Acute hospital activity and NHS beds information (quarterly)
Quarter ending 31 December 2021

A National Statistics publication for Scotland

Published: 31 May 2022
Type: Statistical report
Author: Public Health Scotland

Hospital care

Methods used to produce this data release

This page describes the methodologies used to produce the figures contained in this release. It includes details on the data presented, the data sources, how groups are defined (if applicable) and how calculations are carried out.

1. Outpatients

The following information on outpatient appointments (for consultant-led activity only) is presented:

number of new and return attendances
Did Not Attend (DNA) rates

Information on new attendances and DNA rates is taken from the SMR00 database. Return appointments are taken from ISD(S)1. Please refer to the Data quality section for further information.

Statistical disclosure control has been applied to this analysis.

1.1 New and return appointments

New and return appointments are defined by referral types.

New appointments:

referral type = 1
referral type = 2

Return appointments:

referral type = 3

See the PHS Data Dictionary entry on ‘referral type’ (external website) for further information on what this means.

1.2 Did Not Attends (DNAs)

DNAs are identified from the attendance status on SMR00 records. DNA rates are calculated from new appointments only and are presented as a percentage of the total number of new outpatient appointments.

Did Not Attends (DNAs):

attendance status = 8 (patient did not attend and gave no prior warning)

See the PHS Data Dictionary entry on ‘attendance status’ (external website) for further information on what this means.

2. Inpatient and day case admissions

The following information on inpatient and day case admissions (for acute specialties only) is presented:

the number of episodes and stays by NHS board, hospital, council area, admission type, age and sex, deprivation and specialty
average length of stay

All of this information is taken from the SMR01 database. Please refer to the Data quality section for further information.

Statistical disclosure control has been applied to this analysis.

2.1 Inpatient and day case activity

Inpatient admissions are defined by admission types.

Elective (routine) admissions:

admission type = 10–12 and 19

Emergency admissions:

admission type = 20–22, 30–36, 38–39

Transfers:

admission type = 18

Day cases are defined by the inpatient/day case marker:

IPDC = D

See the PHS Data Dictionary entry on ‘admission type’ (external website) for further information on what this means.

Table 1: Example patient flow

Episode admission	Episode discharge	Continuous inpatient stay	NHS board	Hospital	Episode length of stay	Specialty
01/10/2017	01/10/2017	1	A	A	0	A1
01/10/2017	05/10/2017	1	A	A	4	A1
05/10/2017	10/10/2017	1	A	A	5	A2
10/10/2017	20/10/2017	1	A	A	10	A2
20/10/2017	21/10/2017	1	B	B	1	C1
31/10/2017	01/11/2017	2	B	C	1	A1

2.2 Episodes

This data release would calculate episodes from Table 1 as follows:

episodes by NHS board – four episodes for board A with an average length of stay of 4.75 days and two episodes for board B with an average length of stay of 1 day
episodes by hospital – four episodes for hospital A with an average length of stay of 4.75 days, one episode for hospital B with an average length of stay of 1 day and one episode for hospital C with an average length of stay of 1 day
episodes by specialty – three episodes for General Medicine (A1) with an average length of stay of 1.7 days, two episodes for Cardiology (A2) with an average length of stay of 7.5 days and one episode for General Surgery (C1) with an average length of stay of 1 day

2.3 Stays

A stay is a continuous, unbroken period of time that a patient spends as an inpatient in an acute facility. A patient may change specialty, consultant, significant facility, NHS board and/or hospital during a continuous inpatient stay. Because of this, information used to assign a stay to a specific hospital or NHS board must be taken from a single episode within a stay. The rules to decide which data are taken from which episodes are defined as follows:

age – taken from first episode
NHS board – taken from first episode
hospital – taken from first episode
emergency/elective/transfer – taken from first episode
date of discharge – taken from last episode

A stay which has a mix of inpatient and day case episodes is counted once as an inpatient stay. For example, if a stay begins as a day case but then is subsequently admitted as an inpatient, this will be classed as an inpatient stay. If all of the episodes in a stay are day case episodes, then the stay is counted as a day case.

Using the above rules, this data release would calculate stays using the information from Table 1 above as follows:

stays by NHS board – one stay for board A with a length of stay of 20 days and one stay for board B with a length of stay of 1 day
stays by hospital – one stay for hospital A with a length of stay of 20 days and one stay for hospital C with a length of stay of 1 day

The length of stay associated with hospital B is incorporated into the same stay as the admitting (first) hospital of the stay, hospital A in this case, which is attributed all of the length of stay for this stay (20 days).

2.4 Specialty spells

A specialty spell is an unbroken period of time within a continuous inpatient stay that a patient spends in a specific specialty in a specific location. There has been a change in how a specialty spell has been calculated to be consistent with our annual publication. The new method better describes the number of admissions to a given specialty in a given location.

There can be multiple specialty spells within a larger continuous inpatient stay and, as such, the episodes are grouped by link number, CIS marker, specialty and NHS board. The inclusion of NHS board in the aggregation is to account for any movements out of the board. The other assumptions in the spell calculation follow similar rules to continuous inpatient stays:

emergency/elective/transfer – taken from first episode within stay
date of discharge – taken from last episode within specialty

This change in methodology means that figures pre-November 2020 are not comparable with this publication. For more information on the specialty spells methodology, please see the Specialty Spells Methodology paper (PDF, 313 KB).

3. Beds

The following information on hospital beds is presented:

total number of available staffed bed days over the quarter
total number of occupied bed days over the quarter
average number of available staffed beds per day
average number of occupied beds per day
percentage occupancy

All of this information is taken from the ISD(S)1 data returns. Please refer to the Data quality section for further information.

3.1 Beds calculation

Bed figures are calculated based on the ISD(S)1 data returns.

Total number of available staffed bed days (AASB) = Sum of all available staffed beds (external website) for each day in the quarter

Average number of available staffed beds per day (ASB) = AASB ÷ number of days in the quarter

Total number of occupied bed days (TOBD) = Sum of all occupied beds (external website) for each day in the quarter

Average number of occupied beds per day (AOB) = TOBD ÷ number of days in the quarter

Percentage occupancy = (AOB ÷ ASB) × 100

Please refer to the Glossary section for more information about the terms used.

Due to the way specialties are recorded for beds data, it is not possible to use the PHS beds statistics to estimate the total number of beds available for use for different services and/or departments. For example, selecting the Paediatric specialty grouping will only provide a partial picture of the staffed beds that are used for children’s services. This is because many beds used for children are not recorded under paediatric specialties and are instead recorded under more specific specialties such as Haematology, Neurology and Respiratory Medicine. Furthermore, the specialty recorded for a bed depends partly on what the patient is being treated for; therefore, the mix of specialties may change over time for some wards. Similarly, analysis of the Accident & Emergency specialty bed usage will only provide inpatient and day case information on beds within the Accident & Emergency specialty, for example Accident & Emergency ward beds and observation beds staffed overnight. It will not provide information on the services/capacity within Accident & Emergency departments as a whole.

4. Other points to note

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.

Specialties have been assigned a specialty grouping based on their specialty code. There are two specialty groupings (external website) that most specialties sit in: Medical and Surgical. The Acute specialty grouping includes the Medical and Surgical groupings combined. Further information on which specialty codes are assigned to which specialty groupings is available in the specialty grouping file (XLS, 23.2 KB)

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 day case figures.