CIT ASE Event Slides April 19 th 2010 v6 1. PCH2.1: Elective surgical procedures under GA for children Publish Remington Scrivens, Modified 6 months ago

CIT ASE Event Slides

April 19th 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

Provider Q4 0708 FY 0708 Q1 0809 Q2 0809 Q3 0809 Q4 0809 FY 0809 Q1 0910 Q2 0910 Q3 0910

FREEMAN HOSPITAL 210 751 224 191 171 211 797 257 216 174

FRIARAGE HOSPITAL SITE 5 24 9 6 5 5 25

HEXHAM GENERAL HOSPITAL 2 20 5 1 1 2 9 1

NEWCASTLE DENTAL HOSPITAL 0 66 41 54 63 224 62 82 70

NEWCASTLE GENERAL HOSPITAL ACUTE SERVICES 50 181 60 55 50 41 206 39 20 8

NORTH TYNESIDE GENERAL HOSPITAL 36 152 34 27 37 26 124 15 28 22

QUEEN ELIZABETH HOSPITAL 28 3 1 4 1

SOUTH TYNESIDE DISTRICT HOSPITAL 3 21 6 4 8 0 18 6 4 3

SUNDERLAND EYE INFIRMARY 27 150 43 49 43 45 180 47 42 35

SUNDERLAND ROYAL HOSPITAL 195 669 178 204 150 160 692 207 177 165

THE ROYAL VICTORIA INFIRMARY 410 1509 421 392 396 403 1612 389 426 385

UNIVERSITY HOSPITAL OF HARTLEPOOL 8 54 9 13 14 7 43 13 19 38

UNIVERSITY HOSPITAL OF NORTH DURHAM 9 36 13 7 10 9 39 5 14 8

UNIVERSITY HOSPITAL OF NORTH TEES 54 162 50 36 36 44 166 50 38 42

WANSBECK HOSPITAL 18 60 17 19 13 17 66 16 20 13

SITE UNSPECIFIED -- RESULTS REPORTED BY TRUST:

COUNTY DURHAM AND DARLINGTON NHS FOUNDATION TRUST 93 394 103 98 96 105 402 113 81 75

SOUTH TEES HOSPITALS NHS FOUNDATION TRUST 225 816 201 208 219 196 824 167 202 208

THE NEWCASTLE UPON TYNE HOSPITALS NHS FOUNDATION TRUST 0 0 3

NHS North East 1345 5027 1439 1354 1304 1334 5431 1387 1369 1250

NHS National 19776 77065 22086 21461 19238 19657 82442 21482 21020 18707

Total episodes with a main operation code associated with the use of GA


Chart 1: Time Series

Data obtained from HES: 2007/08, 2008/09, and 2009/10

3

0

50

100

150

200

250

300

350

400

450

Ep

iso

des

wit

h s

urg

ical

pro

ced

ure

s -

-C

hild

ren

<5y

(el

ecti

ve)




4



FRIARAGE HOSPITAL SITE 6 4 2 2 8

NEWCASTLE DENTAL HOSPITAL 0 12 8 10 8 38 16 23 13



QUEEN ELIZABETH HOSPITAL 22 1 1

SOUTH TYNESIDE DISTRICT HOSPITAL 2 3 3

SUNDERLAND EYE INFIRMARY 12 70 20 23 29 21 93 23 21 20



UNIVERSITY HOSPITAL OF HARTLEPOOL 5 30 5 6 5 3 19 6 2 7

UNIVERSITY HOSPITAL OF NORTH DURHAM 3 4 1 3 2 1 7 1 1


WANSBECK HOSPITAL 6 17 6 3 4 7 20 5 4 1





NHS North East 666 2523 724 650 684 674 2732 701 691 629

NHS National 9954 38650 11281 10709 9982 10246 42218 11174 10812 10027





5

0

50

100

150

200

250

300

350

Ep

iso

des

wit

h s

urg

ical

pro

ced

ure

s -

-C

hild

ren

<3y

(el

ecti

ve)


PCH3.1: Emergency surgical procedures under GA for children <5y


6



FRIARAGE HOSPITAL SITE 11 0



QUEEN ELIZABETH HOSPITAL 3 16 3 8 5 3 19 5 3

SOUTH TYNESIDE DISTRICT HOSPITAL 4 109 3 5 1 9 7 3 5

SUNDERLAND EYE INFIRMARY 0 1 2 1 4 2



UNIVERSITY HOSPITAL OF HARTLEPOOL 1 49 1 1 3

UNIVERSITY HOSPITAL OF NORTH DURHAM 1 11 2 4 1 2 9 3 2 2


WANSBECK HOSPITAL 2 147 3 4 3 10 3 6





NHS North East 259 1229 338 342 269 277 1226 324 357 289

NHS National 3565 15953 4868 4765 3766 3719 17118 4990 5152 3870





7

0

20

40

60

80

100

120

140

Ep

iso

des

wit

h s

urg

ical

pro

ced

ure

s -

-C

hild

ren

<5y

(em

erg

nec

y)




8



FRIARAGE HOSPITAL SITE 4 0


NORTH TYNESIDE GENERAL HOSPITAL 2 14 4 1 4 5 14 7 2

QUEEN ELIZABETH HOSPITAL 2 5 1 2 3

SOUTH TYNESIDE DISTRICT HOSPITAL 1 2 1 1 2 1

SUNDERLAND EYE INFIRMARY 1 1 2 1 4 1



UNIVERSITY HOSPITAL OF HARTLEPOOL 1 3 1 1 1

UNIVERSITY HOSPITAL OF NORTH DURHAM 1 2 0 1 1 1


WANSBECK HOSPITAL 1 4 1 1 1




NHS North East 175 719 188 201 180 181 750 207 189 194

NHS National 2240 9521 2835 2802 2434 2382 10453 2908 2951 2558





9

0

10

20

30

40

50

60

70

80

90

100

Ep

iso

des

wit

h s

urg

ical

pro

ced

ure

s -

-C

hild

ren

<3y

(em

erg

nec

y)


PCH8.1 LOS by Trust for Children for General Surgery

Table 1: Data Data obtained from HES 2009/10

Provider 0 days 1 day 2-3 days 4+ days

GATESHEAD HEALTH NHS FOUNDATION TRUST * *

NORTHUMBRIA HEALTHCARE NHS FOUNDATION TRUST * * *

NORTH TEES AND HARTLEPOOL NHS FOUNDATION TRUST 96 36 35 15

THE NEWCASTLE UPON TYNE HOSPITALS NHS FOUNDATION TRUST * * *

SOUTH TEES HOSPITALS NHS FOUNDATION TRUST 80 25 33 17

SOUTH TYNESIDE NHS FOUNDATION TRUST 8 * 11 *

COUNTY DURHAM AND DARLINGTON NHS FOUNDATION TRUST 66 12 * *

CITY HOSPITALS SUNDERLAND NHS FOUNDATION TRUST 8 * *

NHS North East 260 83 91 43

NHS National 10,163 6,164 4,502 1,651

* Data suppressed due to low cell count

Data obtained from HES: 2009/10Chart 1: Stacked bar


0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

4+

2-3

1

0



0

20

40

60

80

100

120

140

160

180

200

CDDFT CHSFT GHFT NHFT NTHFT NUTHFT STFT STHFT

4+

2-3

1

0

PCH8.2 LOS by Trust for Children for Orthopaedic Surgery

Table 1: Data


GATESHEAD HEALTH NHS FOUNDATION TRUST19 * *

NORTHUMBRIA HEALTHCARE NHS FOUNDATION TRUST259 127 39 18

NORTH TEES AND HARTLEPOOL NHS FOUNDATION TRUST141 138 94 22

THE NEWCASTLE UPON TYNE HOSPITALS NHS FOUNDATION TRUST167 160 118 122

SOUTH TEES HOSPITALS NHS FOUNDATION TRUST247 203 116 75

SOUTH TYNESIDE NHS FOUNDATION TRUST57 40 32 14

COUNTY DURHAM AND DARLINGTON NHS FOUNDATION TRUST142 162 78 23

CITY HOSPITALS SUNDERLAND NHS FOUNDATION TRUST286 185 108 60

NHS North East1,318 1,018 587 334

NHS National 23,951 20,211 9,554 5,215

Data obtained from HES: 2009/10


Chart 1: Stacked bar



0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

4+

2-3

1

0




0

100

200

300

400

500

600

700


4+

2-3

1

0

PCH8.3 LOS by Trust for Children for Urology Surgery

Table 1: Data


GATESHEAD HEALTH NHS FOUNDATION TRUST

NORTHUMBRIA HEALTHCARE NHS FOUNDATION TRUST

NORTH TEES AND HARTLEPOOL NHS FOUNDATION TRUST66

THE NEWCASTLE UPON TYNE HOSPITALS NHS FOUNDATION TRUST* * * *

SOUTH TEES HOSPITALS NHS FOUNDATION TRUST118 20 *

SOUTH TYNESIDE NHS FOUNDATION TRUST

COUNTY DURHAM AND DARLINGTON NHS FOUNDATION TRUST55 *

CITY HOSPITALS SUNDERLAND NHS FOUNDATION TRUST24 8 *

NHS North East267 29 * 7

NHS National 10,332 1,727 591 417






0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

4+

2-3

1

0




0

20

40

60

80

100

120

140

160


4+

2-3

1

0

PCH8.4 LOS by Trust for Children for Plastic Surgery

Table 1: Data

Provider0 days 1 day 2-3 days 4+ days



NORTH TEES AND HARTLEPOOL NHS FOUNDATION TRUST*





CITY HOSPITALS SUNDERLAND NHS FOUNDATION TRUST

NHS North East1,589 280 215 81

NHS National16,989 4,558 2,110 881






0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

CDD

FT

CHSF

T

GH

FT

NH

FT

NTH

FT

NU

THFT

STFT

STH

FT

NE

Regi

on

Nati

onal

4+

2-3

1

0




0

200

400

600

800

1000

1200

CDD

FT

CHSF

T

GH

FT

NH

FT

NTH

FT

NU

THFT

STFT

STH

FT

4+

2-3

1

0

PCH8.5 LOS by Trust for Children for Neurosurgery

Table 1: Data




NORTH TEES AND HARTLEPOOL NHS FOUNDATION TRUST

THE NEWCASTLE UPON TYNE HOSPITALS NHS FOUNDATION TRUST 56 8 27 24

SOUTH TEES HOSPITALS NHS FOUNDATION TRUST 8 5 9 11


COUNTY DURHAM AND DARLINGTON NHS FOUNDATION TRUST



NHS National 1,683 752 1,095 1,855





0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

CDD

FT

CHSF

T

GH

FT

NH

FT

NTH

FT

NU

THFT

STFT

STH

FT

NE

Regi

on

Nati

onal

4+

2-3

1

0




0

20

40

60

80

100

120

140

CDD

FT

CHSF

T

GH

FT

NH

FT

NTH

FT

NU

THFT

STFT

STH

FT

4+

2-3

1

0

PCH8.6 LOS by Trust for Children for Ophthalmic Surgery

Table 1: Data





THE NEWCASTLE UPON TYNE HOSPITALS NHS FOUNDATION TRUST 259 11 8 *

SOUTH TEES HOSPITALS NHS FOUNDATION TRUST 106 * * *


COUNTY DURHAM AND DARLINGTON NHS FOUNDATION TRUST75 5 *

CITY HOSPITALS SUNDERLAND NHS FOUNDATION TRUST 270 * * *


NHS National 11,709 796 274 120






0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

4+

2-3

1

0




0

50

100

150

200

250

300


4+

2-3

1

0

PCH8.7 LOS by Trust for Children for ENT Surgery

Table 1: Data








COUNTY DURHAM AND DARLINGTON NHS FOUNDATION TRUST243 166 10


NHS North East2,044 1,512 212 43

NHS National42,832 20,355 3,221 1,020



Chart 1: Stacked bar Data obtained from HES: 2009/10

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

4+

2-3

1

0



0

200

400

600

800

1000

1200

1400

1600


4+

2-3

1

0

PCH8.8 LOS by Trust for Children for Maxillo-Facial Surgery

Table 1: Data





THE NEWCASTLE UPON TYNE HOSPITALS NHS FOUNDATION TRUST26 21 4

SOUTH TEES HOSPITALS NHS FOUNDATION TRUST


COUNTY DURHAM AND DARLINGTON NHS FOUNDATION TRUST437 21 6 *


NHS North East463 42 10 *

NHS National 5,466 748 202 46





0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

4+

2-3

1

0



0

50

100

150

200

250

300

350

400

450

500


4+

2-3

1

0

PCH8.9 LOS by Trust for Children for Cardiac Surgery

Table 1: Data








COUNTY DURHAM AND DARLINGTON NHS FOUNDATION TRUST


NHS North East18 21 14 171

NHS National 407 234 203 1,561




0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

4+

2-3

1

0



0

50

100

150

200

250


4+

2-3

1

0

PCH8.10 LOS by Trust for Children for Paediatric Surgery

Table 1: Data





THE NEWCASTLE UPON TYNE HOSPITALS NHS FOUNDATION TRUST1,527 353 273 301



COUNTY DURHAM AND DARLINGTON NHS FOUNDATION TRUST*

CITY HOSPITALS SUNDERLAND NHS FOUNDATION TRUST157 9

NHS North East1,685 362 273 301

NHS National22,021 7,246 4,797 5,176





0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

4+

2-3

1

0



0

500

1000

1500

2000

2500

3000


4+

2-3

1

0

PCH9.1 Overnight Paediatric beds by trust

Table 1: Data

40

Provider 2003/04 2004/05 2005/06 2006/07 2007/08 2008/09

COUNTY DURHAM AND DARLINGTON NHS FOUNDATION TRUST 131 111 108 97 87 84

SOUTH TEES HOSPITALS NHS FOUNDATION TRUST 94 122 100 101 95 95

GATESHEAD HEALTH NHS FOUNDATION TRUST 38 38 38 38 38 38

NORTH TEES AND HARTLEPOOL NHS FOUNDATION TRUST 66 62 61 56 55 48

NORTHUMBRIA HEALTHCARE NHS FOUNDATION TRUST 53 53 53 51 53 41

CITY HOSPITALS SUNDERLAND NHS FOUNDATION TRUST 83 84 77 80 80 70

SOUTH TYNESIDE NHS FOUNDATION TRUST 31 32 32 28 27 27

THE NEWCASTLE UPON TYNE HOSPITALS NHS FOUNDATION TRUST 214 219 217 212 214 219

NHS North East 709 721 687 664 650 627

NHS National 11835 11660 11404 11020 10865 10732


PCH9.1 Overnight Paediatric beds by trust


Data obtained from DH KH03 data: 2003/04 through 2008/09

41

0

25

50

75

100

125

150

175

200

225

250

Avera

ge N

um

ber

of A

vail

ab

le P

aed

iatr

ic B

ed

s

PCH9.2a Overnight Paediatric bed occupancy rate by trust


42

Provider 2004/05 2005/06 2006/07 2007/08 * 2008/09

COUNTY DURHAM AND DARLINGTON NHS FOUNDATION TRUST 43.2% 43.5% 37.1% 46.0%

SOUTH TEES HOSPITALS NHS FOUNDATION TRUST 41.8% 56.0% 56.4% 56.8% 56.8%

GATESHEAD HEALTH NHS FOUNDATION TRUST 50.0% 50.0% 47.4% 42.1%

NORTH TEES AND HARTLEPOOL NHS FOUNDATION TRUST 72.6% 70.5% 62.5% 56.4% 62.5%

NORTHUMBRIA HEALTHCARE NHS FOUNDATION TRUST 41.5% 43.4% 39.2% 39.6% 43.9%

CITY HOSPITALS SUNDERLAND NHS FOUNDATION TRUST 40.5% 49.4% 42.5% 41.3%

SOUTH TYNESIDE NHS FOUNDATION TRUST 46.9% 40.6% 50.0% 44.4% 51.9%

THE NEWCASTLE UPON TYNE HOSPITALS NHS FOUNDATION TRUST 66.2% 66.8% 67.5% 67.8% 67.1%

NHS North East 52.6% 55.9% 53.8% 54.2% 41.9%

NHS National 64.3% 65.1% 65.3% 66.1% 34.8%

* Missing data in 2008/09



Data obtained from DH KH03 data: 2003/04 through 2008/09

43

0%

10%

20%

30%

40%

50%

60%

70%

80%

Avera

ge d

ail

y P

aed

iatr

ic B

ed

Occu

pan

cy

Rate

* Missing data in 2008/09


Chart 2: Box and whisker plot

Data obtained from DH KH03 data: 2007/08

44

1 2 3 4 5 6 7 8

0.0%

10.0%

20.0%

30.0%

40.0%

50.0%

60.0%

70.0%

80.0%

90.0%

100.0%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%Av

erag

e da

ily P

aedi

atri

c Bed

Occ

upan

cy R

ate


Chart 3: Funnel plot

Data obtained from DH KH03 data: 2007/08

45

CDDFT

STFT

GHFT

NTHFT

NHFTCHSFT

STHFT

NUTHFT

0

10

20

30

40

50

60

70

80

90

100

0 50 100 150 200 250 300

Ave

rag

e p

erce

nt

of

ove

rnig

ht

bed

s o

ccu

pie

d

Average number of available overnight beds

Source: DH KH03 Beds Overnight data

PCH9.2b Paediatric bed throughput by trust, average

Table 1: Data Data obtained from HES: 2007/08, 2008/09

46

Provider Q1 0708 Q2 0708 Q3 0708 Q4 0708 FY 0708 Q1 0809 Q2 0809 Q3 0809 Q4 0809 FY 0809COUNTY DURHAM AND DARLINGTON NHS FOUNDATION TRUST 0.54 0.53 0.64 0.56 0.57 0.54 0.53 0.62 0.59 0.57

SOUTH TEES HOSPITALS NHS FOUNDATION TRUST 0.51 0.49 0.54 0.50 0.51 0.52 0.52 0.55 0.54 0.53GATESHEAD HEALTH NHS FOUNDATION TRUST 0.46 0.41 0.50 0.44 0.45 0.47 0.44 0.55 0.52 0.49

NORTH TEES AND HARTLEPOOL NHS FOUNDATION TRUST 0.57 0.54 0.62 0.57 0.58 0.65 0.62 0.73 0.67 0.66

NORTHUMBRIA HEALTHCARE NHS FOUNDATION TRUST 0.56 0.55 0.62 0.58 0.58 0.72 0.67 0.78 0.68 0.71

CITY HOSPITALS SUNDERLAND NHS FOUNDATION TRUST 0.37 0.40 0.40 0.40 0.39 0.48 0.48 0.47 0.42 0.46SOUTH TYNESIDE NHS FOUNDATION TRUST 0.49 0.47 0.52 0.44 0.48 0.45 0.48 0.56 0.52 0.50

THE NEWCASTLE UPON TYNE HOSPITALS NHS FOUNDATION TRUST 0.37 0.38 0.42 0.39 0.39 0.40 0.40 0.42 0.41 0.40

NHS North East 0.46 0.45 0.51 0.47 0.47 0.49 0.48 0.53 0.50 0.50

NHS National 0.42 0.41 0.46 0.43 0.43 0.46 0.45 0.50 0.47 0.47


Chart 1: Time Series Data obtained from HES: 2007/08, 2008/09 and KH03 Data 2007/08, 2008/09

47

0.00

0.10

0.20

0.30

0.40

0.50

0.60

0.70

0.80

0.90R

atio

of

avg

dai

ly e

pis

od

es t

o a

vg d

aily

av

aila

ble

bed

s

mtallentire

need total admissions for 07/08


Chart 2: Box and whisker plot

48

1 2 3 4 5 6 7 8

0.0%

10.0%

20.0%

30.0%

40.0%

50.0%

60.0%

70.0%

80.0%

0.00

0.10

0.20

0.30

0.40

0.50

0.60

0.70

0.80

0.90

1.00

CDDFT STHFT GHFT NTHFT NHFT CHSFT STFT NUTHFT

Ratio

: av

g da

ily a

dmis

sion

s: a

vg d

aily

ava

ilabl

e ov

erni

ght b

eds

Data obtained from HES: 2008/09 and KH03 Data 2008/09


49


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

Newcastle

PCH9.3 A&E paediatric attendance outcome by trust

Table 1: Data

50

Data obtained from HES 2009/10

Provider Discha

rged

- no fo

llow

up reqd

Discha

rged

- fo

llow u

p

by GP

Referre

d to A

&E

clin

ic/o

ther

profe

ssio

nal

Admitt

ed /

becam

e a

lodge

d pat

ient

Left D

epar

tmen

t befo

re

being tr

eate

d/refu

sed

treat

men

t

Transf

erre

d to o

ther

Health

Car

e Pro

vide

r

Other a

nd unkn

own

NORTH TEES AND HARTLEPOOL NHS FOUNDATION TRUST 14287 695 751 1947 224 133 1

NORTHUMBRIA HEALTHCARE NHS FOUNDATION TRUST 14269 1988 4965 2067 707 635 10

SOUTH TEES HOSPITALS NHS FOUNDATION TRUST 10541 2784 3614 2228 257 2 5

CITY HOSPITALS SUNDERLAND NHS FOUNDATION TRUST 9537 564 2436 2290 125 76 24

COUNTY DURHAM AND DARLINGTON NHS FOUNDATION TRUST 7521 7149 3549 2752 493 110 3

GATESHEAD HEALTH NHS FOUNDATION TRUST 5202 1125 1084 1396 122 98 2

THE NEWCASTLE UPON TYNE HOSPITALS NHS FOUNDATION TRUST 1819 5499 968 1242 382 41 53

SOUTH TYNESIDE NHS FOUNDATION TRUST 1 5239 1192 1037 325 85 4

NHS North East63177 25043 18559 14959 2635 1180 102

NHS National1246348 452085 336185 302739 66121 42955 46940


PCH9.3 A&E paediatric attendance outcome by trust


51


0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

NTHFT NHFT STHFT CHSFT CDDFT GHFT NUTHFT STFT NE AVG UK AVG

Other and unknown

Transferred to other Health Care Provider

Left Department before being treated/refused treatment

Admitted / became a lodged patient

Referred to A&E clinic/other professional

Discharged - follow up by GP

Discharged - no follow up reqd

PCH9.3 A&E paediatric attendance outcome, region and national view

Chart 2: Pie chart

52


50%

18%

13%

12%

3%

2%2%

NHS National







Other and unknown

50%

20%

15%

12%

2%

1%

0%

NHS NE SHA







Other and unknown

PCH9.4.1 Admissions with Breathing Difficulties (<16)


ProviderQ4 0708 FY 0708 Q1 0809 Q2 0809 Q3 0809 Q4 0809 FY 0809 Q1 0910 Q2 0910 Q3 0910

COUNTY DURHAM AND DARLINGTON NHS FOUNDATION TRUST32.0% 31.3% 24.0% 23.0% 52.4% 33.0% 33.9% 11.9% 12.9% 25.8%

SOUTH TEES HOSPITALS NHS FOUNDATION TRUST29.9% 29.1% 25.3% 23.8% 48.7% 36.1% 33.7% 11.7% 12.5% 29.4%

GATESHEAD HEALTH NHS FOUNDATION TRUST34.7% 32.6% 26.4% 27.6% 53.2% 38.6% 37.5% 28.0% 33.5% 42.7%

NORTH TEES AND HARTLEPOOL NHS FOUNDATION TRUST31.9% 34.9% 22.5% 24.1% 49.5% 39.8% 35.0% 12.8% 13.9% 27.7%

NORTHUMBRIA HEALTHCARE NHS FOUNDATION TRUST38.4% 35.9% 24.7% 29.5% 63.3% 43.1% 41.0% 13.9% 18.0% 29.4%

CITY HOSPITALS SUNDERLAND NHS FOUNDATION TRUST27.5% 29.3% 20.2% 21.0% 45.7% 27.4% 28.7% 25.9% 26.8% 46.1%

SOUTH TYNESIDE NHS FOUNDATION TRUST31.4% 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 TRUST14.9% 19.5% 11.6% 13.4% 34.8% 23.1% 21.1% 8.6% 8.9% 16.3%

NHS North East28.9% 29.7% 21.5% 22.2% 48.8% 33.5% 32.1% 13.3% 14.6% 27.4%

NHS National30.3% 31.0% 23.8% 24.3% 47.9% 32.1% 32.5% 17.5% 19.3% 37.4%


Data obtained from HES: 2008/09, 2009/10Chart 1: Time Series

0%

10%

20%

30%

40%

50%

60%

70%%

of <

16 B

reat

hing

Diffi

culty

Adm

issi

ons


Chart 2: Box and whisker plot Data obtained from HES: 2008/09, 2009/10

1 2 3 4 5 6 7 8

0.0%

5.0%

10.0%

15.0%

20.0%

25.0%

30.0%

35.0%

40.0%

45.0%

0%

5%

10%

15%

20%

25%

30%

35%

40%

45%


% o

f <16

Bre

athi

ng D

ifficu

lty A

dmis

sion

s


Chart 3: Funnel Plot Data obtained from HES: 2008/09, 2009/10

CDDFTSTHFT

GHFT

NTHFTNHFT

CHSFT

STFT

NUTHFT

0

10

20

30

40

50

0 2000 4000 6000 8000 10000 12000 14000% o

f <

16

adm

issi

on

s fo

r B

reat

hin

g D

iffi

cult

ies

Number of <16 admissions

Source: HES Q4 0809 to Q3 0910

PCH9.4.2 LOS for Children with Breathing Difficulties

Table 1: Data


GATESHEAD HEALTH NHS FOUNDATION TRUST369 143 44 7








NHS North East4,691 2,480 1,181 473

NHS National61,928 41,175 21,070 9,922




0%10%20%30%40%50%60%70%80%90%

100%

4+ days

2-3 days

1 day

0 days



0

200

400

600

800

1,000

1,200

1,400

1,600

1,800

4+ days

2-3 days

1 day

0 days

PCH9.5.1 Admissions with Gastrointestinal problems (<16)










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 East27.0% 21.9% 23.7% 16.9% 17.5% 26.9% 21.3% 13.3% 9.6% 9.7%

NHS National24.5% 20.2% 21.2% 16.6% 16.4% 24.7% 27.0% 15.0% 11.6% 11.3%


Chart 1: Time Series Data obtained from HES: 2008/09, 2009/10

0%

5%

10%

15%

20%

25%

30%

35%

40%%

<16

Adm

issi

ons w

ith G

astr

oint

estin

al P

robl

ems



1 2 3 4 5 6 7 8

0.0%

5.0%

10.0%

15.0%

20.0%

25.0%

30.0%

0%

5%

10%

15%

20%

25%

30%


% <

16 A

dmis

sion

s with

Gas

troi

ntes

tinal

Pro

blem

s



CDDFTSTHFT

GHFT

NTHFTNHFT

CHSFT

STFT

NUTHFT

0

10

20

30

40

50

0 2000 4000 6000 8000 10000 12000 14000% o

f <

16

adm

issi

on

s fo

r G

astr

oin

test

inal

Pro

ble

ms



PCH9.5.2 LOS for Children with Gastrointestinal Problems

Table 1: Data











NHS North East2,861 1,363 643 287

NHS National31,050 20,307 11,467 4,847


mtallentire

Need to re-run, contains total episodes = 0





0%10%20%30%40%50%60%70%80%90%

100%

4+ days

2-3 days

1 day

0 days





0

200

400

600

800

1,000

1,200

4+ days

2-3 days

1 day

0 days

PCH9.6.1 Admissions with Feverish Illness (<16)










THE NEWCASTLE UPON TYNE HOSPITALS NHS FOUNDATION TRUST19.2% 23.4% 16.7% 18.3% 40.2% 28.9% 26.4% 10.9% 11.2% 17.9%

NHS North East35.1% 35.0% 27.9% 26.9% 54.9% 39.8% 38.0% 16.1% 16.6% 28.6%

NHS National34.1% 34.2% 27.9% 25.9% 51.3% 35.6% 35.6% 18.8% 20.1% 35.0%


Chart 1: Time Series Data obtained from HES: 2008/09, 2009/10

0%

10%

20%

30%

40%

50%

60%

70%

80%%

<16

Adm

issi

ons w

ith F

ever

ish

Illne

ss



1 2 3 4 5 6 7 8

0.0%

5.0%

10.0%

15.0%

20.0%

25.0%

30.0%

35.0%

40.0%

45.0%

50.0%

0%

5%

10%

15%

20%

25%

30%

35%

40%

45%

50%


% <

16 A

dmis

sion

s with

Fev

eris

h Ill

ness



CDDFTSTHFT

GHFT

NTHFTNHFT

CHSFT

STFT

NUTHFT

0

10

20

30

40

50

0 2000 4000 6000 8000 10000 12000 14000

% o

f <

16

adm

issi

on

s fo

r F

ever

ish

Ill

nes

s



PCH9.6.2 LOS for Children with Feverish Illness

Table 1: Data









COUNTY DURHAM AND DARLINGTON NHS FOUNDATION TRUST1,059 672 218 87


NHS North East5,670 2,437 1,138 511

NHS National65,895 36,814 20,060 10,767






0%10%20%30%40%50%60%70%80%90%

100%

4+ days

2-3 days

1 day

0 days





0

500

1,000

1,500

2,000

2,500

4+ days

2-3 days

1 day

0 days

PCH9.7 ASE Paediatric first outpatient appointment by trust

Table 1: Data Data obtained from HES: 2009/10

74


ProviderFirst

AppointmentFollow-up

Ratio follow-up/first

THE NEWCASTLE UPON TYNE HOSPITALS NHS FOUNDATION TRUST 19681 49589 2.52

SOUTH TEES HOSPITALS NHS FOUNDATION TRUST 15916 33132 2.08

CITY HOSPITALS SUNDERLAND NHS FOUNDATION TRUST 11827 31593 2.67

COUNTY DURHAM AND DARLINGTON NHS FOUNDATION TRUST 11798 24827 2.10

NORTH TEES AND HARTLEPOOL NHS FOUNDATION TRUST 4994 12110 2.42

NORTHUMBRIA HEALTHCARE NHS FOUNDATION TRUST 6072 10339 1.70

SOUTH TYNESIDE NHS FOUNDATION TRUST 3686 6008 1.63

GATESHEAD HEALTH NHS FOUNDATION TRUST 4120 10833 2.63

NHS NORTH EAST 78157 178431 2.28

NHS NATIONAL 1653317 3105101 1.88

PCH9.7 ASE Paediatric first outpatient appointment by trust

Chart 1: Histogram and ratio Data obtained from HES: 2009/10

75

2.5

2.1

2.7

2.1

2.4

1.71.6

2.6

2.3

1.9

0

0.5

1

1.5

2

2.5

3

0

10000

20000

30000

40000

50000

60000

NU

THFT

STFT

CHSF

T

CDD

FT

NTH

FT

NH

FT

STH

FT

GH

FT

NE

AVG

ENG

AV

G

Num

ber o

f epi

sode

s

First Appointment

Follow-up

Ratio follow-up/first

DATA SPECIFICATIONSHIGH 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 < 5yElective – 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 dateOPCS codes limited to those agreed with NE that are associated with the use of GAOrdinary and day case admissions onlyUsed site code “sitetret” from HES – if blank, use 5-digit organisation code “procode”

78



• Indicator:Total number of episodes with elective surgical procedures performed on patients whose age at start of episode < 3yElective – 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)


79



• Indicator:Total number of episodes with emergency surgical procedures performed on patients whose age at start of episode < 5yEmergency – 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)


80



• Indicator:Total number of episodes with emergency surgical procedures performed on patients whose age at start of episode < 3yEmergency – 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)


81


• 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



• Indicator:Length of stay by trust for children for Orthopaedic Surgury


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



• Indicator:Length of stay by trust for children for Urology Surgery


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



• Indicator:Length of stay by trust for children for Plastic Surgery


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



• Indicator:Length of stay by trust for children for Neurosurgery


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



• Indicator:Length of stay by trust for children for Ophthalmic Surgery


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



• Indicator:Length of stay by trust for children for ENT Surgery


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



• Indicator:Length of stay by trust for children for Maxillo-facial Surgery


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



• Indicator:Length of stay by trust for children for Cardiac Surgery


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



• Indicator:Length of stay by trust for children for Paediatric Surgery


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 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.


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


Number of paediatric admissions is defined as all in year episodes where: • Age at start of episode “startage” < 16Divided by 365, giving average episodesper day.

94


• 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 :o Admitted to hospital of the same health care provider (01 = Admitted to hospital bed / became a

lodged patient of the same health care provider)o Discharged – follow up by GP (02 = Discharged – follow-up treatment to be provided by general

practitioner)o Discharged – no follow up required (03 = Discharged – did not require any follow-up treatment)o Referred 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)o Transferred to another Health Care Provider (07 = Transferred to other healthcare provider)o Other and unknown (10 = Died in department, 14 = Other, 99 = Not known)o Left 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)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)

• Admission method “admimeth” = emergency

In order to stratify by procedure and by trust the following fields are required:• Provider code “OrgID” 3-digit code



• 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+ dayso o Age at admission “admiage” < 16o 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 codeo Admission method “admimeth” = emergencyo Additionally, the following fields are required:o Date of admission “admidate”o Date of discharge “disdate”



• Indicator:Percentage of emergency admissions for children with a primary diagnosis of gastrointestinal problems

• Data Handling Notes:Total emergency admissions


o A00* Cholerao A01* Typhoid and Paratyphoid Feverso A02* Other Salmonella Infectionso A03* Shigellosiso A04* Other Bacterial Intestinal Infectionso A05* Other Bacterial Foodborne Intoxicationso A06* Amoebiasiso A07* Other Protozoal Intestinal Diseaseso A08* Viral and Other Specified Intestinal Infectionso A09* Diarrhea and Gastroenteritis of Presumed Infectious Origino K21* GORDo K50*, K51*, Crohns and UCo K528, K529 other specified and Noninfective gastroenteritis and colitis, unspecifiedo K25*-K38* Appendicitiso K561 Intussusceptionso K590 Constipationo R100 – R104 Abdominal paino R14* Flatulence & related conditions• Admission method “admimeth” = emergency




• 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+ dayso Age at admission “admiage” < 16o 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 conditionso 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 codeo Additionally, the following fields are required:o Date of admission “admidate”o Date of discharge “disdate



• Indicator:Percentage of emergency admissions for children with a primary diagnosis of feverish illness

• Data Handling Notes:Total emergency admissions


O R50* Fever of other and unknown origino A39 * Meningococcalo A40* -A41* Septicaemiao A488 Other specified bacterialo A490, A491, A492 Staph, Strep and HiBo A499 Bacterial unspecifiedo A85* - A87* Viral encephalitiso B05* Measleso B06* Rubellao B26* Mumpso B27* CMVo B30*, B34* Adenoviruso B99* Other unspecified infectious diseaseo J00* - J22* Respiratory infections

• Admission method “admimeth” = emergency




• 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” < 16o Primary diagnosis “diag4” in list of ICD10 codes:o R50* Fever of other and unknown origino A39 * Meningococcal, A40* -A41* Septicaemia, A488 Other specified bacterial, A490, A491, A492 Staph, Strep and

HiB, A499 Bacterial unspecified, A85* - A87* Viral encephalitiso B05* Measles, B06* Rubella, B26* Mumps, B27* CMV, B30*, B34* Adenovirus, B99* Other unspecified infectious

diseaseo 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 codeo Additionally, the following fields are required:o Date of admission “admidate”o Date of discharge “disdate”

DATA SPECIFICATIONSDETAILED 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 episodeElective and EmergencyMethod of admissionProcode5 Description [5-digit provider code name]5 digit provider codeMain operative procedureDate of main operation1st secondary operative procedureDate of 1st secondary operationSiteret Description [Site code name]Site code of treatmentTreatment specialtyTotal 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

S065 Excision of lesion of skin of head or neck NEC S151 Biopsy of lesion of skin of head or neck NEC

X482 Change of plaster cast U091 Computed tomography of pelvis

U051 Computed tomography of head U215 Contrast fluoroscopy NEC

S069 Unspecified other excision of lesion of skin A842 Electromyography

U055 Magnetic resonance imaging of spine E096 Laser destruction of lesion of external nose

U071 Computed tomography of chest S565 Attention to dressing of skin of head or neck NEC

S091 Laser destruction of lesion of skin of head or neck S701 Avulsion of nail

X483 Removal of plaster cast M492 Change of suprapubic tube into bladder

S092 Laser destruction of lesion of skin NEC U128 Other specified diagnostic imaging of genitourinary system

U212 Computerised tomography NEC X493 Removal of splint NEC

X481 Application of plaster cast S101 Cauterisation of lesion of skin of head or neck NEC

S662 Repair of nail bed U136 Computed tomography of bone

U133 Magnetic resonance imaging of bone U061 Computed tomography of sinuses

M478 Other specified urethral catheterisation of bladder U011 Computed tomography of whole body

U103 Cardiac magnetic resonance imaging U114 Computed Tomography scan of cerebral vessels

U072 Magnetic resonance imaging of chest S083 Curettage of lesion of skin of head or neck NEC

U081 Computed tomography of abdomen NEC X411 Insertion of ambulatory peritoneal dialysis catheter

E098 Other specified operations on external nose U162 Magnetic resonance cholangiopancreatography

S068 Other specified other excision of lesion of skin U371 Magnetic resonance imaging of kidneys

U117 Magnetic resonance angiography U088 Other specified diagnostic imaging of abdomen

S575 Attention to dressing of skin NEC U018 Other specified diagnostic imaging of whole body

X461 Donation of bone marrow F167 Polishing teeth

S132 Punch biopsy of lesion of skin NEC X412 Removal of ambulatory peritoneal dialysis catheter

S131 Punch biopsy of lesion of skin of head or neck S141 Shave biopsy of lesion of skin of head or neck

S152 Biopsy of lesion of skin NEC S063 Shave excision of lesion of skin of head or neck

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

A203 Monitoring of pressure in ventricle of brain

A541 Injection of destructive substance into cerebrospinal fluid

A559 Unspecified diagnostic spinal puncture

A848 Other specified neurophysiological operations

C273 Irrigation of nasolacrimal duct

C274 Removal of tube from nasolacrimal duct

C275 Probing of nasolacrimal duct NEC

C434 Subconjunctival injection

D071 Irrigation of external auditory canal for removal of wax

G211 Intubation of oesophagus for ph manometry

G345 Attention to gastrostomy tube

G453 Fibreoptic endoscopic insertion of Bravo pH capsule into upper gastrointestinal tract

H012 Emergency excision of abnormal appendix NEC

H159 Unspecified other exteriorisation of colon

H625 Irrigation of bowel NEC

L912 Insertion of central venous catheter NEC

L913 Attention to central venous catheter NEC

L914 Removal of central venous catheter

L916 Cannulation of vein NEC

L951 Venography

S403 Tape closure of skin of head or neck

S431 Removal of clip from skin of head or neck

T124 Insertion of tube drain into pleural cavity

T744 Injection of therapeutic substance into tendon NEC

W351 Introduction of therapeutic substance into bone

X562 Endotracheal intubation

Note: current analysis is based on total episodes -- previous NE analysis is based on sum of total procedures per episode

Documents

CIT ASE Event Slides April 19 th 2010 v6 1. PCH2.1: Elective surgical procedures under GA for children Publish Remington Scrivens, Modified 6 months ago