Patients: Safety

(asked on 24th November 2014) - View Source

Question to the Department of Health and Social Care:

To ask the Secretary of State for Health, what the rates of (a) pulmonary embolism, (b) blood-stream infection and (c) foreign body left in after procedure has been in England in each year since 2000.


Answered by
Dan Poulter Portrait
Dan Poulter
This question was answered on 1st December 2014

The Health and Social Care Information Centre (HSCIC) has provided data on (a) a count of finished admission episodes (FAEs) where there was a primary diagnosis of pulmonary embolism and the number of FAEs as a rate per 100,000 of the total number of FAEs and (b) a count of finished consultant episodes (FCEs) with a primary or secondary diagnosis of pulmonary embolism and the number of FCEs as a rate per 100,000 of the total number FCEs, for the years 2000-01 to 2012-13.

This is summarised in the following table:

Year

FAEs with primary diagnosis of "pulmonary embolism"

Rate per 100,000 of total FAEs

FCEs with primary or secondary diagnosis of "pulmonary embolism"

Rate per 100,000 of total FCEs

2000-01

15,179

136.5

32,937

268.6

2001-02

14,735

133.0

33,537

271.8

2002-03

15,536

136.6

37,093

291.8

2003-04

16,095

136.3

39,196

294.8

2004-05

15,621

129.1

40,059

292.3

2005-06

16,347

128.9

43,360

300.6

2006-07

16,629

128.1

46,685

315.8

2007-08

16,948

125.7

49,114

319.8

2008-09

18,214

128.7

56,029

345.2

2009-10

19,763

135.9

62,367

371.1

2010-11

20,908

140.4

67,477

390.7

2011-12

21,525

143.3

70,466

403.5

2012-13

23,578

155.7

79,058

446.3

Public Health England (PHE) collects data on blood stream infections caused by bacteria (bacteraemia) relating to specific organisms as part of its mandatory Healthcare Associated Infection surveillance programmes.

Microbiology laboratories in England, Wales and Northern Ireland also voluntarily submit data to PHE relating to episodes of bacteraemia and blood stream infections caused by fungi (fungaemia).

The data summarised in Tables 1-3, taken from PHE’s mandatory surveillance programmes, represent bacteraemia cases reported in England resulting from: Methicillin-resistant Staphylococcus aureus (MRSA); Methicillin-susceptible Staphylococcus aureus (MSSA) and E.coli where comparable data is available. Rates of all reported cases per 100,000 population are included, where available.

Table 1a: All reported cases of MRSA bacteraemia (April 2007-March 2014)

Financial year

April 2007 to March 2008

April 2008 to March 2009

April 2009 to March 2010

April 2010 to March 2011

April 2011 to March 2012

April 2012 to March 2013

April 2013 to March 2014

Count

4,451

2,935

1,898

1,481

1,116

924

862

Rate per 100,000 population

3.6

2.8

2.1

1.7

1.6

Note: Data is available at: https://www.gov.uk/government/statistics/mrsa-bacteraemia-annual-data

Table 2: All reported cases of MSSA bacteraemia (April 2011 - March 2014)

Financial year

April 2011 to March 2012

April 2012 to March 2013

April 2013 to March 2014

Count

8,767

8,812

9,290

Rate per 100,000 population

16.5

16.5

17.4

Note: Data is available at: https://www.gov.uk/government/statistics/mssa-bacteraemia-annual-data

Table 3: All reported cases of E. coli bacteraemia (April 2012-March 2014)

Financial year

April 2012 to March 2013

April 2013 to March 2014

Count

32,309

34,275

Rate per 100,000 population

60.4

64.1

Note: Data is available at: https://www.gov.uk/government/statistics/escherichia-coli-e-coli-bacteraemia-annual-data

The data summarised in Table 4, taken from PHE’s voluntary surveillance database, represents all voluntarily reported patient episodes involving either bacteraemia and/or fungaemia for the period of January 2008 to December 2012 in England, Wales and Northern Ireland.

Table 4: Patient episodes involving either bacteraemia and/or fungaemia 2008-2012, England, Wales and Northern Ireland

Calendar Year

2008

2009

2010

2011

2012

Count

95,931

94,190

92,867

94,166

95,647

Note: Data extracted from the Public Health England (PHE) voluntary surveillance database, LabBase2, on 3 December 2013.

Before 2009, information was not collated on foreign bodies retained after procedures (which is classed as a ‘never event’) and so we are unable to provide data for the period prior to 2009.

In 2009-10, there were nine retained foreign objects post procedure reported during this period.

In 2010-11, there were 67 retained foreign object never events reported to Strategic Executive Information System (STEIS) and 22 reported to the National Reporting and Learning Service (NRLS).

In 2011-12, there were 161 retained foreign object never events reported to STEIS and 86 reported to the NRLS in 2011-12.

In 2012-13, there were 130 retained foreign object never events reported to STEIS and 124 reported to the NRLS in 2012-13 (please note incidents are potentially reported to both systems but the exact degree of overlap of reported incidents during the period 2010-11 and 2011-12 is unclear).

Since April 2013 reports made to the NRLS and STEIS have been directly reconciled to provide a single total and provisional data published by NHS England shows 123 retained object never events were reported in 2013-14 and 44 in the six months to September 2014:

http://www.england.nhs.uk/ourwork/patientsafety/never-events/ne-data/

Methods for identifying and collating the data from two systems (NRLS and STEIS) have changed over the years, with specific reporting fields for Never events replacing keyword searches, and year-end attempts to reconcile events reported in both systems replaced with direct communication as and when incidents were reported. This is a further reason why events from the earlier years are not directly comparable. The numbers of Never Events reported for 2010-11 and 2011-12 were reported in Annex A of the ‘The never events policy framework: An update to the never events policy

https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/213046/never-events-policy-framework-update-to-policy.pdf

It should be noted that the updated policy expanded the list of never events from 8 to 25 in 2012 and the detail of definitions of retained foreign objects was also clarified in The never events list; 2013/14 update:

http://www.england.nhs.uk/wp-content/uploads/2013/12/nev-ev-list-1314-clar.pdf.

Note numbers in different years are not directly comparable due to these definitional changes.

Reticulating Splines