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Patients: Safety

Answer

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.

Secondary information

Type

Written question

Reference

215682

Session

2014-15

Subjects

Medical treatments Patients Safety Surgery Pulmonary embolism

Contains statistics

Yes

Link

View this Written question on www.parliament.uk