Patient Safety Indicators - Decubitus Ulcer - 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: 29

    Expected: 44.9

    Relative Risk: 64.6

  • Airedale

    Observed: 7

    Expected: 21.9

    Relative Risk: 31.9

  • Ashford & St Peter's

    Observed: 44

    Expected: 40.3

    Relative Risk: 109.2

  • Barking, Havering & Redbridge

    Observed: 50

    Expected: 62.9

    Relative Risk: 79.6

  • Barnet & Chase Farm

    Observed: 18

    Expected: 15.0

    Relative Risk: 120.2

  • Barnsley Hospital

    Observed: 15

    Expected: 23.3

    Relative Risk: 64.3

  • Barts & the London NHS

    Observed: 7

    Expected: 24.4

    Relative Risk: 28.7

  • Basildon & Thurrock

    Observed: 110

    Expected: 47.2

    Relative Risk: 232.9

  • Basingstoke & North Hampshire

    Observed: 11

    Expected: 19.3

    Relative Risk: 56.9

  • Bedford Hospital

    Observed: 39

    Expected: 24.4

    Relative Risk: 159.7

  • Blackpool, Fylde & Wyre

    Observed: 74

    Expected: 49.9

    Relative Risk: 148.1

  • Bradford Teaching Hospitals

    Observed: 52

    Expected: 41.2

    Relative Risk: 126.3

  • Brighton & Sussex

    Observed: 61

    Expected: 62.4

    Relative Risk: 97.8

  • Buckinghamshire

    Observed: 44

    Expected: 33.7

    Relative Risk: 130.7

  • Burton

    Observed: 27

    Expected: 23.5

    Relative Risk: 115.1

  • Calderdale & Huddersfield

    Observed: 45

    Expected: 49.4

    Relative Risk: 91.2

  • Cambridge

    Observed: 50

    Expected: 66.2

    Relative Risk: 75.5

  • Central Manchester

    Observed: 67

    Expected: 44.2

    Relative Risk: 151.4

  • Chelsea & Westminster

    Observed: 30

    Expected: 15.6

    Relative Risk: 192.8

  • Chesterfield Royal

    Observed: 40

    Expected: 38.8

    Relative Risk: 103.1

  • City Hospitals Sunderland

    Observed: 42

    Expected: 45.4

    Relative Risk: 92.4

  • Colchester

    Observed: 48

    Expected: 51.1

    Relative Risk: 94.0

  • Countess Of Chester

    Observed: 23

    Expected: 29.5

    Relative Risk: 78.0

  • County Durham & Darlington

    Observed: 25

    Expected: 50.4

    Relative Risk: 49.6

  • Croydon

    Observed: 43

    Expected: 34.2

    Relative Risk: 125.8

  • Dartford & Gravesham

    Observed: 28

    Expected: 23.9

    Relative Risk: 117.3

  • Derby

    Observed: 42

    Expected: 70.0

    Relative Risk: 60.0

  • Doncaster & Bassetlaw

    Observed: 96

    Expected: 59.4

    Relative Risk: 161.7

  • Dorset County

    Observed: 21

    Expected: 34.3

    Relative Risk: 61.3

  • Ealing

    Observed: 16

    Expected: 20.3

    Relative Risk: 79.0

  • East & North Hertfordshire

    Observed: 47

    Expected: 42.7

    Relative Risk: 110.0

  • East Cheshire

    Observed: 15

    Expected: 17.2

    Relative Risk: 87.3

  • East Kent

    Observed: 68

    Expected: 84.6

    Relative Risk: 80.4

  • East Lancashire

    Observed: 77

    Expected: 52.5

    Relative Risk: 146.6

  • East Sussex

    Observed: 76

    Expected: 60.8

    Relative Risk: 125.1

  • Epsom & St Helier

    Observed: 65

    Expected: 29.2

    Relative Risk: 222.7

  • Frimley Park

    Observed: 50

    Expected: 42.7

    Relative Risk: 117.0

  • Gateshead

    Observed: 38

    Expected: 32.8

    Relative Risk: 115.9

  • George Eliot

    Observed: 54

    Expected: 18.8

    Relative Risk: 286.5

  • Gloucestershire

    Observed: 26

    Expected: 76.4

    Relative Risk: 34.0

  • Great Western

    Observed: 31

    Expected: 44.1

    Relative Risk: 70.4

  • Guy's & St Thomas'

    Observed: 19

    Expected: 46.4

    Relative Risk: 40.9

  • Harrogate & District

    Observed: 20

    Expected: 19.4

    Relative Risk: 103.3

  • Heart Of England

    Observed: 105

    Expected: 92.9

    Relative Risk: 113.0

  • Heatherwood & Wexham Park

    Observed: 49

    Expected: 35.2

    Relative Risk: 139.3

  • Hereford

    Observed: n/a

    Expected: n/a

    Relative Risk: 61.9

  • Hinchingbrooke

    Observed: 14

    Expected: 15.1

    Relative Risk: 92.9

  • Homerton

    Observed: n/a

    Expected: n/a

    Relative Risk: 94.1

  • Hull & East Yorkshire

    Observed: 42

    Expected: 70.1

    Relative Risk: 59.9

  • Imperial College

    Observed: 55

    Expected: 73.5

    Relative Risk: 74.8

  • Ipswich

    Observed: 45

    Expected: 39.2

    Relative Risk: 114.9

  • Isle Of Wight

    Observed: 25

    Expected: 14.3

    Relative Risk: 174.9

  • James Paget

    Observed: 21

    Expected: 29.8

    Relative Risk: 70.4

  • Kettering

    Observed: 40

    Expected: 33.4

    Relative Risk: 119.7

  • King's College

    Observed: 58

    Expected: 44.9

    Relative Risk: 129.3

  • Kingston

    Observed: 26

    Expected: 17.9

    Relative Risk: 145.4

  • Lancashire

    Observed: 31

    Expected: 45.4

    Relative Risk: 68.3

  • Leeds

    Observed: 73

    Expected: 106.3

    Relative Risk: 68.7

  • Lewisham

    Observed: 21

    Expected: 20.9

    Relative Risk: 100.4

  • Luton & Dunstable

    Observed: 87

    Expected: 27.0

    Relative Risk: 321.8

  • Maidstone & Tunbridge Wells

    Observed: 120

    Expected: 50.8

    Relative Risk: 236.0

  • Medway

    Observed: 141

    Expected: 36.4

    Relative Risk: 387.9

  • Mid Cheshire

    Observed: 13

    Expected: 22.2

    Relative Risk: 58.6

  • Mid Essex

    Observed: 40

    Expected: 35.1

    Relative Risk: 113.9

  • Mid Staffordshire

    Observed: 29

    Expected: 25.1

    Relative Risk: 115.5

  • Mid Yorkshire

    Observed: 30

    Expected: 63.5

    Relative Risk: 47.3

  • Milton Keynes

    Observed: 30

    Expected: 20.5

    Relative Risk: 146.0

  • Newham

    Observed: 15

    Expected: 6.1

    Relative Risk: 245.5

  • Norfolk & Norwich

    Observed: 34

    Expected: 73.3

    Relative Risk: 46.4

  • North Bristol

    Observed: 59

    Expected: 60.9

    Relative Risk: 96.9

  • North Cumbria

    Observed: 25

    Expected: 33.8

    Relative Risk: 74.1

  • North Middlesex

    Observed: 36

    Expected: 18.6

    Relative Risk: 193.6

  • North Tees & Hartlepool

    Observed: 33

    Expected: 30.1

    Relative Risk: 109.8

  • North West London

    Observed: 75

    Expected: 54.4

    Relative Risk: 137.9

  • Northampton

    Observed: 45

    Expected: 38.6

    Relative Risk: 116.7

  • Northern Devon

    Observed: 61

    Expected: 20.8

    Relative Risk: 292.8

  • Northern Lincolnshire & Goole

    Observed: 34

    Expected: 46.1

    Relative Risk: 73.7

  • Northumbria Healthcare

    Observed: 116

    Expected: 51.6

    Relative Risk: 224.9

  • Nottingham

    Observed: 91

    Expected: 92.1

    Relative Risk: 98.8

  • Oxford Radcliffe

    Observed: 40

    Expected: 75.4

    Relative Risk: 53.1

  • Pennine Acute

    Observed: 151

    Expected: 95.8

    Relative Risk: 157.7

  • Peterborough & Stamford

    Observed: 45

    Expected: 32.7

    Relative Risk: 137.6

  • Plymouth

    Observed: 43

    Expected: 32.5

    Relative Risk: 132.3

  • Poole Hospital

    Observed: 23

    Expected: 41.2

    Relative Risk: 55.8

  • Portsmouth

    Observed: 50

    Expected: 44.2

    Relative Risk: 113.0

  • Royal Berkshire

    Observed: 44

    Expected: 43.2

    Relative Risk: 101.9

  • Royal Bolton

    Observed: 107

    Expected: 32.1

    Relative Risk: 332.9

  • Royal Cornwall

    Observed: 42

    Expected: 58.3

    Relative Risk: 72.1

  • Royal Devon & Exeter

    Observed: 26

    Expected: 63.0

    Relative Risk: 41.3

  • Royal Free Hampstead

    Observed: 34

    Expected: 38.2

    Relative Risk: 89.0

  • Royal Liverpool & Broadgreen

    Observed: 80

    Expected: 56.1

    Relative Risk: 142.6

  • Royal Surrey County Hospital

    Observed: 58

    Expected: 33.2

    Relative Risk: 174.5

  • Royal United Hospital Bath

    Observed: 34

    Expected: 53.1

    Relative Risk: 64.0

  • Salford Royal

    Observed: 69

    Expected: 34.1

    Relative Risk: 202.4

  • Salisbury

    Observed: 76

    Expected: 27.3

    Relative Risk: 278.4

  • Sandwell & West Birmingham

    Observed: 83

    Expected: 54.4

    Relative Risk: 152.6

  • Scarborough & North East Yorkshire

    Observed: 15

    Expected: 22.8

    Relative Risk: 65.8

  • Sheffield Teaching

    Observed: 110

    Expected: 79.4

    Relative Risk: 138.5

  • Sherwood Forest

    Observed: 70

    Expected: 38.5

    Relative Risk: 181.6

  • Shrewsbury & Telford

    Observed: 30

    Expected: 49.5

    Relative Risk: 60.7

  • South Devon

    Observed: 24

    Expected: 40.7

    Relative Risk: 58.9

  • South London

    Observed: 68

    Expected: 74.5

    Relative Risk: 91.3

  • South Tees

    Observed: 91

    Expected: 67.6

    Relative Risk: 134.7

  • South Tyneside

    Observed: 42

    Expected: 19.3

    Relative Risk: 217.5

  • South Warwickshire

    Observed: 14

    Expected: 24.5

    Relative Risk: 57.2

  • Southampton

    Observed: 38

    Expected: 70.8

    Relative Risk: 53.7

  • Southend

    Observed: 179

    Expected: 52.1

    Relative Risk: 343.8

  • Southport & Ormskirk

    Observed: 11

    Expected: 23.4

    Relative Risk: 47.0

  • St George's

    Observed: 36

    Expected: 50.7

    Relative Risk: 71.0

  • St Helens & Knowsley

    Observed: 53

    Expected: 36.2

    Relative Risk: 146.6

  • Stockport

    Observed: 86

    Expected: 32.8

    Relative Risk: 262.2

  • Surrey & Sussex

    Observed: 10

    Expected: 12.1

    Relative Risk: 82.4

  • Tameside

    Observed: 15

    Expected: 23.6

    Relative Risk: 63.6

  • Taunton & Somerset

    Observed: 51

    Expected: 45.1

    Relative Risk: 113.1

  • Dudley Group Of Hospitals

    Observed: 52

    Expected: 44.0

    Relative Risk: 118.2

  • Hillingdon

    Observed: 32

    Expected: 19.5

    Relative Risk: 164.1

  • Newcastle Upon Tyne

    Observed: 61

    Expected: 66.9

    Relative Risk: 91.1

  • Princess Alexandra

    Observed: 80

    Expected: 31.5

    Relative Risk: 253.6

  • Queen Elizabeth King's Lynn

    Observed: 19

    Expected: 27.6

    Relative Risk: 68.8

  • Rotherham

    Observed: 35

    Expected: 26.4

    Relative Risk: 132.6

  • Royal Bournemouth & Christchurch

    Observed: 9

    Expected: 41.2

    Relative Risk: 21.9

  • Royal Wolverhampton

    Observed: 55

    Expected: 50.5

    Relative Risk: 108.8

  • Whittington

    Observed: 15

    Expected: 16.7

    Relative Risk: 89.7

  • Trafford

    Observed: 19

    Expected: 11.9

    Relative Risk: 160.1

  • Lincolnshire

    Observed: 71

    Expected: 78.8

    Relative Risk: 90.0

  • University College London

    Observed: 41

    Expected: 33.2

    Relative Risk: 123.5

  • Birmingham

    Observed: 63

    Expected: 57.0

    Relative Risk: 110.6

  • North Staffordshire

    Observed: 39

    Expected: 62.9

    Relative Risk: 62.0

  • South Manchester

    Observed: 47

    Expected: 46.0

    Relative Risk: 102.3

  • Bristol

    Observed: 28

    Expected: 47.6

    Relative Risk: 58.8

  • Coventry & Warwickshire

    Observed: 48

    Expected: 66.1

    Relative Risk: 72.6

  • Leicester

    Observed: 53

    Expected: 32.0

    Relative Risk: 165.4

  • Morecambe Bay

    Observed: 38

    Expected: 39.0

    Relative Risk: 97.3

  • Walsall

    Observed: 58

    Expected: 34.1

    Relative Risk: 170.0

  • Warrington & Halton

    Observed: 135

    Expected: 32.7

    Relative Risk: 413.4

  • West Hertfordshire

    Observed: 155

    Expected: 46.8

    Relative Risk: 331.4

  • West Middlesex

    Observed: 40

    Expected: 19.2

    Relative Risk: 208.0

  • West Suffolk

    Observed: 81

    Expected: 27.3

    Relative Risk: 296.3

  • Western Sussex

    Observed: 59

    Expected: 42.4

    Relative Risk: 139.2

  • Weston Area

    Observed: 17

    Expected: 14.5

    Relative Risk: 117.4

  • Whipps Cross

    Observed: 70

    Expected: 35.8

    Relative Risk: 195.7

  • Winchester & Eastleigh

    Observed: 16

    Expected: 10.8

    Relative Risk: 148.2

  • Wirral

    Observed: 67

    Expected: 45.0

    Relative Risk: 149.0

  • Worcestershire

    Observed: 64

    Expected: 58.1

    Relative Risk: 110.2

  • Wrightington, Wigan & Leigh

    Observed: 42

    Expected: 37.8

    Relative Risk: 111.0

  • Yeovil

    Observed: 22

    Expected: 19.5

    Relative Risk: 112.6

  • York

    Observed: 87

    Expected: 45.2

    Relative Risk: 192.6

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 29 44.9 3811 64.6 43.3 92.8
Airedale 7 21.9 1819 31.9 12.8 65.8
Ashford & St Peter's 44 40.3 3038 109.2 79.3 146.6
Barking, Havering & Redbridge 50 62.9 4884 79.6 59.0 104.9
Barnet & Chase Farm 18 15.0 2145 120.2 71.2 190.0
Barnsley Hospital 15 23.3 1958 64.3 35.9 106.0
Barts & the London NHS 7 24.4 4457 28.7 11.5 59.2
Basildon & Thurrock 110 47.2 4004 232.9 191.4 280.7
Basingstoke & North Hampshire 11 19.3 2133 56.9 28.4 101.8
Bedford Hospital 39 24.4 2009 159.7 113.6 218.3
Birmingham 63 57.0 7019 110.6 85.0 141.5
Blackpool, Fylde & Wyre 74 49.9 4583 148.1 116.3 186.0
Bradford Teaching Hospitals 52 41.2 4177 126.3 94.3 165.6
Brighton & Sussex 61 62.4 5703 97.8 74.8 125.6
Bristol 28 47.6 5103 58.8 39.1 85.0
Buckinghamshire 44 33.7 3153 130.7 94.9 175.4
Burton 27 23.5 2011 115.1 75.8 167.5
Calderdale & Huddersfield 45 49.4 4034 91.2 66.5 122.0
Cambridge 50 66.2 6838 75.5 56.0 99.5
Central Manchester 67 44.2 5586 151.4 117.3 192.3
Chelsea & Westminster 30 15.6 1873 192.8 130.1 275.3
Chesterfield Royal 40 38.8 3143 103.1 73.7 140.5
City Hospitals Sunderland 42 45.4 3758 92.4 66.6 124.9
Colchester 48 51.1 4121 94.0 69.3 124.6
Countess Of Chester 23 29.5 2592 78.0 49.4 117.0
County Durham & Darlington 25 50.4 4387 49.6 32.1 73.2
Coventry & Warwickshire 48 66.1 7097 72.6 53.5 96.2
Croydon 43 34.2 2577 125.8 91.0 169.4
Dartford & Gravesham 28 23.9 2361 117.3 77.9 169.5
Derby 42 70.0 6504 60.0 43.3 81.1
Doncaster & Bassetlaw 96 59.4 4610 161.7 131.0 197.5
Dorset County 21 34.3 2831 61.3 37.9 93.7
Dudley Group Of Hospitals 52 44.0 3625 118.2 88.3 155.1
Ealing 16 20.3 1662 79.0 45.1 128.2
East & North Hertfordshire 47 42.7 4288 110.0 80.8 146.3
East Cheshire 15 17.2 1456 87.3 48.8 144.1
East Kent 68 84.6 6368 80.4 62.4 101.9
East Lancashire 77 52.5 4739 146.6 115.7 183.2
East Sussex 76 60.8 4473 125.1 98.5 156.5
Epsom & St Helier 65 29.2 3526 222.7 171.8 283.8
Frimley Park 50 42.7 3796 117.0 86.9 154.3
Gateshead 38 32.8 2600 115.9 82.0 159.1
George Eliot 54 18.8 1510 286.5 215.2 373.8
Gloucestershire 26 76.4 7163 34.0 22.2 49.9
Great Western 31 44.1 4049 70.4 47.8 99.9
Guy's & St Thomas' 19 46.4 7459 40.9 24.6 63.9
Harrogate & District 20 19.4 1943 103.3 63.0 159.5
Heart Of England 105 92.9 8229 113.0 92.4 136.8
Heatherwood & Wexham Park 49 35.2 3059 139.3 103.0 184.1
Hereford N/A N/A 1149 61.9 19.9 144.4
Hillingdon 32 19.5 1901 164.1 112.2 231.7
Hinchingbrooke 14 15.1 1421 92.9 50.8 155.9
Homerton N/A N/A 610 94.1 10.6 339.9
Hull & East Yorkshire 42 70.1 7630 59.9 43.2 81.0
Imperial College 55 73.5 8339 74.8 56.3 97.4
Ipswich 45 39.2 3277 114.9 83.8 153.8
Isle Of Wight 25 14.3 1280 174.9 113.1 258.2
James Paget 21 29.8 2274 70.4 43.5 107.6
Kettering 40 33.4 2941 119.7 85.5 163.1
King's College 58 44.9 6080 129.3 98.2 167.2
Kingston 26 17.9 1512 145.4 95.0 213.1
Lancashire 31 45.4 5163 68.3 46.4 96.9
Leeds 73 106.3 11683 68.7 53.8 86.3
Leicester 53 32.0 3232 165.4 123.9 216.3
Lewisham 21 20.9 1732 100.4 62.1 153.4
Lincolnshire 71 78.8 6725 90.0 70.3 113.6
Luton & Dunstable 87 27.0 2646 321.8 257.8 397.0
Maidstone & Tunbridge Wells 120 50.8 4212 236.0 195.7 282.3
Medway 141 36.4 3203 387.9 326.5 457.4
Mid Cheshire 13 22.2 2025 58.6 31.2 100.3
Mid Essex 40 35.1 3611 113.9 81.3 155.1
Mid Staffordshire 29 25.1 2270 115.5 77.3 165.8
Mid Yorkshire 30 63.5 5550 47.3 31.9 67.5
Milton Keynes 30 20.5 1979 146.0 98.5 208.4
Morecambe Bay 38 39.0 3917 97.3 68.9 133.6
Newcastle Upon Tyne 61 66.9 8286 91.1 69.7 117.1
Newham 15 6.1 984 245.5 137.3 405.0
Norfolk & Norwich 34 73.3 6545 46.4 32.1 64.8
North Bristol 59 60.9 6546 96.9 73.8 125.0
North Cumbria 25 33.8 3038 74.1 47.9 109.3
North Middlesex 36 18.6 1581 193.6 135.6 268.0
North Staffordshire 39 62.9 6411 62.0 44.1 84.7
North Tees & Hartlepool 33 30.1 2731 109.8 75.6 154.2
North West London 75 54.4 4471 137.9 108.4 172.8
Northampton 45 38.6 3573 116.7 85.1 156.1
Northern Devon 61 20.8 1952 292.8 223.9 376.1
Northern Lincolnshire & Goole 34 46.1 4088 73.7 51.0 103.0
Northumbria Healthcare 116 51.6 3795 224.9 185.8 269.7
Nottingham 91 92.1 10082 98.8 79.6 121.4
Oxford Radcliffe 40 75.4 8231 53.1 37.9 72.3
Pennine Acute 151 95.8 8704 157.7 133.5 184.9
Peterborough & Stamford 45 32.7 2967 137.6 100.3 184.1
Plymouth 43 32.5 5111 132.3 95.7 178.2
Poole Hospital 23 41.2 2949 55.8 35.4 83.8
Portsmouth 50 44.2 4463 113.0 83.9 149.0
Princess Alexandra 80 31.5 2755 253.6 201.1 315.6
Queen Elizabeth King's Lynn 19 27.6 2014 68.8 41.4 107.4
Rotherham 35 26.4 2481 132.6 92.3 184.4
Royal Berkshire 44 43.2 4026 101.9 74.0 136.8
Royal Bolton 107 32.1 2725 332.9 272.8 402.2
Royal Bournemouth & Christchurch 9 41.2 3817 21.9 10.0 41.5
Royal Cornwall 42 58.3 5007 72.1 51.9 97.4
Royal Devon & Exeter 26 63.0 5586 41.3 27.0 60.5
Royal Free Hampstead 34 38.2 4276 89.0 61.6 124.4
Royal Liverpool & Broadgreen 80 56.1 5106 142.6 113.1 177.5
Royal Surrey County Hospital 58 33.2 3028 174.5 132.5 225.5
Royal United Hospital Bath 34 53.1 4001 64.0 44.3 89.4
Royal Wolverhampton 55 50.5 4989 108.8 82.0 141.6
Salford Royal 69 34.1 3513 202.4 157.5 256.1
Salisbury 76 27.3 2491 278.4 219.4 348.5
Sandwell & West Birmingham 83 54.4 4473 152.6 121.5 189.2
Scarborough & North East Yorkshire 15 22.8 1720 65.8 36.8 108.6
Sheffield Teaching 110 79.4 9639 138.5 113.9 167.0
Sherwood Forest 70 38.5 3320 181.6 141.6 229.5
Shrewsbury & Telford 30 49.5 4609 60.7 40.9 86.6
South Devon 24 40.7 2969 58.9 37.8 87.7
South London 68 74.5 6386 91.3 70.9 115.7
South Manchester 47 46.0 5352 102.3 75.1 136.0
South Tees 91 67.6 6842 134.7 108.5 165.4
South Tyneside 42 19.3 1353 217.5 156.7 294.0
South Warwickshire 14 24.5 1963 57.2 31.2 95.9
Southampton 38 70.8 7607 53.7 38.0 73.7
Southend 179 52.1 4184 343.8 295.3 398.1
Southport & Ormskirk 11 23.4 2070 47.0 23.4 84.0
St George's 36 50.7 5738 71.0 49.7 98.3
St Helens & Knowsley 53 36.2 3250 146.6 109.8 191.7
Stockport 86 32.8 3443 262.2 209.7 323.9
Surrey & Sussex 10 12.1 1562 82.4 39.4 151.5
Tameside 15 23.6 2044 63.6 35.6 104.9
Taunton & Somerset 51 45.1 3670 113.1 84.2 148.7
Trafford 19 11.9 935 160.1 96.4 250.1
University College London 41 33.2 5713 123.5 88.6 167.6
Walsall 58 34.1 2571 170.0 129.1 219.7
Warrington & Halton 135 32.7 2942 413.4 346.6 489.3
West Hertfordshire 155 46.8 3871 331.4 281.3 387.9
West Middlesex 40 19.2 1476 208.0 148.6 283.2
West Suffolk 81 27.3 2010 296.3 235.3 368.2
Western Sussex 59 42.4 4203 139.2 106.0 179.6
Weston Area 17 14.5 1117 117.4 68.4 188.0
Whipps Cross 70 35.8 3001 195.7 152.6 247.3
Whittington 15 16.7 1583 89.7 50.2 148.0
Winchester & Eastleigh 16 10.8 1240 148.2 84.7 240.7
Wirral 67 45.0 3940 149.0 115.4 189.2
Worcestershire 64 58.1 5151 110.2 84.8 140.7
Wrightington, Wigan & Leigh 42 37.8 4115 111.0 80.0 150.0
Yeovil 22 19.5 1596 112.6 70.5 170.5
York 87 45.2 3654 192.6 154.2 237.5

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

  • Banding:
  • Low
  • Within expected
  • High
Provider Observed Expected Denominator Relative Risk LCL UCL
East Midlands Strategic Health Authority 452 422.2 39520 107.1 97.4 117.4
East Of England Strategic Health Authority 1094 669.3 58835 163.5 153.9 173.4
London Strategic Health Authority 872 774.1 83966 112.7 105.3 120.4
North East Strategic Health Authority 448 364.0 33752 123.1 111.9 135.0
North West Strategic Health Authority 1274 886.0 85049 143.8 136.0 151.9
South Central Strategic Health Authority 347 367.4 37171 94.4 84.8 104.9
South East Coast Strategic Health Authority 715 489.5 41947 146.1 135.5 157.2
South West Strategic Health Authority 593 720.4 65958 82.3 75.8 89.2
West Midlands Strategic Health Authority 726 669.6 63077 108.4 100.7 116.6
Yorkshire and The Humber Strategic Health Authority 661 674.3 64986 98.0 90.7 105.8

Measure: Decubitus Ulcer Patient Safety Indicator

Description
The ratio of the observed number of cases of decubitus ulcer to the expected number, per all surgical and medical discharges with an operating room procedure.
Definition

Observed: Number of denominator spells with the ICD10 code for decubitus ulcer 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 where length of stay is at least 5 days, 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: All spells with ICD10 code for decubitus ulcer in any secondary field across the spell.

ICD10 code: L89 Decubitus Ulcer

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 and OPCS codes.

See Appendix A: Surgical HRGs. See Appendix B: Medical HRGs. See Appendix C: Derived Operating Room Procedures.

Exclude cases:

  • With length of stay less than 5 days
  • With ICD10 code of decubitus ulcer (see numerator) in the principal diagnosis field
  • Any diagnosis of ICD10 codes for Hemiplegia, paraplegia, quadriplegia, spina bifida or anoxic brain damage across the spell.

ICD10 codes for Hemiplegia, paraplegia, quadriplegia, spina bifida or anoxic brain damage.

ICD10 code Description
G801 Spastic diplegia
G802 Infantile hemiplegia
G808 Other infantile cerebral palsy
G809 Infantile cerebral palsy, unspecified
G810 Flaccid hemiplegia
G811 Spastic hemiplegia
G819 Hemiplegia, unspecified
G822 Paraplegia, unspecified
G825 Tetraplegia, unspecified
G830 Diplegia of upper limbs
G831 Monoplegia of lower limb
G832 Monoplegia of upper limb
G833 Monoplegia, unspecified
G834 Cauda equina syndrome
G838 Other specified paralytic syndromes
G839 Paralytic syndrome, unspecified
N319 Neuromuscular dysfunction of bladder, unspecified
G931 Anoxic brain damage, not elsewhere classified
G939 Disorder of brain, unspecified
G978 Other postprocedural disorders of nervous system

With an OPCS procedure code for debridement or pedicle graft op before or on the same day as the major operating room procedure (surgical cases only):

OPCS code Description
T778 Other specified excision of muscle
S571 Debridement of skin NEC (includes excision of devitalised skin)
S573 Toilet of skin NEC
S17 + Y703 Distant flap of skin &muscle (first stage of staged operations NOC)
S18 + Y703 Distant flap of skin &fascia (first stage of staged operations NOC)
S19 + Y703 Distant pedicle flap of skin (first stage of staged operations NOC)
S24 + Y703 Local flap of skin &muscle (first stage of staged operations NOC)
S25 + Y703 Local flap of skin &fascia (first stage of staged operations NOC)
S26 + Y703 Local pedicle flap of skin (first stage of staged operations NOC)
S17 + Y713 Distant flap of skin &muscle (Revisional operations NOC)
S18 + Y713 Distant flap of skin &fascia (Revisional operations NOC)
S19 + Y713 Distant pedicle flap of skin (Revisional operations NOC)
S24 + Y713 Local flap of skin &muscle (Revisional operations NOC)
S25 + Y713 Local flap of skin &fascia (Revisional operations NOC)
S26 + Y713 Local pedicle flap of skin (Revisional operations NOC)
Admission source (ADMISORC) indicating long-term care
54 NHS run nursing home, residential care home or group home
85 Non-NHS (other than Local Authority) run residential care home (from 1996-97)
86 Non-NHS (other than Local Authority) run nursing home (from 1996-97)
88 non-NHS (other than Local Authority) run hospice
Transferred from acute care facility
Transfer (ADMIMETH=81 or ADMISORC=50-54) where previous trust is acute
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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