Knowledge Matters Volume 10 Issue 5

Volume 10 Issue 5 December 2016 Welcome to Knowledge Matters It’s Chriiistmaaaas!!!! Congratulations everybody – we’ve made it to the end of another year – and what a year it’s been for the Quality Observatory! Very busy, at times frustrating, but certainly not dull – and plenty to celebrate.

We managed to retain one of our biggest contracts (the Friends and Family Test) at the start of the year and have ended the year with another big contract under our belt – the Primary Care Enquiry Management Service and there’s been lots of very successful work undertaken along the way – Insights, Maternity Dashboard, Safety Thermometer Apps and Central Alerts cascading for the South of England, to mention but a few of the excellent pieces of work undertaken by our team this year.

It’s been all change within the Quality Observatory over the past 12 months with lots of moving about between and within the Development and Analytical teams. And in December we were all very sad to lose Kate from the QO who has now moved on from the NHS to head up Business Intelligence for the Children’s Society (more about this inside).

I’m sure we’ll still see plenty of her though, so will still be able to tap into her invaluable knowledge.

The Quality Observatory is continuing to expand, and in this issue we welcome Joe to the Programmes Team and Tao to the Development Team. Both of them have settled in well already and proving themselves to be very useful additions to the QO. In January we will also have another two Programme Support Assistants joining us—so it’s definitely onwards and upwards for the QO. There are lots of lovely articles to have a look at inside—you can read all about (previously Head of the QO) Samantha Rley’s new role at NHS Improvement, there’s a page from Kate on her new job, plus all the usual Christmas fun and news.

Have a great festive period, and in the words of a very wise man: “Look to the future now, it’s only just begun”.

Inside This Issue : Samantha Riley—new role at NHS Improvement

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Christmas Crossword

8

Ask An Analyst

12

Team Christmas Do!

4

Kate Cheema’s new role

10

Coming soon—a new regular feature

13

‘Big action, not big data’

6

Festive attire!

11

News

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twitter.com/SECSHAQO issuu.com/SECQO http://www.networks.nhs.uk/nhs-networks/sec-qo www.QualityObservatory.nhs.uk

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My new role within NHS Improvement Samantha Riley, Head of Improvement Analytics, NHS Improvement Hello Knowledge Matters readers. Long time no see!!! Festive greetings to you all!

I wanted to let you know about my new, exciting role: I recently started working at NHS Improvement as Head of Improvement Analytics.

NHS Improvement (NHSI) is responsible for overseeing foundation trusts and NHS trusts, as well as independent providers that provide NHS-funded care. NHSI offers the support these providers need to give patients consistently safe, high quality, compassionate care within local health systems that are financially sustainable. By holding providers to account and, where necessary, intervening, NHSI aims to support the NHS to meet its short-term challenges and secure its future.

Here’s a short video which explains what NHSI does https://www.youtube.com/ watch?v=CAnDJun6e0M

NHS Improvement was formed on 1st April 2016 and is the operational name for an organisation that brings together: Monitor NHS Trust Development Authority Patient Safety (including the National Reporting and Learning System) Advancing Change Team Intensive Support Teams The priority of NHSI is to offer support to providers and local health systems to help them improve.

Here’s a link to the website if you would like to learn more https://improvement.nhs.uk So, what does my new role involve?

There are a number of elements to the role.

The first involves looking at how we can increase the capacity and capability of individuals and teams to understand variation and apply measurement for improvement techniques. Clearly there are two elements to this – firstly there are analysts who need to manipulate data and secondly, decision makers (at a whole range of levels) who need to understand concepts of variation to ensure that they make the best possible decisions based on the data in front of them.

qoteam.scwcsu@nhs.net

www.QualityObservatory.nhs.uk

3 So, I continue the mission to ban poorly presented data which is, (as Knowledge Matters readers will be all too familiar with), often presented in large tables with cells coloured with red, green and amber to indicate performance. Depressingly, many Trust board reports continue to utilise this blunt, dangerous format for reporting.

Secondly, I want to ensure that we develop suites of measures and analytical tools to both help NHSI and providers across the system to understand the effectiveness of interventions that are being made to improve services. The NHS is a complex adaptive system with many different influences and interdependencies. A good example of this is achievement of the 4 hour A&E standard. There are so many factors which influence this – across many organisations. I want to help people identify the key measures that they should track as a result of making certain interventions rather than simply looking at whether performance has instantly improved. So, I want to make sure that we join up the approach to performance monitoring with improvement insight.

I will be looking to establish a national centre of excellence in the development of approaches to measurement for improvement including, data collection approaches trend, before and after, improvement tracking, management of attributable and continuous data and underpinning statistical approaches. If any Knowledge Matters readers have thoughts on the best approach for this – please do get in touch.

I will be writing regular articles for Knowledge Matters updating you on the progress that I am making and also asking for feedback and thoughts from readers. I am currently in the process of recruiting a small team so hopefully in the next edition I will have news of individuals who will be joining me on this exciting mission.

If readers have any thoughts or suggestions, please do get in touch (Samantha.riley1@nhs.net).

You can also follow me on twitter @samriley So, festive greetings everyone. Have a great break and I look forward to seeing you next time!

qoteam.scwcsu@nhs.net

info@quailtyobservatory.nhs.uk

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Team Christmas Do!

Being the innovative folks that we are, we decided no turkey and sprouts for our team Christmas dinner, and instead opted for a pub lunch followed by an all you can eat Brazilian meat buffet and cocktails in nearby Crawley. Most of the team were able to make it and even newcomers Tao and Joe came along.

There were 14 courses of meat in total—although the majority of the team managed considerably less than that. The surprising exception to this was Aleks who managed to try everything! (Note for next time—don’t fill up on salad)!

The QO Christmas Do wasn’t a complete break with tradition though and several of the team sported very fetching Christmas jumpers.

There may be a jumper that embodies the spirit of Christmas more than Simon’s does, but we have yet to find it!

qoteam.scwcsu@nhs.net

www.QualityObservatory.nhs.uk

5 We followed our tradition of buying Secret Santa gifts from local charity shops which threw up some unusual presents including a Countdown board game (complete with realistic timer clock) and a very special outfit for one very lucky member of the team.

Can you guess who is in the picture to the right? (Hint—this talented member of the team is also the Quality Observatory’s resident rapper).

We’ll post the solution in the next solution of Knowledge Matters, just in case you’re having trouble working it out!

www.QualityObservatory.nhs.uk

qoteam.scwcsu@nhs.net

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‘Big action, not big data’

By Dani Collier, Information Analyst

On Thursday 8th December I attended the Big action please, not big data event which was collaborated by ‘Kent, Surrey, Sussex Academic Health Science Network’; ‘Beautiful Information’; and of course the Quality Observatory.

The event brought together people passionate about informatics in health and social care, this varied from analysts to nurses, statisticians to operations managers and more.

The main aim of the day was to discuss how data can help improve the way in which healthcare is provided.

It was about using data in near real time and predictive way to help create closer working relations and more productive loop between informatics and clinicians, managers and commissioners. By using data, visualisation and technology, many processes can be used more efficiently.

The day began with questions about who we are and what we do in the world of data. How do people perceive us? There appears to be an understanding that people in the world of analytics do not deal well with people and are described as the following; shy, poor communicators, they are IT people that work in a back office only understanding numbers. We need to change this and become the people that others go to, to solve problems, to translate complex issues into plain speak. We need to be able to be validators and the experts in the subject.

We heard from Dr Marc Farr and Ben Rosling about the use of mobiles and push data to inform operations about the number of beds available within A&E. Dr Marc Farr also spoke about the changes made within East Kent Hospitals University NHS Foundation Trust (EKHUFT) around how to best manage their admissions by introducing an Acute Medical Unit (AMU). EKHUFT say “The AMU looks after patients who are admitted for urgent investigation or care by their GP, an outpatient clinic or the Emergency Department.

It is an innovative, modern way of treating emergency patients which means there is a rapid service, better treatment as they can receive an earlier diagnosis from a consultant and a more effective unit as quicker access to investigations and diagnosis avoids patients being admitted unnecessarily.” Using data, the Trust can measure how effective the changes made are.

qoteam.scwcsu@nhs.net

www.QualityObservatory.nhs.uk

7 There was a lot of talk about leadership and questions raised such as “Where can being an information analyst lead?”. Paul Stroner from NHS Improvement informed us that NHS England have published the ‘Developing People - Improving Care’ framework.

This framework is a national framework for action on improvement and leadership development in NHSfunded services. The purpose is to equip and encourage people in NHS-funded roles, both clinical and otherwise, to deliver continuous improvement in local health and care systems and gain pride and joy from their work. https://improvement.nhs.uk/resources/developing-people-improving-care/

Following on from this we heard from Louise Brennan from the Health Innovation Network.

Louise explained the way in which apprenticeships are funded is changing from May 2017.

Organisations will have to pay into the apprenticeship scheme even if they do not have any apprenticeships. Louise initially talked around cherry picking the best graduates to join the NHS as information analysts and the like. We soon found out there is also scope to join the scheme within our own NHS organisation to develop ourselves on an apprenticeship scheme.

With the routes of learning and how working within the NHS and Social Care with the use of data becoming clearer, there was a table discussion on setting up communities of practice amongst analytical professionals in Kent, Surrey and Sussex. We questioned how this could help ensure analytics is fully recognised for the value it brings. How would a communities of practice work? Who would lead this? What would this mean for analytics and healthcare?

The event lead to more questions than answers, but this is not a bad thing. The right questions can help us all improve things.

www.QualityObservatory.nhs.uk

qoteam.scwcsu@nhs.net

8 CHRISTMAS CROSSWORD!

Use the clues on the right hand side to fill In the festive crossword below!

The letters in the shaded squares spell out a Winter saying (solution in the next issue).

qoteam.scwcsu@nhs.net

www.QualityObservatory.nhs.uk

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www.QualityObservatory.nhs.uk

qoteam.scwcsu@nhs.net

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A move to the dark side…..dispatches from the third sector Kate Cheema, Head of Business Intelligence, The Children’s Society Is the third sector really the dark side? Maybe light grey?

Greetings from The Children’s Society (TCS)! It’s been a whirlwind couple of weeks, lots of reading and getting my head around terms like ‘unrestricted income’ and ‘multiple disadvantage’. I’ve learned a lot; in keeping with this edition’s festive theme, did you know that TCS popularised the Christingle service in the UK back in the 60s as a means of fundraising?

It’s a tough but exciting time as TCS looks to the future in an (as ever) increasingly challenging financial environment but where the needs of vulnerable young people are as acute as ever.

8 days into a new role at TCS as Head of Business Intelligence and it has struck me just how many challenges it has in common with business intelligence in the NHS. Let’s run through the checklist:

Many familiar challenges but I’ve also been struck by how enthusiastic everyone has been, both from a management and a service delivery perspective, about effective use of data and the advantages it can bring.

Watch this space for more updates from out here in the third sector! In the meantime, if you want to know more about what TCS does, take a look at http://www.childrenssociety.org.uk/ and follow the links to the data blog for some handy visualisations of some of the key issues.

Merry Christmas!

qoteam.scwcsu@nhs.net

www.QualityObservatory.nhs.uk

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The Twelve Days of Christmas (Jumpers)

We’ve pulled out all the festive stops this season in the Quality Observatory offices in Horley—the Christmas tree has been up for weeks, decorations have adorned the ceiling tiles, and the open fire has been crackling away merrily on the television in the meeting room. But the Analytics Team have been made especially festive by the addition of one analyst’s multiple Christmas jumpers/ dresses.

It loos like this member of the QO team has a different one for each day of Christmas and more to spare! A few examples of these festive delights are provided below:

So—any ideas who this tinsel-tastic member of the team is. Hint—it’s not Simon (or is it……)?

www.QualityObservatory.nhs.uk

qoteam.scwcsu@nhs.net

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CALCULATING MEDIANS IN EXCEL Application: Microsoft Excel I have a large dataset which details, amongst other things, the length of stays for several hospital spells for a number of hospital trusts, going back several quarters. The data is also split by specialty. I want to calculate the median length of stay for each provider, for each quarter, for each specialty. Obviously there is an easy formula in Excel to calculate medians—the issue I’ve got though is how to get the formula to calculate the median for the specific combination of provider, specialty and quarter without manually adjusting the formula each time—is there a way to automate this?

Solution: Complexity 2/5 — Calculating medians in Excel

The simple answer is yes—there’s always a way to automate what you want to do! Manually adjusting several thousand rows of formulas should never be an option you’d consider as you run the risk of making errors—not to mention the number of hours you’d have to spend doing this! We have suggested a better solution below.

From the information you’ve given us, we understand that the dataset you have follows the format we’ve shown below (note—for the Information Governance bods out there—the data we’ve shown below is just an example and bears no relation to actual people living or dead).

And the actual dataset you are using is approximately 60,000 rows long. There isn’t an in-built function to do this in Excel, but it is possible to do this using an array function built up of a few different Excel functions. An array formula is one that can perform multiple calculations on one or more items in a set of data, or array.

So for example, looking at the data in the first row below the column names—you would be looking to calculate the median where speciality code = 300, quarter = Dec-15 and Provider code = RN7. The formula to use is: = MEDIAN(IF($E:$E=E2,IF($F:$F=F2,IF($G:$G=G2,$D:$D))) Because it is in an array function, you will need to hit CTRL+SHIFT+ENTER at the same time, rather than just enter after you have typed in the formula—you’ll now you’ve done this right as Excel will then put curly brackets around your formula.

Basically what you’re telling Excel to do in the formula above is for each row, look for other rows in the dataset with the same speciality code, discharge quarter and provider code then calculate the median of the length of stays in those rows.

Note that if you are doing this for a large set of data it could take a little while for the formula to calculate—but definitely quicker and more accurate than trying to adjust the formula manually each time!

qoteam.scwcsu@nhs.net

www.QualityObservatory.nhs.uk

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COMING SOON, A MAPPY NEW YEAR! (Introducing Trevor) In the 2017 we’re planning an exciting new regular feature provided by Trevor Foster (pictured) and his team.

Trevor is Head of Geographic Intelligence and Mapping for South, Central and West Commissioning Support Unit and Trevor and his team will be producing an article each issue around anything and everything to do with maps.

Trevor has 30 years experience as a cartographer and GIS specialist and started his career as Military Survey cartographer where he was involved in all aspects of cartographic map production, involving such areas as mapping The Falkland Islands in 1982, liaison with Ordnance Survey in the production of UK Military Training Areas maps, and management of senior staff operational charts for the Gulf War in 1990.

After leaving The Army in 1993, Trevor worked with Intergraph UK Ltd for 2 years as a GIS developer and then joined the NHS with Avon Health Authority as a GIS Analyst. After a move for a four year period working as an application developer and data warehouse developer, he returned to the Avon IM&T Consortium GIS service.

Now with South, Central and West Commissioning Support Unit he now leads a team of GIS Analysts and Developers who provide mapping and spatial analysis services to Clinical Commissioning Groups, GPs, NHS England, Public Health, and Strategic Clinical Senates.

Trevor was awarded the runner-up prize in the international Meridian Awards in 2010 for his work around Planning for Pandemic Swine Flu, and was presented with his prize at the Insights Conference in Miami, Florida.

Trevor has led the development of the CSU’s on-line mapping portal, HealthGIS, a web-based interactive mapping tool for end users, who can visualise and interrogate their data on a map, zoom, pan, measure, draw annotations and print their own maps. Interest and take-up of this product has been extended to CCGs, NHS England and other NHS organisations around the country.

Trevor and his team have lots of exciting ideas for features in the new year, so watch this space!

www.QualityObservatory.nhs.uk

qoteam.scwcsu@nhs.net

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NEWS Planning round in full swing The 2017/18 planning round is now well underway with Commissioner plans due to be submitted on Unify2 imminently. For more details, see the news items on Unify2—there is currently a link on the front page which has all of the details.

Child immunisation and maternity risk assessment—delay in publication of the data Publications of the child immunisation and maternity risk assessment data has unfortunately been delayed. NHS England are working to set a new date as quickly as possible—watch Unify2 for more details.

Office for National Statistics—views sought from users for their Data Discovery project As part of their data discovery project, the ONS are asking users of their datasets to complete a short online survey, so they can better understand how their data is being used. The survey can be found via this link if you’d like to complete this: https://www.surveymonkey.co.uk/r/FZZ9DLQ The survey only has ten questions so shouldn’t take too long to complete.

The data discovery project aims to add some new features to the ONS website, allowing users to interact with data at lower geographical levels (for example using a single postcode instead of the whole country) and exploring datasets with multiple dimensions. If you are interested in learning more about this project, visit the ‘Getting started with Data Discovery’ page on the ONS website using this link:

Local Statistics published by the ONS The ONS have published a handy guide on where to find local statistics—this can be found here: https://www.ons.gov.uk/help/localstatistics and includes details of Official Labour Market Statistics and Neighbourhood Statistics

New and Improved Medicines Optimisation Dashboard On 1st December, NHS England launched an improved Medicines Optimisation dashboard on their website, aimed at helping healthcare professionals ensure that their patients get the best outcomes from their medicines. The Medicines Optimisation programme is aligning with RightCare, with the MO Dashboard and the RightCare resources providing a powerful ‘toolkit’ for commissioners and healthcare professionals to help achieve the best patient outcomes and value for the NHS from the medicines they prescribe.

Medicines play a vital role in improving people’s lives but up to 50% of medicines are not taken as intended by the prescriber, resulting in wasted resources and poor outcomes for patients.

In 2014 NHS England launched its Medicines Optimisation Dashboard to help inform local discussions about how to improve patient outcomes and get better value from our medicines spend.

Since then it has been evaluated and modified based on what commissioners, prescribers and other healthcare providers want to see.

The new dashboard can be found here: https://www.england.nhs.uk/ourwork/pe/mo-dash/ So take a look and see what you think.

https://blog.ons.digital/2016/11/15/getting-startedwith-data-discovery/

qoteam.scwcsu@nhs.net

www.QualityObservatory.nhs.uk

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NEWS Congratulations to Charlene

Welcome to Tao

Congratulations to the QO’s Charlene who’s daughter, Cosima, was born on 30th October 2016. The latest Quality Observatory baby weighed 6ib 5oz and all the family are doing well.

Hi everyone, my name is Taofiqiya Adelakun and I joined the South, Central and West CSU on the 21th of November and so far I have absolutely loved working here. I am a Developer Analyst and a recent graduated of MSc Web and Cloud Computing from Sheffield Hallam University. I love everything Technology; I am fascinated by new technologies and future possibilities. The fact that I get to code everyday as a job is amazing because it’s my favourite thing to do. If I am not coding I can be found reading or watching movies .My favourite genre is Sci-fi obviously :)

Team Birthdays Happy birthday to Matt in the development team, who celebrated his birthday in November.

We decided that his commute in on Southern Trans wasn’t quite challenging enough so got him a nice big bulky box of beer plus a musical biscuit tin to transport on his journey home.

Welcome to Joe Hey! I’m Joe, I’m a programme Support Assistant who joined the team on 12th December. I have worked in recruitment for the last few years and am therefore brand new to the NHS. I have started working on the Primary Care project and am very much looking forward to taking on some other projects with the team here!

Outside work I am a volunteer for the Surrey Army Cadet Force and dedicate a lot of my time to the development of young people today. Plus it’s an excuse for me to run around and get muddy! Thank you for the warm welcome and I look forward to working with you all.

www.QualityObservatory.nhs.uk

New people set to join us We have now recruited to our Programme Support Assistant vacancy within Rebecca’s Programmes Team to work alongside Joe. We were so impressed by the people who applied we decided to snap two of them up and are hoping they will both be able to join us in early January. Lisandra and Sophie will split their time between sorting out the team admin and supporting the various programmes within the Quality Observatory including Friends and Family Test, Primary Care and Central Alerts reporting. More from them in the next issue of Knowledge Matters!

New Quality Observatory mailbox and Team contact details We’ve had to move with the times and are gradually switching from using our Quality Observatory emails over to NHS.net. We have a brand new team email address now: qoteam.scwcsu@nhs.net The downside is we can’t give you a standard email format for contacting specific individuals within the team, but you can search for us on NHS.net—or just drop the generic mailbox a line. The mailbox is monitored daily so you can expect a swift reply.

qoteam.scwcsu@nhs.net

Goodbye to Kate This month we were very sad to say goodbye to Kate. Kate was one of the founding members of the Quality Observatory back in the SHA days, and will be much missed by the team. We might actually have to start researching things ourselves instead of just asking Kate! We presented her with a bottle of ‘Unicorn’s Tears’ gin and 2 Sherlock Holmes glasses. Kate has now taken up a new role as Head of Business Intelligence with the Children’s Society—and has already contributed an article to Knowledge Matters to tell us all about it (which can be found on page 10). I

Fascinating Facts

IN THE BLEAK MIDWINTER...

In the bleak midwinter, A&E will groan, with all the waiting people, each with a different moan.

OAP has fallen, trip on ice, slip on snow , In the bleak midwinter not so long ago.

The beds on wards can't hold them,'cos they are all closed, So they lay on trollies, and wait to be disposed.

In the bleak midwinter Norovirus spreads, Staff get sick and then shut up all the beds.

Matrons and staff nurses will have gathered there, Angels ready to start dispensing care, Unsocial hours, long, long shifts, day and night, Tirelessly working to set our bodies right.

What can we do to make the pressure ease?

Calling 111 or visit pharmacies, With minor ailments medicate yourself, In the bleak midwinter, take care of your health

No Christmas hits compilation would be complete without Jona Lewie’s ‘Stop the Cavalry’ but did you know this wasn’t actually written as a Christmas song originally, but was an anti-war song.

Luckily for Mr Lewie, he was able to sneak the line ‘Wish I was at home for Christmas’ in there, so wnsuring the song would be played every year. A lot!

Simon says…….

There is a village in Peru where the tradition at this time of year is to settle the previous year’s grudges with a fist fight. They can then start the new year with a clean slate.

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 E-mail: qoteam.scwcsu@nhs.net