COVID-19 Hospital Activity Stats

What NHS England statistics tell us about COVID-19 patients.

There are queries about NHS England hospitals during this pandemic.

This article aims aim to answer those questions.

Questions and answers

Here are some questions about NHS hospital statistics.

Where can I find statistics about hospitals in England?

The NHS England website contains several reports about COVID-19:

  • COVID-19 Daily Deaths: this data set contains figures on deaths in English hospitals. The deceased person must have a positive test result in the past 28 days.
  • COVID-19 Hospital Activity: there is a daily and monthly report. Those reports cover COVID-19 admissions, occupied beds and mechanical ventilator beds.
  • COVID-19 Vaccinations: the weekly report contains the number of NHS COVID-19 vaccinations. The report breaks these numbers down by age band and dose.
  • Urgent and Emergency Care Winter Situation Reports: these are daily returns from acute trusts. The reports features adult critical care beds, among other measures.

There is also the coronavirus.data.gov.uk dashboard from Public Health England. The dashboard contains key measures by different areas.

Hospitals are always busy during winter, aren’t they?

The COVID-19 pandemic has many effects on hospital capacity. It means there is less space for beds, as patients have to be more gaps between them. Wards separate patients with the virus, those awaiting results, and COVID-19 negative patients. Hospitals use greater infection control. There are also increased critical care beds — which need more intensive staffing.

The levels of occupied critical care beds may be more heightened in some areas than others. John Burn-Murdoch (Financial Times) compared occupied adult critical care beds in London. That analysis found occupancy was around 50% higher at the end of December than in past years.

The statistics come from the NHS Urgent and Emergency Care Daily Situation Reports. (Image: Twitter/John Burn-Murdoch)

How does NHS England define a COVID-19 patient?

A COVID-19 patient is someone who has:

  • COVID-19 admissions: Admitted to hospital, with a positive PCR test result in the last 14 days.
  • COVID-19 diagnoses: Received a positive PCR test after admission. This measure counts diagnoses against the previous day.
This is the number of COVID-19 admissions and diagnoses in England. (Image: Public Health England)

The latter part does not mean those in-patients were all admitted ‘for another reason’. Clinicians may suspect the person has COVID-19. They need to run a polymerase chain reaction test to confirm that suspicion.

PCR tests have a very low false-positive ratio. For example, the Office for National Statistics wrote in their methods note:

[In] the most recent six-week period (31 July to 10 September), 159 of the 208,730 total samples tested positive. Even if all these positives were false, specificity would still be 99.92%.

How many people catch the virus in hospital?

Some people catch the virus in hospital. These are nosocomial infections. Statistics on this type of infection are not in regular reports.

One measure would be to find the difference between:

  • Estimated new hospital cases: First admissions with a positive PCR test in the last 14 days plus COVID-19 diagnoses.
  • Estimated new admissions to hospital from the community: This is like the first measure. It excludes COVID-19 diagnoses within seven days of admission.

What remains are diagnoses with more than seven days from admission to positive swab. NHS England defines these diagnoses as probable hospital-acquired infections.

Between 1st August 2020 and 9th January 2021, there were around 155,000 new hospital cases. This is the point estimate for England. In that time, there were around 128,000 estimated new admissions from the community. The difference between these two measures is about 26,000.

A Journal of Hospital Infection analysis estimated around 13% of infections were hospital-acquired. That analysis looks at 10 hospitals in the UK and one in Italy, for patients up to 28th April 2020.

What about discharges?

Discharges are a measure in the monthly report, rather than the daily publication. As COVID-19 occupancy rises, there are more COVID-19 patients that could leave hospital.

On 10th January, the number of COVID-19 patients in English hospitals exceeds 30,000. (Image: Public Health England)

Discharges do not include deaths. If there are fewer discharges (plus deaths) than admissions, occupancy increases.

This blog looks at the use of statistics in Britain and beyond. It is written by RSS Statistical Ambassador and Chartered Statistician @anthonybmasters.

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