Background

The Public Health Outcomes Framework (PHOF) sets out a high level overview of public health outcomes, at national and local level, supported by a broad set of indicators. An interactive web tool makes the PHOF data available publicly. This allows local authorities to assess progress in comparison to national averages and their peers, and develop their work plans accordingly.

New in this update

This update includes new data for 50 indicators. This summary provides the main messages for hospital admissions, eye health and loneliness. For a complete list of indicators that have been updated, see the PHOF indicator details table.

Summary of selected updated indicators 

Hospital admissions 

B12a Hospital admissions for violence, including sexual violence

This indicator measures the number of emergency hospital admissions for violence, including sexual violence. It accounts for a small proportion of total cases of violence as it only includes those severe enough to warrant admission to hospital.

The overall admission rate for violence including sexual violence in England has shown a downward trend over the last decade. However, admission rates for males continue to be higher than for females. In the latest period (April 2021 to March 2024), there were 54.1 admissions per 100,000 population for males compared with 14.8 for females (figure 1).

Figure 1: age-standardised hospital admission rate for violence, including sexual violence, England, financial years, April 2009 to March 2012, up to April 2021 to March 2024

The admission rates for violence including sexual violence were 3 times higher in the most deprived decile of district and unitary authorities in England compared with the least deprived authorities (figure 2).

Figure 2: age-standardised hospital admissions for violence, including sexual violence by deprivation decile, England, financial years, April 2021 to March 2024

C11a and C11b Hospital admissions for unintentional and deliberate injuries in children and young people

Injuries are a leading cause of hospitalisation and represent a major cause of premature mortality for children and young people. They are also a source of long term health issues. 

The admission rates for unintentional or deliberate injuries for children and young people have declined over the last decade, with some fluctuations from year to year (figure 3).

Figure 3: crude hospital admission rate for unintentional and deliberate injuries in children and young people, England, financial years, April 2010 to March 2024

C14b Emergency hospital admissions for intentional self harm

This indicator measures self harm events severe enough to warrant hospital admission. These hospital admissions are used as a proxy for the prevalence of severe self harm. There is a significant and persistent risk of future suicide following an episode of self harm.

The rate of emergency hospital admissions for intentional self harm in April 2023 to March 2024 was 117.0 per 100,000 (68,468 admissions). There has been a gradual decrease in this indicator since April 2018 to March 2019 (figure 4).

Figure 4: age standardised hospital admission rate for intentional self harm, England, financial years, April 2010 to March 2024 

Emergency hospital admissions for intentional self harm were higher in females than in males. In April 2023 to March 2024 the female rate was 149.6 per 100,000 (44,318 admissions), compared with 83.6 per 100,000 for males (23,532 admissions).

C29 and E13 Emergency hospital admissions for falls and hip fractures 

Falls significantly impact on long term outcomes for older people. Hip fracture is a debilitating condition and has been demonstrated to have an immediate impact on an individual’s independence. Both these causes of hospital admission can lead to people moving from their own home to long term nursing or residential care.

The rates of emergency hospital admission due to falls showed a small increase in April 2023 to March 2024 compared with April 2022 to March 2023, but remain lower than rates in April 2010 to March 2011 (figure 5).

Figure 5: age-standardised emergency admission rate for falls in people aged 65 years and over, England, financial years, April 2010 to March 2024 

Emergency admission rates for hip fractures have decreased over the last decade for those aged 65 and over (figure 6).

Figure 6: age-standardised emergency admission rate for hip fractures in people aged 65 years and over, England, financial years, April 2010 to March 2024 

Preventable sight loss: indicators E12a, E12b, E12c and E12d

These indicators are included in the framework to ensure that avoidable sight loss is recognised as a critical and modifiable public health issue. Prevention of sight loss will help people maintain independent lives as far as possible and reduce the need for social care support, which would be necessary if sight was lost permanently.

It is important to note that, as these indicators measure certifications of vision impairment (CVI), the values can be affected by the availability of treatment and the number of people who are sight impaired who do not seek treatment or diagnosis. The 4 indicators cover sight loss certifications from all causes (preventable and non-preventable) and the 3 most common causes of preventable sight loss:

• age related macular degeneration (AMD) (ages 65 and over)
• glaucoma (ages 40 and over)
• diabetic eye disease (ages 12 and over)

Total sight loss certifications in England in the financial year 2023 to 2024 increased to 43.5 certifications per 100,000 (25,110 certifications) from 42.0 per 100,000 in 2022 to 2023 (23,993 certifications). Total certifications decreased during the COVID-19 pandemic but are now similar to pre-pandemic levels. A similar trend was seen for diabetic eye disease, age related macular degeneration and glaucoma with an increase in rates since 2020 to 2021 (figure 7).

Figure 7: age-specific crude rates of sight loss certifications by condition, England, financial years, April 2010 to March 2024

Loneliness: indicator C19

Loneliness can affect anyone, at any time, with a negative impact on community and individual wellbeing. When people feel lonely often or always, this is referred to as chronic loneliness. Chronic loneliness can have a serious impact on an individual’s wellbeing, and their ability to function in society.

The definition for this indicator has been revised to include only those who say they feel lonely often or always and combines data from 2 survey periods, to provide a large enough sample size to report chronic loneliness.

The percentage of adults aged 16 and over in England who reported feeling lonely often or always in November 2021 to November 2023 was 6.8%, an increase from 6.0% in November 2019 to November 2021.

Chronic loneliness was higher for women (7.7%) than men (5.6%), and highest in the youngest age group. The rate was 3 times higher in those aged 16 to 24 years (12.1%) than those aged 65 to 74 years (3.3%) (figure 8). However, the proportion in the 85 and over age group was relatively high at 7.9%.

Those living in the most deprived areas (13.0%) were 3 times more likely to report being lonely often or always compared to those in the least deprived areas (4.0%) (figure 9).

Figure 8: chronic loneliness by age group, England, November 2021 to November 2023

Figure 9: chronic loneliness by lower super output area (LSOA) deprivation decile, England, November 2021 to November 2023

Further information

In 2023, NHS England announced a methodological change that may reduce the number of admissions reported for these hospital admissions indicators. For further details, check the detailed metadata for these indicators on Fingertips.

View the PHOF.

For queries relating to this publication, contact pha-ohid@dhsc.gov.uk.

The next planned update is May 2025.