Patient Safety Indicators - Accidental Puncture or Laceration - United Kingdom

The enhanced version of Dr Foster Intelligence's Real Time Monitoring (RTM) tool now features additional Patient Safety Indicators (PSIs) and service line indicators from the 2010 Hospital Guide. These indicators enable the monitoring and identifying of potential instances of patient harm. The new PSIs were developed by the Agency for Healthcare Research and Quality (AHRQ) in the United States and translated by the Dr Foster Unit at Imperial College London and in conversation with other leading indicator developments units. The methodologies for these indicators were also made available pre-Hospital Guide publication for comment and consultation, in partnership with HSJ last summer.

You can change region, or view national data.

Relative Risk with 95% and 99.8% control limits

X-axis: Expected Events, Y-axis: Relative Risk.

  • Aintree

    Observed: 22

    Expected: 63.9

    Relative Risk: 34.4

  • Airedale

    Observed: n/a

    Expected: n/a

    Relative Risk: 10.3

  • Ashford & St Peter's

    Observed: 45

    Expected: 56.9

    Relative Risk: 79.1

  • Barking, Havering & Redbridge

    Observed: 56

    Expected: 85.7

    Relative Risk: 65.3

  • Barnet & Chase Farm

    Observed: 52

    Expected: 79.3

    Relative Risk: 65.6

  • Barnsley Hospital

    Observed: 13

    Expected: 39.3

    Relative Risk: 33.1

  • Barts & the London NHS

    Observed: 41

    Expected: 57.4

    Relative Risk: 71.5

  • Basildon & Thurrock

    Observed: 64

    Expected: 54.0

    Relative Risk: 118.5

  • Basingstoke & North Hampshire

    Observed: 21

    Expected: 35.1

    Relative Risk: 59.8

  • Bedford Hospital

    Observed: 19

    Expected: 36.9

    Relative Risk: 51.5

  • Blackpool, Fylde & Wyre

    Observed: 25

    Expected: 86.6

    Relative Risk: 28.9

  • Bradford Teaching Hospitals

    Observed: 54

    Expected: 76.4

    Relative Risk: 70.7

  • Brighton & Sussex

    Observed: 47

    Expected: 81.6

    Relative Risk: 57.6

  • Buckinghamshire

    Observed: 61

    Expected: 68.8

    Relative Risk: 88.7

  • Burton

    Observed: 25

    Expected: 34.0

    Relative Risk: 73.5

  • Calderdale & Huddersfield

    Observed: 54

    Expected: 79.7

    Relative Risk: 67.8

  • Cambridge

    Observed: 194

    Expected: 113.4

    Relative Risk: 171.1

  • Central Manchester

    Observed: 119

    Expected: 71.0

    Relative Risk: 167.6

  • Chelsea & Westminster

    Observed: 30

    Expected: 32.1

    Relative Risk: 93.5

  • Chesterfield Royal

    Observed: 44

    Expected: 52.7

    Relative Risk: 83.5

  • City Hospitals Sunderland

    Observed: 126

    Expected: 99.7

    Relative Risk: 126.4

  • Colchester

    Observed: 40

    Expected: 53.3

    Relative Risk: 75.1

  • Countess Of Chester

    Observed: 28

    Expected: 54.2

    Relative Risk: 51.6

  • County Durham & Darlington

    Observed: 70

    Expected: 93.5

    Relative Risk: 74.8

  • Croydon

    Observed: 70

    Expected: 45.4

    Relative Risk: 154.2

  • Dartford & Gravesham

    Observed: 25

    Expected: 38.0

    Relative Risk: 65.8

  • Derby

    Observed: 136

    Expected: 123.5

    Relative Risk: 110.1

  • Doncaster & Bassetlaw

    Observed: 82

    Expected: 82.8

    Relative Risk: 99.0

  • Dorset County

    Observed: 58

    Expected: 42.9

    Relative Risk: 135.3

  • Ealing

    Observed: 18

    Expected: 26.9

    Relative Risk: 67.0

  • East & North Hertfordshire

    Observed: 38

    Expected: 71.1

    Relative Risk: 53.4

  • East Cheshire

    Observed: 33

    Expected: 28.1

    Relative Risk: 117.5

  • East Kent

    Observed: 125

    Expected: 122.1

    Relative Risk: 102.4

  • East Lancashire

    Observed: 92

    Expected: 94.5

    Relative Risk: 97.3

  • East Sussex

    Observed: 108

    Expected: 83.4

    Relative Risk: 129.4

  • Epsom & St Helier

    Observed: 101

    Expected: 63.6

    Relative Risk: 158.8

  • Frimley Park

    Observed: 71

    Expected: 70.2

    Relative Risk: 101.2

  • Gateshead

    Observed: 59

    Expected: 31.8

    Relative Risk: 185.6

  • George Eliot

    Observed: 13

    Expected: 29.9

    Relative Risk: 43.5

  • Gloucestershire

    Observed: 97

    Expected: 139.9

    Relative Risk: 69.3

  • Great Western

    Observed: 27

    Expected: 57.2

    Relative Risk: 47.2

  • Guy's & St Thomas'

    Observed: 70

    Expected: 82.1

    Relative Risk: 85.3

  • Harrogate & District

    Observed: 22

    Expected: 42.8

    Relative Risk: 51.4

  • Heart Of England

    Observed: 41

    Expected: 139.8

    Relative Risk: 29.3

  • Heatherwood & Wexham Park

    Observed: 29

    Expected: 54.1

    Relative Risk: 53.6

  • Hereford

    Observed: 16

    Expected: 26.8

    Relative Risk: 59.8

  • Hinchingbrooke

    Observed: 41

    Expected: 32.8

    Relative Risk: 124.9

  • Homerton

    Observed: 18

    Expected: 22.6

    Relative Risk: 79.6

  • Hull & East Yorkshire

    Observed: 109

    Expected: 123.7

    Relative Risk: 88.1

  • Imperial College

    Observed: 72

    Expected: 116.1

    Relative Risk: 62.0

  • Ipswich

    Observed: 80

    Expected: 68.1

    Relative Risk: 117.4

  • Isle Of Wight

    Observed: 11

    Expected: 16.3

    Relative Risk: 67.4

  • James Paget

    Observed: 56

    Expected: 44.9

    Relative Risk: 124.6

  • Kettering

    Observed: 41

    Expected: 53.5

    Relative Risk: 76.6

  • King's College

    Observed: 104

    Expected: 68.8

    Relative Risk: 151.1

  • Kingston

    Observed: 67

    Expected: 39.1

    Relative Risk: 171.3

  • Lancashire

    Observed: 156

    Expected: 93.1

    Relative Risk: 167.5

  • Leeds

    Observed: 206

    Expected: 141.0

    Relative Risk: 146.1

  • Lewisham

    Observed: 25

    Expected: 31.7

    Relative Risk: 79.0

  • Luton & Dunstable

    Observed: 66

    Expected: 49.6

    Relative Risk: 133.2

  • Maidstone & Tunbridge Wells

    Observed: 77

    Expected: 56.8

    Relative Risk: 135.6

  • Medway

    Observed: 27

    Expected: 43.2

    Relative Risk: 62.6

  • Mid Cheshire

    Observed: 50

    Expected: 48.7

    Relative Risk: 102.7

  • Mid Essex

    Observed: 126

    Expected: 70.3

    Relative Risk: 179.2

  • Mid Staffordshire

    Observed: 28

    Expected: 51.2

    Relative Risk: 54.7

  • Mid Yorkshire

    Observed: 45

    Expected: 96.3

    Relative Risk: 46.7

  • Milton Keynes

    Observed: 77

    Expected: 38.5

    Relative Risk: 200.2

  • Newham

    Observed: 23

    Expected: 19.8

    Relative Risk: 116.1

  • Norfolk & Norwich

    Observed: 124

    Expected: 131.4

    Relative Risk: 94.3

  • North Bristol

    Observed: 170

    Expected: 91.9

    Relative Risk: 184.9

  • North Cumbria

    Observed: 49

    Expected: 58.7

    Relative Risk: 83.5

  • North Middlesex

    Observed: 28

    Expected: 29.3

    Relative Risk: 95.5

  • North Tees & Hartlepool

    Observed: 73

    Expected: 62.1

    Relative Risk: 117.5

  • North West London

    Observed: 66

    Expected: 66.5

    Relative Risk: 99.3

  • Northampton

    Observed: 47

    Expected: 70.4

    Relative Risk: 66.8

  • Northern Devon

    Observed: 45

    Expected: 36.8

    Relative Risk: 122.2

  • Northern Lincolnshire & Goole

    Observed: 56

    Expected: 81.3

    Relative Risk: 68.9

  • Northumbria Healthcare

    Observed: 68

    Expected: 89.5

    Relative Risk: 76.0

  • Nottingham

    Observed: 283

    Expected: 139.0

    Relative Risk: 203.6

  • Oxford Radcliffe

    Observed: 150

    Expected: 123.1

    Relative Risk: 121.8

  • Pennine Acute

    Observed: 68

    Expected: 157.7

    Relative Risk: 43.1

  • Peterborough & Stamford

    Observed: 80

    Expected: 62.2

    Relative Risk: 128.5

  • Plymouth

    Observed: 217

    Expected: 92.5

    Relative Risk: 234.5

  • Poole Hospital

    Observed: 33

    Expected: 42.1

    Relative Risk: 78.4

  • Portsmouth

    Observed: 54

    Expected: 92.8

    Relative Risk: 58.2

  • Royal Berkshire

    Observed: 101

    Expected: 69.6

    Relative Risk: 145.0

  • Royal Bolton

    Observed: 26

    Expected: 46.8

    Relative Risk: 55.6

  • Royal Cornwall

    Observed: 98

    Expected: 94.2

    Relative Risk: 104.0

  • Royal Devon & Exeter

    Observed: 250

    Expected: 97.8

    Relative Risk: 255.6

  • Royal Free Hampstead

    Observed: 53

    Expected: 62.3

    Relative Risk: 85.1

  • Royal Liverpool & Broadgreen

    Observed: 46

    Expected: 74.0

    Relative Risk: 62.2

  • Royal Surrey County Hospital

    Observed: 82

    Expected: 61.1

    Relative Risk: 134.1

  • Royal United Hospital Bath

    Observed: 73

    Expected: 55.9

    Relative Risk: 130.5

  • Salford Royal

    Observed: 117

    Expected: 59.0

    Relative Risk: 198.3

  • Salisbury

    Observed: 176

    Expected: 44.4

    Relative Risk: 396.8

  • Sandwell & West Birmingham

    Observed: 47

    Expected: 100.9

    Relative Risk: 46.6

  • Scarborough & North East Yorkshire

    Observed: 25

    Expected: 35.8

    Relative Risk: 69.9

  • Sheffield Teaching

    Observed: 80

    Expected: 164.0

    Relative Risk: 48.8

  • Sherwood Forest

    Observed: 121

    Expected: 60.7

    Relative Risk: 199.2

  • Shrewsbury & Telford

    Observed: 75

    Expected: 91.2

    Relative Risk: 82.2

  • South Devon

    Observed: 46

    Expected: 53.6

    Relative Risk: 85.8

  • South London

    Observed: 127

    Expected: 132.0

    Relative Risk: 96.2

  • South Tees

    Observed: 146

    Expected: 115.4

    Relative Risk: 126.5

  • South Tyneside

    Observed: 23

    Expected: 24.8

    Relative Risk: 92.6

  • South Warwickshire

    Observed: 13

    Expected: 43.1

    Relative Risk: 30.1

  • Southampton

    Observed: 116

    Expected: 85.0

    Relative Risk: 136.5

  • Southend

    Observed: 106

    Expected: 80.5

    Relative Risk: 131.7

  • Southport & Ormskirk

    Observed: 26

    Expected: 48.3

    Relative Risk: 53.8

  • St George's

    Observed: 129

    Expected: 62.5

    Relative Risk: 206.3

  • St Helens & Knowsley

    Observed: 41

    Expected: 60.0

    Relative Risk: 68.4

  • Stockport

    Observed: 79

    Expected: 59.6

    Relative Risk: 132.6

  • Surrey & Sussex

    Observed: 86

    Expected: 46.0

    Relative Risk: 186.9

  • Tameside

    Observed: 21

    Expected: 33.9

    Relative Risk: 62.0

  • Taunton & Somerset

    Observed: 97

    Expected: 63.2

    Relative Risk: 153.4

  • Dudley Group Of Hospitals

    Observed: 41

    Expected: 78.9

    Relative Risk: 52.0

  • Hillingdon

    Observed: 54

    Expected: 39.5

    Relative Risk: 136.8

  • Newcastle Upon Tyne

    Observed: 224

    Expected: 155.3

    Relative Risk: 144.2

  • Princess Alexandra

    Observed: 56

    Expected: 52.2

    Relative Risk: 107.3

  • Queen Elizabeth King's Lynn

    Observed: 15

    Expected: 59.9

    Relative Risk: 25.1

  • Rotherham

    Observed: 31

    Expected: 57.4

    Relative Risk: 54.0

  • Royal Bournemouth & Christchurch

    Observed: 102

    Expected: 109.0

    Relative Risk: 93.6

  • Royal Wolverhampton

    Observed: 61

    Expected: 78.7

    Relative Risk: 77.5

  • Whittington

    Observed: 30

    Expected: 31.1

    Relative Risk: 96.5

  • Trafford

    Observed: 23

    Expected: 23.2

    Relative Risk: 99.1

  • Lincolnshire

    Observed: 120

    Expected: 125.0

    Relative Risk: 96.0

  • University College London

    Observed: 128

    Expected: 92.9

    Relative Risk: 137.7

  • Birmingham

    Observed: 58

    Expected: 75.9

    Relative Risk: 76.5

  • North Staffordshire

    Observed: 69

    Expected: 101.7

    Relative Risk: 67.9

  • South Manchester

    Observed: 30

    Expected: 69.6

    Relative Risk: 43.1

  • Bristol

    Observed: 134

    Expected: 90.8

    Relative Risk: 147.6

  • Coventry & Warwickshire

    Observed: 132

    Expected: 105.6

    Relative Risk: 125.0

  • Leicester

    Observed: 77

    Expected: 50.0

    Relative Risk: 154.1

  • Morecambe Bay

    Observed: 33

    Expected: 70.7

    Relative Risk: 46.7

  • Walsall

    Observed: 41

    Expected: 44.8

    Relative Risk: 91.5

  • Warrington & Halton

    Observed: 70

    Expected: 56.8

    Relative Risk: 123.2

  • West Hertfordshire

    Observed: 100

    Expected: 60.2

    Relative Risk: 166.0

  • West Middlesex

    Observed: 24

    Expected: 22.8

    Relative Risk: 105.5

  • West Suffolk

    Observed: 84

    Expected: 43.1

    Relative Risk: 194.9

  • Western Sussex

    Observed: 104

    Expected: 99.3

    Relative Risk: 104.7

  • Weston Area

    Observed: 20

    Expected: 25.8

    Relative Risk: 77.6

  • Whipps Cross

    Observed: 55

    Expected: 59.9

    Relative Risk: 91.8

  • Winchester & Eastleigh

    Observed: 40

    Expected: 33.1

    Relative Risk: 120.8

  • Wirral

    Observed: 77

    Expected: 71.5

    Relative Risk: 107.8

  • Worcestershire

    Observed: 82

    Expected: 88.5

    Relative Risk: 92.7

  • Wrightington, Wigan & Leigh

    Observed: 31

    Expected: 73.5

    Relative Risk: 42.2

  • Yeovil

    Observed: 23

    Expected: 34.8

    Relative Risk: 66.0

  • York

    Observed: 42

    Expected: 61.8

    Relative Risk: 68.0

Relative Risk with 95% and 99.8% control limits

  • Banding:
  • Low
  • Within expected
  • High

Caveat: Due to variations in secondary diagnosis coding it is difficult to know what the true national picture is, as some trusts are better at recording the information than others. The data is presented in this analysis in terms of 'High', 'Low' and 'Within expected' but it should be noted that a Trust labelled as 'High' may not actually have higher rates of incidents but are simply better at recording what happens.

Provider Observed Expected Denominator Relative Risk LCL UCL
Aintree 22 63.9 71472 34.4 21.6 52.1
Airedale N/A N/A 37700 10.3 2.8 26.4
Ashford & St Peter's 45 56.9 55209 79.1 57.7 105.9
Barking, Havering & Redbridge 56 85.7 93239 65.3 49.4 84.8
Barnet & Chase Farm 52 79.3 81997 65.6 49.0 86.0
Barnsley Hospital 13 39.3 42408 33.1 17.6 56.6
Barts & the London NHS 41 57.4 68338 71.5 51.3 97.0
Basildon & Thurrock 64 54.0 53409 118.5 91.2 151.3
Basingstoke & North Hampshire 21 35.1 35639 59.8 37.0 91.4
Bedford Hospital 19 36.9 35965 51.5 31.0 80.4
Birmingham 58 75.9 84347 76.5 58.1 98.8
Blackpool, Fylde & Wyre 25 86.6 83154 28.9 18.7 42.6
Bradford Teaching Hospitals 54 76.4 81586 70.7 53.1 92.3
Brighton & Sussex 47 81.6 86180 57.6 42.3 76.6
Bristol 134 90.8 86657 147.6 123.7 174.8
Buckinghamshire 61 68.8 64189 88.7 67.8 113.9
Burton 25 34.0 35461 73.5 47.5 108.4
Calderdale & Huddersfield 54 79.7 82020 67.8 50.9 88.5
Cambridge 194 113.4 104811 171.1 147.8 196.9
Central Manchester 119 71.0 76111 167.6 138.9 200.6
Chelsea & Westminster 30 32.1 36779 93.5 63.1 133.5
Chesterfield Royal 44 52.7 54056 83.5 60.7 112.1
City Hospitals Sunderland 126 99.7 96913 126.4 105.3 150.5
Colchester 40 53.3 55072 75.1 53.6 102.2
Countess Of Chester 28 54.2 54196 51.6 34.3 74.6
County Durham & Darlington 70 93.5 96774 74.8 58.3 94.6
Coventry & Warwickshire 132 105.6 103783 125.0 104.6 148.3
Croydon 70 45.4 47744 154.2 120.2 194.9
Dartford & Gravesham 25 38.0 39413 65.8 42.6 97.2
Derby 136 123.5 117306 110.1 92.4 130.3
Doncaster & Bassetlaw 82 82.8 83399 99.0 78.7 122.9
Dorset County 58 42.9 41356 135.3 102.7 174.9
Dudley Group Of Hospitals 41 78.9 78396 52.0 37.3 70.5
Ealing 18 26.9 31965 67.0 39.7 105.9
East & North Hertfordshire 38 71.1 70826 53.4 37.8 73.3
East Cheshire 33 28.1 28744 117.5 80.9 165.0
East Kent 125 122.1 123571 102.4 85.2 122.0
East Lancashire 92 94.5 94018 97.3 78.5 119.4
East Sussex 108 83.4 80855 129.4 106.2 156.3
Epsom & St Helier 101 63.6 64892 158.8 129.3 193.0
Frimley Park 71 70.2 66090 101.2 79.0 127.6
Gateshead 59 31.8 36229 185.6 141.2 239.4
George Eliot 13 29.9 30151 43.5 23.2 74.5
Gloucestershire 97 139.9 126453 69.3 56.2 84.6
Great Western 27 57.2 57762 47.2 31.1 68.7
Guy's & St Thomas' 70 82.1 93129 85.3 66.5 107.7
Harrogate & District 22 42.8 38226 51.4 32.2 77.8
Heart Of England 41 139.8 153212 29.3 21.0 39.8
Heatherwood & Wexham Park 29 54.1 55693 53.6 35.9 77.0
Hereford 16 26.8 26434 59.8 34.2 97.1
Hillingdon 54 39.5 41645 136.8 102.8 178.5
Hinchingbrooke 41 32.8 29946 124.9 89.6 169.5
Homerton 18 22.6 29247 79.6 47.2 125.8
Hull & East Yorkshire 109 123.7 125794 88.1 72.3 106.3
Imperial College 72 116.1 123377 62.0 48.5 78.1
Ipswich 80 68.1 64581 117.4 93.1 146.2
Isle Of Wight 11 16.3 18320 67.4 33.6 120.6
James Paget 56 44.9 42772 124.6 94.1 161.8
Kettering 41 53.5 54652 76.6 55.0 104.0
King's College 104 68.8 73393 151.1 123.5 183.1
Kingston 67 39.1 39432 171.3 132.7 217.5
Lancashire 156 93.1 90753 167.5 142.3 196.0
Leeds 206 141.0 156948 146.1 126.8 167.4
Leicester 77 50.0 53121 154.1 121.6 192.7
Lewisham 25 31.7 35509 79.0 51.1 116.6
Lincolnshire 120 125.0 122202 96.0 79.6 114.8
Luton & Dunstable 66 49.6 48889 133.2 103.0 169.4
Maidstone & Tunbridge Wells 77 56.8 61001 135.6 107.0 169.4
Medway 27 43.2 47057 62.6 41.2 91.0
Mid Cheshire 50 48.7 52142 102.7 76.2 135.4
Mid Essex 126 70.3 69004 179.2 149.3 213.4
Mid Staffordshire 28 51.2 47196 54.7 36.4 79.1
Mid Yorkshire 45 96.3 104321 46.7 34.1 62.5
Milton Keynes 77 38.5 40214 200.2 158.0 250.2
Morecambe Bay 33 70.7 69415 46.7 32.1 65.6
Newcastle Upon Tyne 224 155.3 148829 144.2 126.0 164.4
Newham 23 19.8 27580 116.1 73.6 174.2
Norfolk & Norwich 124 131.4 121824 94.3 78.5 112.5
North Bristol 170 91.9 88002 184.9 158.2 214.9
North Cumbria 49 58.7 58515 83.5 61.8 110.4
North Middlesex 28 29.3 31608 95.5 63.5 138.0
North Staffordshire 69 101.7 105220 67.9 52.8 85.9
North Tees & Hartlepool 73 62.1 67048 117.5 92.1 147.8
North West London 66 66.5 73843 99.3 76.8 126.4
Northampton 47 70.4 67015 66.8 49.0 88.8
Northern Devon 45 36.8 34610 122.2 89.1 163.5
Northern Lincolnshire & Goole 56 81.3 77422 68.9 52.0 89.4
Northumbria Healthcare 68 89.5 96883 76.0 59.0 96.3
Nottingham 283 139.0 145961 203.6 180.6 228.8
Oxford Radcliffe 150 123.1 124949 121.8 103.1 143.0
Pennine Acute 68 157.7 162923 43.1 33.5 54.7
Peterborough & Stamford 80 62.2 59831 128.5 101.9 160.0
Plymouth 217 92.5 89024 234.5 204.4 267.9
Poole Hospital 33 42.1 45340 78.4 54.0 110.2
Portsmouth 54 92.8 96853 58.2 43.7 76.0
Princess Alexandra 56 52.2 50729 107.3 81.1 139.4
Queen Elizabeth King's Lynn 15 59.9 54571 25.1 14.0 41.3
Rotherham 31 57.4 57406 54.0 36.7 76.7
Royal Berkshire 101 69.6 66608 145.0 118.1 176.2
Royal Bolton 26 46.8 49755 55.6 36.3 81.4
Royal Bournemouth & Christchurch 102 109.0 98287 93.6 76.3 113.6
Royal Cornwall 98 94.2 91351 104.0 84.5 126.8
Royal Devon & Exeter 250 97.8 91111 255.6 224.9 289.3
Royal Free Hampstead 53 62.3 64939 85.1 63.7 111.3
Royal Liverpool & Broadgreen 46 74.0 82129 62.2 45.5 82.9
Royal Surrey County Hospital 82 61.1 55896 134.1 106.7 166.5
Royal United Hospital Bath 73 55.9 56939 130.5 102.3 164.1
Royal Wolverhampton 61 78.7 77871 77.5 59.3 99.5
Salford Royal 117 59.0 62498 198.3 164.0 237.6
Salisbury 176 44.4 42453 396.8 340.4 460.0
Sandwell & West Birmingham 47 100.9 105845 46.6 34.2 61.9
Scarborough & North East Yorkshire 25 35.8 34382 69.9 45.2 103.1
Sheffield Teaching 80 164.0 162077 48.8 38.7 60.7
Sherwood Forest 121 60.7 61152 199.2 165.3 238.0
Shrewsbury & Telford 75 91.2 89506 82.2 64.7 103.1
South Devon 46 53.6 53037 85.8 62.8 114.5
South London 127 132.0 127936 96.2 80.2 114.5
South Manchester 30 69.6 70301 43.1 29.1 61.5
South Tees 146 115.4 113447 126.5 106.8 148.8
South Tyneside 23 24.8 27267 92.6 58.7 138.9
South Warwickshire 13 43.1 39573 30.1 16.0 51.5
Southampton 116 85.0 89211 136.5 112.8 163.7
Southend 106 80.5 74202 131.7 107.8 159.2
Southport & Ormskirk 26 48.3 46987 53.8 35.2 78.9
St George's 129 62.5 69625 206.3 172.3 245.2
St Helens & Knowsley 41 60.0 68998 68.4 49.1 92.8
Stockport 79 59.6 61231 132.6 105.0 165.3
Surrey & Sussex 86 46.0 48758 186.9 149.5 230.8
Tameside 21 33.9 36885 62.0 38.3 94.7
Taunton & Somerset 97 63.2 60568 153.4 124.4 187.2
Trafford 23 23.2 21950 99.1 62.8 148.7
University College London 128 92.9 91894 137.7 114.9 163.8
Walsall 41 44.8 44732 91.5 65.6 124.1
Warrington & Halton 70 56.8 60464 123.2 96.0 155.6
West Hertfordshire 100 60.2 58786 166.0 135.1 201.9
West Middlesex 24 22.8 27600 105.5 67.6 157.0
West Suffolk 84 43.1 41089 194.9 155.5 241.3
Western Sussex 104 99.3 97166 104.7 85.6 126.9
Weston Area 20 25.8 25216 77.6 47.4 119.9
Whipps Cross 55 59.9 63503 91.8 69.1 119.5
Whittington 30 31.1 35748 96.5 65.1 137.7
Winchester & Eastleigh 40 33.1 32164 120.8 86.3 164.5
Wirral 77 71.5 74820 107.8 85.0 134.7
Worcestershire 82 88.5 87048 92.7 73.7 115.1
Wrightington, Wigan & Leigh 31 73.5 69674 42.2 28.7 59.9
Yeovil 23 34.8 32844 66.0 41.8 99.1
York 42 61.8 61081 68.0 49.0 91.9

Relative Risk with 95% and 99.8% control limits - SHA data

  • Banding:
  • Low
  • Within expected
  • High
SHA Observed Expected Denominator Relative Risk LCL UCL
East Midlands 869 674.8 675465 128.8 120.4 137.6
East Of England 1289 1084.1 1036307 118.9 112.5 125.6
London 1441 1369.3 1474962 105.2 99.9 110.8
North East 789 672.1 683390 117.4 109.3 125.9
North West 1262 1503.3 1547135 83.9 79.4 88.7
South Central 660 616.4 623840 107.1 99.1 115.6
South East Coast 797 758.5 761196 105.1 97.9 112.6
South West 1666 1172.8 1121010 142.1 135.3 149.0
West Midlands 742 1090.9 1108775 68.0 63.2 73.1
Yorkshire and The Humber 823 1121.0 1144770 73.4 68.5 78.6

Measure: Accidental Puncture or Laceration Patient Safety Indicator

Description:
The ratio of the observed number of cases of accidental cut, puncture, perforation or laceration to the expected number, per all surgical and medical discharges.
Definition:

Observed: Number of denominator spells with the ICD10 code for a accidental cut, puncture, perforation or laceration in any secondary field across the spell

Expected: The expected number of observed spells

Denominator: All surgical and medical spells in patients aged 19 and over, subject to certain exclusions.

Relative Risk: The observed numerator divided by the expected (multiplied by 100)

LCL: Lower 95% confidence limit

UCL: Upper 95% confidence limit

Banding: High - high number of observed events recorded (lower 95% confidence limit is greater than 100), Low - low number of observed events recorded (upper 95% confidence limit is lower than 100); Within Expected Range - as expected number of events recorded.

Technical definition

Observed: Discharges among cases meeting the inclusion and exclusion rules for the denominator with ICD10 code denoting accidental cut, puncture, perforation or laceration during a procedure in any secondary diagnosis field across the spell. ICD10 Unintentional cut, puncture, perforation or haemorrhage during surgical and medical care:

ICD code Description
Y600 During surgical operation
Y601 During infusion or transfusion
Y602 During kidney dialysis or other perfusion
Y603 During injection or immunization
Y604 During endoscopic examination
Y606 During aspiration, puncture and other catheterization
Y605 During heart catheterization
Y607 During administration of enema
Y608 During other surgical and medical care
Y609 During unspecified surgical and medical care
T812 Accidental puncture and laceration during a procedure NEC

Expected: The expected value for this indicator, calculated using a logistic regression model which adjusts for a variety of case-mix factors:

  • Admission method
  • Age group (5 year bands)
  • Co-morbidities (based on the Charlson Score of the secondary diagnosis codes)
  • Deprivation (Carstairs quintile)
  • Sex

Denominator: All surgical and medical spells in patients aged 19 and over, defined by specific HRG codes. See Appendix A: Surgical HRGs, See Appendix B: Medical HRGs

Exclude cases

  • Primary diagnosis denoting accidental cut, puncture, perforation or laceration
  • Pregnancy, childbirth and puerperium: defined by the following HRG codes:
HRG Description
N06 Normal Delivery w cc
N07 Normal Delivery w/o cc
N08 Assisted Delivery w cc
N09 Assisted Delivery w/o cc
N10 Caesarean Section w cc
N11 Caesarean Section w/o cc
N12 Antenatal Admissions not Related to Delivery Event
M09 Threatened or Spontaneous Abortion
M10 Surgical Termination of Pregnancy
M11 Medical Termination of Pregnancy
Basis
NHS Acute (non-specialist) Trusts
Data sources & Time frame

February 2010 - January 2011

Secondary Uses Services (SUS) Commissioning Data set - non frozen SUS extract.

Data licence acknowledgments
Secondary Uses Services (SUS) - Hospital Admitted Patients - Copyright: Re-used with the permission of The Health and Social Care Information Centre. All rights reserved.
Notes

Based on AHRQ PSI indicators.

Translated by the Dr Foster Unit at Imperial College in collaboration with the Care Quality Commission (formerly the Healthcare Commission).

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