Official Statistics

Public Health Outcomes Framework: commentary, May 2024

Published 8 May 2024

Applies to England

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

The latest release includes updated data for 20 indicators. Data for integrated care boards has also been added for 60 indicators. A complete list of indicators that have been updated is available at Public Health Outcomes Framework: indicator updates, 8 May 2024.

This summary provides the main messages for indicators on hospital admissions and deaths from drug misuse.

A summary of the findings for indicators on adults who are overweight or living with obesity, physical activity and inactivity, and diet can be found in the Obesity profile statistical commentary.

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, the admission rate for males continues to be higher than for females. In the latest period (April 2020 to March 2023), there were 53.9 admissions per 100,000 population for males (45,344 admissions) compared with 15.2 for females (13,241 admissions) (Figure 1).

Figure 1: Age-standardised hospital admissions rate for violence, including sexual violence, England, financial years April 2009 to March 2012, up to April 2020 to March 2023

The admission rate for violence, including sexual violence, in the most deprived areas in England was higher than in the least deprived areas. In the latest period (March 2020 to April 2023) admission rates were 3 times higher in the most deprived decile of District and Unitary Authorities in England than the least deprived District and Unitary Authorities (Figure 2).

Figure 2: Age-standardised hospital admissions for violence, including sexual violence by deprivation decile, England, financial years April 2020 to March 2023

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 crude rates of emergency admission 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 2023 

C14b 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 2022 to March 2023 was 126.3 per 100,000 (73,239 admissions). There has been a decrease 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 2023 

The emergency hospital admission rate for intentional self harm was higher in females than in males. In April 2022 to March 2023 the female rate was 168.0 per 100,000 (49,171 admissions), almost double that of the male rate of 85.8 per 100,000 (23,965 admissions) (Figure 4).

C21 Admission episodes for alcohol-related conditions

Alcohol consumption is a contributing factor to hospital admissions for a diverse range of conditions. This indicator measures hospital admissions where the primary diagnosis is an alcohol-related condition.

The rate of hospital admissions where the primary diagnosis is an alcohol-related condition has continued to decline. In April 2022 to March 2023 the rate decreased to 475 admissions per 100,000 (262,094 admissions) compared with 494 per 100,000 (270,774 admissions) in April 2021 to March 2022. The rate of alcohol-related admissions in men during April 2022 to March 2023 (639 per 100,000) was 1.96 times the figure for women (326 per 100,000). 

C29 and E13 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 in people aged 65 and over due to falls were lower in April 2022 to March 2023 than in April 2010 to March 2011, but have fluctuated over time. However, analysis of the trend over the last 5 years shows a continued decrease (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 2023 

Emergency admission rates for hip fractures have also decreased over the last decade for those aged 65 and over and in those aged 80 plus. For the 65 to 79 age group, the admission rate remained similar to the rate in 2010 to 2011 (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 2023 

C19d Deaths from drug misuse

Drug misuse is a significant cause of premature mortality in England. In 2020 to 2022 there were 5.2 deaths per 100,000 (8,582 deaths), a significant increase since 2001 to 2003 when the rate was 3.0 deaths per 100,000 (4,651 deaths). Deaths from drug misuse continue to be higher in males than in females. In 2020 to 2022 the male rate of deaths was 7.6 per 100,000 (6,106 deaths) compared with 2.9 per 100,000 in females (2,476 deaths) (Figure 7).

Figure 7: Age-standardised rate for deaths from drug misuse, England, calendar years 2001 to 2003 up to 2020 to 2022

Further information

Following Census 2021, the Office for National Statistics (ONS) carried out reconciliation and rebasing of the mid year population estimates. This process happens every 10 years following the census. The official population estimates for mid 2012 to mid 2020 have been revised to incorporate the data now available from Census 2021. The back series has been revised for all the remaining hospital admissions indicators in PHOF that were not updated in the February 2024 update: children in absolute and relative low income families, indicators for under 18 conception rates and the deaths from drug misuse. Trend data from 2001 for life expectancy at birth, single year indicators has also been added.

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

View the Public Health Outcomes Framework

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

The next planned update is August 2024.