>>Matthew Cripps: Hello and welcome to your new Commissioning for Value focus packs. I'm
Matthew Cripps and I am National Director of NHS RightCare. This short video will help
you to work through the pack, highlighting key points and explaining what the data is
showing.
This collection of focus packs provides more detailed information for local health economies
on the highest volume programmes of care that were covered in your Commissioning for Value
refresh packs published in January 2016.
The focus packs include a range of process and outcome measures and information focusing
on the most common procedures and diagnoses for which your patients are being admitted
to hospital.
These measures span the whole of the pathway from primary prevention through to the end
of life and facilitate local optimal pathway design and improvement.
Commissioning for Value is part of the RightCare
programme and approach. The RightCare approach aims to help local health economies prioritise
the programmes of care that offer the best opportunities for local population healthcare
improvement.
By providing you with data, evidence, tools and practical support around outcomes, quality
and spend; RightCare helps you to transform the way care is delivered for your patients
and populations - and therefore helps you to reduce unwarranted variation.
Please take a look at the video and if you
need any more help then please do contact us via the email address at the end.
Thank you very much.
>>Voice over: The Pack is a real pack but we have redacted the name of the CCG. We will
make you aware of where we have reduced the amount of slides in the pack for the purpose
of this short video. Pages 2 to 7 provide background information
on RightCare and Commissioning for Value Pages 8 to 10 provide key background information
on Mental Health and the latest data developments. Page 11 provides information on the similar
CCGs that are used as the basis for comparisons in this pack. These CCGs are selected based
on demographic factors such as deprivation and age of the CCG population.
This focus pack is dived into three sections – Common Mental Health Disorders, Severe
mental illness and Dementia. The full range of slides for each of these areas is in your
local pack This page shows the Pathways on a Page chart
for Common Mental Health Disorders that was included in the CfV packs published in January.
This chart presents a range of indicators from across the patient pathway. Bars above
the zero percentage line mean that the CCG value is higher than the average value of
the ten similar CCGs. Indicators that can be classified as better or worse are shaded
red or green, but for some indicators it is not clear cut, and hence they are shaded blue.
The first indicator is ‘deprivation’ which is included as a risk factor so this is shaded
blue. The fourth indicator is recorded prevalence of Depression on GP registers – this is
shaded blue because a high value might reflect true high prevalence or it might reflect that
GPs are doing well at identifying patients with depression and adding them to the register
– therefore this indicator needs local interpretation. The indicator ‘IAPT: percentage referrals
waiting less than six weeks for first treatment’ is rated green because this CCG has a higher
percentage of people who receive treatment within six weeks which is a good thing. However,
the CCG has lower percentages of patients moving to recovery and achieving reliable
improvement which is a bad thing so these bars are shaded red. The black lines or whiskers
on each bar show the confidence intervals for each indicator.
Pages 20 and 21 show spend on primary care prescribing for Common Mental Health Disorders
The CCG expenditure is compared to the average of the five lowest spending similar CCGs.
However, this expenditure needs to be considered alongside all other indicators in the pathway
such as prevalence and outcomes.
This page shows a scatterplot of recorded prevalence against Primary Care Prescribing
expenditure. This CCG is shown by the yellow diamond and has a lower rate of prescribing
spend than most CCGs with similar rates of prevalence.
The next of pages presenting a series of Spine Charts providing information on risk factors,
prevalence, activity, spend and outcomes. For the purpose of this video we have only
shown one but the full set of charts are in your packs
This page includes the activity and quality indicators. The Spine Chart shows the values
for the CCG for each indicator and the yellow dot shows where this falls in the distribution
of all CCGs in England (the white space in the chart). The light green bar shows the
range of values for the similar ten CCGs. The second indicator down is ‘New cases
of depression which have been reviewed’. The yellow dot is towards the left of the
similar ten bar, because the CCG has a worse value (i.e. lower rate) than most of the similar
CCGs. The darker blue bar shows the worst quintile and the yellow dot is within this
darker area so the CCG is in the worst quintile. The ‘Best/Lowest 5 Opportunity’ box shows
the opportunity figure of 272 additional patients that would receive a review if the CCG could
improve to the level of the best five similar CCGs. The blue diamond shows the level of
the best five CCGs and the best performing of the similar CCGs is named to the right
of the chart. The green triangle shows the value of the best CCG in the wider cluster,
which is included as a stretch target for those CCGs who are already performing well.
These features are not included for indicators classified as needing local interpretation
as it would not be right to denote best and worst CCGs.
The next set of pages show more detailed information for some of the key indicators
This page shows the new cases of depression receiving a review indicator we have just
discussed. The opportunity of two hundred and seventy two patients is repeated on the
title line and is shaded red. The top bar chart shows all CCGs in England, with the
CCG bar in yellow and the similar ten shaded grey. The bottom chart shows just the CCG
and the similar ten. The horizontal blue line in the lower chart is the level of the Best
5, where the CCG would need to move to in order to achieve the opportunity of two hundred
and seventy two patients receiving a review ten to fifty six days after diagnosis. The
CCG value is fifty nine point five percent and the Best 5 average value is seventy point
one percent.
This page shows a similar chart for the IAPT waiting times indicator in the pathway on
a page that was discussed earlier. The CCG value is ninety eight point five percent waiting
less than six weeks. The pathway on a page showed that the value for this CCG was better
than the average value of the similar ten CCGs and this chart shows that the CCG has
the third best rate of this group. This is not statistically different to the average
of the best five CCGs so the indicator is rated amber here compared to green in the
pathway on a page. Information on the Severe Mental Illness and
Dementia indicators are presented in the same format and the full range of slides are available
in your local pack
The length of this video means that we are unable to go into full details about all of
the elements in this pack but page 100 shows how to get further support if you require
assistance interpreting these packs. This includes a link to the website where the data
used in the packs, a metadata file and an interactive tool will be placed.
Thank you.