30 May 2023

November 2023

April 2023

Summary of inpatient, day case and outpatient activity and bed statistics for NHSScotland

Hospital care

Health and social care

Data from the quarter ending 31 December 2017 to the quarter ending 31 December 2022

This data release is updated quarterly.

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 does not record information on the age or sex of patients, nor the deprivation of the area in which they live.

All our data releases are in line with our guidelines for accessibility. This data release last underwent assessment in September 2011 (external website) by the UK Statistics Authority.

Reports include quarterly data up to 31 December 2022.

There are known issues with the quality of data presented, such as the inpatient and day case completeness. For more information, please see the Data quality and Trend data sections.

In 2017, the specialty groupings were updated in order to better align with clinical practice. This led to changes in the figures for some groupings compared to previous published figures, including an apparent decrease in ‘acute specialty’ figures. For this reason, the inpatient and outpatient activity and the average available staffed beds for acute specialties from publications prior to November 2017 cannot be directly compared to the numbers presented here.

A review of specialty spells and beds estimations methodologies was 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 the Methods used to produce this data release section and the Specialty Spells Methodology paper (PDF, 313 KB).

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 (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 since been resolved from the November 2020 release onwards.

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.

Acute Assessment Unit (AAU)

The AAU is a dedicated facility for the acute clinical care of patients who 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 that form part of the hospital’s 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 unit
• clinical assessment unit
• acute medical (assessment) unit
• paediatric assessment unit
• 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 day case services only.

These cases should be recorded under significant facility 39.

AAU activity is currently only being submitted by some NHS Boards within SMR01. NHS Greater Glasgow & Clyde AAU activity stopped in 2017. NHS Highland has been submitting AEC cases via SMR01 using criteria agreed by Public Health Scotland (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 it considers a number of these cases to be non-elective day cases that, due to recording rules, cannot be recorded that way on TrakCare. As such, the board took the decision to record them as Emergency Department activity to enable the patient to be tracked throughout the system. However, from September 2019 onwards, the Royal Alexandra Hospital within NHS Greater Glasgow & Clyde has started to record AAU cases again within SMR01.

NHS Western Isles and NHS Ayrshire & Arran started submitting AEC cases via SMR00 from June 2020 and July 2021, respectively. NHS Dumfries & Galloway, NHS Borders and NHS Tayside have been submitting AEC cases via SMR01 from August 2020, May 2022 and June 2022, respectively. Data Management has been in contact with these NHS Boards to discuss whether the records should be updated to reflect a more appropriate significant facility code. NHS Western Isles has since updated the facility code to '11 – Other' and resubmitted these records. NHS Ayrshire & Arran has said that it has changed the Deep Vein Thrombosis (DVT) clinic held at its Clinical Decisions unit to significant facility 39 from July 2021. NHS Dumfries & Galloway has informed that these cases are part of a trial where advanced nurse practitioners see suitable patients. If required, these will be passed to consultants to be seen under significant facility 40 (Acute Assessment Unit/Acute Medical Unit). NHS Borders and NHS Tayside have confirmed that this is valid activity being recorded as per PHS guidance. NHS Lothian has said that it does not plan to update the significant facility codes it uses: therefore, it remains difficult to quantify ambulatory-care activity.

There are ongoing discussions with NHS Boards, the Scottish Government and PHS on the most appropriate way for capturing this activity (including AEC cases). It is hoped that national definitions and guidance on how to record this activity can be agreed by all NHS Boards.

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 nine-digit codes have been generated: council areas, electoral wards, Health Boards, Health and Social Care Partnerships (HSCP), police divisions, fire and rescue, postcodes and LAU1. The changes for geography codes commonly used by PHS are as follows:

The second change has been to the Cardowan and Stepps areas of Glasgow and North Lanarkshire. The official implementation date of this change was 1 April 2019. As a result, the boundaries for the Health Boards (NHS Greater Glasgow & Clyde, NHS Lanarkshire) and HSCPs (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:

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  still exists and is now a treatment centre named 'Mountainhall Treatment Centre' (Y177C).

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 Surgery, Plastic Surgery and Trauma & Orthopaedic Surgery outpatient consultations since the start of July 2020. From January 2021, the hospital treated day case patients within the Gastroenterology and General Surgery specialties. The NHS Louisa Jordan hospital closed at the end of March 2021.

Geographical coding changes have been applied to make the coding of 'Other' locations (such as when patients have no fixed abode and are resident outside Scotland/UK) to be consistent with PHS Open Data Geography Codes (external website).

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 a minimal effect on the statistics. If data providers discover that data submitted for publication are incorrect and/or missing or incomplete (and when this is significant), these data can be re-submitted and published in subsequent releases. Any changes will be highlighted within the publication release following the guidance within the PHS revisions policy.

The geography and SIMD lookup files are based on the latest versions of the National Records of Scotland Scottish Postcode Directory available at the time of data analysis.

'Postcode' has been used to map directly to NHS Boards 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.

Please see the How are the data used section and the strengths and limitations within the Data quality section.

Please see the Methods used to produce this data release and the Glossary sections.

For more information, please see the Data quality and the Trend data sections.

Under terms of the 'Pre-Release Access to Official Statistics (Scotland) Order 2008', PHS is 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 the department concerned 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
• Scottish Government Performance and Delivery Directorate – Deputy Director, Principal Information Analyst(s)/Statistician(s)

Early access for management information

These statistics will also have been made available to those who needed access to ‘management information’, including as part of the delivery of health and care:

• Scottish Government Performance and Delivery Directorate – Deputy Director, Principal Information Analyst(s)/Statistician(s)

Disclosure control methods have been applied to the data to protect patient confidentiality: therefore, some figures may not be additive. The PHS Statistical Disclosure Protocol is followed.

In general, figures are shown as numbers, percentages or rates.

Versions of this publication released before 16 March 2020 may be found on the Data and Intelligence website (external website). Information published prior to September 2019 is listed on the Hospital Care Publication page (external website).

The UK Statistics Authority has designated these statistics as National Statistics (external website), signifying compliance with the Code of Practice for Statistics available on the UK Statistics Authority website (external website).

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.

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. While 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)