This is a publication on maternity activity in English NHS hospitals. This report examines data relating to delivery and birth episodes in 2021-22, and the booking appointments for these deliveries. This annual publication covers the financial year ending March 2022. Data is included from both the Hospital Episodes Statistics (HES) data warehouse and the Maternity Services Data Set (MSDS). HES contains records of all admissions, appointments and attendances for patients admitted to NHS hospitals in England. The HES data used in this publication are called 'delivery episodes'. The MSDS collects records of each stage of the maternity service care pathway in NHS-funded maternity services, and includes information not recorded in HES. The MSDS is a maturing, national-level dataset. In April 2019 the MSDS transitioned to a new version of the dataset. This version, MSDS v2.0, is an update that introduced a new structure and content - including clinical terminology, in order to meet current clinical practice and incorporate new requirements. It is designed to meet requirements that resulted from the National Maternity Review, which led to the publication of the Better Births report in February 2016. This is the third publication of data from MSDS v2.0 and data from 2019-20 onwards is not directly comparable to data from previous years. This publication shows the number of HES delivery episodes during the period, with a number of breakdowns including by method of onset of labour, delivery method and place of delivery. It also shows the number of MSDS deliveries recorded during the period, with breakdowns including the baby's first feed type, birthweight, place of birth, and breastfeeding activity; and the mothers' ethnicity and age at booking. There is also data available in a separate file on breastfeeding at 6 to 8 weeks. The count of Total Babies includes both live and still births, and previous changes to how Total Babies and Total Deliveries were calculated means that comparisons between 2019-20 MSDS data and later years should be made with care. The MethodfDelivery measure counting babies has been replaced by the DeliveryMethodBabyGroup measure which counts deliveries, and the smoking at booking and folic acid status measures have been renamed - these changes have been made to better align this annual publication with the Maternity Services Monthly Statistics publication. Information on how all measures are constructed can be found in the HES Metadata and MSDS Metadata files provided below. In this publication we have also included an interactive Power BI dashboard to enable users to explore key NHS Maternity Statistics measures. The purpose of this publication is to inform and support strategic and policy-led processes for the benefit of patient care. This report will also be of interest to researchers, journalists and members of the public interested in NHS hospital activity in England. Any feedback on this publication or dashboard can be provided to enquiries@nhsdigital.nhs.uk, under the subject “NHS Maternity Statistics”.

Ventilatory strategies and outcomes for patients acutely admitted to hospital

Dataset 14.0 Version 1.0 15.2.2021

Background. Acute respiratory failure is commonly encountered in the emergency department (ED). Early treatment can have positive effects on long-term outcome. Non-invasive ventilation is commonly used for patients with respiratory failure during acute exacerbations of chronic obstructive lung disease and congestive heart failure. For other patients, including neuromuscular dysfunction, mechanical ventilation may be needed. For refractory hypoxemia, new rescue therapies have emerged to help improve the oxygenation, and in some cases mortality. This dataset summarises the demography, admitting complaint, serial physiology, treatments and ventilatory strategies in patients admitted with hypoxaemia. Management options and rescue therapies including extracorporeal membrane oxygenation are included.

PIONEER geography The West Midlands (WM) has a population of 5.9 million & includes a diverse ethnic & socio-economic mix. There is a higher than average percentage of minority ethnic groups. WM has a large number of elderly residents but is the youngest population in the UK. Each day >100,000 people are treated in hospital, see their GP or are cared for by the NHS.

EHR. University Hospitals Birmingham NHS Foundation Trust (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 & 100 ITU beds. ITU capacity increased to 250 beds during the COVID pandemic. 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”. The electronic record captures ventilatory parameters.

Scope: All hospitalised patients with hypoxaemia requiring ventilatory support from 2000 onwards. The dataset includes highly granular patient demographics & co-morbidities taken from ICD-10 & SNOMED-CT codes. Serial, structured data pertaining to care process (timings, staff grades, specialty review, wards), severity, ventilatory requirements, acuity, all physiology readings (pulse, blood pressure, respiratory rate, oxygen saturations), all blood results, microbiology, all prescribed & administered treatments (fluids, antibiotics, inotropes, vasopressors, organ support), all outcomes.

Available supplementary data: Synthetic data. Post discharge care contacts.

Available supplementary support: Analytics, Model build, validation & refinement; A.I.; Data partner support for ETL (extract, transform & load) process, Clinical expertise, Patient & end-user access, Purchaser access, Regulatory requirements, Data-driven trials, “fast screen” services.

This publication contains the official statistics about uses of the Mental Health Act ('the Act') in England during 2022-23. Under the Act, people with a mental disorder may be formally detained in hospital (or 'sectioned') in the interests of their own health or safety, or for the protection of other people. They can also be treated in the community but subject to recall to hospital for assessment and/or treatment under a Community Treatment Order (CTO). In 2016-17, the way we source and produce these statistics changed. Previously these statistics were produced from the KP90 aggregate data collection. They are now primarily produced from the Mental Health Services Data Set (MHSDS). The MHSDS provides a much richer data source for these statistics, allowing for new insights into uses of the Act. People may be detained in secure psychiatric hospitals, other NHS Trusts or at Independent Service Providers (ISPs). All organisations that detain people under the Act must be registered with the Care Quality Commission (CQC). In recent years, the number of detentions under the Act have been rising. An independent review has examined how the Act is used and has made recommendations for improving the Mental Health Act legislation. In responding to the review, the government said it would introduce a new Mental Health Bill to reform practice. This publication does not cover: 1. People in hospital voluntarily for mental health treatment, as they have not been detained under the Act (see the Mental Health Bulletin). 2. Uses of section 136 where the place of safety was a police station; these are published by the Home Office.

Percentage of emergency admissions to any hospital in England occurring within 30 days of the last, previous discharge from hospital after admission: indirectly standardised by age, sex, method of admission and diagnosis/procedure. The indicator is broken down into the following demographic groups for reporting: ● All years and female only, male only and both male and female (persons). ● <16 years and female only, male only and both male and female (persons). ● 16+ years and female only, male only and both male and female (persons) ● 16-74 years and female only, male only and both male and female (persons) ● 75+ years and female only, male only and both male and female (persons) Results for each of these groups are also split by the following geographical and demographic breakdowns: ● Local authority of residence. ● Region. ● Area classification. ● NHS and private providers. ● NHS England regions. ● Deprivation (Index of Multiple Deprivation (IMD) Quintiles, 2019). ● Sustainability and Transformation Partnerships (STP) & Integrated Care Boards (ICB) from 2016/17. ● Clinical Commissioning Groups (CCG) & sub-Integrated Care Boards (sub-ICB). All annual trends are indirectly standardised against 2013/14.

These indicators are designed to accompany the SHMI publication. The SHMI methodology does not make any adjustment for deprivation. This is because adjusting for deprivation might create the impression that a higher death rate for those who are more deprived is acceptable. Patient records are assigned to 1 of 5 deprivation groups (called quintiles) using the Index of Multiple Deprivation (IMD). The deprivation quintile cannot be calculated for some records e.g. because the patient's postcode is unknown or they are not resident in England. Contextual indicators on the percentage of provider spells and deaths reported in the SHMI belonging to each deprivation quintile are produced to support the interpretation of the SHMI. Notes: 1. As of the July 2020 publication, COVID-19 activity has been excluded from the SHMI. The SHMI is not designed for this type of pandemic activity and the statistical modelling used to calculate the SHMI may not be as robust if such activity were included. Activity that is being coded as COVID-19, and therefore excluded, is monitored in the contextual indicator 'Percentage of provider spells with COVID-19 coding' which is part of this publication. 2. Please note that there was a fall in the overall number of spells from March 2020 for England due to COVID-19 impacting on activity and the number has not returned to pre-pandemic levels. Further information at Trust level is available in the contextual indicator ‘Provider spells compared to the pre-pandemic period’ which is part of this publication. 3. There is a shortfall in the number of records for Frimley Health NHS Foundation Trust (trust code RDU), Manchester University NHS Foundation Trust (trust code R0A), Royal Surrey County Hospital NHS Foundation Trust (trust code RA2), and Wrightington, Wigan and Leigh NHS Foundation Trust (trust code RRF). Values for these trusts are based on incomplete data and should therefore be interpreted with caution. 4. There is a high percentage of invalid diagnosis codes for Hampshire Hospitals NHS Foundation Trust (trust code RN5). Values for this trust should therefore be interpreted with caution. 5. A number of trusts are currently engaging in a pilot to submit Same Day Emergency Care (SDEC) data to the Emergency Care Data Set (ECDS), rather than the Admitted Patient Care (APC) dataset. As the SHMI is calculated using APC data, this does have the potential to impact on the SHMI value for these trusts. Trusts with SDEC activity removed from the APC data have generally seen an increase in the SHMI value. This is because the observed number of deaths remains approximately the same as the mortality rate for this cohort is very low; secondly, the expected number of deaths decreases because a large number of spells are removed, all of which would have had a small, non-zero risk of mortality contributing to the expected number of deaths. We are working to better understand the planned changes to the recording of SDEC activity and the potential impact on the SHMI. The trusts affected in this publication are: Barts Health NHS Trust (trust code R1H), Cambridge University Hospitals NHS Foundation Trust (trust code RGT), Croydon Health Services NHS Trust (trust code RJ6), Epsom and St Helier University Hospitals NHS Trust (trust code RVR), Frimley Health NHS Foundation Trust (trust code RDU), Imperial College Healthcare NHS Trust (trust code RYJ), Manchester University NHS Foundation Trust (trust code R0A), Norfolk and Norwich University Hospitals NHS Foundation Trust (trust code RM1), and University Hospitals of Derby and Burton NHS Foundation Trust (trust code RTG). 6. Further information on data quality can be found in the SHMI background quality report, which can be downloaded from the 'Resources' section of the publication page.

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. The proportion of older people (aged 65 and over), expressed as a percentage, who are offered reablement services when they leave hospital. This indicator measures the benefit to individuals from reablement, intermediate care and rehabilitation following a hospital episode, by determining how many individuals are offered rehabilitation services. As of February 2021, please refer to the data tables published as part of the Adult Social Care Outcomes Framework (ASCOF) by NHS Digital. This publication is released on an annual basis. A link to the ASCOF publication, within which the data is held, is available via the resource link below. From the publication page of the latest version, select the ‘Measures from the Adult Social Care Outcomes Framework – England, 20XX-XX: Disaggregated outcomes measures’ excel spreadsheet. The data for this indicator is contained within tab 2B(2): ‘The proportion of older people (aged 65ov) who received reablement/rehabilitation services after discharge from hospital’. Local authority level time series data is impacted by structural changes such as mergers. In order to help users identify local authorities affected by any recent changes, a further link to the ONS geoportal website has been provided. Legacy unique identifier: P01768

Background: Age-related macular degeneration (AMD) is a degenerative disease of the human retina affecting individuals over the age of 55 years. AMD is the leading cause of blindness in industrialized countries. Worldwide, the number of people with AMD is predicted to increase from 196 million in 2020 to 288 million by 2040.

The UHB AMD Dataset is a longitudinal dataset consisting of routinely collected imaging and clinical metadata from patients receiving treatment for age-related macular degeneration (AMD) at UHB, from 2007 to the present.

This dataset encompasses all patients at UHB who have received at least one injection of either Lucentis (ranibizumab) or Eylea (aflibercept) or avastin. This dataset will include data from both eyes in each case - for example, it will include data from fellow eyes that are not receiving injections. For these reasons, the dataset will include longitudinal data from a mixture of eyes with both “dry” and “wet” AMD. Clinical metadata includes demographic information, visual acuities (predominantly measured with Early Treatment Diabetic Retinopathy Study (ETDRS) charts), treatment, and outcomes.

This dataset is continuously updating, however, as of October 2021, it consisted of 15063 eyes receiving treatment for AMD. This is a large single centre database from patients with AMD and covers more than a decade of follow-up for these patients.

Geography The Queen Elizabeth Hospital is one of the largest single-site hospitals in the United Kingdom, with 1,215 inpatient beds. Queen Elizabeth Hospital is part of one of the largest teaching trusts in England (University Hospitals Birmingham). Set within the West Midlands and it has a catchment population of circa 5.9million. The region includes a diverse ethnic, and socio-economic mix, with a higher than UK average of minority ethnic groups. It has a large number of elderly residents but is the youngest population in the UK. There are particularly high rates of diabetes, physical inactivity, obesity, and smoking.

Data source: Ophthalmology department at Queen Elizabeth Hospital, University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom.

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.

These indicators are designed to accompany the SHMI publication. As well as information on the main condition the patient is in hospital for (the primary diagnosis), the SHMI data contain up to 19 secondary diagnosis codes for other conditions the patient is suffering from. This information is used to calculate the expected number of deaths. 'Depth of coding' is defined as the number of secondary diagnosis codes for each record in the data. A higher mean depth of coding may indicate a higher proportion of patients with multiple conditions and/or comorbidities, but may also be due to differences in coding practices between trusts. Contextual indicators on the mean depth of coding for elective and non-elective admissions are produced to support the interpretation of the SHMI. Notes: 1. As of the July 2020 publication, COVID-19 activity has been excluded from the SHMI. The SHMI is not designed for this type of pandemic activity and the statistical modelling used to calculate the SHMI may not be as robust if such activity were included. Activity that is being coded as COVID-19, and therefore excluded, is monitored in the contextual indicator 'Percentage of provider spells with COVID-19 coding' which is part of this publication. 2. Please note that there was a fall in the overall number of spells for England from March 2020 due to COVID-19 impacting on activity and the number has not returned to pre-pandemic levels. Further information at Trust level is available in the contextual indicator ‘Provider spells compared to the pre-pandemic period’ which is part of this publication. 3. There is a shortfall in the number of records for Frimley Health NHS Foundation Trust (trust code RDU) and South Tees Hospitals NHS Foundation Trust (trust code RTR). Values for these trusts are based on incomplete data and should therefore be interpreted with caution. 4. A number of trusts are currently engaging in a pilot to submit Same Day Emergency Care (SDEC) data to the Emergency Care Data Set (ECDS), rather than the Admitted Patient Care (APC) dataset. As the SHMI is calculated using APC data, this does have the potential to impact on the SHMI value for these trusts. Trusts with SDEC activity removed from the APC data have generally seen an increase in the SHMI value. This is because the observed number of deaths remains approximately the same as the mortality rate for this cohort is very low; secondly, the expected number of deaths decreases because a large number of spells are removed, all of which would have had a small, non-zero risk of mortality contributing to the expected number of deaths. We are working to better understand the planned changes to the recording of SDEC activity and the potential impact on the SHMI. The trusts affected in this publication are: Barts Health NHS Trust (trust code R1H), Cambridge University Hospitals NHS Foundation Trust (trust code RGT), Croydon Health Services NHS Trust (trust code RJ6), Epsom and St Helier University Hospitals NHS Trust (trust code RVR), Frimley Health NHS Foundation Trust (trust code RDU), Imperial College Healthcare NHS Trust (trust code RYJ), Manchester University NHS Foundation Trust (trust code R0A), Norfolk and Norwich University Hospitals NHS Foundation Trust (trust code RM1), and University Hospitals of Derby and Burton NHS Foundation Trust (trust code RTG). 5. On 1 April 2023 Yeovil District Hospital NHS Foundation Trust (trust code RA4) was acquired by Somerset NHS Foundation Trust (trust code RH5). However, as we received notification of this change after data processing for this publication began, data for Yeovil District Hospital NHS Foundation Trust have not been included in the SHMI values for Somerset NHS Foundation Trust. The next publication in this series will reflect the updated organisation structure. 6. Further information on data quality can be found in the SHMI background quality report, which can be downloaded from the 'Resources' section of the publication page.

This publication looks at Accident and Emergency activity in England for the financial year 2022-23. 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 Known Data Quality Issues: Royal Cornwall Hospitals NHS Trust (REF) - Due to a system configuration issue which the supplier has been unable to resolve, since January 2023, records which have an NHS Number Status Indicator of '02' are missing the data items Person Birth Date, Organisation Code of Residence and Postcode in submissions from Royal Cornwall Hospitals NHS Trust (REF). This may cause a reduction in certain record counts in this publication and will impact the data quality score for RCHT. Contact details Author: Secondary Care Open Data and Publications, NHS England Responsible Statistician: Emily Michelmore Email: enquiries@nhsdigital.nhs.uk Press enquiries should be made to: Media Relations Manager: telephone 0300 303 3888

This indicator is designed to accompany the SHMI publication. The SHMI includes all deaths reported of patients who were admitted to non-specialist acute trusts in England and either died while in hospital or within 30 days of discharge. Deaths related to COVID-19 are excluded from the SHMI. A contextual indicator on the percentage of deaths reported in the SHMI which occurred in hospital and the percentage which occurred outside of hospital is produced to support the interpretation of the SHMI. Notes: 1. As of the July 2020 publication, COVID-19 activity has been excluded from the SHMI. The SHMI is not designed for this type of pandemic activity and the statistical modelling used to calculate the SHMI may not be as robust if such activity were included. Activity that is being coded as COVID-19, and therefore excluded, is monitored in the contextual indicator 'Percentage of provider spells with COVID-19 coding' which is part of this publication. 2. Please note that there was a fall in the overall number of spells for England from March 2020 due to COVID-19 impacting on activity for England and the number has not returned to pre-pandemic levels. Further information at Trust level is available in the contextual indicator ‘Provider spells compared to the pre-pandemic period’ which is part of this publication. 3. There is a shortfall in the number of records for Frimley Health NHS Foundation Trust (trust code RDU) and South Tees Hospitals NHS Foundation Trust (trust code RTR). Values for these trusts are based on incomplete data and should therefore be interpreted with caution. 4. A number of trusts are currently engaging in a pilot to submit Same Day Emergency Care (SDEC) data to the Emergency Care Data Set (ECDS), rather than the Admitted Patient Care (APC) dataset. As the SHMI is calculated using APC data, this does have the potential to impact on the SHMI value for these trusts. Trusts with SDEC activity removed from the APC data have generally seen an increase in the SHMI value. This is because the observed number of deaths remains approximately the same as the mortality rate for this cohort is very low; secondly, the expected number of deaths decreases because a large number of spells are removed, all of which would have had a small, non-zero risk of mortality contributing to the expected number of deaths. We are working to better understand the planned changes to the recording of SDEC activity and the potential impact on the SHMI. The trusts affected in this publication are: Barts Health NHS Trust (trust code R1H), Cambridge University Hospitals NHS Foundation Trust (trust code RGT), Croydon Health Services NHS Trust (trust code RJ6), Epsom and St Helier University Hospitals NHS Trust (trust code RVR), Frimley Health NHS Foundation Trust (trust code RDU), Imperial College Healthcare NHS Trust (trust code RYJ), Manchester University NHS Foundation Trust (trust code R0A), Norfolk and Norwich University Hospitals NHS Foundation Trust (trust code RM1), and University Hospitals of Derby and Burton NHS Foundation Trust (trust code RTG). 5. On 1 April 2023 Yeovil District Hospital NHS Foundation Trust (trust code RA4) was acquired by Somerset NHS Foundation Trust (trust code RH5). However, as we received notification of this change after data processing for this publication began, data for Yeovil District Hospital NHS Foundation Trust have not been included in the SHMI values for Somerset NHS Foundation Trust. The next publication in this series will reflect the updated organisation structure. 6. Further information on data quality can be found in the SHMI background quality report, which can be downloaded from the 'Resources' section of the publication page.

These indicators are designed to accompany the SHMI publication. The SHMI methodology includes an adjustment for admission method. This is because crude mortality rates for elective admissions tend to be lower than crude mortality rates for non-elective admissions. Contextual indicators on the crude percentage mortality rates for elective and non-elective admissions where a death occurred either in hospital or within 30 days (inclusive) of being discharged from hospital are produced to support the interpretation of the SHMI. Notes: 1. As of the July 2020 publication, COVID-19 activity has been excluded from the SHMI. The SHMI is not designed for this type of pandemic activity and the statistical modelling used to calculate the SHMI may not be as robust if such activity were included. Activity that is being coded as COVID-19, and therefore excluded, is monitored in the contextual indicator 'Percentage of provider spells with COVID-19 coding' which is part of this publication. 2. Please note that there was a fall in the overall number of spells for England from March 2020 due to COVID-19 impacting on activity and the number has not returned to pre-pandemic levels. Further information at Trust level is available in the contextual indicator ‘Provider spells compared to the pre-pandemic period’ which is part of this publication. 3. There is a shortfall in the number of records for Frimley Health NHS Foundation Trust (trust code RDU), Manchester University NHS Foundation Trust (trust code R0A), Royal Surrey County Hospital NHS Foundation Trust (trust code RA2), and Wrightington, Wigan and Leigh NHS Foundation Trust (trust code RRF). Values for these trusts are based on incomplete data and should therefore be interpreted with caution. 4. There is a high percentage of invalid diagnosis codes for Hampshire Hospitals NHS Foundation Trust (trust code RN5). Values for this trust should therefore be interpreted with caution. 5. A number of trusts are currently engaging in a pilot to submit Same Day Emergency Care (SDEC) data to the Emergency Care Data Set (ECDS), rather than the Admitted Patient Care (APC) dataset. As the SHMI is calculated using APC data, this does have the potential to impact on the SHMI value for these trusts. Trusts with SDEC activity removed from the APC data have generally seen an increase in the SHMI value. This is because the observed number of deaths remains approximately the same as the mortality rate for this cohort is very low; secondly, the expected number of deaths decreases because a large number of spells are removed, all of which would have had a small, non-zero risk of mortality contributing to the expected number of deaths. We are working to better understand the planned changes to the recording of SDEC activity and the potential impact on the SHMI. The trusts affected in this publication are: Barts Health NHS Trust (trust code R1H), Cambridge University Hospitals NHS Foundation Trust (trust code RGT), Croydon Health Services NHS Trust (trust code RJ6), Epsom and St Helier University Hospitals NHS Trust (trust code RVR), Frimley Health NHS Foundation Trust (trust code RDU), Imperial College Healthcare NHS Trust (trust code RYJ), Manchester University NHS Foundation Trust (trust code R0A), Norfolk and Norwich University Hospitals NHS Foundation Trust (trust code RM1), and University Hospitals of Derby and Burton NHS Foundation Trust (trust code RTG). 6. Further information on data quality can be found in the SHMI background quality report, which can be downloaded from the 'Resources' section of the publication page.

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. • Update on previously unpublished measures 72 hour follow-up measures (MHS78, MHS79 and MHS80) have now been released for Performance October 2020. Data for these measures for previous reporting periods will be published as soon as they are available. NHS Digital apologises for the inconvenience caused. • Early release of statistics To support the ongoing COVID-19 work, Provisional December 2020 monthly statistics were made available early and presented on our supplementary information pages. https://digital.nhs.uk/data-and-information/supplementary-information/2021/provisional-december-2020-mental-health-statistics • Changing existing measures The move to MHSDS version 4.1 from April 2020 has brought with it changes to the dataset; the construction of a number of measures have been changed as a result. Improvements in the methodology of reporting delay of discharge has also resulted in a change in the construction of the measure from Performance April 2020 onwards. From Performance August 2020 onwards, the methodology for calculating restrictive interventions (MHS76 and MHS77) in the reporting month has been updated to include all restraints that span several months. Previously the measure only includes restraints that started or ended in the month and did not include those spanning more than 2 months. This change predominately impacts segregation. From Performance September 2020 onwards, the methodology for MHS26 (Delayed transfer of care) has been updated. Previously only the first midnight of a delayed transfer of care within a hospital provider spell was excluded. The updated methodology now excludes the first midnight for delay start date where there is a gap of more than one day within the same hospital provider spell. This is to take into account valid gaps between delay reasons. Full details of these changes are available in the associated Metadata file. From Performance September 2020 onwards, a presentational change has been introduced to restrictive interventions csv files to exclude providers with no inpatients. • New measures A number of new measures have been included from Performance July 2020 onwards: - MHS81 Number of Detentions - MHS82 Number of Short Term Orders - MHS83 Number of uses of Section 136 - MHS84 Number of Community Treatment Orders Full details of these are available in the associated Metadata file.

● Region.