SEPHO HES Services

What is HES?

Hospital Episode Statistics (HES) provides information on all admitted patient care delivered by NHS hospitals in England from 1989 onwards. Each financial year NHS Trusts submit record level data on all Finished Consultant Episodes (FCEs) to the NHS-wide Clearing Service, about 12 million records for inpatients and day cases. HES is a subset of these data and contains data such as age, sex, dates of admission and discharge, diagnoses, operations and procedures, place of residence and ethnicity. HES covers all medical specialties and includes private patients treated within NHS hospitals. It does not, however, include private patients treated in private hospitals.

A full list of the variables collected, and their definitions, can be found within the Hospital Episodes Statistics Data Dictionary (Department of Health).

HES is not a live system and there is a time lag (normally 9-12 months) between the end of the financial year and the availability of data.

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HES Safe Haven

Public Health Observatories (PHO) were established as regional “safe havens” for HES following Shifting the Balance of Power and a widening of access to HES. SEPHO has access to an extract of HES data for the South East Region going back 10 years which as well as access to an on-line system (HES2) for the whole of England (although this does not contain sensitive data items e.g. postcode, date of birth and other potential patient identifiers).

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How can HES be used?

The Department of Health lists the main current uses of HES as:

• to develop, monitor and evaluate departmental policies
• to assess the effective delivery of care
• to identify public health issues
• to monitor improvements in public health
• to determine fair access to health care
• to improve the patient/carer experience
• to examine health outcomes
• for public & parliamentary accountability
• for central & local NHS management
• in resource acquisition and distribution
• for general medical research & statistical functions

HES cannot be used to identify individuals admitted to hospital and all HES outputs are strictly controlled to protect the confidentiality of individuals. For further information see the Department of Health HES web pages.

Example of HES data use in the South East Region – atlas of coronary heart disease (CHD)

HES data have been used throughout the atlas of CHD to show inequalities in CHD admission and treatment rates across local authorities. The example below shows the relationship between male CHD mortality and CHD hospital admission rates by local authority in both England and the South East. The local authority data have also been classified by IMD 2000 quintiles to incorporate an element of deprivation. The local authorities in quintiles 1 and 2 (with lowest deprivation) have the lowest male CHD mortality and hospital admission rates. Conversely, those local authorities with the highest deprivation (quintiles 4 and 5) have the highest male CHD mortality and hospital admission rates.

[Please click images for a larger view.]

For further information see An Atlas of CHD mortality, hospital admissions and revascularisations, 2003.

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PHO Regional HES Service - what can SEPHO offer?

National work

SEPHO works with other members of the Association of Public Health Observatories through a HES management group and a HES technical group. The technical group has developed password protected web sites for sharing data quality issues discovered and common data queries and recording requests and projects.

Standard outputs

SEPHO is developing a set of standard outputs (tables & graphics) specifically for the South East Region. These are intended to cover key disease and policy areas

Responsive Ad-hoc service

SEPHO has been dealing with requests for HES data since early 2004. If the HES data you are looking for is not included within the Department of Health’s free data tables and you would like to request HES data or analyses, please use the online HES request form in the first instance. Alternatively, you can e-mail or telephone us.

We will need to know:

• Details of your organisation including contact details
• Details of the data you require e.g. time period, diagnoses & procedure codes, by LA/PCT/Trust
• Business purpose - why you need the data/what the data will be used for
• When you need the data by

A member of the SEPHO HES analysis team will then contact you to refine and confirm the request. Please give as much notice as possible and be aware that:

• In general we provide data to allow you to perform further analysis rather than finished products.
• Information about individuals is highly sensitive. Therefore, in general, we only provide aggregate data – we cannot provide individual record data except under special circumstances and by agreement from the Department of Health. It is recognised that certain data items including postcode, gender and date of birth can in combination be used to identify individuals. SEPHO cannot, therefore, release these identifiers to a third party.
• Department of Health guidelines require the suppression of any aggregated data containing values between 1 and 5 at a local level as these are considered potentially disclosive. Alternatives to suppressing low numbers include considering a higher level of aggregation. However, if compromises are not suitable, customers can make a business case to SEPHO for access to low numbers which will be considered by SEPHO with advice from Department of Health.
• Outpatient data is not presently available - although an experimental dataset is currently being reviewed.
• The most recent data is for 2005/06.

Currently this service is free at the point of enquiry although this may be reviewed depending on demand.

South East of England HES Network

We are establishing an e-mail group for anyone in the South East Region with an interest in HES. You can use this group to discuss any issue relating to the HES data and how to use it. We will consult the group on any new developments to our Regional HES Service and send out updates when new outputs become available. To join, please contact .

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More About HES

A collection of HES related resources, including SEPHO HES strategy, presentations and feedback from HES related regional meetings, and links to HES outputs can be found on the SEPHO web site under A Collection of HES resources.

Please note that SEPHO are unable to provide data extracts or disclose identifiable data items. We are only able to supply aggregated tabular analyses. The use of identifiable data or data extracts requires full Security and Confidentiality (S&CAG) approval. Therefore, queries of this nature should be addressed to at the following address:

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