Until 2000, the current West Hertfordshire NHS Acute Trust was divided into two trusts: St. Albans and Hemel Hempstead NHS Trust and Mount Vernon and Watford NHS Trust. The number of finished consultant episodes (FCEs) in each speciality and in total at the two trusts from 1996-2000 and in West Hertfordshire NHS Acute Trust in 2000-07 are set out in the following tables. The latest year for which information is available is 2007.
1996-97 1997-98 Specialty St. Albans and Hemel Hempstead NHS Trust Mount Vernon and Watford NHS Trust Total St. Albans and Hemel Hempstead NHS Trust Mount Vernon and Watford NHS Trust Total Not known 7 184 191 — 344 344 General Surgery 4,557 5,829 10,386 4,215 5,167 9,382 Urology 1,460 2,965 4,425 1,506 2,810 4,316 Trauma and Orthopaedics 3,077 4,136 7,213 2,968 3,219 6,187 Ear, Nose and Throat 1,136 — 1,136 1,171 — 1,171 Ophthalmology 118 1,240 1,358 116 760 876 Oral Surgery 149 3,160 3,309 53 2,904 2,957 Orthodontics — — — — — — Plastic Surgery 237 5,764 6,001 208 6,649 6,857 Accident and Emergency 268 — 268 376 — 376 Anaesthetics 173 300 473 102 343 445 General Medicine 727 9,729 10,456 31 9,922 9,953 Gastroenterology 2,777 929 3,706 3,743 1,144 4,887 Endocrinology 833 — 833 1,157 — 1,157 Haematology (Clinical) — 691 691 — 1,044 1,044 Palliative Medicine — 387 387 — 449 449 Cardiology 1,153 — 1,153 1,406 — 1,406 Dermatology 856 73 929 882 76 958 Thoracic Medicine 1,138 — 1,138 1,222 * 1,222 Nephrology — — — * — — Medical Oncology — — — — — — Neurology 8 10 18 * * — Rheumatology 50 357 407 28 404 432 Paediatrics 5,726 6,367 12,093 5,537 7,272 12,809 Geriatric Medicine 3,637 2,152 5,789 4,268 2,351 6,619 Obstetrics for patients using a hospital bed 5,192 3,822 9,014 5,352 4,384 9,736 Gynaecology 2,943 2,992 5,935 2,374 2,669 5,043 Radiotherapy 362 3,903 4,265 882 4,761 5,643 Haematology 1,077 — 1,077 1,159 — 1,159 Total 37,661 54,990 92,651 38,756 56,678 95,434
Specialty St. Albans and Hemel Hempstead NHS Trust Mount Vernon and Watford NHS Trust Total St. Albans and Hemel HempsteadNHS Trust Mount Vernon and Watford NHS Trust Total Not known — 268 268 * 296 296 General Surgery 3,674 5,172 8,846 4,341 4,607 8,948 Urology 1,516 2,526 4,042 2,119 2,073 4,192 Trauma and Orthopaedics 2,886 3,268 6,154 3,360 3,133 6,493 Ear, Nose and Throat 1,082 — 1,082 1,249 — 1,249 Ophthalmology 16 861 877 * 1,176 1,176 Oral Surgery 32 2,715 2,747 38 2,387 2,425 Orthodontics * — 0 — — — Plastic Surgery 151 5,595 5,746 143 5,985 6,128 Accident and Emergency 341 — 341 318 — 318 Anaesthetics 116 368 484 122 209 331 General Medicine * 10,612 10,612 — 9,703 9,703 Gastroenterology 3,721 918 4,639 4,050 146 4,196 Endocrinology 1,349 — 1,349 1,466 — 1,466 Haematology (Clinical) — 690 690 — 456 456 Palliative Medicine — 353 353 — 395 395 Cardiology 1,416 — 1,416 1,473 — 1,473 Dermatology 713 33 746 846 42 888 Thoracic Medicine 1,067 9 1,076 1,403 — 1,403 Nephrology — — 0 * — — Medical Oncology — — 0 — 43 43 Neurology 23 22 45 34 10 44 Rheumatology 33 170 203 45 — 45 Paediatrics 4,976 6,668 11,644 5,106 3,217 8,323 Geriatric Medicine 4,461 1,910 6,371 4,409 1,749 6,158 Obstetrics for patients using a hospital bed 5,156 3,566 8,722 5,503 3,640 9,143 Gynaecology 1,946 2,460 4,406 2,260 2,752 5,012 Radiotherapy 956 5,021 5,977 985 4,475 5,460 Haematology 770 — 770 1,223 — 1,223 Total 36,401 53,205 89,606 40,496 46,494 86,990
2000-01 2001-02 2002-03 2003-04 2004-05 2005-06 2006-07 Not known 1,243 97 16 — * — * General Surgery 9,023 8,838 9,195 9,668 9,900 9,697 9,829 Urology 4,180 4,264 4,481 4,658 4,532 4,502 4,109 Trauma and Orthopaedics 6,765 7,432 7,445 7,260 7,246 7,390 7,156 Ear, Nose and Throat 1,229 1,246 918 1,064 1,090 1,236 1,264 Ophthalmology 1,692 1,274 1,173_ 1,977 1,841 2,074 2,037 Oral Surgery 962 521 627 800 706 613 602 Restorative Dentistry — — * — — — — Orthodontics * — — — — — — Plastic Surgery1 6,624 6,679 7,178 7,912 7,712 8,018 3,899 Cardiothoracic Surgery 38 — — — — — — Accident and Emergency 237 299 394 541 3,334 4,800 4,674 Anaesthetics 467 464 448 554 442 506 511 Pain Management — — — * — — — General Medicine 8,547 9,916 9,469 8,633 8,914 9,313 9,207 Gastroenterology 5,052 5,498 5,205 5,631 5,767 5,872 6,946 Endocrinology 1,007 676 389 282 200 129 95 Clinical Haematology 892 2,071 2,761 2,884 2,583 1,928 2,228 Rehabilitation 134 — * — — — — Palliative Medicine 343 400 355 351 331 — — Cardiology 1,706 1,490 1,416 2,073 3,308 3,691 3,889 Dermatology 911 850 675 564 551 252 27 Thoracic Medicine 1,461 1,324 1,305 1,362 1,225 1,714 1,727 Genito-urinary Medicine — — — — * — — Nephrology * — * 16 46 20 * Medical Oncology 538 491 505 707 748 292 69 Neurology 35 23 20 15 17 17 31 Rheumatology 89 183 172 393 502 816 852 Paediatrics2 2,405 — 4,973 5,293 4,998 5,430 7,112 Geriatric Medicine 4,995 4,751 5,930 6,819 7,501 7,313 6,197 Obstetrics 6,325 8,057 7,648 8,385 8,794 8,619 8,613 Gynaecology 5,495 5,085 4,699 4,616 4,487 4,379 4,547 Midwife Episode — — — — — — 148 Learning Disability — — * * * — — Psychotherapy — — — * — — — Clinical Oncology 5,202 5,138 4,606 4,688 4,768 820 530 Haematology 1,149 181 — — — — — Immunopathology 15 73 107 96 112 138 127 Total 78,765 77,321 82,118 87,245 91,662 89,579 86,439 “—” No data retrieved under the main speciality and/or data year. “* ” To protect patient confidentiality, figures between one and five have been suppressed and replaced with an asterisk. 1 In October 2006, the management of the speciality ‘Plastic Surgery’ transferred from the West Hertfordshire NHS Acute Trust to the Royal Free Hampstead NHS Trust. This is a likely explanation for the drop in count of FCEs in 2006-07 compared to the data received in previous years. 2 For 2001-02 no data were received from the trust for the speciality ‘Paediatrics’. This has been investigated with the trust but no conclusive cause has been found. Notes: 1. Data Quality HES are compiled from data sent by over 300 national health service 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. 2. 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 out-patient settings and may no longer be accounted in the HES data. This may account for any reductions in activity over time. 3. FCE A FCE is defined as a period of admitted patient care under one consultant within one healthcare provider. The figures do not represent the number of patients, as a person may have more than one episode of care within the year. 4. Specialty Care is needed when analysing HES data by specialty, or by groups of specialties (such as acute). Trusts have different ways of managing specialties and attributing codes so it is better to analyse by specific diagnoses, operations or other recorded information. Trusts may change the way they manage speciality codes through time. The number of specialities can change over time depending on the patients being treated and the consultants employed by a trust in a particular year. 5. Ungrossed data Figures have not been adjusted for shortfalls in data (ies the data are ungrossed). Source: Hospital Episode Statistics (HES), The Information Centre for health and social care.