Acute hospital activity and NHS beds information (quarterly)
A National Statistics publication for Scotland
Quarter ending 30 September 2021
- Hospital care
Definitions of terms used in this data release
Acute hospital care
'Acute' hospital care includes activity occurring in major teaching hospitals, district general hospitals and community hospitals.
Includes services such as consultation with specialist clinicians; emergency treatment; routine, complex and life-saving surgery; specialist diagnostic procedures; close observation; and short-term care of patients.
Excludes obstetric services; psychiatric services; long stay care services; and non-consultant led clinics.
All Available staffed beds
An available staffed bed is a bed that can be used for an inpatient or day case care. All available staffed beds = Allocated Beds + Borrowed Beds – Lent Beds + Temporary Beds:
Total number of available staffed bed days (aasb) = Sum of the number of all available staffed beds for each day in the quarter.
Average available staffed beds
This is the average daily number of beds, which are staffed and available for the reception of patients (borrowed beds and temporary beds are included):
Average number of available staffed beds per day (asb) = aasb / number of days in the quarter.
Average length of spell
This is the average (mean) number of days that a patient spends in hospital during a specialty spell at a given location. It is calculated by dividing the total length of spell for all inpatients, at a given location, during a quarter by the total number of specialty spells.
Average length of stay
This is the average (mean) number of days that a patient spends in hospital during a continuous inpatient stay (CIS). It is calculated by dividing the total length of stay for all inpatients during a quarter by the total number of CISs.
Continuous Inpatient Stay (CIS)
A continuous inpatient stay is an unbroken period of time that a patient spends as an inpatient. However, a patient may change consultant, significant facility, specialty, and/or hospital during a continuous inpatient stay. A single CIS may contain several episodes / specialty spells.
Probability matching methods have been used to link together individual SMR01 hospitals episodes for each patient, thereby creating "linked" patient histories. Within these patient histories, SMR01 episodes are grouped according to whether they form part of a continuous spell of treatment from first episode admission to last episode discharge (whether or not this involves transfer between hospitals or even NHS Boards).
When showing information by CIS, the admission type e.g. elective/emergency is determined by the first admitting episode. As a result, transfers will generally not appear within the CIS analysis. When a transfer does appear it is often the result of a patient being transferred from another provider unit e.g. outwith Scotland. However, there will also be instances where the admission type has been incorrectly coded (Not Specified). Unfortunately, it is not possible to fully ascertain what the correct admission type should have been. As a result, a small proportion of Not Specified cases (<1%) appear within the data.
Cross-boundary flow refers to the relationship between where patients live and where they are treated. You will find this information in the Data Explorer and the Data Files section.
A day case is when a patient makes a planned attendance for a day to a specialty for clinical care, and requires the use of a bed, or trolley in lieu of a bed. Whilst a day case is usually completed within the same day, the patient may need to be admitted as an inpatient if they are not fit to be discharged.
Did Not Attends (DNAs)
There are people who do not attend their outpatient appointment without making the hospital aware in advance; these appointments are known as Did Not Attends (DNAs).
A hospital discharge marks the end of an episode of care. Discharges include deaths, transfers to other specialties/significant facilities and hospitals, and discharges home or to other regular place of residence.
Elective / Planned Admission
An elective, or planned, admission is when a patient has been given a date to come to hospital for a planned procedure or treatment.
An emergency admission occurs when, for clinical reasons, a patient is admitted unexpectedly at the earliest possible time. This might be after a visit to a doctor, emergency department or calling an ambulance.
An SMR01 episode is generated when a patient is discharged from hospital but also when a patient is transferred between hospitals, significant facilities, specialties or to the care of a different consultant.
A patient is termed an inpatient when they occupy a staffed bed in a hospital and either remains overnight (whether intended or not), or is expected to remain overnight but is discharged earlier. An inpatient’s admission can be an emergency, an elective or as a transfer.
Length of spell
This is the total number of days that a patient spends in hospital during a specialty spell at a given location.
Length of stay
This is the total number of days that a patient spends in hospital during a CIS.
New outpatient attendances
New attendances are the number of attendances at an outpatient service for a new case.
Non-NHS Provider Data
Non-NHS Provider figures relate to patients treated in non-NHS locations such as private hospitals, hospices, nursing homes, care homes, etc. Patients who receive treatment at a Private (independent) hospital which is paid for by the NHS Board should be recorded within the Scottish Morbidity Record (SMR) by the relevant NHS Board. However, if a patient is treated privately (i.e. treatment paid for by patient or private insurer) and there is no NHS involvement then this activity will not be recorded within the SMR.
The Not Specified measure relates to instances where the admission type has been incorrectly coded. Unfortunately, it is not possible to fully ascertain what the correct admission type should have been. As a result, a small proportion of Not Specified cases (<1%) appear within the data.
The percentage occupancy is the percentage of average available staffed beds that were occupied by inpatients during the period:
Percentage occupancy = (aob / asb) x 100
An occupied bed is an available staffed bed, which is either being used to accommodate an inpatient or reserved for a patient on pass:
Total number of occupied bed days (tobd) = Sum of the number of occupied beds for each day in the quarter.
Average number of occupied beds per day (aob) = tobd / number of days in the quarter.
An outpatient is a patient who attends a consultant or other medical clinic or has an arranged meeting with a consultant or a senior member of their team outwith a clinic session. Outpatient attendances involve treatment or assessment that only take a short time to complete. Outpatient attendances are categorised as new or return (follow-up). Outpatient data within this publication are for consultant-led activity only.
This relates to individual patients. However, the same patient can be counted more than once, if they change subgroup (e.g. specialty, type of admission, NHS Board etc.). In these cases, a patient will be counted once within each subtotal, but only once in the overall total.
For example, if a patient was admitted three times in a single year, twice as an emergency admission and once as an elective admission, they would be counted once in each sub-total of emergency and elective admissions, and once in the overall total of admission types.
The same patient will also be counted for each of the financial years they were admitted in hospital, for example if a patient was admitted in 2010/11 and 2012/13 they would be counted in each of these years.
Return outpatient attendances
Return (follow-up) attendances are the number of attendances to an outpatient service which are related to an original case.
Scottish Index of Multiple Deprivation (SIMD)
The SIMD uses a wide range of information for small areas (data zones) to identify concentrations of multiple deprivation across Scotland. Further information can be found on the Scottish Government website (external website).
A specialty is defined as a division of medicine or dentistry covering a specific area of clinical activity. There are two specialty groupings (external website) that most specialties sit in: medical and surgical. The Acute specialty grouping includes the medical and surgery groupings combined. A full listing of specialties covered by the data sets used in this publication is available in the specialty grouping file (XLS). Further information can also be found on the Health & Social Care data dictionary web page (external website).
A specialty spell is a period of time that a patient spends as an inpatient in a specialty at a given location, However, a patient may change consultant, significant facility, and/or hospital during a specialty spell. For more information on the specialty spells methodology please see the Specialty Spells Methodology paper (PDF, 313KB).
A transfer occurs when a patient needs to be moved to another doctor, clinical specialty, or facility within the hospital or another hospital altogether to receive the specialist care they require after they have been admitted to hospital. The majority of these transfers are planned (elective) transfers.
Further details are available in the Health & Social Care data dictionary (external website).