>>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: This Focus Pack provides information on Neurological conditions.
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 Page 7 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.
The Pathways on a Page section of the pack begins on page 10 and repeats the Pathways
on a Page charts that were included in the Commissioning for Value packs published in
January. For the purpose of this video we are only showing this pathway. The full range
of pages is covered in your packs. The page shows the chart for the Epilepsy
Pathway on a Page that is included in the Commissioning for Value online tool. It presents
a range of indicators from across the patient pathway. Bars above the zero percent line
mean that the CCG value is higher than the average value of the ten similar CCGs. For
some indicators a high value is good, for some a high value is bad, and for some it
is not clear cut - the primary care prescribing indicators, for example, are shaded blue because
local interpretation is required – a high value may indicate inefficient prescribing
or it could mean that GPs are managing their patients well and high prescribing is preventing
hospital admissions and leading to better outcomes.
The next set of pages show spend on hospital admissions for Neurological conditions broken
down in different ways. This page shows spend on all Neurological
conditions except Chronic Pain. This shows age-sex weighted spend per thousand population
for the CCG and the average of the lowest spending five CCGs of the similar ten. The
CCG could save 480 thousand pounds on non-elective admissions if it moved down to the level of
the five lowest spending similar CCGs. Note that this is a different comparison to the
Pathway on a Page which compared the CCG to the average of all ten similar CCGs.
This page shows non-elective admission spend for condition groups such as Migraines and
Headaches. The slide shows that the CCG could save 97 thousand pounds on non-elective admissions
for Migraines and Headaches if it moved down to the level of the five lowest spending similar
CCGs. This page shows that the CCG could save 201
thousand pounds on non-elective admissions for tendency to fall if it moved down to the
level of the best five similar CCGs. This page is one of the pages in your pack
showing Chronic Pain. You can see that the CCG could save six hundred and thirty eighty
thousand pounds on non-elective admissions for Chronic Pain if it moved down to the level
of the best five similar CCGs. This page breaks this down by the part of
the body affected. This page and 5 additional pages show information
on length of stay and day cases. The full set of pages is available in your local pack
This page shows spend on drugs for conditions such as epilepsy and migraine
This page shows some of the highest spend individual drugs in these areas.
This page shows individual drugs for Chronic Pain. The CCG could save three hundred and
seventy thousand pounds if it reduced spend on Pregabalin to the level of the lowest spending
five similar CCGs. This Page shows information on common procedures
performed during hospital admissions for Neurological conditions.
There now follow Spine Charts slides that provide 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 pages are in your packs. This 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 blue bar shows the range
of values for the similar ten CCGs. This page includes the spend indicator for
tendency to fall (the third indicator down). The yellow dot is roughly in the middle of
the similar ten bar, but this is higher than the level of the best 5 CCGs which is shown
by the blue diamond. Therefore the ‘Best/Lowest 5 Opportunity’ box shows the opportunity
figure of two hundred and one thousand pounds seen on page 17 that the CCG could achieve
if it could improve to the level of the best 5. The Similar ten best column shows that
Merton is the CCG with the lowest spend out of the similar ten CCGs. For this indicator,
the blue diamond is partially obscured by the green triangle, which 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. The darker blue bar to the left of the yellow
dot shows the worse performing two CCGs in the similar ten.
The fifth indicator down is elective admissions spend for Carpal Tunnel Syndrome. Here the
yellow dot is to the right of the similar ten bar reflecting that the CCG has lower
spend than all the ten similar CCGs. Therefore, there is no value in the opportunity box.
The other features, for example the blue diamond, are not included for the elective admissions
indicator because this needs local interpretation so it would not be right to show best and
worst CCGs. This page and additional pages in your packs
show more detailed information for all indicators that may be red or green.
This page shows the non-elective spend for tendency to fall indicator already discussed.
The value of two hundred and one thousand pounds 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 is the level of the Best 5, where the CCG would need to move to save
two hundred and one thousand pounds a year. This page shows a similar chart for the percentage
of epilepsy patients who are seizure free. The CCG value is sixty one point two percent
and the average of the best five is sixty two percent. If the CCG could improve to this
level, an extra 7 patients would be seizure free but this is not statistically significant
so is shaded amber. 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 75 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 paced. Thank you.