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Obesity

Volume 485: debated on Tuesday 16 December 2008

To ask the Secretary of State for Health how many finished consultant episodes there were for (a) paediatric and (b) adolescent obesity treatment in (i) England and (ii) each strategic health authority in each year since 1997. (241051)

Data are available between 1997-98 and 2006-07. This information has been placed in the Library.

To ask the Secretary of State for Health how many surgical procedures to treat obesity were carried out on the NHS in (a) England, (b) each region and (c) each strategic health authority area in each year since 1997. (241052)

Data on finished consultant episodes (FCEs) with a primary diagnosis of obesity as well as a main procedure of bariatric surgery are provided in the following table. Data are available between 1997-98 to 2006-07.

Count of FCEs with a primary diagnosis of obesity* and a main procedure of bariatric surgery** broken down by strategic health authority of residence for 1997-98 to 2006-07

Activity in English NHS Hospitals and English NHS commissioned activity in the independent sector

Strategic health authority

2006-07

2005-06

2004-05

2003-04

2002-03

2001-02

2000-01

1999-2000

1998-99

1997-98

England Total

1,890

998

711

451

334

279

250

193

187

143

Q01

Norfolk, Suffolk and Cambridgeshire Strategic Health Authority

39

24

12

9

6

7

2

3

6

Q02

Bedfordshire and Hertfordshire Strategic Health Authority

28

17

9

6

8

7

2

3

2

Q03

Essex Strategic Health Authority

11

13

7

5

3

5

4

0

1

Q04

North West London Strategic Health Authority

68

44

11

13

5

5

3

1

1

Q05

North Central London Strategic Health Authority

29

15

11

5

2

3

5

0

2

Q06

North East London Strategic Health Authority

24

9

4

3

1

2

1

1

0

Q07

South East London Strategic Health Authority

30

23

18

11

13

18

11

4

3

Q08

South West London Strategic Health Authority

33

20

11

11

5

7

7

2

3

Q09

Northumberland, Tyne and Wear Strategic Health Authority

43

28

19

11

9

8

8

9

7

Q10

County Durham and Tees Valley Strategic Health Authority

17

13

5

5

7

6

3

4

2

Q11

North and East Yorkshire and Northern Lincolnshire Strategic Health Authority

135

60

37

20

19

8

15

12

4

Q12

West Yorkshire Strategic Health Authority

57

51

62

40

38

56

42

30

30

Q13

Cumbria and Lancashire Strategic Health Authority

11

18

17

11

14

9

14

7

7

Q14

Greater Manchester Strategic Health Authority

20

21

15

9

4

9

5

7

6

Q15

Cheshire and Merseyside Strategic Health Authority

8

33

32

41

36

24

7

17

8

Q16

Thames Valley Strategic Health Authority

12

9

6

9

6

7

4

0

0

Q17

Hampshire and Isle of Wight Strategic Health Authority

2

4

3

0

1

0

3

4

2

Q18

Kent and Medway Strategic Health Authority

12

17

5

5

9

4

3

2

2

Q19

Surrey and Sussex Strategic Health Authority

33

20

14

11

13

9

6

5

0

Q20

Avon, Gloucestershire and Wiltshire Strategic Health Authority

57

19

12

1

3

0

3

3

4

Q21

South West Peninsula Strategic Health Authority

33

22

12

12

24

7

12

6

5

Q22

Dorset and Somerset Strategic Health Authority

31

13

4

3

1

4

2

1

0

Q23

South Yorkshire Strategic Health Authority

107

88

59

40

23

18

15

17

23

Q24

Trent Strategic Health Authority

82

41

19

21

14

14

5

7

10

Q25

Leicestershire, Northamptonshire and Rutland Strategic Health Authority

19

33

11

8

2

4

0

4

3

Q26

Shropshire and Staffordshire Strategic Health Authority

23

21

18

11

3

3

3

11

3

Q27

Birmingham and the Black Country Strategic Health Authority

25

20

12

10

7

3

6

25

7

Q28

West Midlands South Strategic Health Authority

8

15

6

3

2

3

2

2

2

Q30

North East Strategic Health Authority

106

Q31

North West Strategic Health Authority

76

Q32

Yorkshire and the Humber Strategic Health Authority

435

Q33

East Midlands Strategic Health Authority

205

Q34

West Midlands Strategic Health Authority

240

Q35

East of England Strategic Health Authority

86

Q36

London Strategic Health Authority

292

Q37

South East Coast Strategic Health Authority

138

Q38

South Central Strategic Health Authority

110

Q39

South West Strategic Health Authority

202

U

England—not otherwise specified

0

1

0

0

0

1

0

0

0

0

Other, foreign and unknown Strategic Health Authorities

12

6

21

29

12

10

8

6

10

7

Notes:

Finished Consultant Episode (FCE)

1. A FCE is defined as a continuous period of admitted patient care under one consultant within one health care provider. FCEs are counted against the year in which the FCE finishes. 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.

*Primary diagnosis

2. The primary diagnosis is the first of up to 20 (14 from 2002-03 to 2006-07 and seven prior to 2002-03) diagnosis fields in the Hospital Episode Statistics (HES) data set and provides the main reason why the patient was in hospital.

E66—Obesity.

Number of episodes in which the patient had a (named) primary diagnosis

3. These figures represent the number of episodes where the diagnosis was recorded in the primary diagnosis field in a HES record.

**Main procedure

4. The main procedure is the first recorded procedure or intervention in the HES data set and is usually the most resource intensive procedure or intervention performed during the episode. It is appropriate to use main procedure when looking at admission details, e.g. time waited, but a more complete count of episodes with a particular procedure is obtained by looking at the main and the secondary procedure.

Data Quality

5. HES are compiled from data sent by more than 300 NHS trusts and primary care trusts (PCTs) in England. Data is also received from a number of independent sector organisations for activity commissioned by the English NHS. The NHS 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.

Assessing growth through time

6. HES figures are available from 1989-90 onwards. During the years that these records have been collected by 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. Some of the increase in figures for later years (particularly 2006-07 onwards) may be due to the improvement in the coverage of independent sector activity.

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 for in the HES data. This may account for any reductions in activity over time.

Ungrossed Data

7. Figures have not been adjusted for shortfalls in the data, i.e. the data are ungrossed.

Primary Care Trust (PCT)/Strategic Health Authority (SHA) data quality

8. PCT and SHA data was added to historic data years in the HES database using 2002-03 boundaries, as a one-off exercise in 2004. The quality of the data on PCT of treatment and SHA of treatment is poor in 1996-97, 1997-98 and 1998-99, with over a third of all finished episodes having missing values in these years. Data quality of PCT of GP practice and SHA of GP practice in 1997-98 and 1998-99 is also poor, with a high proportion missing values where practices changed or ceased to exist. There is less change in completeness of the residence-based fields over time, where the majority of unknown values are due to missing postcodes on birth episodes. Users of time series analysis including these years need to be aware of these issues in their interpretation of the data.

Source:

Hospital Episode Statistics (HES), The NHS Information Centre for health and social care

The following information needs to be taken into account when interpreting these data.

In 2006-07 there was a SHA configuration change, where 28 SHAs merged into 10. Data for 2006-07 are based on the new configuration.

There is a large increase in episodes between 2005-06 and 2006-07. The Information Centre have studied this and believe it to be due to the change/increase in OPCS-4 coding classifications. In previous years procedures may have been coded under an ‘unknown’ or ‘other’ code and therefore would not have been included in the count. However, some extra codes have been introduced in OPCS-4.3 these procedures would now be coded under their named field and be included within the count.

The number of FCEs does not represent the number of patients as a patient may have more than one episode within a year.

The NHS Information Centre have broken down information by SHA only.