Notes:

1. Finished consultant episode (FCE)

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 they end. It should be noted that the 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. Episode duration/Bed Days

Episode duration is calculated as the difference in days between the episode start date and the episode end date, where both are given. Episode duration is based on finished consultant episodes and only applies to ordinary admissions, i.e. day cases are excluded (unless otherwise stated).

3. Primary diagnosis

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 admitted to hospital.

4. ICD10 codes for Malnutrition

The ICD-10 codes for Malnutrition are:

E40.X Kwashiorkor

E41.X Nutritional marasmus

E42.X Marasmic kwashiorkor

E43.X Unspecified severe protein-energy malnutrition

E44.X Protein energy malnutrition of moderate and mild degree

E45.X Retarded development following protein-energy malnutrition

E46.X Unspecified protein-energy malnutrition

025.X Malnutrition in pregnancy

5. PCT Changes

In July 2006, the national health service reorganised strategic health authorities (SHAs) and primary care trusts (PCTs) in England from 28 SHAs into 10, and from 303 PCTs into 152. As a result data from 2006-07 onwards is not directly comparable with previous years. Please note the following changes in PCTs in 2003-04: Walthamstow, Leyton and Leytonstone PCT became Waltham Forest PCT; Chingford, Wanstead and Woodford PCT and Redbridge PCT became Redbridge PCT; and Bexley PCT became Bexley Care Trust.

6. 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.

7. 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.

8. Small numbers

To protect patient confidentiality, figures between 1 and 5 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.