CIT ASE Event Slides April 19 th 2010 v6 1

PCH2.1: Elective surgical procedures under GA for children <5y Table 1: Data Data obtained from HES: 2007/08, 2008/09, and 2009/10 2 Total episodes with a main operation code associated with the use of GA

PCH2.1: Elective surgical procedures under GA for children <5y Chart 1: Time Series Data obtained from HES: 2007/08, 2008/09, and 2009/10 3 Total episodes with a main operation code associated with the use of GA

PCH2.2: Elective surgical procedures under GA for children <3y Table 1: Data Data obtained from HES: 2007/08, 2008/09, and 2009/10 4 Total episodes with a main operation code associated with the use of GA

PCH2.2: Elective surgical procedures under GA for children <3y Chart 1: Time Series Data obtained from HES: 2007/08, 2008/09, and 2009/10 5 Total episodes with a main operation code associated with the use of GA

PCH3.1: Emergency surgical procedures under GA for children <5y Table 1: Data Data obtained from HES: 2007/08, 2008/09, and 2009/10 6 Total episodes with a main operation code associated with the use of GA

PCH3.1: Emergency surgical procedures under GA for children <5y Chart 1: Time Series Data obtained from HES: 2007/08, 2008/09, and 2009/10 7 Total episodes with a main operation code associated with the use of GA

PCH3.2: Emergency surgical procedures under GA for children <3y Table 1: Data Data obtained from HES: 2007/08, 2008/09, and 2009/10 8 Total episodes with a main operation code associated with the use of GA

PCH3.2: Emergency surgical procedures under GA for children <3y Chart 1: Time Series Data obtained from HES: 2007/08, 2008/09, and 2009/10 9 Total episodes with a main operation code associated with the use of GA

PCH8.1 LOS by Trust for Children for General Surgery Table 1: Data Data obtained from HES 2009/10 Provider 0 days1 day2-3 days4+ days GATESHEAD HEALTH NHS FOUNDATION TRUST * * NORTHUMBRIA HEALTHCARE NHS FOUNDATION TRUST *** NORTH TEES AND HARTLEPOOL NHS FOUNDATION TRUST THE NEWCASTLE UPON TYNE HOSPITALS NHS FOUNDATION TRUST *** SOUTH TEES HOSPITALS NHS FOUNDATION TRUST SOUTH TYNESIDE NHS FOUNDATION TRUST 8*11* COUNTY DURHAM AND DARLINGTON NHS FOUNDATION TRUST 6612** CITY HOSPITALS SUNDERLAND NHS FOUNDATION TRUST 8* * NHS North East NHS National 10,1636,1644,5021,651 * Data suppressed due to low cell count

Data obtained from HES: 2009/10 Chart 1: Stacked bar PCH8.1 LOS by Trust for Children for General Surgery

Data obtained from HES: 2009/10 Chart 2: Stacked bar PCH8.1 LOS by Trust for Children for General Surgery

PCH8.2 LOS by Trust for Children for Orthopaedic Surgery Table 1: Data Provider 0 days1 day2-3 days4+ days GATESHEAD HEALTH NHS FOUNDATION TRUST 19** NORTHUMBRIA HEALTHCARE NHS FOUNDATION TRUST NORTH TEES AND HARTLEPOOL NHS FOUNDATION TRUST THE NEWCASTLE UPON TYNE HOSPITALS NHS FOUNDATION TRUST SOUTH TEES HOSPITALS NHS FOUNDATION TRUST SOUTH TYNESIDE NHS FOUNDATION TRUST COUNTY DURHAM AND DARLINGTON NHS FOUNDATION TRUST CITY HOSPITALS SUNDERLAND NHS FOUNDATION TRUST NHS North East 1,3181, NHS National 23,95120,2119,5545,215 Data obtained from HES: 2009/10 * Data suppressed due to low cell count

Chart 1: Stacked bar PCH8.2 LOS by Trust for Children for Orthopaedic Surgery Data obtained from HES: 2009/10

Chart 2: Stacked bar PCH8.2 LOS by Trust for Children for Orthopaedic Surgery Data obtained from HES: 2009/10

PCH8.3 LOS by Trust for Children for Urology Surgery Table 1: Data Provider 0 days1 day2-3 days4+ days GATESHEAD HEALTH NHS FOUNDATION TRUST NORTHUMBRIA HEALTHCARE NHS FOUNDATION TRUST NORTH TEES AND HARTLEPOOL NHS FOUNDATION TRUST 66 THE NEWCASTLE UPON TYNE HOSPITALS NHS FOUNDATION TRUST **** SOUTH TEES HOSPITALS NHS FOUNDATION TRUST * SOUTH TYNESIDE NHS FOUNDATION TRUST COUNTY DURHAM AND DARLINGTON NHS FOUNDATION TRUST 55 * CITY HOSPITALS SUNDERLAND NHS FOUNDATION TRUST 248 * NHS North East 26729*7 NHS National 10,3321, Data obtained from HES: 2009/10 * Data suppressed due to low cell count

Chart 1: Stacked bar PCH8.3 LOS by Trust for Children for Urology Surgery Data obtained from HES: 2009/10

Chart 2: Stacked bar PCH8.3 LOS by Trust for Children for Urology Surgery Data obtained from HES: 2009/10

PCH8.4 LOS by Trust for Children for Plastic Surgery Table 1: Data Provider 0 days1 day2-3 days4+ days GATESHEAD HEALTH NHS FOUNDATION TRUST NORTHUMBRIA HEALTHCARE NHS FOUNDATION TRUST NORTH TEES AND HARTLEPOOL NHS FOUNDATION TRUST * THE NEWCASTLE UPON TYNE HOSPITALS NHS FOUNDATION TRUST SOUTH TEES HOSPITALS NHS FOUNDATION TRUST SOUTH TYNESIDE NHS FOUNDATION TRUST COUNTY DURHAM AND DARLINGTON NHS FOUNDATION TRUST CITY HOSPITALS SUNDERLAND NHS FOUNDATION TRUST NHS North East 1, NHS National 16,9894,5582, Data obtained from HES: 2009/10 * Data suppressed due to low cell count

Chart 1: Stacked bar PCH8.4 LOS by Trust for Children for Plastic Surgery Data obtained from HES: 2009/10

Chart 2: Stacked bar PCH8.4 LOS by Trust for Children for Plastic Surgery Data obtained from HES: 2009/10

PCH8.5 LOS by Trust for Children for Neurosurgery Table 1: Data Provider 0 days1 day2-3 days4+ days GATESHEAD HEALTH NHS FOUNDATION TRUST NORTHUMBRIA HEALTHCARE NHS FOUNDATION TRUST NORTH TEES AND HARTLEPOOL NHS FOUNDATION TRUST THE NEWCASTLE UPON TYNE HOSPITALS NHS FOUNDATION TRUST SOUTH TEES HOSPITALS NHS FOUNDATION TRUST SOUTH TYNESIDE NHS FOUNDATION TRUST COUNTY DURHAM AND DARLINGTON NHS FOUNDATION TRUST CITY HOSPITALS SUNDERLAND NHS FOUNDATION TRUST NHS North East NHS National 1, ,0951,855 Data obtained from HES: 2009/10

Chart 1: Stacked bar PCH8.5 LOS by Trust for Children for Neurosurgery Data obtained from HES: 2009/10

Chart 2: Stacked bar PCH8.5 LOS by Trust for Children for Neurosurgery Data obtained from HES: 2009/10

PCH8.6 LOS by Trust for Children for Ophthalmic Surgery Table 1: Data Provider 0 days1 day2-3 days4+ days GATESHEAD HEALTH NHS FOUNDATION TRUST NORTHUMBRIA HEALTHCARE NHS FOUNDATION TRUST NORTH TEES AND HARTLEPOOL NHS FOUNDATION TRUST THE NEWCASTLE UPON TYNE HOSPITALS NHS FOUNDATION TRUST * SOUTH TEES HOSPITALS NHS FOUNDATION TRUST 106*** SOUTH TYNESIDE NHS FOUNDATION TRUST COUNTY DURHAM AND DARLINGTON NHS FOUNDATION TRUST 755* CITY HOSPITALS SUNDERLAND NHS FOUNDATION TRUST 270*** NHS North East NHS National 11, Data obtained from HES: 2009/10 * Data suppressed due to low cell count

Chart 1: Stacked bar PCH8.6 LOS by Trust for Children for Ophthalmic Surgery Data obtained from HES: 2009/10

Chart 2: Stacked bar PCH8.6 LOS by Trust for Children for Ophthalmic Surgery Data obtained from HES: 2009/10

PCH8.7 LOS by Trust for Children for ENT Surgery Table 1: Data Provider 0 days1 day2-3 days4+ days GATESHEAD HEALTH NHS FOUNDATION TRUST NORTHUMBRIA HEALTHCARE NHS FOUNDATION TRUST NORTH TEES AND HARTLEPOOL NHS FOUNDATION TRUST THE NEWCASTLE UPON TYNE HOSPITALS NHS FOUNDATION TRUST SOUTH TEES HOSPITALS NHS FOUNDATION TRUST SOUTH TYNESIDE NHS FOUNDATION TRUST COUNTY DURHAM AND DARLINGTON NHS FOUNDATION TRUST CITY HOSPITALS SUNDERLAND NHS FOUNDATION TRUST NHS North East 2,0441, NHS National 42,83220,3553,2211,020 Data obtained from HES: 2009/10

PCH8.7 LOS by Trust for Children for ENT Surgery Chart 1: Stacked bar Data obtained from HES: 2009/10

PCH8.7 LOS by Trust for Children for ENT Surgery Data obtained from HES: 2009/10 Chart 2: Stacked bar

PCH8.8 LOS by Trust for Children for Maxillo-Facial Surgery Table 1: Data Provider 0 days1 day2-3 days4+ days GATESHEAD HEALTH NHS FOUNDATION TRUST NORTHUMBRIA HEALTHCARE NHS FOUNDATION TRUST NORTH TEES AND HARTLEPOOL NHS FOUNDATION TRUST THE NEWCASTLE UPON TYNE HOSPITALS NHS FOUNDATION TRUST SOUTH TEES HOSPITALS NHS FOUNDATION TRUST SOUTH TYNESIDE NHS FOUNDATION TRUST COUNTY DURHAM AND DARLINGTON NHS FOUNDATION TRUST * CITY HOSPITALS SUNDERLAND NHS FOUNDATION TRUST NHS North East * NHS National5, Data obtained from HES: 2009/10 * Data suppressed due to low cell count

PCH8.8 LOS by Trust for Children for Maxillo-Facial Surgery Data obtained from HES: 2009/10 Chart 1: Stacked bar

PCH8.8 LOS by Trust for Children for Maxillo-Facial Surgery Data obtained from HES: 2009/10 Chart 2: Stacked bar

PCH8.9 LOS by Trust for Children for Cardiac Surgery Table 1: Data Provider 0 days1 day2-3 days4+ days GATESHEAD HEALTH NHS FOUNDATION TRUST NORTHUMBRIA HEALTHCARE NHS FOUNDATION TRUST NORTH TEES AND HARTLEPOOL NHS FOUNDATION TRUST THE NEWCASTLE UPON TYNE HOSPITALS NHS FOUNDATION TRUST SOUTH TEES HOSPITALS NHS FOUNDATION TRUST SOUTH TYNESIDE NHS FOUNDATION TRUST COUNTY DURHAM AND DARLINGTON NHS FOUNDATION TRUST CITY HOSPITALS SUNDERLAND NHS FOUNDATION TRUST NHS North East NHS National ,561 Data obtained from HES: 2009/10

PCH8.9 LOS by Trust for Children for Cardiac Surgery Data obtained from HES: 2009/10 Chart 1: Stacked bar

PCH8.9 LOS by Trust for Children for Cardiac Surgery Data obtained from HES: 2009/10 Chart 2: Stacked bar

PCH8.10 LOS by Trust for Children for Paediatric Surgery Table 1: Data Provider 0 days1 day2-3 days4+ days GATESHEAD HEALTH NHS FOUNDATION TRUST NORTHUMBRIA HEALTHCARE NHS FOUNDATION TRUST NORTH TEES AND HARTLEPOOL NHS FOUNDATION TRUST THE NEWCASTLE UPON TYNE HOSPITALS NHS FOUNDATION TRUST 1, SOUTH TEES HOSPITALS NHS FOUNDATION TRUST SOUTH TYNESIDE NHS FOUNDATION TRUST COUNTY DURHAM AND DARLINGTON NHS FOUNDATION TRUST * CITY HOSPITALS SUNDERLAND NHS FOUNDATION TRUST 1579 NHS North East 1, NHS National 22,0217,2464,7975,176 Data obtained from HES: 2009/10 * Data suppressed due to low cell count

PCH8.10 LOS by Trust for Children for Paediatric Surgery Chart 1: Stacked bar Data obtained from HES: 2009/10

PCH8.10 LOS by Trust for Children for Paediatric Surgery Data obtained from HES: 2009/10 Chart 2: Stacked bar

PCH9.1 Overnight Paediatric beds by trust Table 1: Data 40 Data obtained from HES: 2009/10

PCH9.1 Overnight Paediatric beds by trust Chart 1: Time Series Data obtained from DH KH03 data: 2003/04 through 2008/09 41

PCH9.2a Overnight Paediatric bed occupancy rate by trust Table 1: Data Data obtained from HES: 2007/08, 2008/09, and 2009/10 42 * Missing data in 2008/09

PCH9.2a Overnight Paediatric bed occupancy rate by trust Chart 1: Time Series Data obtained from DH KH03 data: 2003/04 through 2008/09 43 * Missing data in 2008/09

PCH9.2a Overnight Paediatric bed occupancy rate by trust Chart 2: Box and whisker plot Data obtained from DH KH03 data: 2007/08 44

PCH9.2a Overnight Paediatric bed occupancy rate by trust Chart 3: Funnel plot Data obtained from DH KH03 data: 2007/08 45

PCH9.2b Paediatric bed throughput by trust, average Table 1: Data Data obtained from HES: 2007/08, 2008/09 46

PCH9.2b Paediatric bed throughput by trust, average Chart 1: Time Series Data obtained from HES: 2007/08, 2008/09 and KH03 Data 2007/08, 2008/09 47

PCH9.2b Paediatric bed throughput by trust, average Chart 2: Box and whisker plot 48 Data obtained from HES: 2008/09 and KH03 Data 2008/09

PCH9.2a Overnight Paediatric bed occupancy rate by trust 49 PCH9.2b Paediatric bed throughput by trust, average We have noticed an inconsistency that overnight bed occupancy (self reported to DH on an annual basis) for Newcastle (NUTHFT) averages near 67%, while average daily throughput is closer to 40%. We have re-checked the data for these indicators and believe the calculations are correct. This could highlight an inconsistency in the reporting of bed occupancy rates to the Department of Health for NUTHFT. Would anyone be able to comment on this? Note to NEQOS Newcastle

PCH9.3 A&E paediatric attendance outcome by trust Table 1: Data 50 Data obtained from HES 2009/10 * Data suppressed due to low cell count

PCH9.3 A&E paediatric attendance outcome by trust Chart 1: Stacked bar 51 Data obtained from HES 2009/10

PCH9.3 A&E paediatric attendance outcome, region and national view Chart 2: Pie chart 52 Data obtained from HES 2009/10

PCH9.4.1 Admissions with Breathing Difficulties (<16) Table 1: Data Data obtained from HES: 2008/09, 2009/10 Provider Q4 0708FY 0708Q1 0809Q2 0809Q3 0809Q4 0809FY 0809Q1 0910Q2 0910Q COUNTY DURHAM AND DARLINGTON NHS FOUNDATION TRUST 32.0%31.3%24.0%23.0%52.4%33.0%33.9%11.9%12.9%25.8% SOUTH TEES HOSPITALS NHS FOUNDATION TRUST 29.9%29.1%25.3%23.8%48.7%36.1%33.7%11.7%12.5%29.4% GATESHEAD HEALTH NHS FOUNDATION TRUST 34.7%32.6%26.4%27.6%53.2%38.6%37.5%28.0%33.5%42.7% NORTH TEES AND HARTLEPOOL NHS FOUNDATION TRUST 31.9%34.9%22.5%24.1%49.5%39.8%35.0%12.8%13.9%27.7% NORTHUMBRIA HEALTHCARE NHS FOUNDATION TRUST 38.4%35.9%24.7%29.5%63.3%43.1%41.0%13.9%18.0%29.4% CITY HOSPITALS SUNDERLAND NHS FOUNDATION TRUST 27.5%29.3%20.2%21.0%45.7%27.4%28.7%25.9%26.8%46.1% SOUTH TYNESIDE NHS FOUNDATION TRUST 31.4%34.4%24.1%24.7%54.2%34.2%35.9%19.2%24.7%58.3% THE NEWCASTLE UPON TYNE HOSPITALS NHS FOUNDATION TRUST 14.9%19.5%11.6%13.4%34.8%23.1%21.1%8.6%8.9%16.3% NHS North East 28.9%29.7%21.5%22.2%48.8%33.5%32.1%13.3%14.6%27.4% NHS National 30.3%31.0%23.8%24.3%47.9%32.1%32.5%17.5%19.3%37.4%

PCH9.4.1 Admissions with Breathing Difficulties (<16) Data obtained from HES: 2008/09, 2009/10 Chart 1: Time Series

PCH9.4.1 Admissions with Breathing Difficulties (<16) Chart 2: Box and whisker plot Data obtained from HES: 2008/09, 2009/10

PCH9.4.1 Admissions with Breathing Difficulties (<16) Chart 3: Funnel Plot Data obtained from HES: 2008/09, 2009/10

PCH9.4.2 LOS for Children with Breathing Difficulties Table 1: Data Provider 0 days1 day2-3 days4+ days GATESHEAD HEALTH NHS FOUNDATION TRUST NORTHUMBRIA HEALTHCARE NHS FOUNDATION TRUST NORTH TEES AND HARTLEPOOL NHS FOUNDATION TRUST THE NEWCASTLE UPON TYNE HOSPITALS NHS FOUNDATION TRUST SOUTH TYNESIDE NHS FOUNDATION TRUST SOUTH TEES HOSPITALS NHS FOUNDATION TRUST COUNTY DURHAM AND DARLINGTON NHS FOUNDATION TRUST CITY HOSPITALS SUNDERLAND NHS FOUNDATION TRUST NHS North East 4,6912,4801, NHS National 61,92841,17521,0709,922 Data obtained from HES: 2009/10

PCH9.4.2 LOS for Children with Breathing Difficulties Chart 1: Stacked bar Data obtained from HES: 2009/10

PCH9.4.2 LOS for Children with Breathing Difficulties Chart 2: Stacked bar Data obtained from HES: 2009/10

PCH9.5.1 Admissions with Gastrointestinal problems (<16) Table 1: Data Data obtained from HES: 2008/09, 2009/10 Provider Q4 0708FY 0708Q1 0809Q2 0809Q3 0809Q4 0809FY 0809Q1 0910Q2 0910Q COUNTY DURHAM AND DARLINGTON NHS FOUNDATION TRUST 27.2%23.4%25.2%18.2%17.7%26.4%21.9%12.9%7.9%9.0% SOUTH TEES HOSPITALS NHS FOUNDATION TRUST 26.4%21.6%23.5%16.9%17.3%31.1%22.4%13.1%9.5%9.4% GATESHEAD HEALTH NHS FOUNDATION TRUST 30.8%24.0%25.4%17.6%17.1%24.2%21.2%26.6%18.3%21.8% NORTH TEES AND HARTLEPOOL NHS FOUNDATION TRUST 34.5%28.1%29.5%20.5%20.2%32.0%25.5%12.5%11.1%10.1% NORTHUMBRIA HEALTHCARE NHS FOUNDATION TRUST 27.7%22.1%27.1%17.0%19.0%29.3%23.1%13.2%8.9%10.5% CITY HOSPITALS SUNDERLAND NHS FOUNDATION TRUST 24.0%16.8%18.4%16.0%16.1%24.7%18.5%17.9%17.3%14.9% SOUTH TYNESIDE NHS FOUNDATION TRUST 30.6%24.5%25.9%18.8%20.4%27.9%23.3%24.3%21.3%19.0% THE NEWCASTLE UPON TYNE HOSPITALS NHS FOUNDATION TRUST 21.0%17.1%18.4%13.3%14.7%21.3%17.0%8.9%5.9%6.3% NHS North East 27.0%21.9%23.7%16.9%17.5%26.9%21.3%13.3%9.6%9.7% NHS National 24.5%20.2%21.2%16.6%16.4%24.7%27.0%15.0%11.6%11.3%

PCH9.5.1 Admissions with Gastrointestinal problems (<16) Chart 1: Time Series Data obtained from HES: 2008/09, 2009/10

PCH9.5.1 Admissions with Gastrointestinal problems (<16) Chart 2: Box and whisker plot Data obtained from HES: 2008/09, 2009/10

PCH9.5.1 Admissions with Gastrointestinal problems (<16) Chart 3: Funnel Plot Data obtained from HES: 2008/09, 2009/10

PCH9.5.2 LOS for Children with Gastrointestinal Problems Table 1: Data Data obtained from HES 2009/10 Provider 0 days1 day2-3 days4+ days GATESHEAD HEALTH NHS FOUNDATION TRUST NORTHUMBRIA HEALTHCARE NHS FOUNDATION TRUST NORTH TEES AND HARTLEPOOL NHS FOUNDATION TRUST THE NEWCASTLE UPON TYNE HOSPITALS NHS FOUNDATION TRUST SOUTH TEES HOSPITALS NHS FOUNDATION TRUST SOUTH TYNESIDE NHS FOUNDATION TRUST COUNTY DURHAM AND DARLINGTON NHS FOUNDATION TRUST CITY HOSPITALS SUNDERLAND NHS FOUNDATION TRUST NHS North East 2,8611, NHS National 31,05020,30711,4674,847 Data obtained from HES: 2009/10

PCH9.5.2 LOS for Children with Gastrointestinal Problems Chart 1: Stacked bar Data obtained from HES 2009/10 Data obtained from HES: 2009/10

Chart 2: Stacked bar PCH9.5.2 LOS for Children with Gastrointestinal Problems Data obtained from HES 2009/10 Data obtained from HES: 2009/10

PCH9.6.1 Admissions with Feverish Illness (<16) Table 1: Data Data obtained from HES: 2008/09, 2009/10 Provider Q4 0708FY 0708Q1 0809Q2 0809Q3 0809Q4 0809FY 0809Q1 0910Q2 0910Q COUNTY DURHAM AND DARLINGTON NHS FOUNDATION TRUST 40.6%38.2%31.9%27.3%59.1%41.3%40.7%16.1%17.0%27.8% SOUTH TEES HOSPITALS NHS FOUNDATION TRUST 33.2%31.7%29.0%27.2%53.0%39.4%37.4%13.5%13.1%30.1% GATESHEAD HEALTH NHS FOUNDATION TRUST 46.9%40.6%38.6%33.9%62.9%46.2%46.5%34.7%37.3%46.1% NORTH TEES AND HARTLEPOOL NHS FOUNDATION TRUST 39.3%42.2%30.3%31.9%55.6%47.2%42.2%17.4%16.4%30.1% NORTHUMBRIA HEALTHCARE NHS FOUNDATION TRUST 45.2%43.1%30.8%34.2%69.8%46.9%46.4%14.2%17.6%27.7% CITY HOSPITALS SUNDERLAND NHS FOUNDATION TRUST 32.4%32.1%24.0%23.1%50.7%34.3%33.0%22.9%22.7%42.5% SOUTH TYNESIDE NHS FOUNDATION TRUST 34.1%40.1%32.5%29.1%60.5%43.5%43.0%28.2%31.2%62.8% THE NEWCASTLE UPON TYNE HOSPITALS NHS FOUNDATION TRUST 19.2%23.4%16.7%18.3%40.2%28.9%26.4%10.9%11.2%17.9% NHS North East 35.1%35.0%27.9%26.9%54.9%39.8%38.0%16.1%16.6%28.6% NHS National 34.1%34.2%27.9%25.9%51.3%35.6% 18.8%20.1%35.0%

PCH9.6.1 Admissions with Feverish Illness (<16) Chart 1: Time Series Data obtained from HES: 2008/09, 2009/10

PCH9.6.1 Admissions with Feverish Illness (<16) Chart 2: Box and whisker plot Data obtained from HES: 2008/09, 2009/10

PCH9.6.1 Admissions with Feverish Illness (<16) Chart 3: Funnel Plot Data obtained from HES: 2008/09, 2009/10

PCH9.6.2 LOS for Children with Feverish Illness Table 1: Data Data obtained from HES 2009/10 Provider 0 days1 day2-3 days4+ days GATESHEAD HEALTH NHS FOUNDATION TRUST NORTHUMBRIA HEALTHCARE NHS FOUNDATION TRUST NORTH TEES AND HARTLEPOOL NHS FOUNDATION TRUST THE NEWCASTLE UPON TYNE HOSPITALS NHS FOUNDATION TRUST SOUTH TYNESIDE NHS FOUNDATION TRUST SOUTH TEES HOSPITALS NHS FOUNDATION TRUST COUNTY DURHAM AND DARLINGTON NHS FOUNDATION TRUST 1, CITY HOSPITALS SUNDERLAND NHS FOUNDATION TRUST NHS North East 5,6702,4371, NHS National 65,89536,81420,06010,767 Data obtained from HES: 2009/10

PCH9.6.2 LOS for Children with Feverish Illness Chart 1: Stacked bar Data obtained from HES 2009/10 Data obtained from HES: 2009/10

Chart 2: Stacked bar PCH9.6.2 LOS for Children with Feverish Illness Data obtained from HES 2009/10 Data obtained from HES: 2009/10

PCH9.7 ASE Paediatric first outpatient appointment by trust Table 1: Data Data obtained from HES: 2009/10 74 Data obtained from HES 2009/10

PCH9.7 ASE Paediatric first outpatient appointment by trust Chart 1: Histogram and ratio Data obtained from HES: 2009/10 75

DATA SPECIFICATIONS HIGH LEVEL NOTES 76

Data Specifications – Selection of relevant OPCS codes OPCS codes that appeared in the HES 2009/10 episodes activity for children <5y were reviewed in consultation with a Consultant Anaesthetist to identify a set of codes that are associated with the use of GA The resulting list totals 150 OPCS main operation codes, some of which are considered valid only if they were performed with a same-day secondary operation with OPCS code in the Y80 series (administration of anaesthetic codes) HES episodes data were cross-referenced to this list and only episodes with OPCS codes on the list were counted 77

Data Specifications – PCH2.1 Data Source: Hospital Episode Statistics (HES) 2007/08, 2008/09, and 2009/10 Indicator: Total number of episodes with elective surgical procedures performed on patients whose age at start of episode < 5y  Elective – Method of admission “admimeth” in (11,12,13,81)  OPCS code – Main operative procedure “oper_01” in agreed list of codes (and oper_02 to check for Y80.x codes)  Age < 5y – Age at start of episode "startage" < 5 and 7000 series (<1y) Data Handling Notes: Count only records with a valid operation date OPCS codes limited to those agreed with NE that are associated with the use of GA Ordinary and day case admissions only Used site code “sitetret” from HES – if blank, use 5-digit organisation code “procode” 78

Data Specifications – PCH2.2 Data Source: Hospital Episode Statistics (HES) 2007/08, 2008/09, and 2009/10 Indicator: Total number of episodes with elective surgical procedures performed on patients whose age at start of episode < 3y  Elective – Method of admission “admimeth” in (11,12,13,81)  OPCS code – Main operative procedure “oper_01” in agreed list of codes (and oper_02 to check for Y80.x codes)  Age < 3y – Age at start of episode "startage" < 3 and 7000 series (<1y) Data Handling Notes: Count only records with a valid operation date OPCS codes limited to those agreed with NE that are associated with the use of GA Ordinary and day case admissions only Used site code “sitetret” from HES – if blank, use 5-digit organisation code “procode” 79

Data Specifications – PCH3.1 Data Source: Hospital Episode Statistics (HES) 2007/08, 2008/09, and 2009/10 Indicator: Total number of episodes with emergency surgical procedures performed on patients whose age at start of episode < 5y  Emergency – Method of admission “admimeth” in (21, 22, 23, 24, 28)  OPCS code – Main operative procedure “oper_01” in agreed list of codes (and oper_02 to check for Y80.x codes)  Age < 5y – Age at start of episode "startage" < 5 and 7000 series (<1y) Data Handling Notes: Count only records with a valid operation date OPCS codes limited to those agreed with NE that are associated with the use of GA Ordinary and day case admissions only Used site code “sitetret” from HES – if blank, use 5-digit organisation code “procode” 80

Data Specifications – PCH3.2 Data Source: Hospital Episode Statistics (HES) 2007/08, 2008/09, and 2009/10 Indicator: Total number of episodes with emergency surgical procedures performed on patients whose age at start of episode < 3y  Emergency – Method of admission “admimeth” in (21, 22, 23, 24, 28)  OPCS code – Main operative procedure “oper_01” in agreed list of codes (and oper_02 to check for Y80.x codes)  Age < 3y – Age at start of episode "startage" < 3 and 7000 series (<1y) Data Handling Notes: Count only records with a valid operation date OPCS codes limited to those agreed with NE that are associated with the use of GA Ordinary and day case admissions only Used site code “sitetret” from HES – if blank, use 5-digit organisation code “procode” 81

Data Specifications – PCH8.1 Data Source: Hospital Episodes Statistics, 2009/10 Indicator: Length of stay by trust for children for General Surgery Data Handling Notes: Length of stay (where length of stay = discharge date – admission date for each episode), grouped by 0 days, 1 day, 2-3 days and 4+ days Age at start of episode “startage” < 16 Treatment specialty “tretspef” = 100 (general surgery) 82

Data Specifications – PCH8.2 Data Source: Hospital Episodes Statistics, 2009/10 Indicator: Length of stay by trust for children for Orthopaedic Surgury Data Handling Notes: Length of stay (where length of stay = discharge date – admission date for each episode), grouped by 0 days, 1 day, 2-3 days and 4+ days Age at start of episode “startage” < 16 Treatment specialty “tretspef” = 110 (trauma & orthopaedics), 214 (Paediatric trauma & orthopaedics) 83

Data Specifications – PCH8.3 Data Source: Hospital Episodes Statistics, 2009/10 Indicator: Length of stay by trust for children for Urology Surgery Data Handling Notes: Length of stay (where length of stay = discharge date – admission date for each episode), grouped by 0 days, 1 day, 2-3 days and 4+ days Age at start of episode “startage” < 16 Treatment specialty “tretspef” = 101 (urology), 211 (paediatric urology) 84

Data Specifications – PCH8.4 Data Source: Hospital Episodes Statistics, 2009/10 Indicator: Length of stay by trust for children for Plastic Surgery Data Handling Notes: Length of stay (where length of stay = discharge date – admission date for each episode), grouped by 0 days, 1 day, 2-3 days and 4+ days Age at start of episode “startage” < 16 Treatment specialty “tretspef” = 160 (plastic surgery), 219 (paediatric plastic surgery) 85

Data Specifications – PCH8.5 Data Source: Hospital Episodes Statistics, 2009/10 Indicator: Length of stay by trust for children for Neurosurgery Data Handling Notes: Length of stay (where length of stay = discharge date – admission date for each episode), grouped by 0 days, 1 day, 2-3 days and 4+ days Age at start of episode “startage” < 16 Treatment specialty “tretspef” = 150 (neurosurgery), 218 (paediatric neurosurgery) 86

Data Specifications – PCH8.6 Data Source: Hospital Episodes Statistics, 2009/10 Indicator: Length of stay by trust for children for Ophthalmic Surgery Data Handling Notes: Length of stay (where length of stay = discharge date – admission date for each episode), grouped by 0 days, 1 day, 2-3 days and 4+ days Age at start of episode “startage” < 16 Treatment specialty “tretspef” = 130 (ophthalmology), 216 (paediatric ophthalmology), 460 (medical ophthalmology) 87

Data Specifications – PCH8.7 Data Source: Hospital Episodes Statistics, 2009/10 Indicator: Length of stay by trust for children for ENT Surgery Data Handling Notes: Length of stay (where length of stay = discharge date – admission date for each episode), grouped by 0 days, 1 day, 2-3 days and 4+ days Age at start of episode “startage” < 16 Treatment specialty “tretspef” = 120 (ENT), 215 (paediatric ENT) 88

Data Specifications – PCH8.8 Data Source: Hospital Episodes Statistics, 2009/10 Indicator: Length of stay by trust for children for Maxillo-facial Surgery Data Handling Notes: Length of stay (where length of stay = discharge date – admission date for each episode), grouped by 0 days, 1 day, 2-3 days and 4+ days Age at start of episode “startage” < 16 Treatment specialty “tretspef” = 144 (maxillo-facial surgery), 217 (maxillo- facial surgery) 89

Data Specifications – PCH8.9 Data Source: Hospital Episodes Statistics, 2009/10 Indicator: Length of stay by trust for children for Cardiac Surgery Data Handling Notes: Length of stay (where length of stay = discharge date – admission date for each episode), grouped by 0 days, 1 day, 2-3 days and 4+ days Age at start of episode “startage” < 16 Treatment specialty “tretspef” = 170 (cardiothoracic surgery), 172 (cardiac surgery), 174 (cardiothoracic transplantation), 221 (paediatric cardiac surgery) 90

Data Specifications – PCH8.10 Data Source: Hospital Episodes Statistics, 2009/10 Indicator: Length of stay by trust for children for Paediatric Surgery Data Handling Notes: Length of stay (where length of stay = discharge date – admission date for each episode), grouped by 0 days, 1 day, 2-3 days and 4+ days Age at start of episode “startage” < 16 Treatment specialty “tretspef” = 171 (paediatric surgery) 91

Data Specifications – PCH9.1 Data Source: Department of Health KH03 Beds Overnight data, 2003/04, 2004/05, 2005/06, 2006/07, 2007/08, 2008/09 Indicator: Average daily number of available Paediatric beds per annum. Data Handling Notes: In order to stratify by Paediatric beds the following ward designations were used: (1) Intensive care: neonates (2) Intensive care: paediatric (7) Younger physically disabled (8) Other general & acute: neonates and children 92

Data Specifications – PCH9.2a Data Source: Department of Health KH03 Beds Overnight data, 2004/05, 2005/06, 2006/07, 2007/08, 2008/09 Indicator: Average daily number of occupied Paediatric overnight beds per annum. Data Handling Notes: In order to stratify by Paediatric beds the following ward designations were used: (1) Intensive care: neonates (2) Intensive care: paediatric (7) Younger physically disabled (8) Other general & acute: neonates and children 2008/09 data is incomplete, it has only been reported for some trusts 93

Data Specifications – PCH9.2b Data Source: Department of Health KH03 Beds Overnight data, 2007/08, 2008/09 Indicator: Ratio of average daily Paediatric episodes to average available beds per day Data Handling Notes: In order to stratify by Paediatric beds the following ward designations were used: (1) Intensive care: neonates (2) Intensive care: paediatric (7) Younger physically disabled (8) Other general & acute: neonates and children Number of paediatric admissions is defined as all in year episodes where: Age at start of episode “startage” < 16 Divided by 365, giving average episodesper day. 94

Data Specifications – PCH9.3 Data Source: Hospital Episodes Statistics A&E Universe (HES) 2009/10 Indicator: A&E attendances by trust, grouped by outcome Data Handling Notes: Age on arrival “arrivalage” < 16 Attendance disposal “aeattenddisp” for individual attendance outcomes : oAdmitted to hospital of the same health care provider (01 = Admitted to hospital bed / became a lodged patient of the same health care provider) oDischarged – follow up by GP (02 = Discharged – follow-up treatment to be provided by general practitioner) oDischarged – no follow up required (03 = Discharged – did not require any follow-up treatment) oReferred to A&E clinic/other professional (04 = Referred to A&E clinic, 05 = Referred to fracture clinic, 06 = Referred to other outpatient clinic, 11 = Referred to other healthcare professional) oTransferred to another Health Care Provider (07 = Transferred to other healthcare provider) oOther and unknown (10 = Died in department, 14 = Other, 99 = Not known) oLeft Department before being treated/refused treatment (12 = Left department before being treated, 13 = Left department having refused treatment) In order to stratify by trust the following field is required: Provider code “procode” 5-digit code 95

Data Specifications – PCH9.4.1 Data Source: Hospital Episodes Statistics, 2007/08, 2008/09, 2009/10 Indicator: Percentage of admitted emergency paediatric patients with a primary diagnosis of breathing difficulty Data Handling Notes: Total emergency admissions Age at admission “admiage” < 16 Primary diagnosis “diag_01” / “diag4” = o R060 (dyspnea) oJ45*, J46* (Asthma) oA37* (Whooping cough) oJ00* - J22* (Respiratory infections) oB349 with secondary diagnosis of R062 (Viral Wheeze) oR061 (Stridor) Admission method “admimeth” = emergency In order to stratify by procedure and by trust the following fields are required: Provider code “OrgID” 3-digit code

Data Specifications – PCH9.4.2 Data Source: Hospital Episodes Statistics, 2009/10 Indicator: LOS for children with a primary diagnosis at emergency admission of a breathing difficulty Data Handling Notes: o Length of stay (where length of stay = discharge date – admission date for each episode), grouped by 0 days, 1 day, 2-3 days and 4+ days o o Age at admission “admiage” < 16 o Primary diagnosis “diag_01” / “diag4” = o R060 (dyspnea) o J45*, J46* (Asthma) o A37* (Whooping cough) o J00* - J22* (Respiratory infections) o B349 with secondary diagnosis of R062 (Viral Wheeze) o R061 (Stridor) o In order to stratify by procedure and by trust the following fields are required: o Provider code “OrgID” 3-digit code o Admission method “admimeth” = emergency o Additionally, the following fields are required: o Date of admission “admidate” o Date of discharge “disdate ”

Data Specifications – PCH9.5.1 Data Source: Hospital Episodes Statistics, 2007/08, 2008/09, 2009/10 Indicator: Percentage of emergency admissions for children with a primary diagnosis of gastrointestinal problems Data Handling Notes: Total emergency admissions Age at admission “admiage” < 16 Primary diagnosis “diag_01” / “diag4” = oA00* Cholera oA01* Typhoid and Paratyphoid Fevers oA02* Other Salmonella Infections oA03* Shigellosis oA04* Other Bacterial Intestinal Infections oA05* Other Bacterial Foodborne Intoxications oA06* Amoebiasis oA07* Other Protozoal Intestinal Diseases oA08* Viral and Other Specified Intestinal Infections oA09* Diarrhea and Gastroenteritis of Presumed Infectious Origin oK21* GORD oK50*, K51*, Crohns and UC oK528, K529 other specified and Noninfective gastroenteritis and colitis, unspecified oK25*-K38* Appendicitis oK561 Intussusceptions oK590 Constipation oR100 – R104 Abdominal pain oR14* Flatulence & related conditions Admission method “admimeth” = emergency In order to stratify by procedure and by trust the following fields are required: Provider code “OrgID” 3-digit code

Data Specifications – PCH9.5.2 Data Source: Hospital Episodes Statistics, 2009/10 Indicator: LOS for children with a primary diagnosis at emergency admission of gastrointestinal problems Data Handling Notes: Length of stay (where length of stay = discharge date – admission date for each episode), grouped by 0 days, 1 day, 2-3 days and 4+ days o Age at admission “admiage” < 16 o Primary diagnosis “diag4” in list of ICD10 codes: o A00* Cholera. A01* Typhoid and Paratyphoid Fevers. A02* Other Salmonella Infections, A03* Shigellosisl, A04* Other Bacterial Intestinal Infections,.A05* Other Bacterial Foodborne Intoxications, A06* Amoebiasis, A07* Other Protozoal Intestinal Diseases, A08* Viral and Other Specified Intestinal Infections, A09* Diarrhea and Gastroenteritis of Presumed Infectious Origin o K21* GORD, K50*, K51*, Crohns and UC, K528, K529 other specified and Noninfective gastroenteritis and colitis, unspecified, K25*-K38* Appendicitis. K561 Intussusceptions, K590 Constipation o R100 – R104 Abdominal pain. o R14* Flatulence & related conditions o Admission method “admimeth” = emergency o o In order to stratify by procedure and by trust the following fields are required: o Provider code “OrgID” 3-digit code o Additionally, the following fields are required: o Date of admission “admidate” o Date of discharge “disdate

Data Specifications – PCH9.6.1 Data Source: Hospital Episodes Statistics, 2007/08, 2008/09, 2009/10 Indicator: Percentage of emergency admissions for children with a primary diagnosis of feverish illness Data Handling Notes: Total emergency admissions Age at admission “admiage” < 16 Primary diagnosis “diag_01” / “diag4” = OR50* Fever of other and unknown origin oA39 * Meningococcal oA40* -A41* Septicaemia oA488 Other specified bacterial oA490, A491, A492 Staph, Strep and HiB oA499 Bacterial unspecified oA85* - A87* Viral encephalitis oB05* Measles oB06* Rubella oB26* Mumps oB27* CMV oB30*, B34* Adenovirus oB99* Other unspecified infectious disease oJ00* - J22* Respiratory infections Admission method “admimeth” = emergency In order to stratify by procedure and by trust the following fields are required: Provider code “OrgID” 3-digit code

Data Specifications – PCH9.6.2 Data Source: Hospital Episodes Statistics, 2009/10 Indicator: LOS for children with a primary diagnosis at emergency admission of feverish illness Data Handling Notes: Length of stay (where length of stay = discharge date – admission date for each episode), grouped by 0 days, 1 day, 2-3 days and 4+ days o Age at admission “admiage” < 16 o Primary diagnosis “diag4” in list of ICD10 codes: o R50* Fever of other and unknown origin o A39 * Meningococcal, A40* -A41* Septicaemia, A488 Other specified bacterial, A490, A491, A492 Staph, Strep and HiB, A499 Bacterial unspecified, A85* - A87* Viral encephalitis o B05* Measles, B06* Rubella, B26* Mumps, B27* CMV, B30*, B34* Adenovirus, B99* Other unspecified infectious disease o J00* - J22* Respiratory infections o In order to stratify by procedure and by trust the following fields are required: o Provider code “OrgID” 3-digit code o Additionally, the following fields are required: o Date of admission “admidate” o Date of discharge “disdate”

DATA SPECIFICATIONS DETAILED NOTES 102

Data Specifications – HES code details Hospital Episode Statistics (HES) 2007/08, 2008/09, and 2009/10 (to Dec 2010) Fields extracted: Age at start of episode Elective and Emergency Method of admission Procode5 Description [5-digit provider code name] 5 digit provider code Main operative procedure Date of main operation 1st secondary operative procedure Date of 1st secondary operation Siteret Description [Site code name] Site code of treatment Treatment specialty Total Episodes [Counts number of episodes with required OPCS code] Key Selection Criteria: Age at start of episode in (1, 2, 3, 4, 7001 – 7007) [ages less than 5y] Patient classification in (1, 2) [Ordinary and day case] Date of main operation is not NULL [Date of main operative procedure is not blank] 103

Variation in approach versus previous NE analysis – Part 1 OPCS codes used in current analysis that were excluded from previous NE analysis 104 Note: current analysis is based on total episodes -- previous NE analysis is based on sum of total procedures per episode

Variation in approach versus previous NE analysis – Part 2 OPCS codes used in previous NE analysis that were excluded from current analysis 105 Note: current analysis is based on total episodes -- previous NE analysis is based on sum of total procedures per episode