Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, if he will make an estimate of the number of (a) patients admitted to hospital and (b) patients receiving medical treatment following a fungal infection in each of the last 3 years.

This information is not held in the format requested. However, the following table shows the number of person IDs with a primary diagnosis of fungal infection and finished admission episodes (FAEs) and finished consultant episodes (FCEs) where a main procedure took place in 2019/20 and 2020/21 in English National Health Service hospitals and English NHS commissioned activity in the independent sector.

Source: NHS Digital

Notes:

1. Person IDs. The Master Person Service (MPS) person identifier. This is a unique identifier for each individual patient, generated via the MPS. This identifier replaces the HESID field and allows an individual’s care to be tracked across years and continuous periods to be identified.
2. Primary Diagnosis. The primary diagnosis is the first of up to 20 (14 from 2002/03 to 2006/07 and seven prior to 2002/03) diagnosis fields in the Hospital Episode Statistics (HES) data set and provides the main reason why the patient was admitted to hospital.
3. ICD-10 coding and description. The following ICD-10 codes are indexed under the term ‘fungal infection’:

- B49.X Unspecified mycosis

- B20.5 HIV disease resulting in other mycoses

- B35.0 Tinea barbae and tinea capitis

- B35.1 Tinea unguium

- B35.2 Tinea manuum

- B35.3 Tinea pedis

- B35.6 Tinea cruris

- B36.9 Superficial mycosis, unspecified

- B48.7 Opportunistic mycoses

Research indicates that fungal infections are also known as mycosis, therefore the ICD-10 block B35-B49 Mycoses may be pertinent and has also been included in the data. It should be noted that there may be other codes within the ICD-10 classification which maybe applicable to the condition.

4. A 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.
5. A FCE is a continuous period of admitted patient care under one consultant within one healthcare provider. FCEs are counted against the year in which it ends. Figures do not represent the number of different patients, as a person may have more than one episode of care within the same stay in hospital or in different stays in the same year.
6. Main procedure. The first recorded procedure or intervention in each episode, usually the most resource intensive procedure or intervention performed during the episode. It is appropriate to use main procedure when looking at admission details, for example, time waited, while a more complete count of episodes with a particular procedure is obtained by looking at the main and the secondary procedures. It should be noted that some patients are treated for a fungal infection condition during an outpatient appointment. However, diagnoses are extremely seldom recorded in outpatient records, therefore it is not possible to provide useful data from the outpatient data set.
7. HES figures are available from 1989/90 onwards. Changes to the figures over time should 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, apparent reductions in activity may be due to a number of procedures which may now be undertaken in outpatient settings and so no longer include in admitted patient HES data. Conversely, apparent increases in activity may be due to improved recording of diagnosis or procedure information.

Data is also held on total systemic antifungal prescribing in NHS hospital trusts recorded as defined daily doses (DDDs) per 1,000 admissions per day in 2020. The total consumption of antifungals in NHS acute trusts in 2020 was 0.63 DDDs per 1,000 admissions per day. This is a 21% increase in the rate of prescribing from 2019. The collection of the NHS England’s antifungal commissioning for quality and innovation data was interrupted by COVID-19.