COPD indicators and dashboard

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qÜÉ=`lma=fåÑçêã~íáçå=pìáíÉ= Chronic Obstructive Pulmonary Disorder (COPD) is a progressive, long term, disease that interferes with normal breathing and includes conditions such as bronchitis and emphysema. Sufferers are often prone to exacerbations and are often admitted to hospital to help manage these.

In the NHS South East Coast region, covering Kent, Surrey and Sussex, there are over 66,000 patients identified with COPD by their GP and statistical estimates suggest that in reality the number of sufferers are even higher than this, with more than 45,000 patients potentially remaining undiagnosed.

COPD has a significant effect on all individuals and the health economy as a whole, with emergency admissions for the condition estimated to cost over £16 million per year in terms of hospital admissions alone; that’s almost £4 per person living in the region. Increased life expectancy and an aging population means that the level of COPD is likely to increase in the years to come.

The Quality Observatory has developed a suite of dashboards and analyses that look at COPD prevalence and cost as well as a wide range of indicators that can help the local NHS measure and monitor how they are progressing towards ensuring the best care and outcomes for COPD patients, and making the most of the resources available. This leaflet describes what is in each of the tools in the suite and, on the back, how you can access them. =

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tÜ~íÛë=áå=íÜÉ=`lma=áåÑçêã~íáçå=ëìáíÉ\= The COPD dashboard is the main tool in the suite and contains the following information from an acute provider perspective. Views are available by trust and by measure: All admissions with COPD as a primary diagnosis on admission to the selected provider, including a 12 month rolling average Total bed days utilised by COPD patients, including a 12 month rolling average Average length of stay for COPD patients against the SHA average, including a rolling 12 month average Crude in-hospital mortality of COPD patients against the SHA rate and a 12 month rolling position The proportion of COPD patients who stay less than 1 day in the acute provider against SHA average and 12 month rolling position The 28-day readmission rate for COPD patients against the SHA rate and 12 month rolling position The proportion of patients receiving invasive and non-invasive ventilation against the SHA-wide proportion

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The dashboard also contains a PCT view which includes 90-day readmission rates and the proportion of the previous 12 months admissions which are accounted for by repeat admissions, among other key PCT indicators.

To complement the main COPD dashboard, a range of other tools and analyses have been developed to be viewed alongside:

mêÉëÅêáÄáåÖ=~å~äóëáë= The Seretide prescribing dashboard is an example of where, variance between PCTs in prescribing practice, can be explored. In this example, one prescription is cheaper to prescribe than the other; this dashboard displays the number of items prescribed, the associated cost, the split between the two items and the saving opportunities if all PCTs prescribed at the same ratio as the best PCT in the SHA. Taken with the PCT indicators included in the main dashboard, such prescribing analyses can provide a wide ranging view of how COPD patients are managed in the primary care setting.

`lma=é~íáÉåíë=ëÉÉå=Äó=~=êÉëéáê~íçêó=Åçåëìäí~åí= The analysis displayed here shows = the proportion of patients admitted with COPD who are seen by a respiratory consultant, shown over time against a rolling 12 month position by trust and site.

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This analysis is designed to support organisations in ensuring that all COPD patients are seen by the most appropriate specialist during their admission. When viewed alongside measures on the main dashboard, such as the percentage of patients with a length of stay below one day, this analysis helps to build up a comprehensive picture of how an organisation manages patients admitted with a COPD diagnosis.

^åÇ=ãçêÉÁKK>= In addition to the tools and analyses shown above, the COPD information suite also contains key information on current and future prevalence, years of life lost to the disease and data at GP practice level, designed to support local improvement projects. Further work on potential efficiency and quality gains in terareas such as home oxygen and ambulance conveyances has also been developed. In addition, the Quality Observatory has assisted front line clinical teams with new research, further improving outcomes and local services for COPD patients.

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_ÉåÅÜã~êâáåÖ= kÉíïçêâáåÖ= `çää~Äçê~íáçå= aÉîÉäçéãÉåí=çÑ=jÉíêáÅë= aÉîÉäçéãÉåí=çÑ=pâáääë= aÉîÉäçéãÉåí=çÑ=qççäë= pí~íáëíáÅ~ä=qÉÅÜåáèìÉë= mêÉëÉåí~íáçå=C=fåíÉêéêÉí~íáçå= a~í~=pçìêÅÉë=C=`çääÉÅíáçåë= Quality Observatory NHS South East Coast York House 18-20 Massetts Road Horley,Surrey, RH6 7DE Phone: 01293 778899 E-mail: Quality.Observatory@SouthEastCoast.nhs.uk Website: www.QualityObservatory.nhs.uk To contact a team member: firstname.surname@southeastcoast.nhs.uk

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