Page last updated: 24-FEB-2009

Acute Activity

ONS kitemarkStatistical Publication Notice

24 February 2009

Acute Activity to 31 March 2008 (quarterly and annual data)

INTRODUCTION

This release contains information on acute hospital activity within NHS Scotland, illustrating current data and historic trends in secondary care provision and patient contact with the service. This information is published on a quarterly basis; ensuring the regular publication of new statistics and allowing previously released information to be revised using an increased and more complete set of data returns.
This release includes revised data for the year ending 31 March 2008 on inpatient, day case and outpatient activity. This data is considered to be provisional and may be subject to slight change in future releases.
New data for the quarter ending December 2008 is also available along with revised data for previously published quarters. Quarterly figures are likely to be less complete than annual data and, as a result, imputation has been used to account for shortfalls in the quarterly data.
This release also includes revised data for beds, multiple emergency admissions, nurse and Allied Health Professional (AHP) outpatient activity; and average length of stay for routine and non-routine admissions.
In addition, information on the number of British Association of Day Surgery (BADS) surgical procedures performed in a day case or outpatient setting has been revised for the years ending March 2005 to June 2008; and new data for the year ending September 2008 is published. It should be noted that nationally collected information about procedures performed in an outpatient setting is a relatively new development and known to be incomplete. ISD Scotland is working with NHS Boards to develop full compliance nationally.

KEY POINTS

  • The total number of hospital discharges (episodes) has increased by 1.7% to 1,339,000 in the year ending March 2008 from 1,316,000 in 2007.
  • Neoplasms (including cancer) were the most common main diagnosis for patients discharged from hospital in the year ending March 2008, accounting for 14.0% of all primary diagnoses.
  • 1,217,000 procedures were carried out in NHS Scotland in 2008, an increase of 2.3% from 1,190,000 in 2007.
  • For patients aged 65 years and over who have had 2 or more emergency admission spells in hospital, the rate per 100,000 population has increased slightly from 4,800 in the year ending March 2007 to 5,000 in 2008, a smaller increase than the previous year (4,500 in 2006).

INTERPRETATION

Outpatient, inpatient and day case activity data are collected across NHSScotland and are based on nationally available information routinely drawn from hospital administrative systems across the country. The principal data sources are the SMR00 (outpatients), SMR01 (acute inpatients and day cases) and ISD(S)1 (aggregate hospital activity) returns.
Data for the year ending March 2008 are still considered to be provisional and will be subject to change in future releases. SMR01 is considered to be 99% complete and SMR00 97% complete for the year ending March 2008. Further information on SMR data completeness is shown at the following link:
http://www.isdscotland.org/isd/1607.html
Quarterly figures up to and including December 2008 are likely to be less complete than annual data and, as a result, imputation has been used to account for shortfalls in the quarterly data.
Nurse and AHP outpatient information is still considered to be in development. The first four full years of data are shown in this release but due to issues relating to data completeness, caution should be shown when making comparisons between years.

DETAILED FINDINGS

Inpatient and Day Case Activity
Annual Trends (revised)
Provisional figures show the following for patients treated in Scotland. It should be noted that figures for year ending 31 March 2008 may increase slightly in future releases.
  • The total number of hospital discharges (episodes) increased by 1.7% to 1,339,000 in the year ending 31 March 2008 from 1,316,000 in year ending March 2007.
  • The number of elective inpatient discharges (episodes) is 198,000 in 2008, a decrease of 3.3% from 204,000 in 2007.
  • The number of emergency inpatient discharges (episodes) rose by 4.2% to 530,000 in 2008 from 509,000 in 2007.
  • The number of day case discharges (episodes) is 398,000 in 2008, a decrease of 1.7% from 405,000 in 2007.
Quarterly Trends (new)
Estimated figures show the following for patients treated in NHSScotland. It should be noted that quarterly figures are likely to change in future releases.
  • The total number of hospital discharges (episodes) increased by 2.7% to 347,000 in quarter ending December 2008 from 338,000 in quarter ending December 2007.
  • The total number of inpatient discharges (episodes) increased by 1.8% to 243,000 in quarter ending December 2008 to 239,000 in quarter ending December 2007.
  • The number of day case discharges (episodes) in quarter ending December 2008 is 104,000, an increase of 4.8% from 99,000 in quarter ending December 2007.
Diagnoses (revised)
  • The most common main diagnoses for patients discharged from hospital in the year ending March 2008 are Neoplasms; Symptoms, Signs and Ill Defined Conditions; and Diseases of the Digestive System, accounting for 14.0%, 13.3% and 13.2% of all main diagnoses respectively.
  • Analysis of eight long term conditions (based on main condition) showed that the hospital episode rate per 100,000 population for these conditions was 1,955 in the year ending 31 March 2008, an 4.5% decrease from 2,054 in the year ending 31 March 2004.
Procedures and operations (revised)
  • A total of 1,217,000 procedures were carried out on inpatients and day cases in NHS Scotland in the year ending March 2008, an increase of 2.3% from 1,190,000 in 2007.
  • The British Association of Day Surgery (BADS) has produced a directory of surgical procedures that contain aspirational goals for day surgery (including outpatient surgery). These cover around 40% of all surgical procedures. In the year ending September 2008, 69% of all elective BADS procedures were carried out as day cases or outpatients, showing a steady increase from 66% in the year ending March 2005. It should be noted that nationally collected information about procedures performed in an outpatient setting is a relatively new development and known to be incomplete. ISD Scotland is working with NHS Boards to develop full compliance nationally.
  • Between the years ending 31 March 2002 and 2007, there was an increase of almost 50% in the number of hip replacements carried out in Scotland. Figures for year ending 31 March 2008 show a slight decrease (4%) in this procedure. Similarly, over the same initial 5 year time period, the number of knee replacements being performed rose by 88%. There has been a slight decrease in the most recent year, down by 2% in year ending 31 March 2008.
  • For some procedures there is a marked increase in the percentage being performed in a day case setting between year ending 31 March 2007 and 2008, including Angioplasties (25.2% to 33.9%), Hernioplasties (36.9% to 43.1%) and Varicose vein operations (47.8% to 56.7%).
  • 94% of cataract operations were performed in a day case or outpatient setting in the year ending 31 March 2008, compared to 84% in 2004.
Average length of stay (revised)
  • The average length of stay for all inpatient admission episodes in the year ending March 2008 is 5.4 days, showing a steady year-on-year decrease from 6.0 days in 2004.
  • Inpatient admissions can be spilt into routine and non-routine admissions and both have seen a decrease in recent years. The average length of stay for routine admissions has fallen from 7.8 to 7.4 days between 2004 and 2008, whilst for non-routine admissions the average has reduced by almost 1 day from 4.7 to 3.9 days in the same time period.
Outpatient Activity
Annual Trends (revised)
Provisional figures show the following for patients treated in NHSScotland. It should be noted that figures for year ending 31 March 2008 may increase slightly in future releases.
  • 4,497,000 outpatients were seen at consultant clinics in the year ending March 2008, showing a slight increase of 0.3% when compared to year ending March 2007. In 2007/08, 1,387,000 were new outpatient attendances, an increase of 1.6% from 1,366,000 in 2006/07.
  • The return to new ratio for outpatient attendances has decreased from 2.6 return outpatients seen for each new outpatient in 2001 to 2.2 in 2008.
Quarterly Trends (new)
Estimated figures show the following for patients treated in NHSScotland. It should be noted that quarterly figures are likely to change in future releases.
  • 1,173,000 outpatients were seen at consultant clinics in the quarter ending December 2008, showing an increase of 2.9% when compared to the same quarter in 2007. In quarter ending December 2008, 370,000 were new outpatient attendances, a rise of 2.6% from 360,000 in same quarter in 2007.
  • The return to new ratio for outpatient attendances has remained at 2.2 return outpatients seen for each new outpatient in the quarter ending 2008, when compared to the same quarter in 2007.
Multiple Emergency Admissions (revised)
  • For patients aged 65 years and over who have had 2 or more emergency admission spells in hospital, the rate per 100,000 population has increased slightly from 4,800 in the year ending March 2007 to 5,000 in 2008, a smaller increase than the previous year (4,500 in 2006).
  • For patients aged 65 years and over admitted as an emergency, the occupied bed day rate appears to have levelled off at around 2.8 million in recent years, up to year ending March 2007. Full information on emergency bed days for year ending 31 March 2008 are not yet available as some relevant patient discharge records may not yet have been submitted to ISD or the patient may still be in hospital.
  • The emergency admission rate per 100,000 population for patients aged under 25 years with 1 admission in a given year has increased steadily from 4,000 in the year ending March 2003 to 4,200 in 2008.
  • The rate per 100,000 population for children aged 0 to 4 years who have had 2 emergency admission spells in hospital has increased over the last 10 years from 925 in year ending March 1999 to 1,300 in 2008.
Beds (revised)
  • The average number of available staffed beds in acute specialties has decreased slightly to 17,340 in the year ending March 2008, compared with 17,470 in 2007.
  • The occupancy rate of acute beds has been fairly constant over the last eight years at between 81-83%.
Nurse and AHP Activity (revised)
  • 769,000 outpatients were seen at nurse led clinics for acute specialties in the year ending March 2008. Of these, 142,000 were new attendances.
  • 5,712,000 outpatients were seen at an allied health professional or other technical department in the year ending March 2008. Of these, 1,557,000 were new attendances.
  • Nurse and AHP outpatient information is still considered to be in development. The first four full years of data are shown in this release but due to issues relating to data completeness, caution should be shown when making comparisons between years.

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MAIN CONTACTS:

Matthew Armstrong
Principal Information Analyst
0131 275 7487
Matthew.Armstrong@isd.csa.scot.nhs.uk
Inpatient, Day Case and Outpatient Activity

Kirsty Anderson
Senior Information Analyst
0141 282 2243
Kirsty.Anderson@isd.csa.scot.nhs.uk
Inpatient, Day Case and Outpatient Activity and Beds, Nurse and AHP activity

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PRE-RELEASE ACCESS TO THIS PUBLICATION WAS GIVEN TO:

NHS Board Chief Executives
NHS Board Communications leads
Scottish Government Health Directorate - ASD

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HISTORY OF THIS PUBLICATION:

Last Published: 25 November 2008
Next Due: 26 May 2009
Data Avaliable Since: For activity and baeds information, some trends are available from April 1997


Main contact: Email Matthew Armstron