The Development of Dementia Metrics in NHS South East Coast Background In the autumn of 2007, South East Coast SHA embarked on a Clinical Metrics Development Programme which had the aim of developing more sophisticated metrics than were currently used locally to describe a number of conditions, one of which was dementia. This work was undertaken jointly with the Information Centre for Health and Social Care. For each pathway, the Clinical Metrics Development Programme aimed to develop intelligent measures which were constructed from existing (credible) data sources, which were relevant to clinicians across the pathway and which incorporated a range of outcome measures to demonstrate quality of care along with cost effectiveness. It was intended that once a set of measures had been agreed, comparative information would be provided for organisations within South East Coast and this information would be updated on a regular basis. A group of clinicians and managers from across South East Coast met on a number of occasions to: • Identify data sets available to describe the pathway; • Define metrics which are useful; • Review analysis which has subsequently been undertaken and debate why variation appears to exist in different areas of South East Coast; • Further refine measures already defined and agree new metrics. DATA SETS RELEVANT TO DEMENTIA As expected, only a limited number of data sets relevant to dementia were identified. It has, however, been possible to provide analysis for a number of indicators which clinicians have told us are useful in prompting discussion. The work so far has focussed on utilising health data sets. It is likely that a number of social care indicators could supplement the health indicators already developed. A summary of the relevant data sets identified appears below: 1. Quality and Outcomes Framework (QOF) The QOF was introduced as part of the new General Medical Services (GMS) contract on 1 April 2004. QOF is measured by QMAS, a national IT system developed by NHS Connecting for Health (CfH). QMAS ensures consistency in the calculation of quality achievement and disease prevalence, and is linked to payment systems. There are two indicators which relate to dementia services. • The practice can produce a register of patients diagnosed with dementia; • The percentage of patients diagnosed with dementia whose care has been reviewed within the previous 15 months; 2. Programme Budget data In 2002, the Secretary of State for Health requested the collection of financial information that identifies all Primary Care Trust (PCT) expenditure, including primary care services, to programmes of care based on medical condition. This information is referred to as Programme Budgeting. One of the programme budget spend areas is organic mental health disorders which includes dementia. 3. Acute Trust inpatient data The inpatient data set enables us to know how many patients were admitted to hospital with a primary or subsequent diagnosis of dementia, what the primary diagnosis was if dementia was not the primary diagnosis, how long each patient stayed in hospital, whether they were male or female, how old they were, the PCT of residence, postcode of where each patient resides and where the patient was discharged to. 4. Mental Health Trust inpatient data The same data set as described for acute Trusts is available for inpatient stays in mental health Trusts. 5. Prescribing data Data for the prescription of anti-dementia drugs in both primary and secondary care is available, however local analysis in this area has not yet been provided due to data not being available for all commissioners and providers.
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