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Hospital Episode Statistics (HES)

The Network of Public Health Observatories is now part of Public Health England.

This page contains historical information.

HES e-Atlas

The HES e-Atlas is no longer maintained or updated. This version, containing 2009-10 data, remains here as an archive. HES-derived indicators are available in other tools, such as Health Profiles and the Public Health Outcomes Framework Tool

HES Group Mission Statement

Representatives from England’s Public Health Observatories (PHOs) have established a Hospital Episode Statistics (HES) group who work together to produce national standard HES outputs.

"Good quality information is paramount in providing good services and planning for the future. The aim of the HES group at APHO is to provide information about key public health issues to a broad range of users, such as health care organisations and the public. By working collaboratively we aim to share our knowledge and expertise to ensure consistency in data and high standards of analysis which result in good quality information."

What are HES?

HES are a suite of record-level data sets comprising inpatient, accident and emergency, outpatient and patient reported outcome measures (PROMs) data.

The inpatient data set is the most commonly used, holding data from 1989 onwards. It is patient based, and is made up of records for each period of care under one consultant (episodes). Each episode is made up of information relating to the patient such as age, sex, ethnicity and home postcode; the treatment journey such as admission and discharge dates, diagnoses, and operations; and information relating to organisations and professionals associated with the patient’s care. These include: the organisations paying for and providing treatment; the patient’s registered GP; and the team providing inpatient treatment. There are also specific subsets of data relating to maternity and psychiatric care.

Outpatient and accident and emergency datasets contain similar information. Outpatient data are available from April 2003 onwards and A&E data from April 2007 onwards.

PROMs data are currently available from April 2009 onwards, for groin hernia, hip replacement, knee replacement and varicose veins. The focus of these data is different from the other HES datasets. They are designed to look at how the patient felt before and after their operation, in order to measure improvement in their wellbeing.

What are HES data used for?

Patient confidentiality is very important. Any organisation that has access to HES data at record level, or aggregation of very small numbers, signs the HES Protocol. The HES protocol is a document containing very specific instructions regarding what the data can be used for, and how to ensure confidentiality is maintained. The data cannot, under any circumstances, be used to identify specific individuals. The HES protocol states that the data may be used for:

  • Local NHS management
  • Planning and target setting
  • Performance management
  • Clinical governance
  • Benchmarking
  • Comparative analysis
  • Needs assessment and fair access to healthcare
  • Epidemiology
  • Monitoring of health improvement and the effective delivery of healthcare
  • Medical/health research

How do the Public Health Observatories use HES data?

PHOs are health intelligence organisations, providing information and analyses that focus on improving health and reducing inequalities.

We offer HES services at a number of levels. Where appropriate we produce national products such as the National HES e-Atlas (see above). This product breaks down the number of hospital admissions by commissioner and local authority. It shows the differences in geographic areas allowing health professionals to identify and build upon good practice.

There are a number of national products produced by individual observatories that are based on HES or include HES data:

PHOs also provide services at a local level. We produce reports, local atlases and tools, and answer bespoke requests. Examples of reports and local atlases can be found on individual PHO websites, along with links to PHO papers and peer reviewed journal articles.

The work of the PHOs often centres on the needs of the public sector such as health service organisations or local authorities however we also work closely with a raft of other organisations both public and private. For example we often provide data to universities and consultancies for the purposes of research or ongoing analyses.

Bespoke requests

We normally only provide aggregate data where the total episodes (or other indicator such as number of days in hospital) amount to six or above, for an area the size of a local authority. This ensures that there is no risk of individual patients being identified from the data. Where this does not give sufficient detail Public Health Observatories have the authority to supply more specific data, under strict guidance contained in the HES Protocol.

The receiving organisation also signs up to the HES protocol to ensure they are fully aware of the conditions under which they can handle data. This includes ensuring that the data are not passed on unless aggregated to a high enough level (over six episodes, or six days in hospital etc.); undertaking to destroy data when they are no longer needed; and ensuring that both the physical and virtual environments in which the data are stored are secure.

Local Public Health Observatories

You can find more detailed information about your local public health observatory and how to contact them by clicking on the links below:

  • East Midlands Public Health Observatory
  • Eastern Region Public Health Observatory
  • London Health Observatory
  • North East Public Health Observatory
  • North West Public Health Observatory
  • South East Public Health Observatory
  • South West Public Health Observatory
  • West Midlands Public Health Observatory

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