Data on finished consultant episodes with a primary diagnosis of obesity as well as a main or secondary procedure of bariatric surgery for England and each health authority or regional area are provided in the following table. Data are available for each year from 1997-98 to 2008-09.
The NHS Information Centre has provided slightly revised data to those previously provided for the years 1997-98 to 2006-07 following a revision of the definition of bariatric surgery.
Count of Finished Consultant Episodes1 with a primary diagnosis2 of obesity4 and a main or secondary procedure3 of bariatric surgery4 broken down by SHA of residence5 for 1997-98 to 2008-09—Activity in English national health service hospitals and English NHS commissioned activity in the independent sectorStrategic health authority (SHA)2008-092007-082006-072005-062004-052003-042002-032001-022000-011999-20001998-991997-98England total4,2212,6951,9341,032736469340280257196196148Norfolk, Suffolk and Cambridgeshire SHAQ01———402512967246Bedfordshire and Hertfordshire SHAQ02———28189687232Essex SHAQ03———12137535411North West London SHAQ04———6946111357311North Central London SHAQ05———2916125235—2North East London SHAQ06———2410431212—South East London SHAQ07———3227181113181143South West London SHAQ08———3322111158724Northumberland, Tyne and Wear SHAQ09———583323119881010County Durham and Tees Valley SHAQ10———21157576342North and East Yorkshire and Northern Lincolnshire SHAQ11———13663372019815124West Yorkshire SHAQ12———595165403856423130Cumbria and Lancashire SHAQ13———131817111491477Greater Manchester SHAQ14———202115949576Cheshire and Merseyside SHAQ15———833324136247188Thames Valley SHAQ16———13969674——Hampshire and Isle of Wight SHAQ17———243—1—342Kent and Medway SHAQ18———12185594333Surrey and Sussex SHAQ19———3321161313975—Avon, Gloucestershire and Wiltshire SHAQ20———57191213—334South West Peninsula SHAQ21———332213122471265Dorset and Somerset SHAQ22———3113431422—South Yorkshire SHAQ23———1078863432422151723Trent SHAQ24———8542202214146710Leicestershire, Northamptonshire and Rutland SHAQ25———193311824—53Shropshire and Staffordshire SHAQ26———23211811333113Birmingham and the Black Country SHAQ27———25201210737257West Midlands South SHAQ28———9156323222North East SHAQ30268217132—————————North West SHAQ313167577————————— Yorkshire and the Humber SHAQ32584491439—————————East Midlands SHAQ33550279205—————————West Midlands SHAQ34445345244—————————East of England SHAQ3524311787—————————London SHAQ36909582299—————————South East Coast SHAQ37446281139—————————South Central SHAQ38157127110—————————South West SHAQ39302181202—————————England—Not otherwise specifiedU100100010000Other, foreign and unknown SHAs522412624291210961071 Finished Consultant Episode (FCE)A FCE is a continuous period of admitted patient care under one consultant within one healthcare provider. FCEs are counted against the year in which they end. Figures do not represent the number of different patients, as a person may have more than one episode of care within the same stay in hospital or in different stays in the same year.2 Primary diagnosisThe 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 HES data set and provides the main reason why the patient was admitted to hospital. 3 Number of episodes with a (named) main or secondary procedure The number of episodes where the procedure (or intervention) was recorded in any of the 24 (12 from 2002-03 to 2006-07 and four prior to 2002-03) procedure fields in a HES record. A record is only included once in each count, even if the procedure is recorded in more than one procedure field of the record. Note that more procedures are carried out than episodes with a main or secondary procedure. For example, patients under going a ‘cataract operation’ would tend to have at least two procedures—removal of the faulty lens and the fitting of a new one—counted in a single episode.4 Obesity and Bariatric Surgery CodesObesity: ICD-10 code used for obesity was E66.Bariatric Surgery Procedure Codes:Recent guidance from the standards and classification team at Connecting for Health has led to a revision of the definition for ‘Bariatric Surgery’. Due to these changes revised data has been provided. (See: OPCS-4 explanatory notes for more details on the bariatric surgery procedure codes)The OPCS-4 procedure codes below are used to denote bariatric surgery.The OPCS-4 procedure codes (1996-97 to 2005-06, and 2006-07 to 2008-09) are: G28.1, G28.2, G28.3, G28.8, G28.9, G30.1, G30.2, G30.8, G30.9, G31.1, G31.2, G31.3, G31.4, G31.8, G31.9, G31.0, G32.1, G32.2, G32.3, G32.8, G32.9, G32.0, G33.1, G33.2, G33.3, G33.8, G33.9, G33.0, G38.8, G48.1, G48.2. The following additional four digit OPCS-4 codes have been added due to the use of OPCS-4.3 in 2006-07 data:G28.4, G28.5, G30.3, G30.4, G31.5, G31.6, G32.4, G32.5, G33.5, G33.6, G38.7, G71.6Additional OPCS-4.4 codes used for the 2007-08 and 2008-09 data are: G27.1, G27.2, G27.3, G27.4, G27.5,G27.8 and G27.9.5 SHA/primary care trust (PCT) of residenceThe SHA or PCT containing the patient’s normal home address. This does not necessarily reflect where the patient was treated as they may have travelled to another SHA/PCT for treatment. PCT/SHA data qualityIn July 2006, the NHS reorganised SHA and PCT in England from 28 SHAs into 10, and from 303 PCTs into 152. As a result data from 2006-07 onwards are not directly comparable with previous years. Data have been presented for those SHA/PCTs which have valid data for the breakdown presented here. As a result some SHA/PCTs may be missing from the list provided.Assessing growth through timeHES figures are available from 1989-90 onwards. Changes to the figures over time need to be interpreted in the context of improvements in data quality and coverage (particularly in earlier years), improvements in coverage of independent sector activity (particularly from 2006-07) and changes in NHS practice. For example, apparent reductions in activity may be due to a number of procedures which may now be undertaken in outpatient settings and so no longer include in admitted patient HES data.Strategic Health Authority ConfigurationIn 2006-07 there was a SHA configuration change, where 28 SHAs merged into 10. For this reason, 2006-07 is based on the new configuration.Bariatric Surgery Procedure Codes:The OPCS-4 procedure codes below are used to denote bariatric surgery.The OPCS-4 procedure codes (1996-97 to 2005-06, and 2006-07 to 2008-09) are:G28.1 Partial gastrectomy and anastomosis of stomach to duodenumG28.2 Partial gastrectomy and anastomosis of stomach to transposed jejunumG28.3 Partial gastrectomy and anastomosis of stomach jejunum necG28.8 Other specific partial excision of stomachG28.9 Unspecified partial excision of stomachG30.1 Gastroplasty necG30.2 Partitioning of stomach necG30.8 Other specified plastic operations on stomachG30.9 Unspecified plastic operations on stomachG31.1 Bypass of stomach by anastomosis of oesophagus to duodenumG31.2 Bypass of stomach by anastomosis of stomach to duodenumG31.3 Revision of anastomosis of stomach to duodenumG31.4 Conversion to anastomosis of stomach to duodenumG31.8 Other specified connection of stomach to duodenumG31.9 Unspecified connection of stomach to duodenumG31.0 Conversion from previous anastomosis of stomach to duodenumG32.1 Bypass of stomach by anastomosis of stomach to transposed jejunumG32.2 Revision of anastomosis of stomach to transposed jejunumG32.3 Conversion to anastomosis of stomach to transposed jejunumG32.8 Other specified connection of stomach to transposed jejunumG32.9 Unspecified connection of stomach to transposed jejunumG32.0 Conversion from previous anastomosis of stomach to transposed jejunumG33.1 Bypass of stomach by anastomosis of stomach to jejunum necG33.2 Revision of anastomosis of stomach to jejunum necG33.3 Conversion of anastomosis of stomach to jejunum nec G33.8 Other specified other connection of stomach to jejunumG33.9 Unspecified other connection of stomach to jejunumG33.0 Conversion from previous anastomosis of stomach to jejunum necG38.8 Other specified other open operations on stomachG48.1 Insertion of gastric bubbleG48.2 Attention to gastric bubbleThe following additional four digit OPCS-4 codes have been added due to the use of OPCS-4.3 in 2006-07 data:G28.4 Sleeve gastrectomy and duodenal switchG28.5 Sleeve gastrectomy necG30.3 Partitioning of stomach using bandG30.4 Partitioning of stomach using staplesG31.5 Closure of connection of stomach and duodenumG31.6 Attention to connection of stomach and duodenumG32.4 Closure of connection of stomach to transposed jejunumG32.5 Attention to connection of stomach to transposed jejunumG33.5 Closure of connection of stomach to jejunum necG33.6 Attention to connection of stomach to jejunumG38.7 Removal of gastric bandG71.6 Duodenal switchAdditional OPCS-4.4 codes used for the 2007-08 and 2008-09 data are:G27.1 Total gastrectomy and excision of surrounding tissueG27.2 Total gastrectomy and anastomosis of oesophagus to duodenumG27.3 Total gastrectomy and interposition of jejunumG27.4 Total gastrectomy and anastomosis of oesophagus to transposed jejunumG27.5 Total gastrectomy and anastomosis of oesophagus to jejunum necG27.8 Other specified total excision of stomachG27.9 Unspecified total excision of stomachSource:Hospital Episode Statistics (HES), The NHS Information Centre for health and social care