QIPP DashboardMarch 2012 position
Healthier Horizons
Work stream levelMedicines Management: Chart 1Benchmarked overall prescribing costs to March 2012
The overall costs for primary care prescribing are high in the NW compared to the England average, except for 3 PCTs.
KNOWSLEY
OLDHAM
HMR
HALTON & ST.HELENS
TAMESIDE & GLOSSOP
BwD
EAST LANCS
TRAFFORD
SEFTON
NORTH LANCS
CENTRAL LANCASHIRE
England average
WESTERN CHESHIRE
£0.00 £5.00 £10.00 £15.00 £20.00 £25.00 £30.00 £35.00 £40.00
£33.85£33.48
£32.09£31.95£31.74
£31.06£30.61£30.47
£29.78£29.31£29.21
£28.76£28.47
£28.01£27.20£27.11
£26.67£26.30£26.22£26.15£26.03
£25.22£24.47
£23.98£23.71
£23.21
Cost Per Astro PU (£)
Work stream levelMedicines Management: (2a)Performance on national QIPP indicators Q4
Prescriber Name ScoreACE inhibitor %
items
Low cost lipid modifying
drugsLow cost PPIs
% itemsHypoglycaemic
agentsNSAIDs
ADQ/STAR PU
NSAIDs: Ibuprofen & Naproxen %
Items
ASHTON,LEIGH & WIGAN 11 71.69 h 69.52 h 93.29 h 81.28 i 1.53 i 70.36 h
BLACKPOOL 30 76.19 h 79.81 h 97.60 h 85.45 h 1.26 i 70.08 h
BOLTON 11 66.45 h 73.92 h 95.05 h 80.75 i 1.14 i 69.08 h
BURY 23 68.95 h 76.58 h 97.07 h 80.92 h 1.15 i 70.65 h
CENTRAL & EASTERN CHESHIRE 28 73.23 i 76.74 h 95.88 h 85.62 h 0.92 i 69.55 h
CENTRAL LANCASHIRE 23 74.67 i 72.82 h 95.47 h 84.19 h 0.91 i 65.09 h
CUMBRIA TEACHING 31 72.37 h 78.31 h 98.24 h 87.88 i 1.05 i 47.39 h
EAST LANCASHIRE TEACHING 19 70.46 h 79.50 h 95.95 h 83.79 h 1.13 i 58.74 h
HALTON & ST.HELENS 14 71.64 h 70.26 h 96.19 h 85.01 i 1.34 i 65.02 h
HEYWOOD, MIDDLETON & ROCHDALE 11 67.81 h 73.77 h 96.39 h 79.35 i 1.91 h 56.76 h
KNOWSLEY 8 73.56 h 66.32 h 96.28 h 85.72 i 1.30 h 56.68 h
LIVERPOOL 12 75.24 h 66.65 h 95.73 h 82.56 i 1.21 i 67.08 h
MANCHESTER 18 71.74 h 71.38 h 96.95 h 81.44 h 1.25 h 64.45 h
NORTH LANCASHIRE TEACHING 24 69.86 h 75.84 h 96.15 h 82.67 h 1.08 i 66.27 h
OLDHAM 8 65.82 h 67.69 h 93.71 h 80.59 i 1.56 i 55.16 h
SALFORD 26 74.71 h 76.02 h 97.73 h 77.40 h 1.00 i 60.70 h
SEFTON 15 72.90 h 65.60 h 95.48 h 85.20 i 1.06 i 67.07 h
STOCKPORT 23 71.79 h 73.02 h 97.18 h 83.37 i 0.94 i 56.27 h
TAMESIDE & GLOSSOP 15 69.07 h 71.26 h 95.55 h 82.88 h 1.45 i 46.54 h
TRAFFORD 15 72.48 h 66.39 h 94.00 h 80.85 i 1.14 i 48.96 h
WARRINGTON 14 69.68 h 72.98 h 96.86 h 84.42 i 1.26 i 63.71 h
WESTERN CHESHIRE 23 71.24 h 75.23 h 96.11 h 83.46 h 0.97 i 70.34 h
WIRRAL 15 70.01 i 74.35 h 97.81 h 80.30 i 1.24 i 62.59 h
BLACKBURN WITH DARWEN CTP 23 71.56 h 81.77 i 96.99 h 80.57 i 1.46 i 68.18 h
Work stream levelMedicines Management: (2b)Performance on national QIPP indicators Q4
Prescriber Name Score
Antibacterial items/STAR
PU
Cephalosporins & quinolones
% items
Inhaled Corticosteroid
s NIC/ADQ
Alendronate as % of all
biphosphonates
Long/Intermediate
Insulin Analogues
Enteral Feeds (SIPS) Cost
Per PU
Hypnotics ADQ/STAR
PU
ASHTON,LEIGH & WIGAN 11 0.38 h 5.67 i £0.57 n 83.83 h 92.17 i £0.51 h 1.90 i
BLACKPOOL 30 0.37 h 4.04 i £0.66 n 85.44 h 75.01 h £0.39 h 0.95 i
BOLTON 11 0.38 h 8.13 i £0.56 h 77.07 h 86.70 h £0.45 h 1.42 i
BURY 23 0.36 h 5.67 i £0.53 h 84.04 n 80.58 h £0.28 i 1.45 i
CENTRAL & EASTERN CHESHIRE 28 0.35 h 5.50 i £0.51 h 85.50 i 90.73 i £0.33 i 1.04 i
CENTRAL LANCASHIRE 23 0.35 h 6.53 i £0.50 h 85.49 h 85.10 i £0.41 i 1.02 i
CUMBRIA TEACHING 31 0.35 h 5.76 i £0.50 h 85.68 i 85.89 i £0.20 i 1.21 i
EAST LANCASHIRE TEACHING 19 0.39 h 5.38 i £0.56 i 82.83 h 77.78 i £0.49 h 1.71 i
HALTON & ST.HELENS 14 0.40 h 8.41 h £0.65 h 83.97 h 82.00 h £0.52 h 1.60 i
HEYWOOD, MIDDLETON & ROCHDALE 11 0.42 i 6.24 i £0.55 h 83.62 h 85.72 i £0.50 i 1.69 i
KNOWSLEY 8 0.38 h 7.98 i £0.65 h 82.13 h 91.85 h £0.74 h 1.41 i
LIVERPOOL 12 0.35 h 8.30 i £0.60 i 79.32 h 92.54 h £0.81 i 1.32 i
MANCHESTER 18 0.35 h 4.17 i £0.56 i 84.45 h 92.59 i £0.43 i 1.66 i
NORTH LANCASHIRE TEACHING 24 0.33 h 6.19 i £0.60 h 83.64 h 83.22 i £0.35 i 1.21 i
OLDHAM 8 0.40 h 4.52 i £0.54 h 75.86 h 96.90 i £0.48 h 1.74 i
SALFORD 26 0.35 h 5.70 i £0.53 h 90.57 h 55.36 i £0.40 i 1.16 i
SEFTON 15 0.36 h 9.11 i £0.60 i 82.63 i 91.98 i £0.64 i 1.32 i
STOCKPORT 23 0.35 h 4.08 i £0.58 i 84.43 h 86.11 h £0.18 h 1.40 i
TAMESIDE & GLOSSOP 15 0.33 h 6.70 i £0.57 h 86.67 h 95.81 i £0.27 i 1.40 i
TRAFFORD 15 0.35 h 5.75 i £0.50 h 86.78 h 96.00 i £0.26 i 1.19 i
WARRINGTON 14 0.37 h 6.22 i £0.62 n 79.62 h 82.04 i £0.35 i 1.68 h
WESTERN CHESHIRE 23 0.35 h 6.83 i £0.51 h 85.78 h 91.49 i £0.39 h 1.10 i
WIRRAL 15 0.38 h 8.71 i £0.57 h 85.48 i 96.82 h £0.38 h 1.48 i
BLACKBURN WITH DARWEN CTP 23 0.38 h 5.37 i £0.53 h 87.53 h 83.15 i £0.32 i 1.70 i
Work stream level Medicines Management (3)PCT cost growth 11/12 (compared to 10/11)
The NW has good reduction in PCT ongoing cost growth, ranging from -5.98% in Bury to -0.46% in ALW.Increasing investment maintained in treatments for hypertension and vaccinations as part of the Quality improvements.
Work stream levelMedicines Management: (4)PCTs (Specials) Year on Year Change (% reduction) to Q4 11 /12
Special formulations highlighted as a key cost pressure in 09/10. PCTs have taken action to reduce costs.DH have introduced drug tariff prices from Nov 11 to mitigate the
ongoing risks.
Reduction in Expenditure %
PCT BLACKBURN WITH DARWEN CTP
PCT BURY
PCT HEYWOOD, MIDDLETON & ROCHDALE
PCT NORTH LANCASHIRE TEACHING
PCT EAST LANCASHIRE TEACHING
PCT MANCHESTER
PCT SALFORD
PCT CENTRAL & EASTERN CHESHIRE
PCT CENTRAL LANCASHIRE
PCT LIVERPOOL
PCT OLDHAM
PCT SEFTON
PCT HALTON & ST.HELENS
PCT STOCKPORT
PCT TAMESIDE & GLOSSOP
PCT ASHTON,LEIGH & WIGAN
PCT TRAFFORD
PCT KNOWSLEY
PCT BLACKPOOL
PCT CUMBRIA TEACHING
PCT WIRRAL
PCT BOLTON
PCT WESTERN CHESHIRE
PCT WARRINGTON
-70% -60% -50% -40% -30% -20% -10% 0%
-65%
-59%
-58%
-53%
-51%
-45%
-43%
-42%
-42%
-40%
-40%
-40%
-37%
-35%
-35%
-34%
-31%
-29%
-24%
-14%
-12%
-11%
-6%
-4%
-37%
Growth in Expenditure %
Growth %
Work stream levelMedicines Management: (5)PCTs (Antibacterial Drugs) Change (%) to Q4 11/12
The PCTs have been working to reduce the use of antibacterial drugs in primary care as part of initiatives to reduce C. Diff incidence –(1.2% down), BUT Q4 figures for most PCTs have risen
PCT WARRINGTON
PCT KNOWSLEY
PCT BOLTON
PCT LIVERPOOL
PCT OLDHAM
PCT MANCHESTER
PCT EAST LANCASHIRE TEACHING
PCT STOCKPORT
PCT TRAFFORD
PCT BURY
PCT WIRRAL
PCT CENTRAL & EASTERN CHESHIRE
PCT CENTRAL LANCASHIRE
PCT BLACKBURN WITH DARWEN CTP
PCT SALFORD
PCT HALTON & ST.HELENS
PCT SEFTON
PCT NORTH LANCASHIRE TEACHING
PCT WESTERN CHESHIRE
PCT ASHTON,LEIGH & WIGAN
PCT CUMBRIA TEACHING
PCT HEYWOOD, MIDDLETON & ROCHDALE
PCT BLACKPOOL
PCT TAMESIDE & GLOSSOP
NORTH WEST
-8.0% -6.0% -4.0% -2.0% 0.0% 2.0% 4.0% 6.0% 8.0% 10.0%
7.8%
6.9%
6.8%
6.2%
6.1%
6.0%
5.6%
5.0%
4.9%
4.4%
4.1%
3.0%
2.5%
1.9%
1.9%
1.7%
0.7%
0.6%
0.4%
-0.4%
-1.1%
-1.2%
-1.2%
-6.8%
2.8%
Anti Bacterial Drug Growth (%) Items
Work stream levelMedicines Management: (6)PCTs (Nutritional Supplements) Year on Year Change (%) to Q4 11/12
PCTs identified this as a cost pressure in 2010/11 and took measures to reduce expenditure in 2011/12. Outcome small growth of 1% across the NW at year end
PCT WESTERN CHESHIRE
PCT BLACKPOOL
PCT EAST LANCASHIRE TEACHING
PCT HALTON & ST.HELENS
PCT SALFORD
PCT TRAFFORD
PCT ASHTON,LEIGH & WIGAN
PCT SEFTON
PCT CENTRAL LANCASHIRE
PCT STOCKPORT
PCT BOLTON
PCT NORTH LANCASHIRE TEACHING
PCT HEYWOOD, MIDDLETON & ROCHDALE
PCT OLDHAM
PCT MANCHESTER
PCT KNOWSLEY
PCT CENTRAL & EASTERN CHESHIRE
PCT WIRRAL
PCT LIVERPOOL
PCT WARRINGTON
PCT CUMBRIA TEACHING
PCT BLACKBURN WITH DARWEN CTP
PCT TAMESIDE & GLOSSOP
PCT BURY
NORTH WEST
-20% -15% -10% -5% 0% 5% 10% 15% 20%
14%
12%
12%
11%
11%
8%
5%
5%
5%
5%
4%
4%
3%
0%
-3%
-4%
-4%
-4%
-4%
-5%
-5%
-6%
-12%
-14%
1%
Nutritional Supplements Growth (%) in Expenditure
Growth %
Work stream level
Better Care Better Health Better Life
Informatics – Choose & Book for 3 months ending at 31st March 2012
Whilst Choose & Book continues to perform well the opportunity remains to save a further £2m per quarter if at least 90% of referrals are conducted via thisroute
Period Jan,Feb,March 2012
Actual savingsPotential additional
savings
Cheshire 400,828£ 305,720£ Cumbria 221,981£ 122,362£ Lancashire 479,368£ 580,023£ Manchester 1,139,154£ 729,567£ Merseyside 480,029£ 429,319£
Total 2,721,361£ 2,166,991£
Work stream level
Better Care Better Health Better Life
Informatics – Electronic prescription service
at 31st March 2012
Some clusters still not engaging fully with this initiative. Further development work is required to maintain momentum
u u
Clu
ster
Release1BGL/TGL*
R2 BGL/R1 TGL
** EPS R1National PCT Rank (/151)
Central and Eastern Cheshire A 91% 0% 51Warrington B 96% 0% 137
Western Cheshire C 98% 3% 58Wirral D 77% 0% 112
Cumbria 30 32 Cumbria E 93% 5% 87Blackburn With Darwen F 97% 24% 56
Blackpool G 100% 0% 41Central Lancashire H 92% 0% 105
East Lancashire I 85% 2% 121North Lancashire J 79% 0% 122
Ashton, Leigh & Wigan K 94% 0% 55Bolton L 90% 0% 91Bury M 100% 21% 1
Heywood, Middleton & Rochdale N 93% 0% 37Manchester O 100% 1% 90
Oldham P 94% 4% 48Salford Q 96% 6% 36
Stockport R 92% 0% 107Tameside & Glossop S 95% 9% 50
Trafford T 89% 3% 117Halton & St Helens U 81% 0% 86
Knowsley V 88% 0% 65Liverpool W 96% 0% 68Sefton X 71% 0% 123
19 18
Merseyside
31 26
Cheshire
27
↓ F
ebru
ary
2012
RA
G S
tatu
s ↓
28
Lancashire
35 37Manchester
rank /
51 *
*
PCTMapRef
GP Practice
Work stream level
Better Care Better Health Better Life
Informatics – Summary Care Record
at 31st March 2012
Only 20 % (152 out of 763) of practices have uploaded Summary Care Records.An increase from Dec 2011 (14.5 % of practices)
Cluster
% of patients
with records created
PCT NameMap Ref
# of Practic
es
PCT Populatio
n
Awareness & EngagementPlanning Adoption
In progress / Not done
Project Manager In
Post
Business Case
Developed
Project Board
EstablishedSCR Clinical Lead In Place
# Potential GP Practices
(EMIS LV, iSoft Synergy, InPS
or TPP)
% of Potential total GP Practices
# Practices Where Patient PIP Letters
Sent(Public Information
Programme)# of PIP Letters Sent(To Patients > 16yrs)
#patient opt outs
Patients surveyed for
opt out
% Patient Opt Out
(of practices reporting)
# Practices Uploaded
# Patient Records Created
# Practices Entered into Provisional
Business Go Live Field
Cheshire
20%
Central and Eastern Cheshire A 53 470,829 39 74% 53 385,625 6347 464503 1.37% 0
Warrington B 25 208,801 ü ü ü ü 23 92% 28 167641 1945 206837 0.94% 22 172,206 0
Western Cheshire C 40 261,783 ü ü ü ü 34 85% 40 215,814 3438 260497 1.32% 7 25,395 17
Wirral D 61 331,710 ü 48 79% 62 269,940 4572 333008 1.37% 11 58,872 0
Cumbria
0% Cumbria E 86 513,923 55 64% 0 0 0.00% 0
Lancashire
1%
Blackburn With Darwen F 29 168,874 16 55% 31 130,729 749 167308 0.45% 27
Blackpool G 22 153,069 n N n n 12 55% 0 0 0.00% 0
Central Lancashire H 89 473,015 49 55% 89 385,063 2700 471573 0.57% 0
East Lancashire I 66 388,318 35 53% 67 314,274 2004 387985 0.52% 60
North Lancashire J 37 339,752 18 49% 39 293,437 1904 337424 0.56% 2 22,582 0
Manchester
17%
Ashton, Leigh & Wigan K 66 320,418 ü ü ü ü 57 86% 66 262,378 1949 320429 0.61% 31 146,202 0
Bolton L 45 296,358 ü ü ü ü 43 96% 44 237,759 3127 289864 1.08% 19 144,755 0
Bury M 33 195,942 ü ü ü ü 33 100% 32 159,073 1455 160359 0.91% 26 147,631 7
Heywood, Middleton & Rochdale N 40 224,321 ü ü ü ü 27 68% 5 0 0.00% 0
Manchester O 103 568,105 ü ü ü ü 32 31% 103 450,633 2727 558490 0.49% 1 9,168 92
Oldham P 49 240,857 ü ü ü ü 25 51% 49 187,082 192 28294 0.68% 6 43,413 42
Salford Q 56 250,190 ü 40 71% 0 0 247488 0.00% 0
Stockport R 52 299,487 ü ü 17 33% 0 0 0.00% 10
Tameside & Glossop S 43 240,706 ü ü 24 56% 0 0 0.00% 15
Trafford T 40 234,400 ü 25 63% 41 187,762 2887 233396 1.24% 0
Merseyside
10%
Halton & St Helens U 55 321,194 n 25 45% 55 261,045 2459 319591 0.77% 0
Knowsley V 33 158,349 ü ü ü ü 28 85% 31 0 780 158514 0.49% 27 127,968 0
Liverpool W 97 492,835 ü n n n 36 37% 98 401,489 4180 490081 0.85% 0
Sefton X 55 280,117 n n n 22 40% 55 232,058 279196 0.00% 0
N/West Total 1275 7,433,353 763 60% 988 4,541,802 43,415 5,714,837 0.76% 152 898,192 270
Work stream levelDemand & Threshold Management :Increased number of patients dying at home
Better Care Better Health Better Life
Slight increase in the number of patients dying at home overall (0.35%) but not in Warrington, HMR, Stockport, Tameside & Glossop, Trafford, Blackburn with Darwen and Halton & St Helens.
Cluster Q4 Self Assessment of QIPP Programme Milestones
SHA TriangulationMay 2012
Cumbria PCT
A/R Watching brief: Outpatients and electives,recognise improvements made on finance and sickness absence.
Confidential North West SHA
CumbriaCluster QIPP Update
Q4 Self Assessment R
SHA Triangulation A/R
0%20%40%60%80%100%120%
% C
om
plet
e
QIPP Milestone Programmes
Cluster Self Assessment Exceptions
Activity for unscheduled care at month 10 is 7.8% above the contract plan (but about level with the outturn for 2010/11). Each of the six localities is focused on putting in place the local community based actions which are now required in these areas
Urgent Care
This section of the QIPP Programme is RAG rated Amber/red because the month 10 activity monitoring for the C2H condition groups reveals Cumbria to be 7.8% above plan for the C2H LTC condition groups ( but performance varies across the six localities)
Long Term Conditions
Planned Care
Activity at month 10 is now below the contract plan by 1.6% (but in value is up by 4%, £2.5m). NCUHT is below plan by 9% but UHMBFT is above plan by 8.3%. The Planned Care Turnaround workstream has a remit to confirm the operational plans to deliver the changes required in planned care and the delivery of the activity and financial targets over the next three years.
Transition Planning
A GP-led Clinical Commissioning Group has been operational since April 2011 and a Managing Director and the senior team have been appointed. Six Locality Directors have been appointed and the locality commissioning teams are in place. The QIPP plan brings together the commissioning intentions of all six localities and has been led by the Clinical Senate, which have also conducted the 2012/13 contracts negotiation. The CCG and Cluster jointly oversee operational delivery of the QIPP programme.
A/R
The 4th quarter saw some reductions in a trend of rises across a number of areas.But, growth continued for;other referrals (7.5%),All referrals (1.7%)elective day cases (7%)all electives (4.7%)
Cluster level
Better Care Better Health Better Life
Activity - Cumbria March 2012
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NHS North WestActivity Monitoring Planned Activity Previous Year Actual Activity
CumbriaCUMBRIA PARTNERSHIP NHS TRUSTCUMBRIA PCTNORTH CUMBRIA ACUTE HOSPITALS NHS TRUST
Cluster Level - CumbriaWorkforce – March 2012
RAGDec 11
RAG Mar 12
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