Hospital episode statistics: time for clinicians to get involved?

Hospital episode statistics contain clinical data. They are used for many purposes, including monitoring activity in the NHS and the allocation of funds. More recently they have been applied to monitoring performance, and it is intended that they will inform consultant appraisal and revalidation. The validity of hospital episode statistics was questioned by Korner in 1982. Recent publications have shown that problems persist in England and Wales, and that the quality of the data is inadequate for the task. The lack of involvement of clinicians in the process of data collection and validation is no longer acceptable. To rectify the situation there should be a change of process and culture, supported by education and investment. NHS data definitions of terms such as 'spells', 'episodes' and 'diagnoses' need to be reviewed. The development of separate data processes to monitor national service frameworks is regrettable.