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"

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

● Region.

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This publication of the SHMI relates to discharges in the reporting period March 2023 - February 2024. The SHMI is the ratio between the actual number of patients who die following hospitalisation at the trust and the number that would be expected to die on the basis of average England figures, given the characteristics of the patients treated there. The SHMI covers patients admitted to hospitals in England who died either while in hospital or within 30 days of being discharged. To help users of the data understand the SHMI, trusts have been categorised into bandings indicating whether a trust's SHMI is 'higher than expected', 'as expected' or 'lower than expected'. For any given number of expected deaths, a range of observed deaths is considered to be 'as expected'. If the observed number of deaths falls outside of this range, the trust in question is considered to have a higher or lower SHMI than expected. The expected number of deaths is a statistical construct and is not a count of patients. The difference between the number of observed deaths and the number of expected deaths cannot be interpreted as the number of avoidable deaths or excess deaths for the trust. The SHMI is not a measure of quality of care. A higher than expected number of deaths should not immediately be interpreted as indicating poor performance and instead should be viewed as a 'smoke alarm' which requires further investigation. Similarly, an 'as expected' or 'lower than expected' SHMI should not immediately be interpreted as indicating satisfactory or good performance. Trusts may be located at multiple sites and may be responsible for 1 or more hospitals. A breakdown of the data by site of treatment is also provided, as well as a breakdown of the data by diagnosis group. Further background information and supporting documents, including information on how to interpret the SHMI, are available on the SHMI homepage (see Related Links).

Update 2 March 2023: Following the merger of NHS Digital and NHS England on 1st February 2023 we are reviewing the future presentation of the NHS Outcomes Framework indicators. As part of this review, the annual publication which was due to be released in March 2023 has been delayed. Further announcements about this dataset will be made on this page in due course. Patient experience measured by scoring the results of a selection of questions from the National Accident and Emergency (A&E) Department Survey. This indicator aims to capture the experience of patients who have used A&E services. Legacy unique identifier: P01780

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.

Summary of A&E performance and arrivals per site.

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Legacy unique identifier: P01790

Please note (05/02/2014): The following correction was made to the Accident and Emergency Attendances in England (Experimental Statistics) 2008-09 report on 5 February 2014. A labelling error was found in charts 4.2 and 4.3; values were labelled as being for patients aged 100+, when this should have read 101+, these labels have been corrected. This is the second annual publication of the Accident and Emergency (A&E) Attendance data within Hospital Episodes Statistics (HES). It covers the period April 2008 to March 2009 and draws on nearly 13.8 million detailed records of attendances at major A&E departments, single specialty A&E departments, minor injuries units and walk-in centres in England. Publishing the A&E HES data, as experimental statistics, enables initial conclusions to be presented for discussion and aims to promote and highlight the uses of this potentially rich data set. During the period covered by this publication, not all providers have completed data submissions and data quality is poor in some cases. The publication also includes analysis of the A&E HES data compared to the Quarterly Monitoring of Accident and Emergency (QMAE) return, the official source of A&E information, to highlight areas for further investigation. NHS organisations will be able to review their own data to ascertain the extent to which their local trend follows the national pattern. This can be done by using the accompanying interactive spreadsheet tool available above A&E Attendances - Provider level analysis (Experimental statistics) 2008-09.xls. The full report and accompanying tables are also available on our dedicated website HESonline, along with inpatient, outpatient and maternity data.

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Legacy unique identifier: P01758

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