Volume 10 Issue 4 October 2016 Welcome to Knowledge Matters Well, autumn has finally arrived and so we’ve decided upon a conker-themed edition of Knowledge Matters this time, which is full of the usual fun and informative stuff you’ve come to expect. However it is the first time for me in the hot seat as editor so I do hope the usual high standards have been maintained! Firstly, the award-winning QO team have done it again! Read about our collaboration with BAPEN on a new tool to help improve nutritional practices, which has won Nutritional Resource of the Year. Also for this edition, Rebecca has written a piece about NHS England’s Primary Care Web Tool and, more specifically, how the QO will be playing an important role in this. Dani has shared her experience of visiting the UK Health Show in London with Becki (there was much more to the day than just the free pens). Kate Cheema recently organised a very successful away day for everyone in the Transformation Analytics and Health Economics team, of which the QO are just one part. It was a rare chance to meet up with our other Business Intelligence colleagues in the south and Kate has written about it on page 6. Look out as well for a very special contribution from someone you may recognise.: We have the usual news towards the back of the issue, including a fond (temporary) farewell to Charlene, who is off on maternity leave. Also, not that we could ever replace her, there are introductions from our new team members, Angela and KJ. The Quality Observatory team are still continuing to expand, so if you fancy joining the most awe-inspiring analytical team ever, then get in touch! There’s a bit on page 11 about our latest trip out; just think, next time this could be you.:!
Inside This Issue : Primary Care Web Tool
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Transformation Analytics & Health Economics team away day
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QO outing
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The QO win another award!
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UK Health Show
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Ask An Analyst
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Skills Builder
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Managing To Inspire programme
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News
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Primary Care Web Tool By Rebecca Matthews, Specialist Information Manager
The Quality Observatory are pleased to have won an exciting new bid to work with NHS England on their Primary Care Web Tool.
The Primary Care Web Tool is an NHS facing website, with nearly 24,000 registered users from across the primary care community, including CCGs, NHS England Regional Teams, CSUs and GP practices. Anyone with an NHS email address can automatically register for an account with other user requests being considered on a case by case basis.
The website aims to facilitate collaborative discussions between practices, CCGs and NHS England regional teams and acts as both a tool for displaying GP practice data as well as collecting data for a number of mandatory data collections by GP practices, namely the GP Extended Access Collection, annual declaration, the annual complaints data collection and the workforce returns run by NHS Digital.
The General Practice Outcomes Standards module on the website utilises data from several different data sources including QOF, NHS Business Services Authority, Exeter systems and the GP Patient Survey, to populate a set of Quality Improvement indicators for GP Practices. These indicators have been agreed with the profession and all its stakeholders and include details of practice demographics and catchment areas, clinical indicators and secondary care activity. Indicators show a comparison to England and other practices so practices can easily see how they compare to the rest of the country.
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The General Practice Higher Level Indicators module allows the user to view a number of indicators at CCG and practice level, based around the CCG Outcomes Framework domains of premature mortality, long term conditions, recovery from illness/injury, patient experience and patient safety. All indicators show a comparison to the national average.
The Programmes Team within the Quality Observatory will be assisting the Primary Care Web Tool Team with managing their mailboxes, fielding queries about the data collections, issues with logging on to the website and anything else that users of the site want to email in about. We are very much looking forward to working with NHS England on this project and applying the methods we’ve perfected with the Friends and Family Test helpdesk to getting the mailboxes organised and helping users to access and use the Primary Care Web Tool. Please do get in touch with us if you’d like any further information!
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Nutritional Resource of the Year! By Kate Cheema, Head of Transformation Analytics September 28th found Kate and Kiran hobnobbing with the great and the good of the Nutritional Care world at the Clinical Nutrition Awards, recognising excellence and achievement in clinical, medical and health nutrition. The awards are a real mix of NHS and industry focussed achievements, ranging from ‘Coeliac Professional of the Year’ to ‘New Product of the Year’. We were up for ‘Nutritional Resource of the Year’ for our work with the British Association of Parenteral and Enteral Nutrition (BAPEN) on a data collection tool that organisations can use to monitor and improve their nutritional practices in areas such as nutritional screening and patient experience of receiving nutrition.
It was lovely to be invited to be part of the team receiving the award; very often as analysts and developers we don’t get to see the final results of the tools we help to build! In this case we were very much part of the team and we’re looking forward to building on our work with BAPEN so far, to continue to enhance the tool and undertake clinically meaningful analysis of the data collected through it. Just a few statistics to finish on; so far 4,745 patients have been surveyed using the tool, with 85% reporting that they have received all the food and drink they have needed. 80% of surveyed patients were screened using MUST on entry to their care setting, although only 72% were rescreened at an appropriate interval.
A whopping 49% of surveyed patients were deemed as being at risk of malnutrition on their entry to the care setting; whilst there may well be some bias in this figure (as many organisations choose to use the tool in higher risk specialties) this still serves to highlight just how prevalent malnutrition can be in patients in our care, and the importance of getting their nutrition right at a time when they are most vulnerable.
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Create a dynamic list By Dani Collier, Information Analyst •
Using organisation types as an example, first create a fixed list combining your different organisation types in columns D and E
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Name the organisation type in Column B
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From 1 onwards, number your organisations depending on type. Make sure your list is in Org_Type order Create a Unique ID in column A by concatenating the Org_Type & Number •
Create a list of the different organisation types and use a combo box
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In a fixed cell, create a VLOOKUP to this list that will change depending on what is selected
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Create your dynamic list by creating the following columns: Lookup, Number, Org_code, Org_Name
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Number the ‘Number’ column from 1 onwards. Ensure this list contains the maximum number of different organisations you have; for example if Local Authority (LA) has 257 different organisations within it, CCGs have 150 and Trusts have 25, your list should be numbered from 1 – 257. •
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Your ‘Lookup’ column should be a formula referencing the ‘Selected Type’ cell and the fixed number. This will create a lookup to search for the ‘UID’ in the fixed list
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Using the ‘Lookup’ code, use VLOOKUP to search for both the ‘Org_code’ and ‘Org_name’. Use this nested in IFERROR to return a blank cell if the lookup is not found.
Examples of each list are shown below.
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Transformation Analytics & Health Economics Team Away Day By Kate Cheema, Head of Transformation Analytics The QO team was delighted to be part of the Transformation Analytics and Health Economics all team away day in early September. The QO team are a key part of the TA&HE sub-directorate which numbers almost 50 people overall, based across the South Central and West CSU patch. The day brought together teams from Bristol, Eastleigh, Reading and Devizes (and a few other places in between) to get everyone up to speed on the latest developments and what’s coming over the horizon. Sarah Scobie, Associate Director of Transformation Analytics and Health Economics, kicked off the day with an overview of what the team has achieved so far and an outline of how our environment is changing, especially in light of the emerging STPs. Sarah also exhorted people to ‘blow their own trumpets’ more, celebrating the good stuff and showing the world more of what we can do! The most important part of the day was to help teams get to know each other better and start to build a knowledge of ‘who can do what’ across the wider team. To this end there was a skills gap analysis (using stickers!) to help understand where our ‘Development Divas’ are and where we might need some more ‘Excel Ninjas’. Working in teams, we were then asked to develop analytical plans around a new and exciting technology, the iDoc, using all the skills we had identified earlier in the day. Through a range of group work and a leisurely lunch time of a whole hour (what luxury is this!) teams really had an opportunity to get to know each other and exchange knowledge and skills. Looking to the future it is becoming more and more critical that, as a wider team, we are able to mobilise the staggering range of skills and experience we have within our teams quickly to add value to our customers and continue to develop each other. Also as part of the day, Kate asked each of the ’sub-teams’ to come prepared with a short overview of their work which was to be presented to the rest of the teams. From the QO, this meant something from both Kiran’s Development team and Simon’s Analytics team. Everybody was given the basic rules of: • • •
no more than 3 minutes a single slide only if using PowerPoint any method allowable, including the medium of modern dance
Just to give you a flavour of the kind of things we were treated to; one team called out a long list of skills and
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7 all stood up each time they could lay claim to one of them, while another incorporated children’s toys into their presentation. Kiran took a more conventional approach on behalf of the QO Development team and, with Simon himself being away on holiday, it fell to “Crawley’s only west country rapper” to do the honours for the QO Analytics team. Yep, the legendary MC AC (aka Adam Cook) came out of retirement to bust a rhyme and, since we think everyone would appreciate re-living such a special moment, here is the rhyme he delivered so beautifully: A very good morning and welcome to you, We're the Quality Observatory Analytics crew. There's Simon B. at the top of the tree Working on stroke and databases Making sure the data is in all the right places. Next down the line is a team of three, There's Nikki, Rebecca and Adam - That's me! Me and Charlene are the Projects team We're the go-to people for every fresh new scheme. We'll start up projects and see them through, We'll put data in dashboards and on websites too. We've been supporting mental health and maternity, The clinical networks and some patient safety. There's the Analytics team headed by Nikki, With Becki and Dani - they do the jobs that are tricky. They harvest the data that needs collating, and plug in the numbers when dashboards need updating. They're providing support on clinical pathways, Guiding Vanguards and STPS through the logic models maze. Rebecca looks after the Programmes gang Where Liam and Trishna get to do their thang. For guidance and support they're the best, Doing CAS alerts and the Friends and Family Test. Then there's the cancer work that keeps them going, They won't stop now 'cos the team is growing. We've a whole lot of clients from around this land, Let's start with NHS England if that's not too grand. Clinical Networks and AHSNs, CCGs are among our friends. We also do stuff for the CSU, 'Cos we're the Quality Observatory Analytics crew.
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UK HEALTH SHOW By Dani Collier, Information Analyst On Wednesday 28th September 2016, Becki and I attended the UK Health Show at Olympia, London. This was the first time either of us had attended one of these shows and did not really know what to expect.
The event featured five leading healthcare shows; Technology, Commissioning, Procurement, Estates, and Cyber Security. I was mostly interested in the Commissioning shows so I attended a couple of presentations in the conference theatre. I was lucky enough to watch two presentations: ‘NHS Commissioning Strategy – realising our 5YFV commitments’ by James Sanderson (Director of Personalisation and Choice, NHS England) and also a panel discussion ‘The Five Year Fast-forward View: what will commissioning look like in 2021?’ with Julie Wood (Chief Executive, NHS Clinical Commissioners), Michael Bell (Chairman, Croydon Health Services NHS Trust), James Sanderson and chaired by Dr Phil Moore (Chair and Deputy Chair Clinical, NHSCC Mental Health Commissioners Network and NHS Kingston CCG).
These were both really interesting and spoke about the challenges or ‘three gaps’ the NHS faces. The three gaps are: Health and Wellbeing, Care and Quality, and Finance and Efficiency. I could see how much work the Quality Observatory, and South, Central and West CSU have done to help the wider NHS try and succeed in this vision. There were talks on Sustainability and Transformation Plans (STPs) and Vanguards. There were also talks about Personalisation and Choice, which included information about personal budgets and how this has been working in maternity services. All of this work has been mentioned by our great team in previous issues of Knowledge Matters.
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I was also able to attend a couple of other presentations in the HETT Conference Theatre. They were ‘Improving information governance - Building public trust in the use of data’ by Professor Martin Severs (Member of National Data Guardian’s Panel) and ‘Improving patient outcomes through better information governance’ by Professor Martin Severs, David Hodson (Head of Information, East and North Hertfordshire CCG) and Nicola Perrin (Head of Policy, Wellcome Trust).
The main theme of these was around how little knowledge the public has about the use and sharing of data. The general consensus is that the public want to support their care being improved but are not comfortable with their personal information being shared. This obviously causes problems for organisations trying to use data (even anonymised) to make improvements. The lack of public knowledge around data can cause issues for the patient, such as patient A going to the GP feeling unwell and 5 days later turning up to A&E. Patient A is likely to not understand why the A&E team do not have access to his notes:.
There was a lot of talk about organisations working together and the difficulties of sharing data. This appears to be an ongoing concern for many teams and it doesn’t look like it will get much easier anytime soon unfortunately.
After lunch we were unable to get into any more talks as they were all booked to capacity! Instead this gave us a chance to have a wander around the venue and see what others had to exhibit. There was a huge variety of stands, most of which were aimed at providers of healthcare and Clinical Commissioning Groups. The main theme appeared to be around technology and getting providers on board with electronic notes and the quick collection and analysis of data etc.
Overall it was an interesting and informative day out with lots of leaflets, highlighters and pens to take home. I look forward to the UK Health Show next year.
Useful links UK Health Show - http://www.ukhealthshow.com/ Latest IG News - http://systems.digital.nhs.uk/infogov/iga/news NHS England: 5 Year Forward View - https://www.england.nhs.uk/ourwork/futurenhs/
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Managing To Inspire By Nikki Lawford, Specialist Information Manager Being relatively new to managing actual people, when the opportunity arose earlier this year to sign up for a programme called Managing To Inspire, I decided to apply. The programme is being run by our esteemed commanders-in-chief, South, Central and West CSU, and is designed to help develop self-awareness, enhance personal skills, increase confidence, and enable different ways of working. Following a fairly rigorous application process, I was fortunate enough to be accepted onto the programme along with 12 other colleagues from across the CSU who also want to learn about what it takes to be an effective leader. The programme is being led by Anthea Aristotelous, Organisational Learning and Development Lead for the CSU and, as a group, we’re a fairly diverse bunch from a variety of different backgrounds and service arenas. There are five sessions taking place over the next few months and we met as a group for the first time in September in Bristol . Over the day we looked at the types of cultures and values that exist within teams and organisations, contrasting leadership styles and the different roles people can play within a team, as well as things like emotional intelligence, dealing with negativity and toxic leadership! There was also an exercise called ‘Why should anyone follow you?’ - yep, fair point! It was a rather enlightening day for some, but we all agreed that improving understanding of yourself and others is a really useful place to start when hoping to improve the way things are done within a team. Before we meet up again in November, there are various assignments to be done, including undertaking a 360 degree assessment - so there could be some more revelations there! In addition, we have each been assigned a mentor to help guide us throughout the process, so we will all be arranging to meet up with them, and their advice and support will no doubt be invaluable. The group are all in agreement that it’s been a fine start to the MTI programme; an opportunity to meet with like-minded people, whose paths may not otherwise cross, to talk about how things are done elsewhere, exchange honest opinions and hold constructive conversations about things that affect us all. We’ve used some tried and tested models but also been encouraged to incorporate our own opinions and insight to determine what kind of leader we want to be, to challenge the status quo and continue to develop ourselves and others within our team.
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The team have a shot at crazy golf Regular team bonding is par for the course at the QO and last month the team decided to ‘putt’ the dashboards away for a bit and headed off to Swingers - The Crazy Golf Club in London. Many of us were novices to the art of swinging a golf club but gave it our best shot anyway. By and large, we all found we weren’t too bad at it, and Adam actually managed a hole in one! After a thoroughly enjoyable 9 holes, Becki cheerily advised Dani that she was the winner:. based on the fact that she had the most points! Dani, unsurprisingly, didn’t look so impressed and had to inform her that that actually meant she had come last. It turned out the winner was in fact Nikki, who was as stunned as anyone to hear that. Here are a few action shots of the team doing their stuff:.
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Adding in an add-in! Microsoft Excel I know there’s some statistical tools in Excel that I can use, I’m sure I used them in earlier versions of excel, but I can’t remember where they are, or how to get at them—can the QO help?
Solution: Complexity 2/5 — How to add-in an add-in Fortunately, you’re in luck I know exactly what you’re talking about, because I’ve had exactly the same problem recently. These days I’m working mainly in Excel 2010—only a couple of versions out of date then—and I had to do a bit of work where I needed the functionality of the Analysis ToolPak. This is a funky little suite of stuff that can do a number of useful statistical calculations without the user having to put too much effort into working out the intricacies of various formulae. I remembered that the Analysis ToolPak was an add-in, and in earlier versions of Excel it could be accessed via the tools menu. Add-ins was an option under there and from there you could install it, and other add-ins. So I went into 2010—and firstly there is no tools menu, after a brief moment of panic I noticed that there was an actual Add-ins menu option. This was going to be easy! So clicked on that menu—and the picture below was what I was faced with:
Nothing there apart from some Bluetooth option that I’ll never need. I was not to be deterred and decided to investigate further. I clicked on the menu options, in reverse order eventually ending back up at the File menu, where, to my delight there was an Add-ins option halfway down the page— Result! No—not really, this was just another way of accessing already installed add-ins—an alternative to the earlier menu options. Did I give up? No, dear reader I did not, something made me click on the Options button, just below the Add-ins on. This brings up an
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13 Excel Options pop-up box, and part way down this box is an Add-ins option. Clicking on this takes us to the very place that I’d been searching for the options to install Addins to excel. Analysis ToolPak was there on the list, so I highlighted that and clicked OK—nothing happened. I clicked around my spreadsheet for a bit, with a feeling of despair and hopelessness, until I came back to the Add-ins dialog box.
Down the bottom of this box you can see there’s a section labelled Manage, with a button labelled Go. More out of curiosity than hope I clicked this button, et voila!
Up popped what I’d been expecting all along—a little box listing which Add-ins were available to be installed. So I clicked Analysis ToolPak and hit OK. This time something seemed to work, and once the little spinning icon had stopped spinning, I went back to the Add-ins menu, and absolutely nothing had changed. So, knowing when I’m beaten I gave up. After sometime working in Excel I noticed that I had a new option under the data menu. It was labelled data analysis, I clicked on this and the Analysis ToolPak dialog box appeared. So the Add-in had been installed—just not where I expected it. So don’t be disheartened the Analysis ToolPak , amongst other useful add-ins, is there and can be found and installed (eventually!)
There are a variety of add-ins available, some already there and others that can be gleaned off the internet, and they can be used to do many exciting and complex things, and we will look at some of the functions of the Analysis ToolPak in greater detail in future issues.
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NEWS NHS Shared Planning Guidance released NHS England and NHS Improvement have now published this year’s operational and contracting planning guidance.
Information Governance Alliance Conference The Information Governance Alliance are holding their conference on Tuesday 22 November at Edgbaston Stadium in Birmingham.
For the first time, the planning guidance covers two financial years and is underpinned by a two-year tariff and two-year NHS Standard Contract. It provides local NHS organisations with an update on the national priorities for 2017/18 and 2018/19, as well as updating on longer term financial challenges for local systems.
The conference is free to attend and is aimed at leaders with responsibilities for or an interest in information sharing. Dame Fiona Caldicott will be the keynote speaker and the theme of the day is implementing the findings of the National Data Guardian review.
NHS Improvement Single Oversight Framework - initial segmentation of acute trusts indicates concerns
Calling all budding analysts and developersC. fancy a new challenge?
The Single Oversight Framework (SOF) was launched in June by NHS Improvement and is designed to help NHS provider trusts achieve and maintain a CQC rating of Good or Outstanding.
Have you ever read Knowledge Matters and thought to yourself “I wish I could be a part of that rather splendid team”? Well, maybe you could:.
Using five broad themes of quality of care, finance and use of resources, operational performance, strategic change and leadership and improvement capability, trusts have been segmented into one of four categories according to the level of support needed. According to a shadow, or indicative, segmentation of provider trusts which has just been released, over half of acute trusts have been designated as either requiring mandated support for concerns about breaches of their licence or needing to go into special measures. The first formal segmentation is due to be released in November. You can download the results here: https://improvement.nhs.uk/resources/singleoversight-framework-shadow-segmentation/
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Being one of the bestest analytical teams around (if we, erm, say so ourselves), we are always finding ourselves to be extremely busy and lately have found the need to expand at a fairly rapid pace. We’ve already taken on several newbies recently and are often recruiting for more, so if you fancy working with an award-winning team of analysts then get in touch! We know what you’re thinking – QO Towers seems so far away and where the bloomin’ heck is Horley anyway?! Well, don’t let that put you off. We’re nothing if not adaptable so even if you don’t want to see all our smiling faces every day, it doesn’t necessarily mean you can’t be a part of the team. If you’re interested, then just write to us at info@qualityobservatory.nhs.uk
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NEWS Say hi to the newest members of the Quality Observatory, Angela and KJC. Hello All. I’m Angela Chung and I joined the team on 26th Sept. I’m an ex South West CSU employee and have been based in South Plaza, Bristol since 2010. I have transferred from the Data Services Business Intelligence Team. In my previous role I managed the BI reporting team and portal in the West, and was an operational lead for the new Intelligence Point portal – working collaboratively across the CSU to migrate the BI portals.
Birthdays It’s been a busy time for birthdays since our last edition. Becki and Nikki both had their birthday in September and received various presents from their team mates. As you can see below, a bit of a theme occurred:
My work involvement spans from maintenance of systems to project development, most recently NDPP (National Diabetes Prevention Programme) a collaborative project with NHSE and PHE to prevent pre-diabetic people from going onto develop Type 2 diabetes. I lead on the co-ordination of reporting and sharepoint site.
Hi, I’m KJ, Senior Web Developer, Graphics Ninja, Supercar lover, Gadget freak, gym dude and Dad to a 3 and 5 yr old. Hailing from what was South CSU, I’ve been working with the NHS since 2009 and have seen it change almost as many times as I change my beard wax brand. I’m currently working on web projects for North East Hampshire Farnham CCG, West Hampshire CCG, Southampton City CCG and Portsmouth CCG. I look forward to working with you all! KJ
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And it was a special one for Dani, who turned 30 in October. The rest of the team have been doing their best to persuade her that she’ll be OK and that life does indeed go on beyond your twenties, however she remains unconvinced! She chose to celebrate in sunnier climes with a long weekend in Turkey and returned to find a few things waiting for her from her QO buddies:.
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Goodbye Charlene It doesn’t seem that long ago that Charlene left us before – she went off for an extended trip around the world, taking in almost all the continents and visiting exotic and exciting parts. Well she’s off again, and this time for an adventure that’s even bigger, more thrilling, more scary, but ultimately even more rewarding – she has left for maternity leave. At the QO we are all delighted by her impending motherhood, we all know how good she’ll be at it from her experiences looking after her nieces and nephews. We hope that you’ll join us in wishing her a safe and happy birth, and sending all our love and best wishes to Charlene, Stuart and their new baby.
THE JOY OF CONKERS
Fascinating Facts
There they are on the ground,
Until conkers arrived in Britain in the 1600s, the game conkers was played with hazelnuts, cob nuts or even snail shells!
Green and spikey, ready to be found. Don't get pricked when you open the case, Polished and smooth and ready to lace. Grab a drill, grab a gimlet,
Extracts from horse chestnuts have been used to treat malaria, frostbite and even ringworm.
begin to bore a little inlet. Make the hole straight and thin, then thread it on a piece of string. Knot the end - nice and tight. Now you're ready for the fight. Stand quite still, taking aim, Hit it hard is the game. One-er, two-er, three-er - more, Tally up and keep the score. Crashing, smashing, it's all bonkers, Welcome to the joy of conkers.
Simon saysCC. In these days of ever tighter regulation and restriction of the information and analytics within the NHS, you have to wonder whether people creating and feeding the bureaucratic hell have lost sight of what’s actually important; improving care and outcomes for patients.
Knowledge matters is the newsletter of NHS Quality Observatory. To discuss any items raised in this publication, for further information or to be added to our distribution list, please contact us. Hosted by: South, Central & West Commissioning Support Unit
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To contact a team member: firstname.surname@qualityobservatory.nhs.uk