EMPHO Hospital Episode Statistics (HES) Service
What is HES?
Hospital Episode Statistics (HES) provides information on admitted patient care delivered by NHS hospitals in England from 1989 onwards. Each financial year around 12 million records for inpatients and day cases are generated containing data such as age, sex, dates of admission and discharge, diagnoses and operations and procedures.
A full list of variables collected, and their definitions, can be found within the Hospital Episodes Statistics Data Dictionary.
HES provides a comprehensive picture of inpatient care that can support public health analysis, planning and resource allocation, benchmarking, clinical audit, monitoring and performance management and research. It can offer a longitudinal picture of particular conditions or procedures. It can support local NHS analysis of activity and allows comparisons between Trusts, PCTs, SHAs, LAs, etc. In addition it also provides data for the construction of a large percentage of the NHS Performance Indicators which summarise quality and performance in the NHS.
HES Safe Haven
Following Shifting the Balance of Power, the Department of Health widened access to the Hospital Episodes Statistics (HES) through HES Safe Havens managed by the Public Health Observatories. EMPHO has access to a safe haven extract for the East Midlands - patients resident or treated in the East Midlands or registered with GPs in the region - going back 10 years as well as access to on-line national data.
Work already undertaken using data supplied from the EMPHO HES Safe Haven includes:
- Admission rates for accidental injury by PCT of residence and local authority
- Revascularisation rates by PCT of residence
- Admission rates for children by PCT of residence
- Admission rates for childhood asthma by PCT of residence
- 28 day in-hospital mortality rates for Heart Failure and COPD
- Numbers of admission by ethnic group for various diagnoses
- Health equity audit.
HES is not a live system and it usually takes between 9 and 12 months for a full financial year to be available through on-line HES or the safe haven extract. So, for example, complete 2003/04 data would not be available until December 2004 or thereabouts.
What can EMPHO provide?
Responsive ad-hoc service
If you want to request HES data please see the 'How to contact us' section below.
We may need to discuss your request in order to refine and confirm your requirements. Please give as much notice as possible.
- We generally provide data to allow you to perform further analysis rather than finished products.
- We provide aggregate data - we cannot provide individual record data, except in exceptional cases and with agreement from the Department of Health.
- We are keen that, wherever possible, information requested should inform regional knowledge and not just be for a local enquiry, and may prioritise work on the basis of this.
- We may also advise you when information requested could be more reasonably obtained from another source.
It is anticipated that requests for the service will come primarily from the NHS, particularly PCTs, although, data may be of use to academics and the research community. Those involved in partnerships with health, e.g. local authorities will also be able to use the service.
The HES service will be provided free at the point of enquiry, although this may need to be reviewed in the future.
Standard outputs
We are in the process of developing a set of standard PCT-based key HES indicators. Initially these will cover eight key topic areas: general admissions, accidents, CHD and stroke, diabetes, mental health, older people, respiratory disease and sure start. The set will expand over time.
Confidentiality
Information about individuals is highly sensitive. Therefore, in general, we only provide aggregate data – we cannot provide individual record data, except in exceptional cases and with agreement from the Department of Health. It is recognised that certain data items, including postcode, sex and date of birth (collectively known as “the potential identifiers”), can in combination be used to identify individual patients. Hence, EMPHO cannot, under any circumstances, release these potential identifiers to a third party.
In addition to this, Department of Health guidelines require the suppression of any aggregated data containing values between 1 and 5 at a local level as these are considered to be potentially disclosive. Alternatives to suppressing low numbers include considering a higher level of aggregation. However, if compromises are not suitable, customers can make a business case for access to low numbers which will be considered by EMPHO with advice from the Department of Health.
National work
EMPHO works closely with other members of the Association of Public Health Authorities (APHO) via the HES management group and HES technical group. The technical group has developed password-protected web pages for the sharing of data quality issues and useful data queries and the recording of ad-hoc requests and projects.
Future enhancements
A number of enhancements to online HES are planned. These include:
- The inclusion of outpatient data from 2003/2004 (HES currently only includes data on admitted patients)
- The addition of IMD (indices of multiple deprivation) scores to records
- The creation of calendar year views of data (currently financial)
- The creation of continuous inpatient spells (as used in the creation of clinical indicators).
How to contact us
Data requests
To make an ad-hoc request for HES data please please send an e-mail to
which should include the following details:
- Name
- Job title
- Organisation
- Address
- Phone number
- Purpose/use of analyses
- Financial years required
- OPCS procedure codes required
- ICD10 codes required
- Organisation codes (NHS Trust, PCT)
- Coverage area [e.g. PCT, local authority, Region etc]
- Date by which data is required
E-mail or phone
If you would prefer to discuss your request or have any suggestions for future standard outputs please contact Heather Heard on (01623) 812069 or by