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Eating Disorders

Volume 489: debated on Thursday 19 March 2009

To ask the Secretary of State for Health how many 18 to 21 year-olds were admitted to each (a) hospital and (b) university hospital for eating disorders in each of the last 10 years; and what the rate of admissions for eating disorders per 1,000 admissions for 18 to 21 year-olds was for (i) university hospitals, (ii) other hospitals and (iii) all hospitals in each of the last 10 years. (264148)

The following tables show what data is held on the number of 18 to 21 year-olds admitted into national health service care for eating disorders in the last 10 years.

Count and rate of admissions where there was a primary diagnosis of eating disorders* per 1,000 admissions for 18 to 21 year-olds in each Strategic Health Authority (SHA) of treatment from 2005-06 to 1998-99, Activity in English national health service hospitals and English NHS commissioned activity in the independent sector

2005-06

2004-05

2003-04

2002-03

Total admissions for eating disorders

Rate per 1,000 admissions

Total admissions for eating disorders

Rate per 1,000 admissions

Total admissions for eating disorders

Rate per 1,000 admissions

Total admissions for eating disorders

Rate per 1,000 admissions

Total (England)

284

0.60

271

0.61

262

0.62

234

0.57

Q01

Norfolk, Suffolk and Cambridgeshire SHA

12

0.60

9

0.49

10

0.54

15

0.86

Q02

Bedfordshire and Hertfordshire SHA

*

*

*

*

*

*

6

0.73

Q03

Essex SHA

7

0.60

*

*

*

*

*

*

Q04

North West London SHA

*

*

8

0.63

8

0.67

*

*

Q05

North Central London SHA

19

1.64

12

1.09

15

1.38

9

0.85

Q06

North East London SHA

*

*

Q07

South East London SHA

12

0.77

14

1.02

14

1.11

10

0.83

Q08

South West London SHA

29

3.01

17

1.86

15

1.83

12

1.54

Q09

Northumberland, Tyne and Wear SHA

*

*

11

0.69

12

0.79

6

0.39

Q10

County Durham and Tees Valley SHA

6

0.41

14

1.02

9

0.67

6

0.47

Q11

North and East Yorkshire and Northern Lincolnshire SHA

7

0.47

*

*

*

*

*

*

Q12

West Yorkshire SHA

23

0.92

17

0.70

13

0.53

14

0.58

Q13

Cumbria and Lancashire SHA

*

*

*

*

7

0.40

11

0.63

Q14

Greater Manchester SHA

7

0.21

*

*

*

*

Q15

Cheshire and Merseyside SHA

11

0.39

8

0.31

13

0.54

10

0.42

Q16

Thames Valley SHA

21

1.27

13

0.81

20

1.38

13

0.98

Q17

Hampshire and Isle of Wight SHA

7

0.55

6

0.51

*

*

Q18

Kent and Medway SHA

*

*

*

*

*

*

11

1.05

Q19

Surrey and Sussex SHA

7

0.43

15

0.98

13

0.90

8

0.62

Q20

Avon, Gloucestershire and Wiltshire SHA

16

0.78

13

0.66

17

0.91

17

0.99

Q21

South West Peninsula SHA

8

0.53

13

0.94

12

0.90

10

0.80

Q22

Dorset and Somerset SHA

28

3.14

25

2.95

17

2.12

20

2.48

Q23

South Yorkshire SHA

*

*

7

0.40

*

*

*

*

Q24

Trent SHA

*

*

11

0.52

10

0.48

9

0.44

Q25

Leicestershire, Northamptonshire and Rutland SHA

9

0.56

6

0.41

15

1.05

9

0.66

Q26

Shropshire and Staffordshire SHA

*

*

6

0.47

9

0.70

*

*

Q27

Birmingham and The Black Country SHA

12

0.40

10

0.38

8

0.32

13

0.51

Q28

Coventry, Warwickshire, Herefordshire and Worcestershire SHA

19

1.57

21

1.75

*

*

7

0.61

Y

Not known

2001-022000-011999-001998-99

Total admissions for eating disorders

Rate per 1,000 admissions

Total admissions for eating disorders

Rate per 1,000 admissions

Total admissions for eating disorders

Rate per 1,000 admissions

Total admissions for eating disorders

Rate per 1,000 admissions

Total (England)

253

0.63

224

0.54

280

0.68

212

0.53

Q01

Norfolk, Suffolk and Cambridgeshire SHA

16

0.95

13

0.81

10

0.62

*

*

Q02

Bedfordshire And Hertfordshire SHA

*

*

*

*

*

*

Q03

Essex SHA

8

0.83

*

*

6

0.60

*

*

Q04

North West London SHA

10

1.11

*

*

8

0.75

Q05

North Central London SHA

*

*

14

1.25

*

*

*

*

Q06

North East London SHA

*

*

*

*

Q07

South East London SHA

10

0.91

11

0.98

16

1.33

Q08

South West London SHA

15

1.92

20

2.41

21

2.61

*

*

Q09

Northumberland, Tyne and Wear SHA

*

*

*

*

*

*

*

*

Q10

County Durham And Tees Valley SHA

*

*

*

*

*

*

*

*

Q11

North And East Yorkshire And Northern Lincolnshire SHA

9

0.66

6

0.45

*

*

Q12

West Yorkshire SHA

26

1.10

17

0.69

17

0.75

8

0.56

Q13

Cumbria And Lancashire SHA

*

*

*

*

*

*

*

*

Q14

Greater Manchester SHA

*

*

*

*

*

*

*

*

Q15

Cheshire and Merseyside SHA

10

0.42

8

0.38

18

0.85

8

0.42

Q16

Thames Valley SHA

11

0.78

11

0.76

6

0.45

6

0.50

Q17

Hampshire and Isle of Wight SHA

*

*

7

0.54

16

1.37

*

*

Q18

Kent and Medway SHA

*

*

8

0.77

12

1.33

*

*

Q19

Surrey and Sussex SHA

*

*

*

*

*

*

*

*

Q20

Avon, Gloucestershire and Wiltshire SHA

9

0.71

20

1.52

11

0.87

*

*

Q21

South West Peninsula SHA

12

0.97

*

*

*

*

9

0.77

Q22

Dorset and Somerset SHA

18

2.34

*

*

22

2.79

13

1.74

Q23

South Yorkshire SHA

*

*

6

0.57

*

*

*

*

Q24

Trent SHA

10

0.49

*

*

*

*

*

*

Q25

Leicestershire, Northamptonshire and Rutland SHA

*

*

*

*

7

0.52

*

*

Q26

Shropshire and Staffordshire SHA

*

*

*

*

8

0.68

*

*

Q27

Birmingham and The Black Country SHA

23

1.09

11

0.52

11

0.52

10

0.55

Q28

Coventry, Warwickshire, Herefordshire and Worcestershire SHA

*

*

*

*

*

*

*

*

Y

Not Known

22

0.73

34

0.69

51

0.83

115

0.86

‘—’ = No data available

Notes:

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. Admissions do not represent the number of inpatients, as a person may have more than one admission within the year.

Primary diagnosis

The primary diagnosis is the first of up to 20 (14 from 2002-03 to 2006-07 and 7 prior to 2002-03) diagnosis fields in the Hospital Episode Statistics (HES) data set and provides the main reason why the patient was admitted to hospital.

* Eating disorders are classified between the following ICD10 codes;

F50.0 Anorexia nervosa

F50.1 Atypical anorexia nervosa

F50.2 Bulimia nervosa

F50.3 Atypical bulimia nervosa

F50.4 Overeating associated with other psychological disturbances

F50.5 Vomiting associated with other psychological disturbances

F50.8 Other eating disorders

F50.9 Eating disorder, unspecified

F98.2 Feeding disorder of infancy and childhood

F98.3 Pica of infancy and childhood

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.

Primary Care Trust (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 general practitioner (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.

Data quality

HES are compiled from data sent by more than 300 NHS trusts and 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.

Ungrossed data

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

Small numbers

To protect patient confidentiality, figures between one and five have been suppressed and replaced with “*” (an asterisk). Where it was possible to identify numbers from the total due to a single suppressed number in a row or column, an additional number (the next smallest) has been suppressed.

Source:

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

Count and rate of admissions where there was a primary diagnosis of eating disorders* per 1000 admissions for 18 to 21 year-olds in each Strategic Health Authority of treatment from 2007-08 to 2006-07, Activity in English national health service hospitals and English NHS commissioned activity in the independent sector

2007-08

2006-07

Total admissions for eating disorders

Rate per 1000 admissions

Total admissions for eating disorders

Rate per 1000 admissions

Total (England)

250

0.51

313

0.65

Q30

North East Strategic Health Authority

10

0.32

20

0.63

Q31

North West Strategic Health Authority

20

0.24

23

0.28

Q32

Yorkshire and the Humber Strategic Health Authority

44

0.74

38

0.66

Q33

East Midlands Strategic Health Authority

16

0.40

16

0.42

Q34

West Midlands Strategic Health Authority

16

0.27

29

0.51

Q35

East of England Strategic Health Authority

24

0.57

20

0.49

Q36

London Strategic Health Authority

26

0.37

71

1.05

Q37

South East Coast Strategic Health Authority

9

0.31

20

0.72

Q38

South Central Strategic Health Authority

29

0.95

40

1.41

Q39

South West Strategic Health Authority

56

1.15

36

0.78

Notes:

Q30 North East SHA

Q09 Northumberland, Tyne and Wear

Q10 County Durham and Tees Valley

Q31 North West SHA

Q13 Cumbria and Lancashire

Q14 Greater Manchester

Q15 Cheshire and Merseyside

Q32 Yorkshire and Humber SHA

Q11 North and East Yorkshire and Northern Lincolnshire

Q12 West Yorkshire

Q23 South Yorkshire

Q33 East Midlands SHA

Q24 Trent

Q25 Leicestershire, Northamptonshire and Rutland

Q34 West Midlands SHA

Q26 Shropshire and Staffordshire

Q27 Birmingham and the Black Country

Q28 West Midlands South

Q35 East of England SHA

Q01 Norfolk, Suffolk and Cambridgeshire

Q02 Bedfordshire and Hertfordshire

Q36 London

Q04 North West London

Q05 North Central London

Q06 North East London

Q07 South East London

Q08 South West London

Q38 South East Coast SHA

Q16 Thames Valley

Q17 Hampshire and Isle of Wight

Q37 South Central SHA

Q18 Kent and Medway

Q19 Surrey and Sussex

Q39 South West SHA

Q20 Avon, Gloucestershire and Wiltshire

Q21 South West Peninsula

Q22 Dorset and Somerset

The data do not include patients with overeating (ICD10 code R63.2 Polyphagia) that have not been formally diagnosed with a condition classified as a mental or behavioural disorder.