HES is a database of all in-patient hospital activity in NHS hospitals across England. It includes daycare, inpatient, maternity and mental health episodes. It does not currently include outpatients, A&E and private hospital episodes.

It contains record-level information on all Finished Consultant Episodes (FCE's) within NHS hospitals in England. HES covers all medical specialities and includes private patients treated in NHS Hospitals. It does not currently include private patients treated in private hospitals. It is populated by the data submitted by NHS trusts to the NHS-wide clearing service. There are approximately 12 million FCEs for each financial year at present.

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HES currently contains a wide range of information. It includes demographic information about people admitted to hospital including age, sex, place of residence and ethnicity. It includes information about the reason for admission such as diagnoses and procedures carried out along with where information about how and where the patient was admitted. A full list of information collected can be viewed in the HES Data Dictionary.

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The HES data are a fundamental part of providing information about health and healthcare for local populations. HES is particularly important in the comparative analysis of access to health care for different areas and groups. This is vital when looking at health inequalities, social exclusion or the development of local services.

The Department of Health has listed the main current uses of the HES database 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 and parliamentary accountability;
• for central and local NHS management;
• in resource acquisition and distribution;
• for general medical research and statistical functions.

HES can not be used to identify individuals admitted to hospital and all HES outputs are strictly controlled to protect the confidentiality of patients. For further information see the confidentiality section on the Department of Health's HES Website.

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The Department of Health (DH) has awarded the PHOs significant funding to implement a Regional HES Service. As part of this The Public Health Observatories (PHOs) have been established as Regional Safe Havens for Hospital Episode Statistics (HES). As a safe haven the London Health Observatory has:

1. On-line access to HES data for the whole of England, excluding sensitive data items.
2. An extract of HES data for London residents and those treated in London, including all sensitive data items.

Funding has been provided for the provision of three specific services:

• HES analyses which are likely to be of interest to all Public Health Observatories (PHOs) and their partners. These are to be conducted by one or more PHOs on behalf of the Association of Public Health Observatories (APHO). The queries and outputs should be done once and shared across the PHO network, either as outputs if they can comprise the national dataset or as queries for others to run on their regional dataset. During 2004 discussions will take place within the APHO to take this part of the service forward.
• A London analytical strategy, agreed in discussion with London's major stakeholders. This was discussed at the LHO Health Intelligence Network in January 2004, however, the priorities within this strategy are continually evolving. London's Health Intelligence Network agreed a need for both basic HES indicators and more complex analyses and methodology development.
• Dealing with ad hoc requests for access to data or analyses.

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The LHO has access to on-line HES data for the whole of England for 1989/90 - 2003/04. In addition the LHO has further detailed information (including sensitive data items) for HES data for London residents and those treated in London for 2001/02 and 2002/03.

Date	Title	Format	View
3 Jun 2005	HES Strategy Feedback Form
11 Jan 2005	Update on implementing the LHO Regional HES Service
15 Apr 2004	LHO HES (Hospital Episode Statistics) analytical strategy

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The London Health Observatory has been dealing with request for HES data since February 2004. If you would like to request HES data or analysis from the LHO please view our HES Request Form.

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