Knowledge Matters Volume 2 Issue 1

Knowledge Management Team, South East Coast Strategic Health Authority knowledge.management@southeastcoast.nhs.uk nww.sec.nhs.uk/knowledge

INSIDE THIS BUMPER BIRTHDAY ISSUE 1

Welcome

Fascinating Fact

Coding Corner

PbR Poser

A : Ask an Analyst

4 6 8

Skills builder – conditional formatting What’s in Andrew’s favourites? Making links – Workforce Review Team

Clinical Metrics

Data Quality

11 12 12 12

News Website statistics Peter’s diary Quick Quiz

April 2008 Volume 2 Issue 1

Welcome to Knowledge Matters By Samantha Riley

Welcome to the 1st Anniversary edition of Knowledge Matters. Over the past 12 months we hope that we have provided you with a range of informative articles, an insight into other health related organisations, up-to-date news items, links to useful tools and websites and we hope that in addition we have made you smile! I am pleased to announce that in March, the Board of NHS South East Coast approved the Knowledge Management Strategy. The strategy outlines the key knowledge management priorities for the SHA over the next 12-24 months and is available to download from our website. We now have over 200 registered users of the website – see the back page for some statistics on utilisation of the site and also to find out who has won the prize draw. The team has continued to work hard over the past couple of months and has updated existing/developed new tools. Analysis has been undertaken on the recently published staff survey results from 2007. The outpatient follow up calculator has been updated with the 2007/8 data and two additional outpatient tools have been published. The first tool enables you to obtain a speciality view of how your follow up rates compare to: all other Trusts in the country; national average and top quartile. The second tool provides a speciality view of how follow rates have changed over time. All of these outpatient tools now contain data for all Trusts in England making them of use to people outside South East Coast. A range of tutorials have been developed which will help those of you who are users of ESR. All of these tools/products are available for download from the website. Also this month, Kiran presented his workforce profiling tool at the Chief Nursing Officer business meetings in Leeds and London. We will be working with other SHAs to enable them to populate the tool with local data and cascade training to Trusts in other parts of the country.

Fascinating Fact Did you know that across South East Coast there are 15 different Job titles with the word cook in, 35 different job titles with the word chef in them and over 80 different job titles with the word catering in them?

For those of you who are more technically minded, Skills Builder On-line has a new section – the Analyst Toolkit. This contains a collection of VBA scripts for Excel and Access designed to automate some of those really monotonous tasks. Simply by copying the code into your personal workbooks you should be able to save some valuable time. Finally, it is with regret that we say good bye to Andrew Wilk who retires at the end of April. I am sure that many of you know Andrew and would like to join everyone at the SHA in thanking Andrew for his commitment to the world of NHS information and analysis and wish him well for the future. Samantha Riley

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Andrew’s Coding Corner Numbers of episodes with the following diagnoses in the first three positions in the year 2007 for SEC trusts. V95.4 - 0 V97.3 - 2 T79.4 - 4 X50 - 1103 R57.9 - 4

External Causes of Morbidity and Mortality Driving home up the A21 near Farnborough, Kent, the other Sunday, a newsflash on the car radio caught my attention. An aircraft which had taken off from nearby Biggin Hill Aerodrome had just crashed onto houses a short distance ahead. We could see smoke plumes and the first thought that flashed through my mind was… V97.3 Other specified transport accidents, including non-occupants of aircraft, person on ground injured. Coding of external causes of injury draws the interesting distinction between injuries to occupants of aircraft and those unfortunates in its path. Miraculously the house residents were away and no-one on the ground was injured, though some people close to the accident site needed treatment for shock at nearby Farnborough Hospital, - R57.9 Shock unspecified, rather than T79.4 Traumatic Shock, which would apply where shock followed on from injuries. External cause coding separates the proximate cause of the injury from the nature and location of the injury and its treatment. It is particularly useful in economic analysis, for example permitting the NHS to calculate the cost to society of treatment due to road traffic accidents, or falls in the elderly population. It can also provide an insight into the perils of modern living, such as X50 injury due to excessive exercise including marathon running, which unsurprisingly tends to occur in the run up to the London Marathon each April. Looking to the future, there is one external cause code I have yet to see in use, but I’m keeping my eye out for it just in case: V95.4 Spacecraft accident injuring occupant. “Area 51, abduction by aliens” anyone? This is the last edition of Coding Corner from me, I’m handing over the mantle Adam Cook. Please let Adam know if there are particular topics you would like covered.

Do you have something you would like to contribute to Knowledge Matters? Please contact us!

PbR Poser Here’s a scenario to test your knowledge of Payment by Results……... “A friend of mine is expecting twins soon. So far she has had six maternity related admissions to her local hospital maternity ward, 4 for ultrasound monitoring and 2 for false labour. The babies are not due yet and I saw in the local paper that her Primary Care Trust is worried about its finances. How much would they be expected to pay the Trust for her care so far, according to the local rules for Payment by Results?” Answer: four follow-up Obstetrics outpatient ward attendances at £66 each occasion and two admissions for false labour at £319 each (HRG N12). Classification as admitted care is appropriate only where a patient “requires a bed to lie down due to their general condition”. In this case, a bed was used only to carry out a procedure – a period of ultrasound monitoring – which according to the Data Dictionary is classified as outpatient care. Send your PbR queries and quandaries to us at the usual address: knowledge.management@southeast coast.nhs.uk and we will do our best to provide you with helpful advice and guidance.

Welcome to … …. the new addition of the Cheema family and many congratulations to Kate and Kiran. Kate will be returning to the team at the end of August.

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A3: ASK AN ANALYST

If you have a question for the team please e-mail: Knowledge.management@southeastcoast.nhs.uk Q – I haven’t used Unify 2 for a while and have forgotten my user name. What can I do? A – People forget things. It's human nature. Users often have too many passwords. How many passwords and user names do you have to keep track of? A typical PC user in an organisation like the NHS may have 10 to 20 passwords. If you forget your Unify 2 password or login details, simply email your username, first and last names and organisation name to Knowledge.management@southeastcoast.nhs.uk , asking for your username and/or password to be reset. It’s that easy ……. The knowledge management team will reset the password for you and email you a new password which needs to be changed on the first login. Just remember, in creating a new password, use something simple and easy to remember not forgetting that passwords are case sensitive and, specifically for Unify 2, they need to be 6 characters long.

- Peter Nyaga

Q – I have a lot of data stored in table format and I’m spending a lot of time “UnPivoting” it into a flat file format to process, is there an easier way to do this? A – Here is some code that will do that for you – simply save it to your personal workbook and use it anytime! For those of you who are registered users of the website, you don’t need to type this in – you can copy it from the website…. Sub Unpivot() startrow = ActiveCell.Row startcolumn = ActiveCell.Column startrowloop = startrow columnoffset = InputBox("Column Offset?") Range(Cells(startrow, startcolumn), Cells(startrow, 256)).Select Selection.Find("").Activate endcol = ActiveCell.Column Range(Cells(startrow, startcolumn), Cells(64000, startcolumn)).Select Selection.Find("").Activate endrow = ActiveCell.Row a = endrow - startrow b = endcol - startcolumn - columnoffset - 2 Cells(startrowloop, startcolumn).Activate For J = 1 To a For i = 1 To b ActiveCell.Offset(1, 0).Select Selection.EntireRow.Insert Range(Cells(startrowloop, startcolumn), Cells(startrowloop, startcolumn + columnoffset)).Select Selection.Copy Cells(startrowloop + i, startcolumn).Select ActiveCell.PasteSpecial Next i Range(Cells(startrowloop, startcolumn + columnoffset + 2), Cells(startrowloop, startcolumn + columnoffset + b + 1)).Select Selection.Copy Cells(startrowloop + 1, startcolumn + columnoffset + 1).Select Selection.PasteSpecial Paste:=xlPasteAll, Operation:=xlNone, SkipBlanks:= _ False, Transpose:=True Range(Cells(startrow - 1, startcolumn + columnoffset + 1), Cells(startrow - 1, startcolumn + columnoffset + b + 1)).Select Selection.Copy Cells(startrowloop, startcolumn + columnoffset + 2).Select Selection.PasteSpecial Paste:=xlPasteAll, Operation:=xlNone, SkipBlanks:= _ False, Transpose:=True startrowloop = startrowloop + b + 1 Cells(startrowloop, startcolumn).Activate Next J End Sub - Adam Cook Is there something that you wish you knew more about? To suggest future topics for knowledge matters contact the team

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Skills Builder: Conditional Formatting – Formula is In Issue 4 of volume 1, Adam Cook looked at applying conditional formatting to cell values. In this issue we are continuing with this theme and looking at the use of formulas in conditional formatting. As we saw previously in Excel 2003, it is possible to change the formatting of a cell depending on the cell content i.e. you can set Excel to change the cell background colour, text colour or text size when values are changed in the cell. You can also set Excel to change these parameters when values are changed in other cells. This can also be achieved by using the conditional formatting function. To access this function, the fifth menu along in the Excel menu bar is “Format”. Click on this and towards the bottom of the options is one called “Conditional Formatting”, choose this. You will now see the Conditional formatting dialog box shown below. By default the conditional formatting dialog box shows the “Cells value is” option. In order to create a formula, you will need to click the arrow next to the box and select “Formula is” from the drop down box. The first thing that you will notice is that there are no predefined conditions like “between” or “greater than” for you to choose from, you have to create these using logical operators (>=<) When conditional formatting with formulas you need to create a formula that evaluates to a logical value - TRUE (1) or FALSE (0) Some basic rules to bear in mind when creating conditional formats using Formulas : The formula must always start with an ‘=’ For example =A1>2 You can use a mixture of standard operators (‘=’,’ >’,‘<’,‘<=’ ,’>=’,’+’,’-‘,’/’,’*’) For Example =A1>A2 or = A1+A2=10 The formula must results in the logical values TRUE (1) or FALSE (0) And you can use functions like sum or Average For Example =A1>sum (B2:C2) You can use a mixture of Relative and Absolute cell references For example =$A1>=A2 Do you have something you would like to contribute to Knowledge Matters? Please contact us!

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“So”, I hear you ask, “this all seem rather complicated to use so why bother?” Well once you have got the hang of writing conditional formulas they can be incredibly handy to create interactive displays of your data, below are a few examples: Applying a Red/ Amber/ Green Status to an Entire row based on a data in a singe cell: Take the data set below, how would you highlight the rows which had values in column D less than 5? In this example we have selected the range and you can see that cell D6 is not “grayed out” this is the “start cell” for your formula and Excel will copy the format to all cells in the selected range. In the conditional format box select “formula is” and type: $D6 is used to keep the column reference absolute and allow the row reference to change when it is copied. Select the colour formats to apply and hit OK. You can alternatively set the format on a single cell and use the format painter ( )to apply it to the areas you want. Using custom formatting to highlight every other row. In this example we are using the same example data as above. This time select “formula is” and type Select the colour formats to apply and hit OK. Apply this format to the area you want using the format painter Using Custom Formatting to match % change between different data sets: In this example the conditional formula checks the month on month % change in each column and highlights the ones that are the same. This time type: Select the colour formats to apply and hit OK. Apply this format to the area you want using the format painter. You can use “formula is” in a number of ways not described here, you can even use “formula is” to flag deviation in a data set. The best way to get a hold on the technique is to go have a play! Things • • •

to be careful of when using formulas to conditionally format: You can apply up top 3 conditional formats and they can be a mixture of ‘cell value’ or ‘formula is’ Remember to order your conditions - Excel will stop at the first condition that evaluates true. Do not use the arrow keys on your keyboard as these will modify the cell references that you use in the formula rather than moving the position of the cursor! • Remember that when using the button to select cells for use in the formula will automatically create an absolute cell reference that will need to be changed to if you want to paste the format to other cells!

More prizes …… You may remember in the last issue we had a news item on the lucky winner of the Christmas Quiz. In addition to winning ‘Excel Charts’, Damon received a unique, personalised mug designed by the Knowledge Management team. Here’s a quote from one of Damon’s colleagues: ‘Do you remember the look on Gwyneth’s face when she received her award at the Oscars? It was nothing compared to the look of pride and pleasure on Damon’s face when he unwrapped his prize from the Christmas knowledge matters quiz’. Watch out for future competitions – you never know, next time it could be you…….

Is there something that you wish you knew more about? To suggest future topics for knowledge matters contact the team

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What’s in Andrew’s favourites? Top Tips from the outgoing Business Intelligence and Information Advisor Andrew Wilk

“What’s on your i-pod?” “What’s in your Favourites?” These are questions of modern times. What could be more revealing than those essential links that complement the ubiquitous Google Search Engine on your “Favourites”? After so many years of working in NHS information, I have a multitude of items in my favourites – far too many to cover in one article. So, this will be the first in a number of articles in which I give away the links which have underpinned my workflow, some of which may be known to you, but others may be new. Bear in mind that links may not last forever and are often the first casualty of organisational change. So to start with, here are my favourite websites which are relevant to coding and classification…………………….. NHS Data Dictionary (England) http://www.datadictionary.nhs.uk/index.asp “The NHS Data Model and Dictionary provides a reference point for assured information standards to support health care activities within the NHS in England. It has been developed for everyone who is actively involved in the collection of data and the management of information in the NHS.” The data dictionary is one of the most important sites for all NHS information professionals – it has definitions for all data items on all major datasets, and should be the first point of reference for any definitional queries. CDS Schema v6 http://www.datadictionary.nhs.uk/web_site_content/pages/cds_and_hes_indices/cds_version_cds006_ type_list.asp?shownav=1 CDS Schema v6 is the latest version of the CDS and covers the all the CDS datasets – A&E, Outpatients, Inpatients and Waiting Lists. This site lists all and mandatory and optional fields along with their definitions. Schema v6 has special relevance to coding data items along the 18-week pathway. Data Set Change Notices (DSCN) http://www.connectingforhealth.nhs.uk/dscn/dscn2007/ “The Data Set Change Notice (DSCN) gives notification of changes to information requirements which will be included as appropriate in the NHS Data Dictionary, and the NHS Commissioning Data Set Manual.” All the changes to data collections (including CDS), are listed via the DSCNs. They show where and when the change takes place, and how the change affects current practice.

Do you have something you would like to contribute to Knowledge Matters? Please contact us!

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OPCS 4.4 order form http://www.connectingforhealth.nhs.uk/systemsandservices/data/clinicalcoding/codingstandards/opcs 4/downloads/register-4.4 The OPCS Classification of Interventions and procedures has upgraded from version 4.3 to 4.4. Register with this site to download the full new code set to use as lookups, and also tables of equivalence to map from OPCS4-4.4 back to earlier releases. HRG Version 4 http://www.ic.nhs.uk/our-services/standards-and-classifications/casemix/hrg4 “HRG4 is a major revision of existing groupings to take into account complex cases and extend the scope of groupings beyond admitted care to new clinical settings.” HRG4 is the next phase of HRG coding and includes a much greater level of detail and sophistication than ever before. This site from The Information Centre helps with preparation for the transition to HRG4. HRG4 has been used for reference costing since April 07, and will be used for tariff for 2009/10. Professional Association of Clinical Coders – News and “Coding Clinic” http://codeinfo.org/paccuk/news.html Clinical coding is no longer something esoteric and obscure, the impact that is has on finances through PbR is enormous. This site keeps you up-to-date with all of the developments in the clinical coding world. Records Management Code of Practice http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_4 131747 “The Records Management: NHS Code of Practice is a guide to the required standards of practice in the management of records for those who work within or under contract to NHS organisations in England. It is based on current legal requirements and professional best practice” Information governance, and the correct handling and maintenance of patient sensitive information is of paramount importance. Download the Department of Health guidelines from this site. Finally, I’m going to finish this issue with an essential desktop productivity website: Excel Guru John Walkenbach Spreadsheet Page http://j-walk.com/ss/ John Walkenbach has forgotten more about Excel than most of us will ever know. This site has spreadsheet help and history, resources and books – and even a page with spreadsheet jokes – a geek’s paradise! I retire from the NHS in a few days, but don’t worry I have provided the team with such a long list of favourites that my presence in Knowledge Matters will be felt for some time yet……. Enjoy!

Is there something that you wish you knew more about? To suggest future topics for knowledge matters contact the team

Page 8

Knowledge Matters

Workforce Review Team By Dr Judy Curson, Director

The Workforce Review Team (WRT), based in Winchester, Hampshire, with an office in Leeds, is a national body working on behalf of the NHS in England, primarily to support workforce decision making within the 10 Strategic Health Authorities and the Department of Health. Key activities undertaken by the WRT include: •

Influencing workforce planning and development priorities e.g. via WRT’s workforce risk assessment process and workforce supply and demand models

•

Stimulating the way that NHS services are delivered by sharing evidence, analysis and best practice via review meetings, conferences and workshops, and

•

Advising managers and policy makers on how to adopt effective workforce strategies.

The Workforce Review Team consists of expert analysts, data modellers and professional advisers for medicine, dental teams, allied health professions, the healthcare sciences, pharmacy, nursing and midwifery. WRT produces over 100 workforce summaries for a range of individual medical specialties and professions. The summaries provide intelligence to the workforce planning community across England as well was individual workforce assessments on the main risks in relation to the supply of and demand for qualified staff working in the specialties and professions.

Dr Judy Curson, Director WRT

“The Workforce Review Team consists of expert analysts, data modelers and professional advisers.”

Dr Judy Curson, FFPH, is the Director of WRT. Judy has spent her career in the NHS in clinical and managerial roles including as assistant medical director at Frimley Park Hospital, as director of public health for North and Mid-Hampshire Health Authority and was a member of the Audit Commission. WRT completed a three-month review of the specialties and professions on the current Home Office Shortage Occupation List (HOSOL) for the Department of Health. The review consisted of qualitative research techniques and quantitative data collection and analysis covering all healthcare sectors across the UK. The HOSOL affords employers the ability to fast-track UK work permits in order to expedite the recruitment of overseas healthcare professionals from outside the UK/EA.

“A library of over 130 anonymised WTD compliant rotas can be searched”

The list has now been rationalised with a number of staff groups being removed. A subsequent study, identified staff groups needing to be added to the list. This final piece of work brought the HOSOL fully up to date. As a member of the Home Office Health Sector panel, WRT is committed to updating the list on an annual basis. Working in partnership with National Workforce Projects, WRT has designed a ‘rota database’ with powerful search engine capabilities. A library of over 130 anonymised WTD compliant rotas can be searched using a range of options and then used by colleagues in the NHS involved in workforce planning. The database went ‘live’ on the healthcare workforce portal in September 2007 WRT also gets involved with workforce planning at a local level, recently providing information support to some Trusts seeking foundation status and currently working with a District General Hospital to identify some options for reconfiguring their infection control team (ICT) To find out more about these and other WRT work streams visit the website: WWW.WRT.NHS.UK

Do you have something you would like to contribute to Knowledge Matters? Please contact us!

“The review consisted of qualitative research techniques and quantitative data collection and analysis covering all healthcare sectors across the UK”

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Clinical Metrics – stroke services Simon Berry, Development Analyst South East Coast SHA is undertaking an exciting programme of work to develop metrics from existing data sources that are useful to clinicians involved with stroke care. This work commenced last autumn and a wide range of clinicians from across South East Coast have met on a number of occasions to: Define metrics which are useful to them; 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 Mortality Rate by Trust and Site within 28 Days of Admission A wide range of metrics have already been agreed and Stroke Source: HES 04/05 to Q2 07/08 Provisional, Emergency Admissions, 1st Episode, 1ry Diagnosis I60-I61, Discharge Method 4 - Death analysed. These include mortality rates, length of stay, discharge destination, HRG coding, proportion of stroke admissions with a prior attendance for a cerebro-vascular condition and the percentage of patients attending A&E with a cerebro-vascular condition arriving by ambulance. All of this analysis is available to download from the Knowledge Management website once users have registered of the site (nww.sec.nhs.uk/knowledge). England Average 2006/07

Surrey

ASPH

60%

Sussex

BSUH

Frimley

60%

RSC PRH HWP

Kent

ESHT

60%

D&G

EKH

60%

Conqest

Eastbourne

50%

40%

30%

20%

10%

K&C

0405 Q1 0405 Q2 0405 Q3 0405 Q4 0506 Q1 0506 Q2 0506 Q3 0506 Q4 0607 Q1 0607 Q2 0607 Q3 0607 Q4 0708 Q1 0708 Q2

04/05 Q1 04/05 Q2 04/05 Q3 04/05 Q4 05/06 Q1 05/06 Q2 05/06 Q3 05/06 Q4 06/07 Q1 06/07 Q2 06/07 Q3 06/07 Q4 07/08 Q1 07/08 Q2

0405 Q1 0405 Q2 0405 Q3 0405 Q4 0506 Q1 0506 Q2 0506 Q3 0506 Q4 0607 Q1 0607 Q2 0607 Q3 0607 Q4 0708 Q1 0708 Q2

M&TW

WASH

Medway 60%

60%

K&S

50%

40%

30%

20%

10%

0405 Q1 0405 Q2 0405 Q3 0405 Q4 0506 Q1 0506 Q2 0506 Q3 0506 Q4 0607 Q1 0607 Q2 0607 Q3 0607 Q4 0708 Q1 0708 Q2

50%

04/05 Q1 04/05 Q2 04/05 Q3 04/05 Q4 05/06 Q1 05/06 Q2 05/06 Q3 05/06 Q4 06/07 Q1 06/07 Q2 06/07 Q3 06/07 Q4 07/08 Q1 07/08 Q2

Maidstone

04/05 Q1 04/05 Q2 04/05 Q3 04/05 Q4 05/06 Q1 05/06 Q2 05/06 Q3 05/06 Q4 06/07 Q1 06/07 Q2 06/07 Q3 06/07 Q4 07/08 Q1 07/08 Q2

A99 Complex Elderly with a Nervous System 1ry Diag

RWS 60%

04/05 Q1 04/05 Q2 04/05 Q3 04/05 Q4 05/06 Q1 05/06 Q2 05/06 Q3 05/06 Q4 06/07 Q1 06/07 Q2 06/07 Q3 06/07 Q4 07/08 Q1 07/08 Q2

A23 Non-Trans Stroke or CV Acc<70 or wo cc

Source: HES 04/05 to Q2 07/08 Provisional, 1st Episode, 1ry Diagnosis I60-I61

SASH 60%

04/05 Q1 04/05 Q2 04/05 Q3 04/05 Q4 05/06 Q1 05/06 Q2 05/06 Q3 05/06 Q4 06/07 Q1 06/07 Q2 06/07 Q3 06/07 Q4 07/08 Q1 07/08 Q2

A22 Non-Trans Stroke or CV Acc>69 or w cc

HRG Coding for Emergency Admissions with a Primary Diagnosis of Stroke

RSC 60%

04/05 Q1 04/05 Q2 04/05 Q3 04/05 Q4 05/06 Q1 05/06 Q2 05/06 Q3 05/06 Q4 06/07 Q1 06/07 Q2 06/07 Q3 06/07 Q4 07/08 Q1 07/08 Q2

This is very much work in progress. Clearly a range of models of care are in place across the patch which can explain the variation evidenced by the analyses. The stroke sub group are able to provide the local context which is critical when interpreting the data to draw conclusions.

0405 Q1 0405 Q2 0405 Q3 0405 Q4 0506 Q1 0506 Q2 0506 Q3 0506 Q4 0607 Q1 0607 Q2 0607 Q3 0607 Q4 0708 Q1 0708 Q2

04/05 Q1 04/05 Q2 04/05 Q3 04/05 Q4 05/06 Q1 05/06 Q2 05/06 Q3 05/06 Q4 06/07 Q1 06/07 Q2 06/07 Q3 06/07 Q4 07/08 Q1 07/08 Q2

WH QEQM

A19 Haemorrhagic Cerebrovascular Disorders Other

Sussex

Kent ESHT

D&G

EKH

20%

10%

0607

0708 0708

0% 0708

10%

0607

10%

0506

10%

0405

10%

0304

10%

0708

20%

10%

0607

20%

0506

20%

0405

20%

0304

20%

0708

30%

20%

0607

40%

30%

0506

40%

30%

0405

40%

30%

0304

40%

30%

0708

40%

30%

0607

40%

0506

50%

0405

60%

50%

0304

60%

50%

0708

60%

50%

0607

60%

50%

0506

60%

50%

0405

0506

Medway

60%

0304

0405

0304

0708

0607

0506

0405

0304

M&TW

WASH

0607

RWS

0506

SASH

0708

0304

RSC

0607

30%

20%

0506

40%

30%

0405

40%

30%

0304

40%

30%

0708

40%

30%

0607

40%

30%

0506

40%

0405

50%

0304

50%

0607

50%

0506

50%

0405

50%

0708

50%

0607

60%

0506

60%

0405

60%

0304

60%

0405

BSUH

Frimley 60%

0304

Surrey ASPH 60%

Further work is now underway to: Develop an SPC based length of stay tool which will enable Trusts to understand the variation in length of stay for individual patients and also the distribution of patient stays; Re-run a number of the Trust based analyses already produced to enable a comparison between sites; Combine data sets relating to patient admission for stroke at Worthing and Southlands Trust with information from the radiology system. By combining these data sets it will be possible to understand the variation in how long patients wait for CT and MRI scans

As expected, there are issues relating to the quality of data recorded within some organisations and functions. The stroke sub group will be issuing a range of guides and advice on how to pro-actively improve the quality of data where issues have been identified. This will form part of the SHA data quality improvement strategy which is currently in development. I have recently learnt of work on stroke analysis being undertaken by the Kent HIS and will be linking with them over coming months. If you are aware of additional work underway in this area, or if you would like to become involved with the programme, please contact me.

Dementia Metrics A programme of work is also underway focussed on the development of metrics to describe dementia services. Analyses have been undertaken on the following areas: programme budget spend; number of admissions and length of stay to non mental health hospitals where patients had a primary diagnosis or dementia; QOF indicators; predicted vs actual prevelance. In the next issue of Knowledge Matters, an article will be published by Adam Cook which describes the work of the dementia group in more detail. In the meantime, if you would like further details or would like to be involved, please feel free to contact Adam (adam.cook@southeastcoast.nhs.uk) Is there something that you wish you knew more about? To suggest future topics for knowledge matters contact the team

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Data Quality – the SUS Data Quality Dashboard Samantha Riley, Head of Knowledge Management Data quality is one of the key priorities within NHS South East Coast’s Knowledge Management strategy. The National Audit Office, Audit Commission and Information Centre for Health and Social Care have all published a range of documents which describe the data quality issues facing the NHS and make a range of recommendations for the improvement of data quality. Recently a number of toolkits have been launched which provide both commissioners and providers with a wealth of information to identify the areas where data quality issues exist. How many of you are aware of the SUS 18 week Data Quality Dashboard? This was launched in February and was designed to assist Trusts in preparing to report for 18 week waits on measuring Referral to Treatment (RTT), by providing data quality reports on their SUS data. The dashboard provides a range of data quality indicators for inpatients, outpatients and A&E and is a great tool to improve the general quality of data. The dashboard is currently populated with SUS data for 2007/08 Q1 and Q2. The tool is easy to navigate and can provide a graphical representation of the performance of Trusts and Independent Sector Providers against national benchmarks A colour coded dial clearly identifies areas of concern and each indicator is accompanied with a clear definition. There is also a help page which describes data sources in some detail.

A South East Coast

The dashboard is run using Internet Explorer and the file type is a shockwave file (“.swf”) file. This is available to use on the knowledge management website at: http://nww.sec.nhs.uk/knowledge/index.php?option=com_content&view=article&id=171&Itemid=137 , You can alternatively download the file for use on your local machine instructions on use and interpretation can also be found on the website. If you have any problems accessing the dashboard, please contact either Adam Cook or the Information Centre Helpdesk (enquiries@ic.nhs.uk) The Data Quality dashboard is a really useful tool which should be used to support a review of the quality of data submitted to SUS. The review should ensure that the data entered into or derived in PAS and other local systems is: • Comprehensive and covers all services managed by Providers; • Compliant with published data standards. These can be found at http://www.datadictionary.nhs.uk/web_site_content/pages/cds_and_hes_indices/commissioning_data_set_version s.asp?shownav=1 • Complete and accurate.

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Knowledge Matters

News National SUS User Group established A National SUS user group has been established with representation from Trusts and PCTs across the country. The Trust representative for NHS South East Coast is Andy Banks from the Royal West Sussex NHS Trust and the PCT rep is Laura Moogan from the Surrey HIS. Laura and Andy will provide an important link between the local SUS group which has met for some time now and national developments. BCBV indicators

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Ode to Andrew Let us raise a glass of Rosé to the incomparable Mr. Wilk It will be a long time before we meet another of his ilk. From the tumult of the NHS to a life of peace, Relaxing on a sun-kissed balcony in Nice. For many a long year he’s displayed rigour and determination, In providing our health services with first class information. Building up a picture from the details to the whole, Giving us the numbers to met each Department goal. He’s challenged the assumptions with good old solid facts, And put wayward ways of coding back upon the tracks.

Unfortunately, Quarter 3 data has still not been published. There is no definite date for this information to be published. We are keeping a careful eye on the website and will post updates on our website as and when data/further news becomes available.

Health & happiness to Andrew, he’ll be sorely missed, And have another glass of wine. I know you won’t resist*

Vital Signs

Z600**

Thanks to all organisations who submitted Vital Signs plans in the recent planning round. The Department of Health have met with the SHA to discuss these and we are in the process of feeding back comments to PCTs where required.

*what do you mean you can think of a better rhyme for missed ** Go look it up.

Following concerns raised regarding the mismatch between the timetable for LAAs and the Tier 3 Vital Signs plans, the DH have decided to extend the VSC deadline. VSC trajectories will need to be loaded onto Unify by late May – exact date to be confirmed. If you need to make any changes to your Tier 3 submissions, or have any general Vital Signs queries, please email the South East Coast planning mailbox – planning@southeastcoast.nhs.uk If your organisation’s Vital Signs/planning contacts change please could you let us know – again, via the Planning mailbox.

Would you like to work in East Sussex as part of the public health intelligence team based in the beautiful town of Lewes?

We would also like to hear from you if you have any comments on or suggestions for improvement regarding the Vital Signs process. 18 weeks All providers have recently completed an exercise to refine the ready reckoner figures used in calculating their data completeness. The Department of Health 18 weeks team are currently reviewing Trusts’ submissions and are aiming to give feedback on these in early May, after the publication of the February RTT data, showing the impact of the new figures on February data and also giving any general data completeness messages. It is expected that the revised ready reckoners will be used for the March RTT data (published 29th May) with the weekly PTL reports reflecting these in June.

And now, at last, the time has to come to conclude this ode, What better way to finish than with a clinical code.

Public Health Information Specialist Vacancy

East Sussex Downs & Weald PCT and Hastings & Rother PCT are looking for an experienced analyst with knowledge and experience of working with/in public health. Pay band 7 £28,313-£37,326 Closing date Friday 2nd May 2008 If you would like more details on this post, please contact Graham Evans, Head of Public Health Intelligence on 01273 403693 or graham.evans@esdwpct.nhs.uk For the job description and to apply please go to NHS jobs at the link below: http://www.jobs.nhs.uk/cgibin/vacdetails.cgi?selection=911988761 Note: the post is advertised separately under each PCT, however they are both for the same post that will be covering both PCTs Have you got a vacancy for an analyst??? Let us know and we will advertise it in Knowledge Matters and also alert potential applicants via our website – all free of charge …..

Is there something that you wish you knew more about? To suggest future topics for knowledge matters contact the team

Knowledge Matters

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Website statistics Since it’s launch at the end of January the knowledge management website has be accessed 4306 times and attracted 219 registered users. The site currently holds 106 articles available for review, these articles have been accessed a massive 9019 times! Among the most popular articles you seem interested in finding out about: • • •

The Knowledge Management Team; Our Work Programmes; This informative publication!

Peter’s Diary Being an analyst new to the NHS – reflections after 3 months So it is almost three months since I joined the NHS South East Coast. Having joined the NHS from a different field, it has been a steep learning curve coupled with a lot of exciting experiences. I have learnt a huge amount ‘on the job’ (also known as “Baptism by Fire”). But the first days were not all an easy ride. The memory of the first morning is still fresh in my mind where, after icebreaking and brief introductions with the team, anxiety, panic and phobia started to set in as I tried to get a grip of terminologies NHS staff around were using. Why did they have to use initials in almost everything they said?

We also have 136 files available for download. 1191 downloads have been made from the site with the most popular downloads being the 18 week RTT tools which have been downloaded 297 times making up 25% of the downloads! This is closely followed by the Knowledge Matters Newsletters which have been downloaded 172 times making up 14% of all downloads!

To get me into the tempo and rhythm of work, I took over some Unify 2 tasks (including daily sitreps – aaaghh!), learnt about SUS, HESonline, and of course updating dashboards. To begin with I was startled by how frustrating systems like Unify 2 can be, but have learnt that patience certainly is a virtue!

The site has attracted users from all over the country including London, Cornwall & Isles Scilly, Coventry and Lancashire.

Sure, an analyst's job is not “just to analyse”. I have realised that rather, it invites and in fact requires investigative skills and a wider reflection that is much needed in order to provide good quality, accurate analysis.

Knowledge Matters C/O Knowledge Management Team NHS South East Coast York House 18-20 Massetts Road Horley,Surrey, RH6 7DE Phone: 01293 778899 E-mail: Knowledge.management@southeastcoast.nhs.uk To contact a team member: firstname.surname@southeastcoast.nhs.uk

In the last issue we announced that we were going to enter the first 200 registered users of the knowledge management website into a prize draw. Having now reached 219 users we are happy to announce that the winner was Kevin Tansley (user Kevint504) from West Sussex PCT. Congratulations Kevin! You win a limited edition mug and Ask An Analyst Mouse Mat – they are winging their way to you!

Quick Quiz A manufacturing machine produces 100 pieces of drills in 30 minutes. After 1 hour, the drills are divided into groups of 4 and placed in a box. If 2% of the manufactured drills are defective, in how many ways can one select a box containing 2 defective products? 1. 3.

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4,950 119,400

2. 4.

4,753 114,660 The answer is 4: 114,660

Knowledge matters is the newsletter of NHS South East Coast’s Knowledge Management Team, to discuss any items raised in this publication, for further information or to be added to our distribution list, please contact:

Despite initial challenges, I feel that I am becoming more attuned to the NHS. In general, the experience so far has been great. Ive been faced with a variety of situations each day and they all seem to have a unique twist to them. This morning as I read information on the better use of information by “Dr. Foster intelligence” I couldn’t stop wondering who is this Dr. Foster? (I remember something from my childhood about him jumping into a puddle up to his middle…?)