were born in one particular week in 1958. The aim of the study is to improve understanding of the factors affecting human development over the whole lifespan.

The NCDS has its origins in the Perinatal Mortality Survey (PMS) (the original PMS study is held at the UK Data Archive under SN 2137). This study was sponsored by the National Birthday Trust Fund and designed to examine the social and obstetric factors associated with stillbirth and death in early infancy among the 17,000 children born in England, Scotland and Wales in that one week. Selected data from the PMS form NCDS sweep 0, held alongside NCDS sweeps 1-3, under SN 5565.

Survey and Biomeasures Data (GN 33004):
To date there have been nine attempts to trace all members of the birth cohort in order to monitor their physical, educational and social development. The first three sweeps were carried out by the National Children's Bureau, in 1965, when respondents were aged 7, in 1969, aged 11, and in 1974, aged 16 (these sweeps form NCDS1-3, held together with NCDS0 under SN 5565). The fourth sweep, also carried out by the National Children's Bureau, was conducted in 1981, when respondents were aged 23 (held under SN 5566). In 1985 the NCDS moved to the Social Statistics Research Unit (SSRU) - now known as the Centre for Longitudinal Studies (CLS). The fifth sweep was carried out in 1991, when respondents were aged 33 (held under SN 5567). For the sixth sweep, conducted in 1999-2000, when respondents were aged 42 (NCDS6, held under SN 5578), fieldwork was combined with the 1999-2000 wave of the 1970 Birth Cohort Study (BCS70), which was also conducted by CLS (and held under GN 33229). The seventh sweep was conducted in 2004-2005 when the respondents were aged 46 (held under SN 5579), the eighth sweep was conducted in 2008-2009 when respondents were aged 50 (held under SN 6137) and the ninth sweep was conducted in 2013 when respondents were aged 55 (held under SN 7669).

Four separate datasets covering responses to NCDS over all sweeps are available. National Child Development Deaths Dataset: Special Licence Access (SN 7717) covers deaths; National Child Development Study Response and Outcomes Dataset (SN 5560) covers all other responses and outcomes; National Child Development Study: Partnership Histories (SN 6940) includes data on live-in relationships; and National Child Development Study: Activity Histories (SN 6942) covers work and non-work activities. Users are advised to order these studies alongside the other waves of NCDS.

From 2002-2004, a Biomedical Survey was completed and is available under End User Licence (EUL) (SN 8731) and Special Licence (SL) (SN 5594). Proteomics analyses of blood samples are available under SL SN 9254.

Linked Geographical Data (GN 33497):
A number of geographical variables are available, under more restrictive access conditions, which can be linked to the NCDS EUL and SL access studies.

Linked Administrative Data (GN 33396):
A number of linked administrative datasets are available, under more restrictive access conditions, which can be linked to the NCDS EUL and SL access studies. These include a Deaths dataset (SN 7717) available under SL and the Linked Health Administrative Datasets (SN 8697) available under Secure Access.

Additional Sub-Studies (GN 33562):
In addition to the main NCDS sweeps, further studies have also been conducted on a range of subjects such as parent migration, unemployment, behavioural studies and respondent essays. The full list of NCDS studies available from the UK Data Service can be found on the NCDS series access data webpage.

How to access genetic and/or bio-medical sample data from a range of longitudinal surveys:
For information on how to access biomedical data from NCDS that are not held at the UKDS, see the CLS Genetic data and biological samples webpage.

Further information about the full NCDS series can be found on the Centre for Longitudinal Studies website.

The National Child Development Study: Linked Health Administrative Datasets (Hospital Episode Statistics), England, 1997-2017: Secure Access includes data files from the NHS Digital HES database for those cohort members who provided consent to health data linkage in the Age 50 sweep. The HES database contains information about all hospital admissions in England. The following linked HES data are available:

1) Accident and Emergency (A&E)
The A&E dataset details each attendance to an Accident and Emergency care facility in England, between 01-04-2007 and 31-03-2017 (inclusive). It includes major A&E departments, single speciality A&E departments, minor injury units and walk-in centres in England.

2) Admitted Patient Care (APC)
The APC data summarises episodes of care for admitted patients, where the episode occurred between 01-04-1997 and 31-03-2017 (inclusive).

3) Critical Care (CC)
The CC dataset covers records of critical care activity between 01-04-2009 and 31-03-2017 (inclusive).

4) Out Patient (OP)
The OP dataset lists the outpatient appointments between 01-04-2003 and 31-03-2017 (inclusive).

CLS/ NHS Digital Sub-licence agreement
NHS Digital has given CLS permission for onward sharing of the Next Steps/HES dataset via the UKDS Secure Lab. In order to ensure data minimisation, NHS Digital requires that researchers only access the HES variables needed for their approved research project. Therefore, the HES linked data provided by the UKDS to approved researchers will be subject to sub-setting of variables. The researcher will need to request a specific sub-set of variables from the Next Steps HES data dictionary, which will subsequently make available within their UKDS Secure Account. Once the researcher has finished their research, the UKDS will delete the tailored dataset for that specific project. Any party wishing to access the data deposited at the UK Data Service will be required to enter into a Licence agreement with CLS (UCL), in addition to the agreements signed with the UKDS, provided in the application pack.

Latest edition information
For the second edition (September 2022), 7 previously unavailable variables have been added to the A&E, APC and OP data files. The User Guide has also been updated, along with the variable list, to reflect the changes.

The Emergency Care Data Set (ECDS) is the national data set for urgent and emergency care. ECDS supports the care provided in emergency departments by including the data items needed to understand capacity and demand and help improve patient care.

Forecast: Number of Practising Physicians in Accident and Emergency Medicine in the UK 2024 - 2028 Discover more data with ReportLinker!

Provisional Accident and Emergency Quality Indicators for England uses data submitted to the Emergency Care Data Set (ECDS) to compare England and providers in terms of the care quality indicators for Emergency Departments. The measures included in this publication report on data coverage in ECDS compared with the emergency monthly situation reports MSitAE published by NHS England and NHS Improvement. They also report statistics for total time in A&E, time to assessment, time to treatment, A&E attendances that left before treatment and unplanned reattendances within 7 days. Each report contains national figures and provider level figures. From the January 2023 release, the format of the publication was updated to open data format following a review and consultation. We are continuing to improve publications, please let us know if you have any feedback using the survey link below.

Background

The large volume of patients, rapid staff turnover and high work pressure means that the usability of all systems within the Emergency Department (ED) is important. The transition to electronic health records (EHRs) has brought many benefits to emergency care but imposes a significant burden on staff to enter data. Poor usability has a direct consequence and opportunity cost in staff time and resources that could otherwise be employed in patient care. This research measures the usability of EHR systems in UK EDs using a validated assessment tool.

Methods

This was a survey completed by members and fellows of the Royal College of Emergency Medicine conducted during summer 2019. The primary outcome was the System Usability Scale score, which ranges from 0 (worst) to 100 (best). Scores were compared to an internationally recognised measure of acceptable usability of 68. Results were analysed by EHR system, country, healthcare organisation and physician grade. Only EHR systems with at least 20 responses were analysed.

Results

There were 1,647 responses from a total population of 8,794 (19%) representing 192 healthcare organisations (mainly UK National Health Service), and 25 EHR systems. Fifteen EHR systems had at least 20 responses and were included in the analysis. No EHR system achieved a median usability score that met the industry standard of acceptable usability.

The median usability score was 53 (interquartile range [IQR] 35 – 68). Individual EHR systems' scores ranged from 35 (IQR 26 to 53) to 65 (IQR 44 to 80).

Conclusion

In this survey, no UK ED EHR system met the internationally validated standard of acceptable usability for information technology. Better usability of emergency department EHRs is a cheap and effective way of increasing staff productivity.

Objective: to investigate factors associated with unscheduled admission following presentation to Emergency Departments (EDs) at three hospitals in England. Design and setting: cross-sectional analysis of attendance data for patients from three urban EDs in England: a large teaching hospital and major trauma centre (Site 1), and two district general hospitals (Sites 2 and 3). Variables included: patient age, gender, ethnicity, deprivation score, arrival date and time, arrival by ambulance or otherwise, a variety of ED workload measures, inpatient bed occupancy rates and admission outcome. Coding inconsistencies in routine ED data used for this study meant that diagnosis could not be included. Outcome measure: The primary outcome for the study was unscheduled admission. Participants: all adults aged 16 and over attending the three inner London EDs in December 2013. Data on 19,734 unique patient attendances were gathered. Results: outcome data were available for 19,721 attendances (>99%), of whom 6,263 (32%) were admitted to hospital. Site 1 was set as the baseline site for analysis of admission risk. Risk of admission was significantly greater at Sites 2 and 3 (AOR relative to Site 1 for Site 2 was 1.89, 95% CI 1.74-2.05, p<0.001), and for patients of black or black British ethnicity (1.29, 1.16-1.44, p<0.001). Deprivation was strongly associated with admission. Analysis of departmental and hospital-wide workload pressures gave conflicting results, but proximity to the "four-hour target" (a rule that limits patient stays in EDs to four hours in the NHS in England) emerged as a strong driver for admission in this analysis (3.61, 3.30-3.95, p<0.001). Conclusion: this study found statistically significant variations in odds of admission between hospital sites when adjusting for various patient demographic and presentation factors, suggesting important variations in ED- and clinician-level behaviour relating to admission decisions. The four-hour target is a strong driver for emergency admission.

● Region.

Patient experience measured by scoring the results of a selection of questions from the National Accident and Emergency (A&E) Department Survey.

Purpose

This indicator aims to capture the experience of patients who have used A&E services.

Current version updated: Feb-15

Next version due: Aug-17

In April 2011 a new set of clinical quality indicators was introduced to replace the previous four hour waiting time standard, and measure the quality of care delivered in A&E departments in England. Further details on the background and management of the quality indicators are available from the Department of Health (DH) website. This is the second publication of data on the Accident and Emergency (A&E) clinical quality indicators, drawn from A&E data within provisional Hospital Episode Statistics (HES). These data relate to A&E attendances in May 2011 and draw on just over 1.4 million detailed records of attendances at major A&E departments, single speciality A&E departments (e.g. dental A&Es), minor injury units and walk-in centres in England. This report sets out data coverage, data quality and performance information for the following 5 A&E indicators: Left department before being seen for treatment rate Re-attendance rate Time to initial assessment Time to treatment Total time in A&E Publishing these data will help share information on the quality of care of A&E services to stimulate the discussion and debate between patients, clinicians, providers and commissioners, which is needed in a culture of continuous improvement. These A&E HES data are published as experimental statistics to note the shortfalls in the quality and coverage of records submitted via the A&E commissioning data set. The data used in these reports are sourced from Provisional A&E HES data, and as such these data may differ to information extracted directly from Secondary Uses Service (SUS) data, or data extracted directly from local patient administration systems. Provisional HES data may be revised throughout the year (for example, activity data for April 2011 may differ depending on whether they are extracted in August 2011, or later in the year). Indicator data published for earlier months have not been revised using updated HES data extracted in subsequent months. The data presented here represent the output of the existing A&E Commissioning Dataset (CDS V6 Type 010). It must be recognised that these data will not exactly match the data definitions for the A&E clinical quality indicators set out in the guidance document A&E clinical quality indicators: Implementation guidance and data definitions (external link). The DH is currently working with Information Standards Board to amend the existing CDS Type 10 Accident and Emergency to collect the data required to monitor the A&E indicators. A&E HES data are collected and published by the NHS Information Centre for Health and Social Care. The data in this report are secondary analyses of HES data produced by the Urgent & Emergency Care team, Department of Health. A&E HES data are published as experimental statistics to note the known shortfalls in the quality of some A&E HES data elements. The published information sets out where data quality for the indicators may be improved by, for example, reducing the number of unknown values (e.g. unknown times to initial assessment) and default values (e.g. the number of attendances that are automatically given a time to initial assessment of midnight 00:00). The quality and coverage of A&E HES data have considerably improved over the years, and the Department and the NHS Information Centre are working with NHS Performance and Information directors to further improve the data.

Emergency hospital admission rates for all conditions and all ages. Data is available from Health and Social Care Information Centre Indicator Portal and Hospital episode statistics legacy website containing content from the London Health Observatory].

Indirectly age and sex standardised rates.

Abstract copyright UK Data Service and data collection copyright owner.

The National Patient Survey Programme is one of the largest patient survey programmes in the world. It provides an opportunity to monitor experiences of health and provides data to assist with registration of trusts and monitoring on-going compliance. Understanding what people think about the care and treatment they receive is crucial to improving the quality of care being delivered by healthcare organisations. One way of doing this is by asking people who have recently used the health service to tell the Care Quality Commission (CQC) about their experiences.

The CQC will use the results from the surveys in the regulation, monitoring and inspection of NHS acute trusts (or, for community mental health service user surveys, providers of mental health services) in England. Data are used in CQC Insight, an intelligence tool which identifies potential changes in quality of care and then supports deciding on the right regulatory response. Survey data will also be used to support CQC inspections.

Each survey has a different focus. These include patients' experiences in outpatient and accident and emergency departments in Acute Trusts, and the experiences of people using mental health services in the community.

History of the programme

The National Patient Survey Programme began in 2002, and was then conducted by the Commission for Health Improvement (CHI), along with the Commission for Healthcare Audit and Inspection (CHAI). Administration of the programme was taken over by the Healthcare Commission in time for the 2004 series. On 1 April 2009, the CQC was formed, which replaced the Healthcare Commission.

Further information about the National Patient Survey Programme may be found on the CQC Patient Survey Programme web pages.

The Inpatients Survey, 2013 covered issues that affect the quality of care that patients receive and were identified by patients as important to them. Topics include: admission; the hospital and ward; relationships with healthcare professionals; care and treatment; pain; operations and procedures; and discharge.

Main Topics:

The questionnaire covered: admission to hospital; the accident and emergency department; waiting list/planned admission circumstances and other admissions; the hospital and ward; doctors; nurses; care and treatment; operations and procedures; leaving hospital.

For anonymity and confidentiality reasons a number of variables have been removed or recoded: questions Q74-78 have been removed due to very low numbers at trust level for many sub groups; Q72 has been recoded to use information from the sample file where this was missing; and Q73 has been recoded to use information from the sample file where this was missing and grouped.

Users should note that approval for the 2013 survey was obtained under Section 251 of the NHS Act 2006. This approval allows the common law duty of confidentiality to be put aside in order to enable the processing of patient identifiable information without consent. The approval granted does not allow the Care Quality Commission to share any variables that have been removed from the dataset.

This test dataset consists of one table of variables collected in PRIEST dataset. The PRIEST (Pandemic Respiratory Infection Emergency System Triage) Study for Low and Middle-Income Countries (DP – PRIEST)

To ensure hospitals in low- and middle- income countries are not overwhelmed during the COVID-19 pandemic by developing a risk assessment tool for clinicians to quickly decide whether a patient needs emergency care or can be safely sent home.

Carl Marincowitz and colleagues at the University of Sheffield in the United Kingdom and the University of Cape Town in South Africa have developed a risk assessment tool to help emergency clinicians quickly decide whether a patient with suspected COVID-19 needs emergency care or can be safely treated at home to avoid overburdening hospitals particularly in low- and middle- income countries (LMICs). They have used existing data to which they have access on 50,000 patients with suspected COVID-19 infection who sought emergency care in the United Kingdom, South Africa, and Sudan to develop prediction models for specific COVID-19 related outcomes in all income settings. These prediction models have been used to develop risk stratification tools, which enable providers to identify the right level of care and services for distinct subgroups of patients. These have been developed with input from patient and clinical stakeholders. The team have tested the performance of their risk assessment tools for identifying high-risk patients with existing triage methods.

The Quality and Safety Programme began in January 2012 and built on the review of emergency general surgery and acute medicine in London. This was a clinically-led programme, supported by over 90 clinicians that formed multi-disciplinary expert panels, and involved patient/service user and public groups.

The programme had two key components:

1. Auditing all acute London hospital sites against the agreed and commissioned acute medicine and emergency general surgery standards; and

2. Driving the development and commissioning of London quality standards for further services not covered by the previous review. These were:

Critical care;

Emergency departments;

Fractured neck of femur;

Maternity services; and

Paediatric emergency services.

The audit process was developed by clinical expert and patient panels and quality assured by an independent academic review. Following two pilot audits, the full audit was undertaken between May 2012 and January 2013 to ascertain the status of London hospitals against the achievement of the acute medicine and emergency general surgery London quality standards.

Click here to visit the myhealthlondon website.

This dataset forms part of the OPTIMising therapies, discovering therapeutic targets and AI-assisted clinical management for patients Living with complex multimorbidity (OPTIMAL) NIHR funded programme.

The dataset includes >40,000 adult patients with multimorbidity who were acutely admitted to hospital and had an inpatient stay. Longitudinal data includes serial physiology readings, frailty scores, blood results, medications, comorbidities, drug allergies, treatments, procedures and mortality outcomes up to a year post discharge.

Geography: The West Midlands (WM) has a population of 6 million & includes a diverse ethnic & socio-economic mix. UHB is one of the largest NHS Trusts in England, providing direct acute services & specialist care across four hospital sites, with 2.2 million patient episodes per year, 2750 beds & > 120 ITU bed capacity. UHB runs a fully electronic healthcare record (EHR) (PICS; Birmingham Systems), a shared primary & secondary care record (Your Care Connected) & a patient portal “My Health”.

Data set availability: Data access is available via the PIONEER Hub for projects which will benefit the public or patients. This can be by developing a new understanding of disease, by providing insights into how to improve care, or by developing new models, tools, treatments, or care processes. Data access can be provided to NHS, academic, commercial, policy and third sector organisations. Applications from SMEs are welcome. There is a single data access process, with public oversight provided by our public review committee, the Data Trust Committee. Contact pioneer@uhb.nhs.uk or visit www.pioneerdatahub.co.uk for more details.

All data uses should name both PIONEER and the NIHR Optimal programme in data outputs. This will be specified in the Data Licensing Agreement.

Available supplementary data: Matched controls; ambulance and community data. Unstructured data (images). We can provide the dataset in OMOP and other common data models and can build synthetic data to meet bespoke requirements.

Available supplementary support: Analytics, model build, validation & refinement; A.I. support. Data partner support for ETL (extract, transform & load) processes. Bespoke and “off the shelf” Trusted Research Environment (TRE) build and run. Consultancy with clinical, patient & end-user and purchaser access/ support. Support for regulatory requirements. Cohort discovery. Data-driven trials and “fast screen” services to assess population size.