Knowledge Matters Volume 3 Issue 4

Volume 3 Issue 4 October 2009 Welcome to Knowledge Matters Earlier this month we had our first ‘Meet the Quality Observatory’ session which provided an opportunity for the Quality Observatory to explain the support that we can offer. We also provided an overview of current and planned developments over coming months. Our intention is to provide the local NHS with tools which are as useful as possible and add value to local work—to do this we need your ideas and input!! The next session is 21st January 2010 12.30-14.30.

E-mail suzanne.gregg@southeastcoast.nhs.uk to book your place.

In this issue we launch our on-line QOF tool (see page 7)- there is huge potential to increase the functionality of this tool. The team would be really grateful if you could have a look on-line and provide us with feedback. This month we also launch our World Class Commissioning Outcomes tool which we hope will assist PCTs establish trajectories for their chosen health outcomes (see page 5).

We have developed over 70 tools and benchmarking products and I am conscious that its difficult to keep track of what is available. To make it easier for you to access tools that are useful to you, we are currently developing a catalogue of products. This will be available in November along with our new website which will be totally restructured and easier to navigate. We’ll provide further details on both of these developments in the December edition.

Finally, the closing date for bids to the Regional Innovation Fund is 31st October 2009. If you require any support with the identification of appropriate metrics for your bid, please email quality.observatory@southeastcoast.nhs.uk .

Happy Halloween!

Inside This Issue : Enhancing Quality Programme

2 Quality Accounts

6

Skills Builder - linking external data sources in excel

Quality Observatory website

4 QOF Tool

7

Skills Builder - date transformation 14 functions

World Class Commissioning Outcomes Tool

5 NHS Comparators

8

News

A3: Ask an Analyst

10 Fun Fact, Quick Quiz, plus more!

http://nww.sec.nhs.uk/QualiityObservatory

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15 16

Page 2

Enhancing Quality Programme, live across Kent, Surrey & Sussex

By Kay MacKay, Director, Enhancing Quality The Enhancing Quality (EQ) Programme in South East Coast will be having its official launch soon – watch out for publication of the date or email kay.mackay@westsussexpct for more information.

This PCT Alliance sponsored programme takes its starting point from the innovative work done in North West SHA and we will be collaborating with this and two other SHA areas to join up our learning and development.

Whilst we are accountable to the PCT Alliance, we also report to the SHA Quality Board to ensure we dovetail into the whole quality agenda.

What is it?

Essentially it is a clinical change programme which uses triangulated information to drive quality improvements in clinical interventions; patient reported outcomes and patient experience. An incentive system through CQUIN will recognise and reward providers to deliver reliable care for their patients every time.

One of our clinical colleagues in the North West said: “This was the first time in my career that I had seen clinically meaningful information about my patients, information that I trusted which showed me that we could and should improve”

The programme has three work streams: -

•

Acute pathways for heart failure, hips and knees, community acquired pneumonia and heart attack;

•

Rolling out the heart failure pathway to include primary and community care services;

•

Developing a new pathway in dementia.

Why is it important?

The baseline information from the North West shows that despite what you would think – many patients were not always receiving the interventions that would maximise their recovery and health – there is no reason to believe that we are any different in South East Coast, in fact we already know from the work of the Quality Observatory that there are huge variations across the patch. (See Using Data to Evidence Innovation and Variation August Knowledge Matters) EQ aims to streamline care, improve documentation, and generally make the care provision more consistent and reliable – every time for every patient. We know that reliable care will yield higher quality clinical care, better outcomes and lower costs.

How does it work?

Using international evidence, a set of clinical indicator metrics are agreed with clinicians across SEC. These are the interventions known to have the greatest impact on optimising patient outcome. You may well say that this is nothing new and you would be right – we’ve had NICE, NSFs and other initiatives but EQ is different – it then goes on to measure and report whether each and every patient received that appropriate care at the right time.

Once the required metrics are defined and agreed, all providers must have an efficient mechanism to collect and submit the data, as well as review individual and comparative results. A standardised data collection and reporting tool will be made available to all provider organisations. We are looking to see if we can find innovative solutions to the data collection to make it easier for clinicians to record the necessary information as part of their clinical care – this is subject to a bid for additional funding.

Page 3 Patients meeting the criteria for each pathway can be identified using algorithms from SUS data. In this way, each Trust can provide the data required for those patients into the standardised tool..

At any time, the Trusts can review their performance in the tool.

Once the information is collected it is benchmarked against other providers, nationally and internationally, enabling clinical teams to see where they can improve their patient care.

EQ will support providers to improve with Lean and other quality improvement tools, such as:

•

Capability training through education sessions (in person and online);

• Topic specific webinars and focused interventions aimed at driving rapid cycle process change for specific indicators and interventions; Collaborative Learning Series designed around clinical pathway to bring providers together to share knowledge and improvement tips;

• •

Web-based Performance Improvement portal – a collaborative knowledge transfer tool and online library;

• Bespoke consulting improvement

short term advisory services to support poor performers develop approaches to

We will use the power of the collective knowledge and experience of Trusts and providers and will leverage this to drive service improvement and quality outcomes through a collaborative approach supporting providers to drive improvement and knowledge transfer.

Capability, Capacity and Clinical Leadership We are procuring an external partner to provide us with the capability and capacity to deliver the programme. The tender evaluation process has involved many clinicians to ensure that our selected partner has the appropriate skills and abilities to work well with our clinical colleagues. We will be announcing who has been awarded the contract very soon.

To ensure that clinical leadership is core to our programme, our team will consist of clinicians. Our Clinical Director is Rams Ramanan MD FRCS MBA, and we are looking for clinical leads for each pathway and GP leads from each County. If you know of anyone who would be interested – please contact me.

We will keep you posted on our progress and look forward to working with you all on this exciting programme.

Kay Mackay Director Enhancing Quality Kay.mackay@westsussexpct.nhs.uk

Page 4

Quality Observatory website

By Charlene Atcherley-Steers, Performance Analyst

www.qualityobservatory.nhs.uk The new national Quality Observatories website is now online .

The website is hosted by the South East Coast Quality Observatory and is the first stop for anyone wanting to know more about the Quality Observatory in their area.

It is accessible to everyone—even those outside of the NHS. The site contains a page for each of the 10 regions in England as well as a page dedicated to other organisations that provide data or services for the NHS. To access information about an area you can either click on the name in Area Pages contain: •

Information on the number of Trusts and PCTs in that area

•

Maps of trust locations and PCT boundaries

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links to the SHA website(s) for that area

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Links to the area’s Quality Observatory (if available)

•

Links to the Public Health and Government Offices for that area.

The information on other organisations can be access via the Related Organisations tab on the top menu and includes site preview images to let you know what to expect when you click the link!

Check it out today!

Feedback comments & suggestions to: quality.observatory@southeastcoast.nhs.uk.

Page 5

World Class Commissioning Health Outcomes Tool

By Katherine Cheema, Specialist Information Analyst Year two of the World Class Commissioning programme was officially launched on the 16th September 2009.

The WCC assurance framework looks at ten health outcomes measures: • two are mandatory, • eight of which are picked by the PCT to reflect their key strategic priorities in delivering and improving services for, and the health of, their population.

This year, PCTs' are expected to submit 5-year ambition trajectories for each health outcome they have chosen.

To help with this the Quality Observatory has developed a WCC Health Outcomes Tool designed to help PCTs' decide on the levels at which to set ambitious, achievable trajectories.

Features: Excel Based Dashboard Style Displays Historical Data Creates Trend Forecast Data points Interactive Forms allow users to: • choose eight local measures • input plans for 2009/10 -2012/13 Automatically plots Plan Data Includes Benchmark Data where available (national, regional and ONS cluster) User control of Benchmark display

The tool is available for use right now and can be downloaded from the Quality Observatory website.

The tool will undergo revisions as data sources are updated nationally and final definitions are published.

Before the analytical phase of the WCC assurance process the Information Centre’s data pack will be ‘frozen’.

At this point, the WCC Health Outcomes Tool will, if required, be updated to reflect the final national figures for use in PCT assurance.

For more information please contact: Kate Cheema — Katherine.cheema@southeastcoast.nhs.uk

Page 6

Quality Accounts

By Dr Karen Noakes, Quality Accounts Lead Quality accounts are about making quality matter as much as money.

To help make quality information available, we will require in legislation, healthcare providers to publish Quality Accounts just as they publish financial accounts, thereby making quality matter as much as finances.

From April 2010, all providers of acute health care – including all foundation trusts, NHS acute trusts, mental health trusts, learning disability trusts and ambulance trusts - will be required to publish a Quality Account, with primary care and community services following suit in subsequent years.

Quality Accounts, first set out in High Quality Care for All, the final report of the Next Stage Review, will put improving quality at the top of every Board’s agenda allowing patients, the public and commissioners to hold organisations to account.

The content of Quality Accounts has been designed and tested in partnership with NHS staff and stakeholders, and we are currently running a consultation on our detailed proposals. This will be live until 10th December 2009. To take part, please access the consultation document at – www.dh.gov.uk/qualityaccounts - and respond via the dedicated mailbox QualityAccounts@dh.gsi.gov.uk The proposals will see Quality Accounts focus on a select number of crosscutting statements from the board containing prescribed information, which relate strongly to the drive for quality improvement. Boards will then be free to determine the rest of the content, drawing on nationally and locally validated indicators to underpin their narrative and giving a fair and rounded picture on quality.

Many NHS organisations have already started preparing for next year. To help this process, we are working with DH and NHS colleagues to develop a toolkit. This will include information on what a Quality Account might look like; who should help you decide what goes into a Quality Account, making sense of information, and the role of patient organisations to name just a few topics for inclusion. The toolkit will be available from February 2010.

We have also started working with colleagues in NHS North East and NHS East Midlands to design Quality Accounts for primary care and community services providers with the aim of introducing them from 2011.

If you have any further queries for the Quality Accounts team, please contact us at QualityAccounts@dh.gsi.gov.uk

An example quality account is available to download from the Department of Health website—here’s the link http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_097598

Page 7

Quality and Outcomes Framework (QOF) Tool

By Kiran Cheema The Quality Observatory have developed an on-line QOF Data Benchmarking Tool!

Current features are as follows: •

Utilises national QOF data tables ;

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Provide practice benchmarking ;

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Shows actual achievement against total not just achieved points ;

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Provides achievement ranking against PCT/SHA/ Country and ONS categories;

•

Calculates centiles , Means, Medians & Modes.

We are planning many more features—more in future issues!

To the right is a Screen Shot of the Practice level Tool in its current form.

Future developments will include aggregate PCT level information and financial costing estimates.

What else would you like to see? Tell us what you NEED! To make the tool as useful as possible we need people to log on, have a look and leave a message!

The tool is available for you to use Now! Go to the Analytics Online section of our site and follow the links to the QOF Practice tool !

For further information on this development contact: Quality.Observatory@southeastcoast.nhs.uk

Page 8

NHS Comparators Dr Pam Westley, Programme Head Secondary Uses Information (Secondary Care) NHS Comparators is a comparative analytical tool, designed to help NHS organisations improve the quality of care delivered, by benchmarking and comparing activity and costs on a local, regional and national level. Available from SHA to GP practice and provider levels, it offers a standard view of national data and can be used to supplement knowledge and information available in local systems.

And the best thing about NHS Comparators is that it is completely free to NHS users and is designed to be used by all, not just information specialists.

Supporting Commissioners and Providers NHS Comparators can help both commissioning and provider organisations begin to understand the care pathway and identify where improvements can be made. It examines activity and costed data through the PbR tariff from the Secondary Uses Service (SUS), together with Quality and Outcomes Framework (QOF) information, GP practice demographic population profile data, and it now also includes prescribing data.

Whether at SHA, GP practice or provider level, NHS Comparators allows users to investigate local and national patterns of care and because it is designed for use by all, not just information specialists, NHS Comparators is accessible and really easy to use for both clinicians and managers alike.

NHS Comparators in Practice Asthma sufferers are breathing easier at Dr Ian Greaves’ Staffordshire practice. Instead of many patients having to go to hospital for urgent care, the services are coming to them.

The practice developed a new strategic partnership with their local acute trust after NHS Comparators revealed it referred many more sufferers than average for hospital admittance.

“We felt the high number of admissions could be avoided if urgent care services were better,” said Ian. “So we agreed with the trust to bring those services here to the practice.”

Junior doctors and doctors of registrar level are based at the practice 6:30pm-10:30pm every evening, including weekends and bank holidays. They see urgent cases, including asthmatics, as well as hospital outpatient follow-ups.

Ian said: “Any new patient we refer will be seen by the doctors that evening so we can therefore easily meet the 18 weeks target.”

“The patient is presented to the consultant by the junior doctor, who gets apprentice type training. We are using the doctors who have failed to get onto specialist training posts and therefore they will have a better CV for when they reapply next year.”

Four new nebulisers have also been bought for practice and home use. The practice and trust are working together to improve patient safety for early discharge from hospital after NHS Comparators highlighted a high number of practice patients being delayed in discharge.

This process also streamlined the practice’s aim to deliver a more community driven service. Discussions are in progress to integrate community, intermediate care and hospital nurses which will enable hospital care to be delivered at home.

“The NHS Comparators site enabled us to map and plan how we could change from a hospital based to a community based service,“ said Ian. “By involving the hospital we did not undermine them; the site really helped them see what we were about.”

Registering for NHS Comparators is easy.

To register, please contact The NHS Information Centre on 0845 300 6016 or email

enquiries@ic.nhs.uk.

You will need to provide details of your name, job title, organisation and email address to complete your application.

www.ic.nhs.uk/nhscomparators

Page 9

”NHS Comparators is about giving providers the information to gain a greater understanding of the vital care they provide.”

Dr Mark Davies, GP, Hebden Bridge and Medical Director of The NHS IC.

Recent comparators developments Are you already registered? 2009 has seen a number of updates to NHS Comparators, recent updates include: •

Data available up to March 2009 (quarter 4)

•

Launch of new comparators for: •

Maternity

•

length of stay

•

emergency bed days for long term conditions

•

Prescribing cost /1000 by programme budgeting category

•

Updated and reworked readmissions

•

Online demonstrations are now available in the Knowledge Base to help users get started and provide ongoing support.

•

Finally, NHS Comparators is now on Twitter. Follow us at www.twitter.com/nhscomparators

Coming soon….

•

www access to NHS Comparators is in development and will be launched at the end of the year. Some restrictions will be in place dependant on intended use

•

New comparators due for launch in November include

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A&E attendance rate

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Alcohol comparators, reporting on admissions for alcohol related harm

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Three new maternity comparators - % caesareans; % home births or in midwifery unit; and % unplanned transfers to hospital

Page 10

How do I use more than one criteria on a large range?

Application: Microsoft Excel 2003 Dear Quality Observatory I have a spreadsheet a that contains patient episode data.

Each patient can have more than one episode and each episode has a true/false flag against it to indicate that if the treatment was “within network”.

For each patient I then need to check each group of episodes and add another Flag to the last episode The Flag rules are: If any episode for a patient is False If all episodes are True

Flag = False Flag = True

Is there any way I can get excel to do this for me?

-Martin Webb Perinatal Network Data & Information Clerk SEC Specialised Commissioning Group

Solution: Complexity 3.5/5 — Uses array formulas and nested logic statements Hi Martin Within Excel 2003 there 3 possible solutions to your problem. You can use the standard functions / create a bespoke function / use VBA to create a looping macro function. The solution below details the parts of the formula using standard Excel functions that will achieve your desired output.

Part 1: - Find the number of episodes To do this we can use the patient ID in column A . The “=COUNTIF(range,value)” formula will find the number of times that the Patient ID value appears.

Example: the value in cell A8 is “CZHW” The formula “=COUNTIF(A:A,A8)” will return “7” which is the number of Patient episode records for CZHW on this sheet.

Part 2:- Match to the last episode number This data set has each patient episode sequentially numbered in Column B so we can use this to identify the last episode for CZHW which is episode 7. We want the formula to output only on the row that contains the number 7 in column B and CZHW in column A. We can do this with and “IF()” statement using “” to output a blank cell value and the “COUNTIF()” function from part 1.

Example: =IF(COUNTIF(A:A,A8)=B8,’Flag’,””) NOTE: Miss out Steps 1 & 2 If you want to put a flag on every row

Page 11 Part 3: Evaluating all the row records for each patient ID For each row in the range ($A$2:$A$37) we want to evaluate the value in column A to check it equals the Patient ID e.g. CZHW for row 8. We then check the treatment flag ($T$2:$T$37) to see if it evaluates to False.

This can be achieved with the following statement: SUM(IF($A$2:$A$37=A8,IF($T$2:$T$37=FALSE,1))) This Statement is constructed in three Parts: IF($T$2:$T$37=FALSE,1)

IF($A$2:$A$37=A8,true,false) SUM(values)

The treatment flag ($T$2:$T$37) is evaluated for a “False” text value each cell that equals ‘False’ will output a 1 using an IF() Statement This is only evaluated if the Patient ID($A$2:$A$37) equals the value of A8 (CZHW) creating a nested IF() statement: This is then wrapped in a Sum() statement. In this example for CXHW there are 6 evaluations which output “1” This gets summed by the statement to output 6

For any patient with all episode Flags as True this statement will output “0“ we can use this to decide if overall treatment flag should be “true” or “False” This can be achieved buy wrapping the above statement in another IF() function : IF(SUM(IF($A$2:$A$37=A8,IF($T$2:$T$37=FALSE,1)))=0,"true","False") This then needs to be wrapped in the statement described in step 2 to only output the flag on the last treatment episodes The Finished Flag function will look like: {=IF(COUNTIF(A:A,A8)=B8,IF(SUM(IF($A$2:$A$37=A8,IF($T$2:$T$37=FALSE,1)))=0,"true","False"),"")} NOTE: The {} brackets surrounding the finished statement This denotes an Array function and you will need to hold down Ctrl/shift and enter to allow excel to recognise this as an array formula!

You will need to change the range references to suit your data.

You can’t use A:A/T:T column refs with arrays functions.

This won’t work if your episode numbers are not sequential stating from 1 (i.e. 3 records with episode labels 2,3,4)

World Class Commissioning Analytical Fair 2009 Highlights !

Key note speakers: Brian Derry Mike Farrar CBE Dominic Hardy Samantha Riley!

Large “marketplace” including SEC Quality Observatory team!

Watch this space for information on the Next Event and make sure you book your place early!

Copies of the presentations are available from www.ic.nhs.uk Search for Analytical Fair

Page 12

Using external data sources in Excel

by Nia Naibheman, Performance Analyst For those who rely on pivot tables to help them sort through vast amounts of data you may have experienced the unfortunate eventuality of reaching the end of your spreadsheet (users of Excel 2003 or earlier) thus unable to update pivot tables with new data.

Fortunately there is a simple solution to this problem, switch the data source of your pivot table to an external data source; in this case we will be using an Access table/query. Although initially it may take some time in setting up the whole process, in the long run it will prove to be beneficial.

Creating your ‘external data source’ : Whether you have an existing pivot table or are creating a new one, you will need to firstly set up your external data source. You can do this in a number of ways:

Import existing data in Excel into Access In order to move your data from Excel to Access save each sheet of data in a new Excel file and ensure that you have column headings and there are no empty rows at the top of your sheet or gaps in the data. You can transfer data into an Access table by using the ‘Import table’ function. Open up Access, click on ‘Tables’ on the left hand side then select ‘New’ (at the top), this will bring up a new box, select ‘Import table’. Open up the Excel file where your data is saved and follow the instructions.

Manual creation of tables and data Input To add data in an Access database you will need to create tables using the ‘New table’ wizard. This will enable you to manually label your columns and select the format of your data i.e. text, number.

Once your table has been set up, it may be necessary to create a query to organise the data which will be used in your pivot table.

A guide to Queries can be found in the Skills Builder section at http://nww.sec.nhs.uk/knowledge Take a moment to think about your pivot table and what you will need it to show as this will help you select the appropriate columns for your query. Queries can be used to carry out calculations such as sum, product, average and percentages which can be pulled through to your pivot tables.

New pivot tables To create a new Pivot table in Excel and link it to data in Access, click on ‘Data’ (in the tool bar) then on ‘Pivot table and PivotChart Wizard’. The first step will ask you to select the data source- select the second option ‘External data source’. This will then bring up a new box where you will need to choose ‘MS Access Database’. Follow the instructions thereafter and navigate to where your Access database is saved.

Select either the Access table or query you will be basing your pivot table on. You will be asked to select each column for your pivot table

Page 13 Once your data has been retrieved, click ‘next’ then select where you want to place your pivot table. You can then click on the ‘layout’ button and set up your pivot table or alternatively, click on ‘finish’ then drag and drop the content for your pivot table.

The advantage of using Access, especially for users of Excel 2003, as your external data is there is no limit on your data set. It also allows you to organise your data and carry out calculations through queries.

Existing pivot tables Once the data is in Access (refer to ’creating your external data source’ section of the article), click on the Pivot table wizard of the pivot table you will be changing the data source of (right click) then click on ‘back’ until you reach ‘Step 1 of 3’. You will see that it takes you back to the data source option-select ‘External data source’ for your pivot table. From this you will need to retrieve your data, through the options, select the Access database you have saved your data in. Once you have followed the steps it will bring you back to the Pivot table wizard where you can select the layout of your pivot table. As you are working on an existing pivot table it is vital that you follow the same order for your columns and rows and data as this could affect your pivot table adversely. Your pivot table should refresh using the data stored in Access. Ta da!

You may need to tweak your pivot table slightly, for example, the order of rows may not be the same as before, or even your column headings which may require some dragging and dropping, but after initial ‘tweaking’ it should all update smoothly each time you add new data to your access table and refresh your pivot table (right click, refresh).

Additional tips on pivot tables There are several adjustments you can make to improve/tailor your pivot table.

Calculations Click on the ‘Pivot table’ toolbar and select ‘Formulas’. Then click on ‘Calculated Field’. This will bring up a dialogue box allowing you to select the columns in your pivot table you wish to use in your calculation which will appear in the formula bar of the box. The name you select will be visible in your pivot table.

Add/remove column and row totals You will need to right click on your pivot table, then select ‘Table options’. Under ‘Format options’ you will be able to tick or un-tick ‘Grand totals’ for rows/columns. Pivot table options will also enable you to re-name your Pivot table.

Formatting your cells Ensure you are in the relevant column of your pivot table. Right click and select ‘Field Settings’. This will open up a dialogue box with numerous options to choose from. Within the ‘Field settings’ box you can also format your cells by clicking on ‘Number’ where you will be able to change the format to a percentage, number (decimal places) etc.

For more information on this article please contact nia.naibheman@southeastcoast.nhs.uk.

Page 14

Date Transformation function TO_CHAR():

The TO_CHAR() function is a very handy way of converting a date values to year month week or even day numbers In disco there are three TO_Char() functions available Under conversions: TO_CHAR(d[, fmt[, nlsparams]]) TO_CHAR(n[, fmt[, nlsparams]]) TO_CHAR(label[, fmt]) They generally Follow the similar format the important Bits to remember is: TO_CHAR(DATE,FORMAT): Here are a number of Examples of Use: EXAMPLE 1: Converting a Date (E.G. Date of Birth) to a week number (1-53):

EXAMPLE 2: Converting A Date to Month (1-12) and week (1-5):

Page 15

NEWS Unify2 Enhancement The enhanced Unify2 website is due to go live in early December and on 3rd November the DH Unify2 team will be visiting the SHA to give a demonstration and training on using the new website. There are 2 sessions available, morning and afternoon. If you would like to attend please email rebecca.owen@southeastcoast.nhs.uk with your contact details. There will also be a full day’s Unify2 training in London in January, this session is aimed at those less familiar with Unify. Again, if you are interested in attending this please email Rebecca.

A web-enabled version of the Gap Measurement Tool is also available (tinyurl.com/ygrzmxk).

SEEIT is an interactive Excel-based tool displaying trends, projections and PCT plans and LAA trajectories for a range of Vital Signs and National Indicators.

The Gap Measurement Tool provides a standardised approach to analysing gaps and trends in within-area health inequalities based on cause-specific mortality rates for deprivation score-derived quintiles of super output areas.

Further information on both these tools is available from Robert Kyffin (robert.kyffin@dh.gsi.gov.uk, 01483 882 264).

Changes to BCBV Indicators As announced in this week’s Better Care Better Value Indicators steering group there are a number of changes to be made to for the next publication, due early November for Q1 2009/01:

•

Pre-operative bed days will now be average pre-operative stay and will be split into Elective and Non Elective, this is a much more sensible measure and removes the significant penalty for trusts with short lengths of stay.

•

Day cases will now be based upon the latest BADS directory of procedures rather than the much older basket of 25

•

Outpatient new to follow up will now exclude DNAs, the previous measure included an adjustment factor to account for DNAs that weren’t recorded.

•

Q1 09/10 onwards savings will be calculated using HRG4.

Further changes are planned over the coming months so watch this space

Answers from August…..

HoNOS scores are increasingly being referred to as a potentially useful Mental Health outcome measure.

What does HoNOS stand for?

HoNOS stand for Health Of the Nation Outcome Scales. It is based on a 12 item instrument measuring behaviour, impairment, symptoms and social functioning.

For more details go to the Royal College of Psychiatrists website: www.rcpsych.ac.uk

EVENTS November 4th—London HINOS Review workshop in London If you are Interested in workforce development and the Health Informatics Career Framework, Come to the Health Informatics National Occupational Standards (HINOS) review Workshop Contact: Nathan.Laxton@skillsforhealth.org.uk

PH Tools update Included in the last Knowledge Matters was an overview of the two information tools produced by the Department of Health South East:

Website: www.HINOS.org.uk 11th—Development Sessions Group or Individual slots available, book now to get help and advice: Quality.Observatory@southeastcoast.nhs.uk

• South East England Indicator Tool (SEEIT, tinyurl.com/m2ytd8)

December

• South East England Health Inequalities Gap Measurement Tool (tinyurl.com/69gy9j).

16th—Development Sessions

Both these tools have now been published and are available to download from the SEPHO website.

Group or Individual slots available, book now to get help and advice: Quality.Observatory@southeastcoast.nhs.uk

Page 16

Welcome to…...

Robert Kyffin has joined the SHA on a part-time secondment from the Department of Health South East (the Department's presence in the region, based in the Government Office for the South East in Guildford) as an epidemiologist working between the Public Health Directorate and the Quality Observatory.

Robert's role is to support the SHA as a whole and the 'Healthier People, Excellent Care' clinical leads in particular in analysing and interpreting clinical quality and public health information to help ensure the delivery of improved services and health outcomes for the population of NHS South East Coast.

Hi, I’m David. I’m an NHS informatics graduate management trainee, and I am going to be working with the Quality Observatory for the next 9 months.

This will be my first placement on the scheme, and I am looking forward to it, especially since I have heard so many good things about the SEC Quality Observatory. The first project I will be working on is related to HCAIs.

Caption Cook Competition

Innovation Inventing and creating,

Guess What I’m Thinking!

Caption This Image for a Fabulous Prize!

Email your captions with “Caption Cook” in the subject line to Quality.Observatory@southeastcoast.nhs.uk

New ways of seeing things, Never giving up, Observing what life brings, Variety and experiment, Asking unasked queries, Thinking through the problem Investigating theories, Opening new horizons Now – that is Innovation

Fascinating Fact Falling out of trees is subject to seasonal variation. Every year around 80% of SEC hospitalisation due to falling from trees happens in Quarters 1 and 2 (April to September).

Knowledge matters is the newsletter of NHS South East Coast’s Quality Observatory, to discuss any items raised in this publication, for further information or to be added to our distribution list, please contact: NHS South East Coast York House 18-20 Massetts Road Horley,Surrey, RH6 7DE Phone:

01293 778899

E-mail: Quality.Observatory@southeastcoast.nhs.uk To contact a team member: firstname.surname@southeastcoast.nhs.uk