Announcement of methodological change to Provisional Accident and Emergency Quality Indicators - England, by provider

Following a letter written by UKSA and directed to those NHS organisations responsible for collecting and releasing statistics regarding Accident and Emergency (A&E) data, and the subsequent joint response by NHS Digital, NHS England and NHS Improvement

NHS Digital is making a change to the data included within the above publication (commonly known as A&E CQI).

NHS Improvement and NHS England letter dated 2017

UK Statistics letter dated  June 2017

NHS Digital is making a change to the data included within the above publication (commonly known as A&E CQI).

The publication uses Hospital Episode Statistics (HES) data which are created from an extract of records taken from a data mart in the Secondary Uses Service (SUS). Data are submitted to SUS to enable providers to get paid for the activity they have undertaken. Under the NHS Standard Contract there is a two-stage reconciliation process for such payments where providers make an initial submission of a month’s activity by the published ‘inclusion date’ of the following month. This is the reconciliation date (often referred to as the ‘flex’ date) and a snapshot of the data mart in SUS at this point is used to create that month’s HES extract. The inclusion date in the following month (i.e. two months after the month of hospital activity), is the post-reconciliation date (referred to as the ‘freeze’ date) for that month’s activity. The period between flex and freeze allows providers to improve the coverage and completeness of their records in order to get paid accurately for the activity they have undertaken.

HES data from the ‘freeze’ month are used to create the A&E CQI publication, which by the time of release is approximately 10 weeks in arrears. For example the A&E Clinical Quality Indicators released in June 2017 related to data from March 2017.

There was a good rationale behind the current practice, but recent analysis has reviewed the level of completeness, both for the number of records and the detail within them, and a decision has been made that it is now appropriate to change to use the most up to date information from HES for this publication (i.e. from the ‘flex’ month).

This will address some of the issues raised by UKSA in terms of improving timeliness of the data, reducing the time-lag from 10 weeks to around 6 weeks. It will have a negligible effect on the statistics.

Other monthly HES publications already use the ‘flex’ data. It should be noted that all monthly information from HES is classed as provisional. Final data are available at the end of the financial year in the series of annual HES publications.

The changes will take effect from August 2017. The first publication to include this change will include two months (May data based on ‘freeze’ and June data based on ‘flex’) to ensure that a month is not missed from publication.

If you have any comments or questions about these changes to the reporting in the HES official statistics, please contact NHS Digital on 0300 303 5678 or email [email protected].