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Injuries: Firearms

Volume 486: debated on Tuesday 20 January 2009

To ask the Secretary of State for Health how many finished admission episodes there were for gunshot wounds in each NHS trust in each of the last 10 years. (246823)

Information is collected on the number of finished admission episodes to hospital. A finished admission episode is the first period of in-patient care under one consultant within one healthcare provider. Admissions do not represent the number of in-patients, as a person may have more than one admission within the year.

The following table provides data on finished admission episodes for gunshot wounds by each strategic health authority area of residence. It is not possible to provide a response to this question for each national health service trust as the numbers involved are mostly very small and many of them would need to be suppressed in order to preserve confidentiality. The ICD-10 codes used to identify a gunshot wound are included in the background notes to the table.

It is important that the footnotes and clinical codes are consulted when interpreting the data in the table.

Total number of admissions to hospital where the patient had a cause code of a gunshot wound* broken down by Strategic Health Authority (SHA) of residence for the last 10 years: Activity in English NHS hospitals and English NHS commissioned activity in the independent sector

Number of admissions

SHA of residence

2006-07

2005-06

2004-05

2003-04

2002-03

2001-02

2000-01

1999-2000

1998-99

1997-98

Q01

Norfolk, Suffolk and Cambridgeshire SHA

32

29

42

23

42

30

45

49

31

Q02

Bedfordshire and Hertfordshire SHA

19

16

41

26

21

26

25

14

15

Q03

Essex SHA

21

26

27

29

25

27

37

32

24

Q04

North West London SHA

50

43

71

52

32

29

26

18

35

Q05

North Central London SHA

31

25

38

29

51

29

23

14

22

Q06

North East London SHA

64

48

69

74

59

47

41

26

24

Q07

South East London SHA

75

52

55

55

56

45

38

42

43

Q08

South West London SHA

34

21

23

21

21

13

23

13

18

Q09

Northumberland, Tyne and Wear SHA

22

31

35

30

47

52

49

51

41

Q10

County Durham and Tees Valley SHA

28

22

25

39

37

28

28

35

31

Q11

North and East Yorkshire and Northern Lincolnshire SHA

41

35

46

41

47

40

29

32

15

Q12

West Yorkshire SHA

69

64

82

83

101

67

63

54

57

Q13

Cumbria and Lancashire SHA

42

54

51

57

63

62

52

44

53

Q14

Greater Manchester SHA

101

108

111

115

123

110

146

96

97

Q15

Cheshire and Merseyside SHA

108

98

116

85

97

69

74

72

58

Q16

Thames Valley SHA

29

23

34

31

36

37

37

23

27

Q17

Hampshire and Isle of Wight SHA

27

24

34

19

32

27

32

23

26

Q18

Kent and Medway SHA

26

33

32

30

47

28

14

20

24

Q19

Surrey and Sussex SHA

39

44

40

28

42

27

25

39

31

Q20

Avon, Gloucestershire and Wiltshire SHA

40

39

40

43

48

31

39

27

34

Q21

South West Peninsula SHA

22

27

36

26

24

29

31

24

25

Q22

Dorset and Somerset SHA

28

14

14

11

29

14

13

23

15

Q23

South Yorkshire SHA

50

55

40

62

61

48

42

38

24

Q24

Trent SHA

52

46

74

83

69

46

66

63

54

Q25

Leicestershire, Northamptonshire and Rutland SHA

19

22

25

16

28

28

27

25

32

Q26

Shropshire and Staffordshire SHA

23

14

25

29

28

29

37

28

30

Q27

Birmingham and the Black Country SHA

67

73

76

89

86

62

59

27

50

Q28

West Midlands South SHA

38

44

37

28

21

24

26

22

18

Q30

North East SHA

71

Q31

North West SHA

278

Q32

Yorkshire and the Humber SHA

138

Q33

East Midlands SHA

96

Q34

West Midlands SHA

172

Q35

East of England SHA

103

Q36

London SHA

209

Q37

South East Coast SHA

73

Q38

South Central SHA

57

Q39

South West SHA

79

U

England – Not otherwise specified

3

15

7

13

8

8

0

2

Other/Unknown/Foreign SHAs

36

21

26

18

25

39

18

23

13

38

Total

1,315

1,233

1,163

1,370

1,287

1,420

1,122

1,170

987

994

Rates per 100,000 of population

SHA of Residence

2006-07

2005-06

2004-05

2003-04

2002-03

2001-02

2000-01

1999-2000

1998-99

1997-98

Q01

Norfolk, Suffolk and Cambridgeshire SHA

1.41

1.29

1.89

1.05

1.93

1.38

2.09

2.28

1.46

Q02

Bedfordshire and Hertfordshire SHA

1.16

0.98

2.53

1.61

1.31

1.63

1.58

0.89

0.96

Q03

Essex SHA

1.27

1.58

1.65

1.78

1.55

1.68

2.32

2.02

1.52

Q04

North West London SHA

2.73

2.38

3.95

2.89

1.79

1.65

1.51

1.06

2.07

Q05

North Central London SHA

2.50

2.04

3.12

2.39

4.25

2.45

1.97

1.21

1.91

Q06

North East London SHA

4.17

3.13

4.50

4.83

3.88

3.13

2.76

1.77

1.65

Q07

South East London SHA

4.91

3.43

3.64

3.63

3.69

2.99

2.55

2.85

2.94

Q08

South West London SHA

2.57

1.60

1.76

1.61

1.61

1.01

1.80

1.03

1.43

Q09

Northumberland, Tyne and Wear SHA

1.58

2.23

2.51

2.15

3.37

3.72

3.49

3.61

2.89

Q10

County Durham and Tees Valley SHA

2.43

1.91

2.18

3.40

3.23

2.44

2.44

3.04

2.69

Q11

North and East Yorkshire and Northern Lincolnshire SHA

2.44

2.10

2.79

2.50

2.89

2.47

1.80

1.99

0.93

Q12

West Yorkshire SHA

3.22

3.02

3.90

3.96

4.85

3.23

3.04

2.60

2.75

Q13

Cumbria and Lancashire SHA

2.16

2.79

2.65

2.98

3.31

3.26

2.74

2.31

2.79

Q14

Greater Manchester SHA

3.97

4.26

4.39

4.57

4.89

4.37

5.80

3.81

3.85

Q15

Cheshire and Merseyside SHA

4.59

4.17

4.93

3.62

4.12

2.93

3.14

3.04

2.44

Q16

Thames Valley SHA

1.35

1.08

1.61

1.47

1.71

1.77

1.78

1.11

1.31

Q17

Hampshire and Isle of Wight SHA

1.48

1.33

1.89

1.06

1.80

1.52

1.81

1.31

1.49

Q18

Kent and Medway SHA

1.60

2.05

2.00

1.89

2.97

1.78

0.90

1.29

1.55

Q19

Surrey and Sussex SHA

1.50

1.70

1.55

1.09

1.64

1.06

0.98

1.55

1.24

Q20

Avon, Gloucestershire and Wiltshire SHA

1.79

1.76

1.82

1.97

2.21

1.43

1.81

1.26

1.60

Q21

South West Peninsula SHA

1.35

1.67

2.25

1.63

1.52

1.85

2.00

1.56

1.63

Q22

Dorset and Somerset SHA

2.31

1.16

1.16

0.92

2.43

1.18

1.11

1.96

1.29

Q23

South Yorkshire SHA

3.88

4.30

3.14

4.88

4.82

3.79

3.31

2.98

1.88

Q24

Trent SHA

1.92

1.71

2.77

3.13

2.62

1.76

2.53

2.42

2.08

Q25

Leicestershire, Northamptonshire and Rutland SHA

1.18

1.38

1.58

1.02

1.80

1.81

1.75

1.63

2.10

Q26

Shropshire and Staffordshire SHA

1.52

0.93

1.67

1.94

1.88

1.95

2.50

1.89

2.04

Q27

Birmingham and the Black Country SHA

2.93

3.20

3.34

3.92

3.80

2.73

2.59

1.18

2.19

Q28

West Midlands South SHA

2.45

2.85

2.40

1.83

1.38

1.58

1.72

1.46

1.20

Q30

North East SHA

2.78

Q31

North West SHA

4.06

Q32

Yorkshire and The Humber SHA

2.68

Q33

East Midlands SHA

2.20

Q34

West Midlands SHA

3.20

Q35

East of England SHA

1.84

Q36

London SHA

2.78

Q37

South East Coast SHA

1.72

Q38

South Central SHA

1.43

Q39

South West SHA

1.54

Notes:

Ungrossed data

Figures have not been adjusted for shortfalls in data (i.e. the data are ungrossed).

Finished admission episodes

A finished admission episode is the first period of inpatient care under one consultant within one healthcare provider. Finished admission episodes are counted against the year in which the admission episode finishes. Please note that admissions do not represent the number of inpatients, as a person may have more than one admission within the year.

* Cause Code - Gunshot Wounds

The cause code is a supplementary code that indicates the nature of any external cause of injury, poisoning or other adverse effects. HES has used the following ICD-10 external cause codes when referring to gunshot wounds

Gunshot wounds:

W32.- Handgun discharge

W33.- Rifle, shotgun and larger firearm discharge

W34.- Discharge from other and unspecified firearms

X72- Intentional self-harm by handgun discharge

X73- Intentional self-harm by rifle, shotgun and larger firearm discharge

X74- Intentional self-harm by other and unspecified firearm discharge

X93- Assault by handgun discharge

X94- Assault by rifle, shotgun and larger firearm discharge

X95- Assault by other and unspecified firearm discharge

Y22.- Handgun discharge, undetermined intent

Y23.- Rifle, shotgun and larger firearm discharge, undetermined intent

Y24- Other and unspecified firearm discharge, undetermined intent

Y35.0 Legal intervention involving firearm discharge

Y36.4 War operations involving firearm discharge and other forms of conventional warfare.

Data quality

Hospital Episode Statistics (HES) are compiled from data sent by more than 300 NHS trusts and primary care trusts (PCTs) in England. Data are 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.

PCT/SHA data quality

PCT and SHA data were 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.

Assessing growth through time

HES figures are available from 1989-90 onwards. The quality and coverage of the data have improved over time. 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 outpatient settings and may no longer be accounted for in the HES data. This may account for any reductions in activity over time.

Source:

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