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The Ethnic Category Coverage Management Information, published yesterday by NHS Digital, uses data from the GPES¹ Data for Pandemic Planning and Research (GDPPR)² and Hospital Episodes Statistics³ (HES) data sets to show the recorded ethnicity of patients⁴, broken down by Clinical Commissioning Group.

This information aims to inform users of the quality, coverage, and distribution of ethnic category recording within NHS Digital datasets. It can be used to reduce health inequalities⁵ and to allow commissioners of health and care services to better understand and monitor levels of ethnicity recording, so interventions can be targeted where they are needed.

It can also be used for research projects looking into COVID-19. The use of the underlying data is limited to COVID-19 planning and research purposes due to the legal basis under which the dataset is collected⁶.

It is possible for patients to be registered at multiple GP practices therefore some patients may be counted more than once but at different practices.

This information can be used:

• to understand how well ethnic category is recorded in these datasets
• to understand the breakdown of recorded ethnic categories in these datasets
• in conjunction with the information on the GDPPR analyst user guidance webpage⁷
• in conjunction with the ethnic group 2011 Census data published by ONS

The methodology used is one of many possible methods of obtaining ethnic category from these datasets, and the methodology used in future publications may differ following further analysis and investigation

This information should not be used without an understanding of how ethnicity is recorded in clinical systems and the opportunity for bias to be introduced during recording⁹.

The data will be updated in December with further updated scheduled based on usage.

View the Report

Notes for Editors

1. Information on GPES: https://digital.nhs.uk/services/general-practice-extraction-service.
2. Ethnic category can be recorded via two methods within GDPPR: an ETHNIC field within patient information tables, or a SNOMED code for ethnic category within patient journal tables. Patients can only have one recorded ethnic category via the ETHNIC field whereas they may have multiple journal entries with SNOMED codes for ethnicity.
3. The HES datasets included within this MI are HES Admitted Patient Care (APC), HES Accident and Emergency (AE) and HES Outpatients (OP). Ethnic category can only be recorded via the ETHNOS field in the HES datasets. Where patients have multiple records within the HES datasets it is possible for a patient to have multiple recorded ethnic categories.
4. Within this MI, a patient's ethnic category is determined using the following methodology: a) Patients and their recorded ethnic categories from each of the 5 data sources (GDPPR-Journal, GDPPR-Patient, HES-APC, HES-AE, HES-OP) are amalgamated. b) The data source providing the most recent ethnic category recording for each patient is selected to de-duplicate patients with multiple recordings. c) Where conflicts exist between data sources priority is given in the following order: GDPPR-Journal, GDPPR-Patient, HES-APC, HES-AE, HES-OP.  d) Where conflicts still exist (i.e. where the highest priority data source gives different ethnic categories on the latest date of attribution) ethnic category is set to null and the patient is not counted as having a known ethnic category.
5. Information on heath inequalities: https://www.england.nhs.uk/about/equality/
6. Information on GPES data for pandemic planning and research can be found here: https://digital.nhs.uk/coronavirus/gpes-data-for-pandemic-planning-and-research
7. Information for analysts: https://digital.nhs.uk/coronavirus/gpes-data-for-pandemic-planning-and-research#guidance-for-analysts-and-users-of-the-data
8. ONS 2011 Census data: https://www.ons.gov.uk/census/2011census
9. Where a patient is counted as having a recorded ethnic category, this does not necessarily indicate that the recorded ethnic category is an accurate representation of that patient’s ethnic category, merely that they have an ethnic category recorded.