>>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 Cancers and Tumours.
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 8 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 repeats the Pathways on a Page charts that were included
in the CfV packs published in January. For the purpose of this video we are only showing
the Lung cancer pathway on page 13. The full range of pathways are shown in your packs.
This chart 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. For example, elective admissions are shaded blue for local
interpretation because a high value might be good or bad and needs to be considered
alongside other indicators in the pathway such as detection at an early stage and non-elective
admissions. For this CCG non-elective spend is higher than the average of the similar
ten CCGs so is shaded red. Lung cancer detected at an early stage is lower than the average
of the similar ten CCGs, which is bad so this is shaded red, but note that the confidence
intervals cross the zero percent line so this value is not statistically significantly different
from the average of the similar ten. The next set of pages show spend on hospital
admissions for Cancer and tumour conditions broken down in different ways.
Page 15 shows spend on admissions to hospital for Cancer. 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. 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. The CCG could save over nine
hundred thousand pounds a year if it moved down to the level of the five lowest spending
similar CCGs. Although elective spend is higher than non-elective, the bigger potential opportunity
is for non-elective admissions – the CCG has a potential opportunity of six hundred
and eight thousand pounds. Page 17 breaks down this non-elective spend
in more detail. For Haematological Cancer, the CCG spends two hundred and eight thousand
pounds more on non-elective admissions than the lowest five similar CCGs, and the rate
of spend is more than double that of these five CCGs.
Page 40 shows a scatterplot of deprivation and the percentage of women screened for breast
cancer. This shows that more deprived CCGs have lower rates of screening. The CCG value
is shown by the yellow diamond. There now follow 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 spend 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 elective spend for all Cancer admissions. The yellow dot
is in the middle of the similar ten bar, meaning the CCG has roughly average spend on elective
admissions compared to similar CCGs. The ‘Best/Lowest 5 Opportunity’ box shows the opportunity
figure of four hundred and eleven thousand pounds seen on page 15 that the CCG could
achieve if it could improve to the level of the lowest spending five similar CCGs. This
is shaded blue for local interpretation. The indicator below is non-elective spend
for all Cancer admissions. Here the yellow dot is at the left hand side of the range
of the similar ten, showing higher spend. The blue diamond shows the level of the best
five CCGs, i.e. those with the lowest spend on non-elective admissions. The ‘Best/Lowest
5 Opportunity’ box includes the figure of six hundred and eight thousand pounds from
page 15. This is shaded red. The ‘Similar 10 Best’ box names Luton as the best in
the similar ten. 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.
The darker green bar to the right of the yellow dot shows the worse performing two CCGs in
the similar ten. These features are not included for the elective admissions indicator because
this needs local interpretation so it would not be right to name best and worst CCGs.
This page shows more detail for this non-elective spend indicator. The value of six hundred
and eight 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 in order to save six
hundred and eight thousand pounds a year. This chart shows that the CCGs have a higher
rate of spend for non-elective admissions that all ten similar CCGs and names those
CCGs that are performing better. This page shows a similar chart for the lung
cancer detected at an early stage indicator. The pathway on a page chart showed that the
CCG had a lower rate than the average of the similar ten CCGs but this was not statistically
significantly different. This chart shows that the CCG has a lower value than six of
the ten similar CCGs but this is still not statistically significantly different from
the average of the best five similar CCGs. The opportunity of 7 patients is shown as
amber and not statistically significant. 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 101 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.