Question to the Department of Health and Social Care:

To ask the Secretary of State for Health, how many people were (a) admitted to hospital and (b) attended A&E on grounds relating to (i) alcohol and (ii) obesity in each of the last five years.

We are unable to provide the number of people who attended accident and emergency (A&E) on grounds relating to alcohol or obesity as the A&E diagnosis does not record this level of detail.

The following table contains the sum of the estimated partly and wholly attributable alcohol fractions of all finished admission episodes (FAEs) for years 2009-10 to 2013-14. Alcohol fraction data is not yet available for the latest year of published data (2014-15) therefore we have provided figures for the five years from 2009-10 to 2013-14.

Sum of partly and wholly attributable alcohol fractions¹ of finished admission episodes (FAEs)², using broad³ and narrow⁴ measures for 2009-10 to 2013-14⁵

We have also provided a table containing the count of finished FAEs with a primary diagnosis of Obesity for the years from 2010-11 to 2014-15.

A primary diagnosis is the main reason a patient was admitted to hospital, so this count would not include patients with specific conditions that are made more likely by obesity unless the obesity itself was the main reason for the admission.

Count of FAEs² with a primary diagnosis⁶ of Obesity⁷, 2010-11 to 2014-15⁵

Activity in English NHS Hospitals and English NHS commissioned activity in the independent sector

Source: Hospital Episode Statistics (HES), Health and Social Care Information Centre

Notes:

[1]Alcohol-related admissions

The number of alcohol-related admissions is based on the methodology developed by the North West Public Health Observatory (NWPHO), which uses 48 indicators for alcohol-related illnesses, determining the proportion of a wide range of diseases and injuries that can be partly attributed to alcohol as well as those that are, by definition, wholly attributable to alcohol. Further information on these proportions can be found at

http://www.nwph.net/nwpho/publications/AlcoholAttributableFractions.pdf

The alcohol attributable fraction is set to 1 (100%) where the admission is considered to be entirely due to alcohol, e.g. in the case of alcoholic liver disease - these records are described as wholly alcohol attributable.

The alcohol attributable fraction is set to a value greater than 0 but less than 1 according to the NWPHO definition, e.g. the alcohol fraction of an admission with a primary diagnosis of C00 - malignant neoplasm of lip, where the patient is male and between 65 and 74 is 0.44 - these records are described as partly alcohol attributable.

These wholly and partly attributable fractions can be aggregated to supply an estimate of activity which can be considered wholly or partly attributable to alcohol.

Partly alcohol attributable fractions are not applicable to children under 16. Therefore figures for this age group relate only to wholly-attributable admissions, where the attributable fraction is one.

The application of the NWPHO methodology has recently been updated but is not currently available from HES.

[2]Finished admission episodes

A finished admission episode (FAE) is the first period of admitted patient care under one consultant within one healthcare provider. FAEs are counted against the year or month in which the admission episode finishes. Admissions do not represent the number of patients, as a person may have more than one admission within the period.

[3]Broad measure

Broad measure – derived by summing the alcohol attributable fraction associated with each admission based on the diagnosis most strongly associated with alcohol out of all diagnoses (both primary and secondary).

[4]Narrow measure

Narrow measure – is constructed in a similar way but counts only the fraction associated with the diagnosis in the primary position or alcohol-related external causes recorded in secondary diagnosis fields.

[5]Assessing growth through time (Admitted patient care)

HES 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, changes in activity may be due to changes in the provision of care.

[6]Primary diagnosis

The primary diagnosis is the first of up to 20 (14 from 2002-03 to 2006-07 and 7 prior to 2002-03) diagnosis fields in the HES data set and provides the main reason why the patient was admitted to hospital.

[7]ICD-10 codes

The following ICD-10 codes were used to identify Obesity.