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Volume 405: debated on Thursday 22 May 2003

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To ask the Secretary of State for Health if he will list the (a) NHS audits and (b) other statistical assessments which require records to be kept of amputations. [111768]

Clinical audit is organised both locally and nationally. All clinicians are required to participate in clinical audit. Given this requirement it is expected that vascular and orthopaedic surgeons, those most likely to perform amputation procedures, participate in a range of local clinical audit activities. There is no central record of local clinical audits.The Commission for Health Improvement (CHI) has the responsibility for developing a programme of national clinical audits. Currently there is no national clinical audit in the programme specifically targeted at amputation. The development of a national clinical audit for diabetes may provide data of associated amputations.

The Vascular Society of Great Britain and Ireland maintains a clinical database of activity related to vascular surgery, and is actively considering a national clinical audit of amputation.

Amputation data is collected through the Department's Hospital Episodes Statistics system. Current in-patient data from the HES system is shown in the table.

Main operation (X07-X11) amputations; Finished consultant
episodes; In year admissions; NHS hospitals England 1999–00 to

OPCS 4 operation code

3 char Main operation description




X07Amputation of arm113111116
X08Amputation of hand3,1263,0743,081
X09Amputation of leg5,4625,5055,415
X10Amputation of foot580568569
X11Amputation of toe5,0284,9804,777

An FCE is defined as a period of patient care under one consultant in one health care provider. The figures do not represent the number of patients, as one person may have several episodes within the year.

The main operation is the first of four operation fields in the HES data set, and is usually the most resource intensive procedure performed during the episode.

Figures in this table have not yet been adjusted for shortfalls in data.


Hospital Episode Statistics (HES), Department of Health

Information is also available on the National Amputee Statistical Database (NASDAB), managed by representatives from UK NHS Prosthetic Centres, British Healthcare Trade Association, NHS Purchasing and Supply Agency, and Information and Statistics Division Scotland. The database records, and publishes annually, the considerable detail about new referrals to UK prosthetic centres.