Statistical Notes

These notes give details of the basis on which the information in the Performance Tables was calculated. They also provide a description of how Trusts have been grouped into different types of Trust.

TABLE 1 HOSPITAL WAITING TIMES

Waiting times: % of outpatients seen within 13 or 26 weeks of referral by a GP

See entry for Tables 3a and 3b.

Outpatient non-attendance

Definition

The number of first outpatient appointments where the patient did not give advance warning that they would not be attending, as a percentage of all first outpatient appointments.

Period

1 January to 31 March 1998.

Source

Complete count of first outpatient appointments, as reported on the central return QM08.

Notes

The count covers all consultant-led outpatient clinics. Patients who gave advance warning of their non-attendance are not included. Advance warning means that the patient notified the hospital before the day of their appointment.

The base figure includes appointments resulting from all types of referral except those initiated by the consultant in charge of the clinic and those resulting in ward attendance for nursing care. Figures presented are rounded to the nearest whole percentage point.

Arrows are not shown for this indicator.

Wait in outpatient clinics

Definition

The number of outpatient attendances where the primary consultation began within 30 minutes of the appointment time, as a percentage of all outpatient attendances.

Period

1 January to 31 March 1998.

Source

Complete count or estimate based on a representative sample of patients attending outpatient clinics.

Notes

The sample or count covers all clinics where the patient can reasonably expect to have an individual timed appointment, whether led by a consultant, a nurse, or other professional such as a physiotherapist. Certain genito-urinary medicine clinics may be excluded to maintain patient confidentiality. Patients arriving without an appointment are not included. Those arriving late are not included if they arrived after the consultant was ready to see them. The appointment times sampled are those for the primary consultation; appointments for pre-tests are excluded. Figures presented are rounded to the nearest whole percentage point. If sampled, the figure quoted is accurate to within 5 percentage points up or down.

Waiting times: % of patients admitted within 3 or 12 months

See entry for Tables 4a and 4b.

Inpatient non-attendance

Definition

The percentage of elective admissions, for all specialties, for which the patient failed to attend.

Period

1 April 1997 to 31 March 1998.

Source

Data was taken from the KH06 return.

Notes

The count covers all specialties total for both ordinary and day case admissions.

Arrows are not shown for this indicator.

Operations cancelled

Definition

The number of patients admitted electively for their operation between 1 January and 31 March 1998 who had suffered a last-minute cancellation for non-medical reasons and waited over a month for admission since that cancellation

plus

the number of elective patients who had their first cancelled operation before 1 March 1998 and who, at 31 March 1998, had not yet been admitted and treated.

Period

1 January to 31 March 1998.

Source

Complete count of records.

Notes

A last-minute cancellation is one made by the provider for non-medical reasons on the day of or after admission. If a patient is transferred between providers, cancellations by previous providers are taken into account.

The figures do not include cases where a patient has, for personal reasons, turned down a first date for treatment in the following month and a second reasonable date is subsequently offered and turned down by the patient.

Arrows are not shown for this indicator.

TABLE 2 DAY CASE SURGERY

Definition

For each procedure, the number of elective FCEs (finished consultant episodes, waiting list and booked) done on a day case basis, as a percentage of the total number of elective FCEs for that procedure.

Period

FCEs completed between 1 April 1997 and 31 March 1998.

Source

Complete count from inpatient contract minimum dataset for elective admissions.

Notes

A day case episode is one in which the patient is planned to be, and is, admitted, treated and discharged on the same day. The percentages for a procedure are not presented where a unit has 30 or fewer FCEs for that procedure (indicated as + in the Tables). Figures presented are rounded to the nearest whole percentage point.

TABLE 3 WAITING TIMES: % OF OUTPATIENTS SEEN WITHIN 13 OR 26 WEEKS

Definition

For each of the selected specialties, the number of patients who, following written referral by a GP to a consultant, are seen within 13 or within 26 weeks of the date of receipt of the referral letter, as a percentage of the total number of such patients seen.

The figure in the 'all specialties' column is the total for all the specialties offered by that Trust and not just the total of those specialties which are listed separately in Tables 3a and 3b.

Period

Patients seen for their first outpatient appointment between 1 January and 31 March 1998.

Source

Complete count of outpatients seen for their first appointment, as reported on the central return QM08.

Notes

Waiting time is the difference in days between the date the GP's referral letter was received by the hospital or community unit and the date when the patient was seen at the outpatient clinic. For patients who refuse an appointment or who fail to attend, whether giving advance warning or not, the waiting time is the interval between the last missed appointment and the date when the patient was seen at the outpatient clinic. The percentage seen within 26 weeks includes those seen within 13 weeks. The percentages for a specialty are not presented where a unit has seen 30 or fewer written referrals to that specialty (indicated as + in the Tables). Figures presented are rounded to the nearest whole percentage point.

TABLE 4 WAITING TIMES: % OF PATIENTS ADMITTED WITHIN 3 OR 12 MONTHS

Definition

For each of the selected specialties, the number of NHS or amenity patients admitted electively (waiting list or booked, not planned) within 3 or within 12 months of the decision being made to admit, as a percentage of the total admitted electively to the specialty.

The figure in the 'all specialties' column is the total for all consultant-led waiting lists in that Trust and not just the total of those specialties which are listed separately in Tables 4a and 4b.

Period

First episodes that started between 1 April 1997 and 31 March 1998.

Source

Complete count from inpatient contract minimum dataset for elective admissions.

Notes

Waiting time is the difference in days between the date of admission and the date on which the decision to admit was made. This waiting time is not adjusted where patients refuse an offer of admission ('self deferral') or where they are suspended temporarily from the waiting list for medical or social reasons. This waiting time differs from that used to produce published waiting list statistics, which are a count of the number of patients waiting for treatment and how long they have been on a waiting list - adjusted for both self-deferral and medical suspension. Only the first episode of care is counted where there is more than one in the same spell in a provider. Only patients whose waiting time is one or more days are included. Those patients who waited 90 days or less are included under 'within 3 months' and those waiting 364 days or less under 'within 12 months'. The latter category includes those waiting under 3 months. The percentages for a specialty are not presented where a unit has 30 or fewer admissions to that specialty (indicated as + in the Tables). Figures presented are rounded to the nearest whole percentage point.

TABLE 5 NHS COMPLAINTS

Written complaints

Definition

The total number of written complaints made by, or on behalf of NHS patients. A complaint which is put into writing at any stage, even if initiated orally, is treated as a written complaint. Complaints received during the previous year, but dealt with in the reporting period are excluded.

Period

1 April 1997 to 31 March 1998.

Local resolution

Definition

The total number of written complaints for which local resolution action was completed within the 4 weeks performance target, including those which subsequently progressed to independent review.

Period

1 April 1997 to 31 March 1998.

Independent review

Definition

The total number of requests that an Independent Review Panel should be convened. A request for an Independent Review Panel is not regarded as a separate complaint.

Period

1 April 1997 to 31 March 1998.

Source

Data on NHS complaints were taken from KO41A return.

Notes

Arrows are not shown for the above indicators.

TABLE 6 HEALTH AUTHORITIES

Cervical screening

Definition

For each Health Authority, the percentage of eligible women aged between 20 and 64 who had received an adequate cervical smear test in the five years preceding 30 September 1997.

Period

Eligible population of women at 30 September 1997.

Source

Data taken from Quarterly Monitoring return QMX0.

Notes

The figures include all women aged between 20 and 64 at 30 September 1997 who are resident in the Health Authority, with the exception of women who have undergone hysterectomy operations. Women who have received smear tests which doctors decided were clinically inadequate are included in the base figure but do not count towards the numerator. The figures have been rounded to the nearest whole percentage point.

Target

The screening programme target is to ensure that at least 80 per cent of eligible women aged between 20 and 64 receive an adequate cervical smear test at least every five years.

Breast screening

Definition

For each Health Authority, the percentage of eligible women aged between 50 and 64 who had been screened for breast cancer in the three years preceding 30 September 1997.

Period

Eligible population of women at 30 September 1997.

Source

Data taken from Quarterly Monitoring return QMX0.

Notes

The figures include all women aged between 50 and 64 at 30 September 1997 who are resident in the Health Authority, with the exception of women who have undergone a bilateral mastectomy. The figures have been rounded to the nearest whole percentage point.

Breast cancer registrations

Definition

The standardised registration ratio for malignant neoplasm of female breast (ICD Code 174) as defined in the Public Health Common Data Set.

Period

Cancers registered in calendar years 1989-1991, pooled.

Source

Data taken from the Public Health Common Data Set 1997.

Notes

The standardised registration ratio (SRR) is the ratio of observed to expected registration in a Health Authority area multiplied by 100. The expected registrations were derived by applying the age-specific rates for England and Wales to the corresponding age-specific resident population.

Arrows are not shown for this indicator.

Breast cancer mortality

Definition

The standardised mortality ratio for malignant neoplasm of the female breast (ICD Code 174) as defined in the Public Health Common Data Set.

Period

Deaths registered in calendar years 1994-1996, pooled.

Source

Data taken from the Public Health Common Data Set 1997.

Notes

The standardised mortality ratio (SMR) is the ratio of observed to expected deaths in a Health Authority area multiplied by 100. The expected deaths were derived by applying the age-specific death rates for England and Wales to the corresponding age-specific resident population.

Arrows are not shown for this indicator.

Vaccination and immunisation

Definition

For each Health Authority, the percentage of children reaching their second birthday between 1 October and 31 December 1997 who received a full course of immunisations by their second birthday.

Period

Position as at 31 December 1997.

Source

COVER/Körner data supplied by Health Authority Immunisation Co-ordinators to the Public Health Laboratory Service (PHLS).

Notes

The figures are based on a full count of children resident in the Health Authority who had reached their second birthday between 1 October and 31 December 1997. A full course of immunisation represents three doses of diphtheria vaccine and one dose of MMR vaccine respectively. The figures, which were supplied by the Public Health Services Laboratories, have been rounded to the nearest whole percentage point.

Target

The Department of Health's target for each of the vaccines is to ensure that at least 95 per cent of children receive a complete course of immunisations by their second birthday.

Delayed discharge - patients aged 75 and over

Definition

The total number of patients aged 75 and over ready for discharge but still occupying a hospital bed as a percentage of total number of persons aged 75 and over resident in the Health Authority less the number of patients aged 75 and over occupying a hospital bed.

Period

Position as at 16 March 1998.

Source

Data taken from the Quarterly Monitoring return QMX7.

Notes

The number of patients occupying a hospital bed excludes those under the care of a psychiatric consultant. The reasons for delayed discharge include:

awaiting completion of assessment,

awaiting local authority funding,

awaiting transfer to NHS-funded care other than in a hospital,

awaiting nursing/residential care home placement,

awaiting domiciliary package,

and decision on continuing care being reviewed.

Arrows are not shown for this indicator.

Emergency admissions

Definition

The number of emergency admissions of patients aged 75 and over to hospital providers as a percentage of total number of persons aged 75 and over resident in the Health Authority.

Period

1 January to 31 March 1998.

Source

Data on emergency admissions was taken from the Quarterly Monitoring return QMX7.

Notes

The number of patients aged 75 and over excludes those under the care of a psychiatric consultant.

Arrows are not shown for this indicator.

TABLE 7 AMBULANCE SERVICE EMERGENCY (999) RESPONSE TIMES

Emergency response times (Table 7a)

Definition

Of those emergency calls which result in an ambulance arriving at the scene of an incident, the proportion where the ambulance arrives within set target times (14 minutes for urban authorities, 19 minutes for rural).

Period

1 April 1997 to 31 March 1998.

Source

Data taken from return KA34.

Notes

An emergency call is a 999 call requesting a response to an incident or sudden illness, a maternity admission requiring immediate emergency response, or other type of patient for whom an emergency procedure is necessary. Emergency response time is defined as the elapsed time from receipt of an emergency call (ie from when the call is answered or as soon as possible thereafter) to the time of patient rendezvous of a vehicle and two fully trained crew. Calls which prove to be hoaxes once the ambulance arrives at the scene or where patient assistance is not needed after all are included, but calls aborted before arrival at the scene are not. The figures include calls made from outside a Service's usual geographical area of coverage. Figures presented are rounded to the nearest whole percentage point.

Call prioritisation system (Table 7b)

Definition

For those ambulance services operating the new call prioritisation system, the proportion where the rapid response vehicle arrives within set target times (for Category A calls: 8 minutes for both urban and rural areas, and for Category B calls: 19 minutes in rural and 14 minutes in urban areas).

Period

1 April 1997 to 31 March 1998.

Source

Data taken from return KA34 (new).

Notes

The new prioritisation procedures require that all emergency calls are classified as either immediately life threatening, Category A, or other emergency calls, Category B. For Category A and B calls, an emergency response can be a rapid response vehicle crewed by a paramedic equipped to provide treatment at the scene of the incident, or an approved first responder despatched by, and accountable to, the ambulance service.

Arrows are not shown for this indicator.

TYPES OF TRUST

In Tables 1 to 5, the letter that appears next to each Trust name gives an indication of the main services that it provides. This information has been included to help you compare the performance of your local Trust against the performance of other Trusts which provide a broadly similar range of services.

Each Trust has been placed into one of five groups. The groups and the corresponding letters are:

A	All services hospital Trust.
G	General hospital Trust.
M	Mainly mental health/mental illness hospital Trust.
S	Specialist hospital Trust.
T	Teaching hospital Trust.

In general, each Trust has been placed in the group which reflects the greater part of its services. This means, for example, that a Trust in the 'General hospital' group may provide a small amount of mental health services.