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One of the problems highlighted in the letter by Brennan et al (1) relates to the fact that most data submitted by Trusts into Secondary User Services (SUS) for Hospital Episode Statistics (HES) has never been seen by the clinicians responsible for the patients. This is particularly a problem for clinical data. Consequently when clinicians review the data in HES they may identify problems with the quality. Unfortunately this leads to a loss of interest in HES from clinicians as a source of valuable clinical data.
Engaging clinicians with HES is the subject of a joint initiative between the Health and Social Care Information Centre (HSCIC) and the Academy of Medical Royal Colleges (AOMRC) and a discussion paper describing the problems and some suggested solutions has been published (2). In particular there is a need for Trusts to provide clinicians with regular access to their own data with an interface that is both easy to use and with perceived value to clinicians. Tools such as this, which will support appraisal and re-validation along with improvements to patient care, will also lead to improvements in data quality. The HSCIC is planning a number of improvements to SUS and HES following the AOMRC publication, but strong clinical support will be required for real improvement to be realised.
(1) Brennan L, Watson M, Klaber R, Tagore C. The importance of knowing context of hospital episode statistics when reconfiguring the NHS. BMJ 2012; 344:e2432-e2433.
I read the letter from Lauren Brennan and colleagues about the importance of accurately coding clinical data with interest; and applaud this initiative to encourage greater understanding of this important subject. Improving data quality is a key focus of the Health and Social Care Information Centre, which manages HES. We liaise closely with organisations to encourage submission of complete data, offer guidance and training on HES data and seek to minimise inaccuracies, but there is still room for improvement; and we are very keen to increase our engagement with clinicians about hospital data.
HES is rich in detail and potentially can be a powerful driver for decision-making, as Dr Brennan rightly points out. Her study demonstrates this in several ways. It is an interesting and correct assertion that thousands of male finished consultant episodes (FCEs) were recorded under the obstetrics, gynaecological and midwifery specialisms. At first glance this would appear out of the ordinary.
Further analysis of the data, by age as well as gender, showed that almost all such male FCEs related to new-born or very young babies. In fact, 96 per cent of these FCEs related to babies less than one week old; with the most likely explanation therefore that all of these episodes were birth-related and therefore treated by associated specialties.
We are very keen to support initiatives such as this and always willing to offer our assistance. For help or further information, or if readers spot any other findings in our data that they think are of interest, please contact enquiries@ic.nhs.uk or 0845 300 6016.
Chris Roebuck
HES Programme Manager
The Health and Social Care Information Centre
Re: The importance of knowing context of hospital episode statistics when reconfiguring the NHS
One of the problems highlighted in the letter by Brennan et al (1) relates to the fact that most data submitted by Trusts into Secondary User Services (SUS) for Hospital Episode Statistics (HES) has never been seen by the clinicians responsible for the patients. This is particularly a problem for clinical data. Consequently when clinicians review the data in HES they may identify problems with the quality. Unfortunately this leads to a loss of interest in HES from clinicians as a source of valuable clinical data.
Engaging clinicians with HES is the subject of a joint initiative between the Health and Social Care Information Centre (HSCIC) and the Academy of Medical Royal Colleges (AOMRC) and a discussion paper describing the problems and some suggested solutions has been published (2). In particular there is a need for Trusts to provide clinicians with regular access to their own data with an interface that is both easy to use and with perceived value to clinicians. Tools such as this, which will support appraisal and re-validation along with improvements to patient care, will also lead to improvements in data quality. The HSCIC is planning a number of improvements to SUS and HES following the AOMRC publication, but strong clinical support will be required for real improvement to be realised.
(1) Brennan L, Watson M, Klaber R, Tagore C. The importance of knowing context of hospital episode statistics when reconfiguring the NHS. BMJ 2012; 344:e2432-e2433.
(2) Spencer, S A. Hospital Episode Statisitics (HES): Improving the quality and value of hospital data: A discussion document. 2011; http://aomrc.org.uk/publications/reports-a-guidance/doc_download/9379-ho...
andy.spencer@doctors.net.uk
Competing interests: No competing interests