Acute hospital activity and NHS beds information (quarterly)
Quarter ending 30 September 2020
A National Statistics publication for Scotland
- Published
- 23 February 2021
- Type
- Statistical report
- Author
- Public Health Scotland
Official data release information
Date
23 February 2021.
Next release
May 2021.
Date that data were acquired
January 2021 (SMR) / February 2021 (ISD(S)1).
Release Description
Summary of inpatient, day case and outpatient activity and bed statistics for NHSScotland.
Topic
Hospital care.
Theme
Health and social care.
Timeframe of data and timeliness
Data from the quarter ending 30 September 2015 to the quarter ending 30 September 2020.
Frequency
This data release is updated quarterly.
Data Sources
Scottish Morbidity Records SMR01 (inpatient and day case for acute specialties), SMR00 (outpatients) and ISD(S)1 aggregated data returns (beds and return outpatients). ISD(S)1 also does not record information on the age or sex of patients, nor the deprivation of the area in which they live.
Accessibility
All our data releases are in line with our guidelines for accessibility. This data release was last assessed by the UK Statistical Authority in September 2011.
Continuity and Accuracy of Data
Reports include quarterly data up to 30 September 2020.
There are known issues with the quality of data presented, such as the inpatient and daycase completeness. For more information please see the Data Quality and Data Trends sections.
Due to problems with the implementation of a new patient administration system, no ISD(S)1 data was submitted for NHS Highland from quarters ending March 2014 until September 2015.
Missing data were estimated. More details on this estimating process can be found in the Data Quality section.
A review of specialty spells and beds estimations methodologies were conducted prior to the November 2020 publication. As a result, there may be some differences when comparing with previous publications. For more information, please see our methods section and the Specialty Spells Methodology paper.
An issue with matching the Scottish Index of Multiple Deprivation (SIMD) information to SMR01 and SMR00 data has been identified and resolved. However, this means that the SIMD breakdowns shown in previous releases (i.e. quarterly publications released in December 2017, March 2018, and June 2018) may not match those in the current release.
An issue with the Scottish Index of Multiple Deprivation (SIMD) in the May 2020 release has been identified whereby SIMD did not match on for Outpatient activity in 2015 only. As a result, ‘NA’ was identified for all 2015 Outpatient SIMD activity. This issue has been resolved in this release where SIMD has been appropriately matched for all data.
The quarterly publication should not be used to approximate yearly figures as NHS Boards can update and submit their data monthly which may result in changes in the recent data shown from one publication to another. This means that there will likely be more variation in the quarterly data which would level off over the year when presenting annual data within the annual publication. Also, it should be noted that the quarterly publication includes acute hospitals only. In addition, only acute specialties are included in the inpatient and daycase figures.
Acute Assessment Unit (AAU) / Ambulatory Emergency Care (AEC) activity
Definitions
-
Acute Assessment Unit (AAU)
The AAU is a dedicated facility for the acute clinical care of patients that present to hospital as clinical emergencies or who develop an acute clinical problem while in hospital. The units may also carry out some planned healthcare.
Generally, these units have both trolleyed areas and staffed beds which form part of the hospitals bed complement. Where trolleys are used in lieu of beds, patients should be counted as inpatients.
Acute Assessment Unit (AAU) is the preferred term for services also known as:
- medical/surgical assessment unit
- combined assessment units
- clinical assessment units
- acute medical (assessment) units
- paediatric assessment units
- acute receiving ward/unit admission unit
These cases should be recorded under significant facility 40.
-
Ambulatory Emergency Care (AEC)
An Ambulatory Emergency Care Unit is a multidisciplinary 'one stop' service.
It provides Outpatient and Daycase services only.
These cases should be recorded under significant facility 39.
National recording of AAU & AEC activity
Currently AAU activity is only being submitted by some NHS Boards within SMR01. NHS Greater Glasgow & Clyde AAU activity stopped in 2017. NHS Highland have been submitting AEC cases via SMR01 using criteria agreed by PHS to ensure that they pass validation rules as an interim measure. NHS Greater Glasgow & Clyde has opted to record these cases differently from NHS Highland since they consider a number of these cases to be non-elective day cases which, due to recording rules, cannot be recorded that way on Trakcare. As such they took the decision to record them as Emergency Department activity to allow them to be able to follow the patient through the system. However, from September 2019 onwards, the Royal Alexandra Hospital within NHS Greater Glasgow & Clyde have started to record AAU cases again within SMR01. NHS Western Isles have started submitting AEC cases via SMR00 in 2020.
There are ongoing discussions with NHS Boards, the Scottish Government and PHS on the most appropriate way for capturing this activity including AEC cases. AEC is under the scope of SMR00 Modernising Review, and it is hoped that national definitions and guidance on how to record this activity can be agreed by all NHS Boards.
Change to Council Area/NHS board codes
There have been two minor boundary changes to council areas since early 2018. The first change was for Keltybridge and Fife Environmental Energy Park at Westfield. The official implementation date of this change was 2 February 2018. As a result, the following geographies are impacted and new 9-digit codes have been generated: Council Areas, Electoral Wards, Health Boards, Health and Social Care Partnerships, Police Divisions, Fire and Rescue, Postcodes and LAU1. The changes for geography codes commonly used by PHS are as follows:
NHS board
| Old code | New code | |
|---|---|---|
| NHS Fife | S08000018 | S08000029 |
| NHS Tayside | S08000027 | S08000030 |
Council area
| Old code | New code | |
|---|---|---|
| NHS Fife | S12000015 | S12000047 |
| NHS Tayside | S12000024 | S12000048 |
The second change has been to the Cardowan and Stepps areas of Glasgow and Lanarkshire. The official implementation date of this change was 1st April 2019. As a result, the boundaries for Health Board (NHS Great Glasgow & Clyde, NHS Lanarkshire) and HSCP (Glasgow City, North Lanarkshire) have changed to align with the new council area boundary. The changes for geography codes commonly used by PHS are as follows:
Council area
| Old code | New code | |
|---|---|---|
| Glasgow City | S12000046 | S12000049 |
| North Lanarkshire | S12000044 | S12000050 |
Health and Social Care Partnership (HSCP)
| Old code | New code | |
|---|---|---|
| Glasgow City | S37000015 | S37000034 |
| North Lanarkshire | S37000021 | S37000035 |
NHS board
| Old code | New code | |
|---|---|---|
| Greater Glasgow and Clyde | S08000021 | S08000031 |
| Lanarkshire | S08000023 | S08000032 |
NHS board
Hospital/location code changes
Dumfries & Galloway Royal Infirmary (Y104H) moved location in December 2017, and activity is now recorded under a new code, Y146H. The name remains "Dumfries & Galloway Royal Infirmary". To ensure that no activity is missed, and to allow trends to be presented, the two hospital codes Y146H and Y104H (for SMR01 and SMR00 activity) are combined in our analyses under Y146H. The old site (Y104H) still exists and is now a treatment centre named "Mountainhall Treatment Centre". This new activity will be reported separately under a new code (Y177C) which came into effect in December 2017.
From 1st December 2018, Stirling Community Hospital closed along with all its wards and the Bellfield Centre opened. The Bellfield Centre provides short-term inpatient care, assessment or rehabilitation for people who require additional support following an operation or illness. Within the Bellfield Centre there is one new NHS ward, the Wallace Suite. Most of the beds are converting to partnership controlled intermediate beds. This may impact on NHS Forth Valley’s bed figures.
Balfour Hospital (R101H) moved location between April and November 2019. Both the hospital name and code have changed to "The Balfour" and R103H respectively. For inpatient, outpatient and beds activity, both hospital codes have been added together.
NHS Louisa Jordan hospital (G101Z) has been included within this publication. The hospital hasn’t been used to treat coronavirus (COVID-19) patients, but has seen patients receiving dermatology, general and plastic surgery, and orthopaedic outpatient consultations since the start of July 2020.
Geographical coding changes have been applied to make the coding of 'Other' locations e.g. when patients have no fixed abode and are resident outside Scotland/UK to be consistent with PHS Open Data Geography Codes (external website).
Revisions
All revisions to data within this release are planned and are due to incomplete data returns at the time of publication. All tables will be revised annually or quarterly. In general, these revisions have minimal effect on the statistics. If data providers discover that data submitted for publication is incorrect, and/or missing/incomplete and is significant, this can be re-submitted and published in subsequent releases. Any changes will be highlighted within the publication release. Please see the PHS revisions policy (PDF) for further details.
Revisions Relevant to this Publication
The geography and SIMD lookup files are based on the latest versions of the National Records of Scotland 2020v2 Scottish Postcode Directory available at the time of data analysis.
Postcode has been used to map directly to NHS Board and Council Areas rather than using the existing NHS Board and Council Area variables within the SMR dataset. This may introduce minimal changes when compared to previous releases.
Future Developments
In December 2016 the Scottish Government published "The Modern Outpatient: A Collaborative Approach 2017-2020" (external website) that aims to deliver care closer to the patients home, provide more person-centred care, utilise new and emerging technologies, and maximise the role of clinicians across Primary, Secondary and Community based services.
Early in 2018, the Modernising Outpatient Programme (MOP) led by the Scottish Government, commissioned Public Health Scotland (PHS) [previously Public Health & Intelligence (PHI)] to work with stakeholders to review the SMR00 dataset, make an initial assessment of the need for change, and identify key deliverables. PHS Data Advice identified gaps in the existing national dataset (SMR00) that does not allow the full pathway to be appropriately recorded.
In order to meet the objectives that were set out in the “Modern Outpatient” agenda and to ensure our secondary care datasets meet future information needs, PHS has been working with key stakeholders to establish a Modernising Patient Pathways Programme (MPPP) of all SMR datasets, with an initial focus on outpatients, to take account of new, and future, service delivery models. This will support patient and service management at NHS Board level as well as providing more accurate and appropriate clinical information at a national level.
The SMR00 Modernisation work may have an effect on the number of SMR’s submitted. In addition, other disciplines of staff (e.g. nurse practitioners) are increasingly carrying out care for patients which may impact on the number of consultant-led clinics run.
Relevance and key uses of the statistics
Please see the how is the data used section and the Strengths and Limitations within the Data Quality section.
Concepts and definitions
Please see the Methods used to produce the data and the Glossary sections.
Data Quality and Completeness
For more information please see the Data Quality and Data Trends sections.
Pre-Release Access
Under terms of the "Pre-Release Access to Official Statistics (Scotland) Order 2008", PHS are obliged to publish information on those receiving Pre-Release Access. ("Pre-Release Access" refers to statistics in their final form prior to publication.) The standard maximum Pre-Release Access is five working days.
This Pre-Release Access is for the sole purpose of enabling that department to gain an understanding of the statistics prior to briefing others in Scottish Government (during the period of standard Pre-Release Access).
Shown below are details of those receiving Standard Pre-Release Access and those receiving Extended Pre-Release Access.
Standard Pre-Release Access
- Scottish Government Health Department
- NHS Board Chief Executives
- NHS Board Communication Leads
Early Access for Quality Assurance
These statistics will also have been made available to those who needed access to help quality assure the publication:
- Public Health Scotland, Data Driven Innovation – Data Management Team
- Scottish Government Performance and Delivery Directorate – Deputy Director, Principal Information Analyst
Early Access for Management Information
These statistics will also have been made available to those who needed access to ‘management information’, ie as part of the delivery of health and care:
- Scottish Government, Directorate for Mental Health and Social Care – Team Leader Mental Health
Disclosure
Disclosure control methods have been applied to the data in order to protect patient confidentiality, therefore some figures may not be additive. The PHS protocol on Statistical Disclosure Protocol (PDF) is followed.
Value type and unit of measurement
In general, figures are shown as numbers, percentages or rates.
Coherence and clarity
Previous publications are available on the Hospital Care Landing page. Information published prior to September 2019 is listed on the Hospital Care Publication page.
Official Statistics designation
The UK Statistics Authority has designated these statistics (external website) as National Statistics signifying compliance with the Code of Practice for Statistics, available on the UK Statistics Authority website (external website).
UK Statistics Authority Assessment
The statistics last underwent a full assessment (external website) by the Office for Statistics Regulation (OSR) against the Code of Practice in September 2011. The OSR is the regulatory arm of the UK Statistics Authority.
Comparability
The Office of National Statistics United Kingdom Health Statistics 2010 publication (external website) provides a single point of reference for the comparison of key figures between the four constituent countries of the UK. Hospital activity and bed statistics can be found within chapters 6 and 8 respectively. Whilst the four UK countries worked collaboratively to maximise the comparability of the figures, it is important to note that differences between the countries remain in the way that data measures are collected and classified, and because of differences between countries in the organisation of health and social services. The report includes the details of these differences where relevant.
Hospital activity data from England, Wales and Northern Ireland are available separately but should not be directly compared with published data from Scotland.
- England - Hospital Episode Statistics (HES) (external website)
- Wales - NHS Hospital Activity (external website)
- Northern Ireland - Hospital Statistics & Research (external website)