Copyright 2011 Right Care Using Deep Dive Insights packs in
Northern and Yorkshire CCGs Sue Baughan Associate Director,
Knowledge and Intelligence Team (Northern and Yorkshire) Public
Health England January 2014 Online Learning Series Right Care for
Populations
Slide 2
Produced by PHE Knowledge & Intelligence Team Northern and
Yorkshire 2 Commissioning Insights packs 2013 Where to Look -
Prioritising opportunities
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Produced by PHE Knowledge & Intelligence Team Northern and
Yorkshire Diving deeper into the data Deep dive packs were piloted
in Yorkshire and Humber in 2012/13 An example of the pack is
available herehere 3
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Commissioning for Value insight pack NHS England Gateway ref:
00525
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Produced by PHE Knowledge & Intelligence Team Northern and
Yorkshire Programme deep dives preparing to act key elements CCGs
identified programmes to look at further Commitment to use
intelligence to drive transformation Clinical, commissioning,
business intelligence and public health engagement Local
intelligence Quantifying potential impact how ambitious to be
Analysis at practice level 6
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Produced by PHE Knowledge & Intelligence Team Northern and
Yorkshire Programme deep dives - Methodology 7 Analysed indicators
across the pathway from prevention to end of life focussing on
spend and quality Compared CCG with other similar CCGs and
identified key opportunities for value improvement and quantified
the potential impact Identified high performing CCGs in the cluster
and what works from the evidence base Worked with
multi-disciplinary team in CCG to; add local data agree clear
summary and key messages
Slide 8
Annex 1: Spine Charts Minimum value in clusterMaximum value in
cluster Key: Prevention Worse outcomeBetter outcome Prevalence
Higher prevalence / Worse outcome Lower prevalence / Better
outcome
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9 Two CCGs in bottom Quintile
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10 Two CCGs in bottom Quintile This CCG
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11 Two CCGs in bottom Quintile This CCG Ambition
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12 Two CCGs in bottom Quintile This CCG Ambition Average of ten
PCTs
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13
Slide 14
Number of Indicators (/of those looked at) where CCG below the
average for the top two quintiles (best 40% in its benchmark group)
See Annex for full list Indicators in the bottom quintile v
benchmark group -difference between NHS XXX CCG and the benchmark
average of the top 40% in brackets, (p) PCT based indicator
Opportunity if NHS XXX CCG were to equal the benchmark average of
the top 40% 60/66 CVD emergency admissions (DSR) (27.2% higher),
CHD emergency admissions (DSR) male (44.2% higher), CHD emergency
admissions (DSR) female (53.3% higher), Heart failure emergency
admissions (DSR) male (43.8% higher), CHD: average cost per
elective admission (female) (38.4% higher), Non-elective
Angioplasty procedures (DSR) males (48.9% higher), CHD: average LOS
per elective admissions (male) (83.1% higher), Stroke: average LOS
per emergency admissions (female) (90.2% higher), Stroke: average
LOS per emergency admissions (male) (112.4% higher), Angiography:
average LOS per procedure (101.8% higher), Proportion of non-STEMI
patients seen by member of cardiology team (p) (- 12.3% lower), Non
elective spend (p) (52.1% higher), Ambulance spend (p) (55.9%
higher), A&E spend (p) (69.7% higher) 381 fewer people 117
fewer people 66 fewer people 34 fewer people 161k (total cost
savings) 45 fewer procedures 202 bed days 1,693 bed days 1,695 bed
days 1,089 bed days 12% of non-STEMI patients 2.9M 0.4M 0.2M 2/2
None None 1/1 Death at home or usual place of residence (p) (66.3 %
higher) 78 more people Where does the CCG compare poorly against
its benchmark group? Analysis by pathway stage (2) 14 \ \
Management in Secondary Care Social Care End of life Care 14
Slide 15
Number of Indicators (/of those looked at) where CCG below the
average for the top two quintiles (best 40% in its benchmark group)
See Annex for full list Indicators in the bottom quintile v
benchmark group -difference between NHS XXX CCG and the benchmark
average of the top 40% in brackets, (p) PCT based indicator
Opportunity if NHS XXX CCG were to equal the benchmark average of
the top 40% 60/66 CVD emergency admissions (DSR) (27.2% higher),
CHD emergency admissions (DSR) male (44.2% higher), CHD emergency
admissions (DSR) female (53.3% higher), Heart failure emergency
admissions (DSR) male (43.8% higher), CHD: average cost per
elective admission (female) (38.4% higher), Non-elective
Angioplasty procedures (DSR) males (48.9% higher), CHD: average LOS
per elective admissions (male) (83.1% higher), Stroke: average LOS
per emergency admissions (female) (90.2% higher), Stroke: average
LOS per emergency admissions (male) (112.4% higher), Angiography:
average LOS per procedure (101.8% higher), Proportion of non-STEMI
patients seen by member of cardiology team (p) (- 12.3% lower), Non
elective spend (p) (52.1% higher), Ambulance spend (p) (55.9%
higher), A&E spend (p) (69.7% higher) 381 fewer people 117
fewer people 66 fewer people 34 fewer people 161k (total cost
savings) 45 fewer procedures 202 bed days 1,693 bed days 1,695 bed
days 1,089 bed days 12% of non-STEMI patients 2.9M 0.4M 0.2M 2/2
None None 1/1 Death at home or usual place of residence (p) (66.3 %
higher) 78 more people Where does the CCG compare poorly against
its benchmark group? Analysis by pathway stage (2) 15 \ \
Management in Secondary Care Social Care End of life Care 15
Slide 16
Number of Indicators (/of those looked at) where CCG below the
average for the top two quintiles (best 40% in its benchmark group)
See Annex for full list Indicators in the bottom quintile v
benchmark group -difference between NHS XXX CCG and the benchmark
average of the top 40% in brackets, (p) PCT based indicator
Opportunity if NHS XXX CCG were to equal the benchmark average of
the top 40% 60/66 CVD emergency admissions (DSR) (27.2% higher),
CHD emergency admissions (DSR) male (44.2% higher), CHD emergency
admissions (DSR) female (53.3% higher), Heart failure emergency
admissions (DSR) male (43.8% higher), CHD: average cost per
elective admission (female) (38.4% higher), Non-elective
Angioplasty procedures (DSR) males (48.9% higher), CHD: average LOS
per elective admissions (male) (83.1% higher), Stroke: average LOS
per emergency admissions (female) (90.2% higher), Stroke: average
LOS per emergency admissions (male) (112.4% higher), Angiography:
average LOS per procedure (101.8% higher), Proportion of non-STEMI
patients seen by member of cardiology team (p) (- 12.3% lower), Non
elective spend (p) (52.1% higher), Ambulance spend (p) (55.9%
higher), A&E spend (p) (69.7% higher) 381 fewer people 117
fewer people 66 fewer people 34 fewer people 161k (total cost
savings) 45 fewer procedures 202 bed days 1,693 bed days 1,695 bed
days 1,089 bed days 12% of non-STEMI patients 2.9M 0.4M 0.2M 2/2
None None 1/1 Death at home or usual place of residence (p) (66.3 %
higher) 78 more people Where does the CCG compare poorly against
its benchmark group? Analysis by pathway stage (2) 16 \ \
Management in Secondary Care Social Care End of life Care 16
Slide 17
Number of Indicators (/of those looked at) where CCG below the
average for the top two quintiles (best 40% in its benchmark group)
See Annex for full list Indicators in the bottom quintile v
benchmark group -difference between NHS XXX CCG and the benchmark
average of the top 40% in brackets, (p) PCT based indicator
Opportunity if NHS XXX CCG were to equal the benchmark average of
the top 40% 60/66 CVD emergency admissions (DSR) (27.2% higher),
CHD emergency admissions (DSR) male (44.2% higher), CHD emergency
admissions (DSR) female (53.3% higher), Heart failure emergency
admissions (DSR) male (43.8% higher), CHD: average cost per
elective admission (female) (38.4% higher), Non-elective
Angioplasty procedures (DSR) males (48.9% higher), CHD: average LOS
per elective admissions (male) (83.1% higher), Stroke: average LOS
per emergency admissions (female) (90.2% higher), Stroke: average
LOS per emergency admissions (male) (112.4% higher), Angiography:
average LOS per procedure (101.8% higher), Proportion of non-STEMI
patients seen by member of cardiology team (p) (- 12.3% lower), Non
elective spend (p) (52.1% higher), Ambulance spend (p) (55.9%
higher), A&E spend (p) (69.7% higher) 381 fewer people 117
fewer people 66 fewer people 34 fewer people 161k (total cost
savings) 45 fewer procedures 202 bed days 1,693 bed days 1,695 bed
days 1,089 bed days 12% of non-STEMI patients 2.9M 0.4M 0.2M 2/2
None None 1/1 Death at home or usual place of residence (p) (66.3 %
higher) 78 more people Where does the CCG compare poorly against
its benchmark group? Analysis by pathway stage (2) 17 \ \
Management in Secondary Care Social Care End of life Care 17
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Where to focus: Understanding practice variation Practices
compared against other practices within their practice cluster for
all the indicators where data is available at practice level The
start of a conversation Practices will have less influence on
management in secondary care than they do on management in primary
care and this should be taken into account in the way CCGs
interpret the information on practice variation 18 Analysis
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Where to focus: Understanding practice variation 19
Analysis
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Produced by PHE Knowledge & Intelligence Team Northern and
Yorkshire Programme deep dives - bringing in local intelligence
Have the plans worked? Testing the size of the opportunities
identified Links to identified needs of the population JSNA Unmet
need Inequalities Preventative activity 20
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Produced by PHE Knowledge & Intelligence Team Northern and
Yorkshire What happened? Half of the CCGs in the patch took up the
offer of a deep dive all chose respiratory or CVD initially
Opportunities identified used in transformation programmes and QIPP
Many evidenced this approach as part of clear and credible plans
Half of CCGs in the patch have received training in the Right Care
approach to transformation Four CCGs have embedded this approach
21
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22 Online Learning Series Right Care for Populations Follow
Right Care online Subscribe to get a weekly digest of our blog
alerts in your inbox, Receive occasional eBulletins Follow us on
Twitter @qipprightcare Find the full series at:
www.rightcare.nhs.uk/resourcecentre Doncaster CCG
http://bit.ly/doncasterccg_casebook Calderdale CCG
http://bit.ly/calderdaleccg_casebook Anonymous deep dive pack
http://bit.ly/deep_dive