(2) what proportion of patients with coronary heart disease have received (a) coronary artery bypass operations and (b) percutaneous coronary interventions in each year since guidance on the use of coronary artery stents was issued by the National Institute of Clinical Excellence in 2003 in (i) England, (ii) each strategic health authority and (iii) each NHS trust.
It is not possible for the Department to answer these questions because of the way relevant data are collected. Hospital episode statistics (HES) data counts each period of admitted patient care under one consultant within one healthcare provider, known as an “episode”. These figures do not represent numbers of actual patients, as a person may have more than one episode of care within a year.
The information provided in the following table is HES data showing the number of episodes that patients with a coronary heart disease diagnosis have had. This may be of interest to the hon. Member.
Count of finished consultant episodes with a diagnosis mention of coronary heart disease and a procedure mention of coronary artery bypass graft (CABG), percutaneous transluminal coronary angioplasty (PTCA) or insertion of prosthesis: Data for NHS Hospitals, England for 2003-04 to 2005-06Finished consultant episodesProcedure2005-062004-052003-04CABG21,74923,72123,631PTCA55,55950,06241,470Insertion of prosthesis into organ44,19037,42530,938 Notes: Ungrossed Data Figures have not been adjusted for shortfalls in data (i.e. the data are ungrossed). Finished Consultant Episode (FCE) An FCE is defined as a period of admitted patient care under one consultant within one healthcare provider. Please note that the figures do not represent the number of patients, as a person may have more than one episode of care within the year. All Diagnoses count of episodes These figures represent a count of all FCE's where the diagnosis was mentioned in any of the 14 (seven prior to 2002-03) diagnosis fields in a HES record. ICD10 Diagnosis code used: Coronary Heart Disease = I20-I25 Assessing growth through time HES figures are available from 1989-90 onwards. During the years that these records have been collected the NHS there have been ongoing improvements in quality and coverage. These improvements in information submitted by the NHS have been particularly marked in the earlier years and need to be borne in mind when analysing time series. Changes in NHS practice also need to be borne in mind when analysing time series. For example a number of procedures may now be undertaken in outpatient settings and may no longer be accounted in the HES data. This may account for any reductions in activity over time. Data Quality Hospital Episode Statistics (HES) are compiled from data sent by over 300 NHS Trusts and Primary Care Trusts (PCTs) in England. The Information Centre for health and social care liaises closely with these organisations to encourage submission of complete and valid data and seeks to minimise inaccuracies and the effect of missing and invalid data via HES processes. While this brings about improvement over time, some shortcomings remain. All Operations count of Episodes These figures represent a count of all FCE's where the procedure was mentioned in any of the 12 (four prior to 2002-03) operation fields in a HES record. A record is only included once in each count, even if an operation is mentioned in more than one operation field of the record. Procedure codes used (OPCS 4.2): CABG = K40-46 PTCA = K49-50 Insertion of Prosthesis into Organ = Y02.2