Transcript www.cumbria.nhs.uk

QIPP Dashboard
March 2012 position
Healthier Horizons
Work stream level
Medicines Management: Chart 1
Benchmarked overall prescribing costs to March 2012
Cost Per Astro PU (£)
The overall
costs for
primary care
prescribing are
high in the NW
compared to
the England
average,
except for 3
PCTs.
CUMBRIA…
WESTERN…
CEC
England average
STOCKPORT
CENTRAL…
WIRRAL
NORTH LANCS
WARRINGTON
SEFTON
BURY
TRAFFORD
NW average
EAST LANCS
SALFORD
BwD
BLACKPOOL
TAMESIDE &…
BOLTON
HALTON &…
ALW
HMR
LIVERPOOL
OLDHAM
MANCHESTER
KNOWSLEY
£0.00
£23.21
£23.71
£23.98
£24.47
£25.22
£26.03
£26.15
£26.22
£26.30
£26.67
£27.11
£27.20
£28.01
£28.47
£28.76
£29.21
£29.31
£29.78
£30.47
£30.61
£31.06
£31.74
£31.95
£32.09
£33.48
£33.85
£10.00
£20.00
£30.00
£40.00
Work stream level
Medicines Management: (2a)
Performance on national QIPP indicators Q4
Prescriber Name
Low cost lipid
ACE inhibitor %
modifying
Score
items
drugs
Low cost PPIs Hypoglycaemic
NSAIDs
% items
agents
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 level
Medicines Management: (2b)
Performance on national QIPP indicators Q4
Prescriber Name
ASHTON,LEIGH & WIGAN
BLACKPOOL
BOLTON
BURY
CENTRAL & EASTERN CHESHIRE
CENTRAL LANCASHIRE
CUMBRIA TEACHING
EAST LANCASHIRE TEACHING
HALTON & ST.HELENS
HEYWOOD, MIDDLETON &
ROCHDALE
KNOWSLEY
LIVERPOOL
MANCHESTER
NORTH LANCASHIRE TEACHING
OLDHAM
SALFORD
SEFTON
STOCKPORT
TAMESIDE & GLOSSOP
TRAFFORD
WARRINGTON
WESTERN CHESHIRE
WIRRAL
BLACKBURN WITH DARWEN CTP
Alendronate as
Antibacterial Cephalosporin
Inhaled
% of all
Long/Intermediat Enteral Feeds Hypnotics
items/STAR s & quinolones Corticosteroid biphosphonate
e Insulin
(SIPS) Cost ADQ/STAR
Score
PU
% items
s NIC/ADQ
s
Analogues
Per PU
PU
11
30
11
23
28
23
31
19
14
11
8
12
18
24
8
26
15
23
15
15
14
23
15
23
0.38
h
5.67
i
£0.57
n
83.83
h
92.17
i
£0.51
h
1.90
i
0.37
h
4.04
i
£0.66
n
85.44
h
75.01
h
£0.39
h
0.95
i
0.38
h
8.13
i
£0.56
h
77.07
h
86.70
h
£0.45
h
1.42
i
0.36
h
5.67
i
£0.53
h
84.04
n
80.58
h
£0.28
i
1.45
i
0.35
h
5.50
i
£0.51
h
85.50
i
90.73
i
£0.33
i
1.04
i
0.35
h
6.53
i
£0.50
h
85.49
h
85.10
i
£0.41
i
1.02
i
0.35
h
5.76
i
£0.50
h
85.68
i
85.89
i
£0.20
i
1.21
i
0.39
h
5.38
i
£0.56
i
82.83
h
77.78
i
£0.49
h
1.71
i
0.40
h
8.41
h
£0.65
h
83.97
h
82.00
h
£0.52
h
1.60
i
0.42
i
6.24
i
£0.55
h
83.62
h
85.72
i
£0.50
i
1.69
i
0.38
h
7.98
i
£0.65
h
82.13
h
91.85
h
£0.74
h
1.41
i
0.35
h
8.30
i
£0.60
i
79.32
h
92.54
h
£0.81
i
1.32
i
0.35
h
4.17
i
£0.56
i
84.45
h
92.59
i
£0.43
i
1.66
i
0.33
h
6.19
i
£0.60
h
83.64
h
83.22
i
£0.35
i
1.21
i
0.40
h
4.52
i
£0.54
h
75.86
h
96.90
i
£0.48
h
1.74
i
0.35
h
5.70
i
£0.53
h
90.57
h
55.36
i
£0.40
i
1.16
i
0.36
h
9.11
i
£0.60
i
82.63
i
91.98
i
£0.64
i
1.32
i
0.35
h
4.08
i
£0.58
i
84.43
h
86.11
h
£0.18
h
1.40
i
0.33
h
6.70
i
£0.57
h
86.67
h
95.81
i
£0.27
i
1.40
i
0.35
h
5.75
i
£0.50
h
86.78
h
96.00
i
£0.26
i
1.19
i
0.37
h
6.22
i
£0.62
n
79.62
h
82.04
i
£0.35
i
1.68
h
0.35
h
6.83
i
£0.51
h
85.78
h
91.49
i
£0.39
h
1.10
i
0.38
h
8.71
i
£0.57
h
85.48
i
96.82
h
£0.38
h
1.48
i
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 level
Medicines Management: (4)
PCTs (Specials) Year on Year Change (% reduction) to Q4 11 /12
-37%
PCT WARRINGTON
-4%
PCT WESTERN CHESHIRE
-6%
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.
PCT BOLTON
-11%
PCT WIRRAL
-12%
PCT CUMBRIA TEACHING
-14%
PCT BLACKPOOL
-24%
PCT KNOWSLEY
-29%
PCT TRAFFORD
-31%
-34%
PCT ASHTON,LEIGH & WIGAN
-35%
PCT TAMESIDE & GLOSSOP
-35%
PCT STOCKPORT
PCT HALTON & ST.HELENS
-37%
Growth %
-40%
PCT SEFTON
-40%
PCT OLDHAM
-40%
PCT LIVERPOOL
PCT CENTRAL LANCASHIRE
-42%
-42%
PCT CENTRAL & EASTERN CHESHIRE
-43%
PCT SALFORD
PCT MANCHESTER
-45%
PCT EAST LANCASHIRE TEACHING
-51%
PCT NORTH LANCASHIRE TEACHING
-53%
PCT HEYWOOD, MIDDLETON & ROCHDALE
-58%
PCT BURY
-59%
PCT BLACKBURN WITH DARWEN CTP
-65%
-70%
-60%
-50%
-40%
-30%
-20%
-10%
0%
Growth in Expenditure %
Work stream level
Medicines Management: (5)
PCTs (Antibacterial Drugs) Change (%) to Q4 11/12
Anti Bacterial Drug Growth (%) Items
NORTH WEST
2.8%
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 TAMESIDE & GLOSSOP
-6.8%
-1.2%
PCT BLACKPOOL
-1.2%
PCT HEYWOOD, MIDDLETON & ROCHDALE
-1.1%
PCT CUMBRIA TEACHING
PCT ASHTON,LEIGH & WIGAN
-0.4%
PCT WESTERN CHESHIRE
0.4%
0.6%
PCT NORTH LANCASHIRE TEACHING
0.7%
PCT SEFTON
1.7%
PCT HALTON & ST.HELENS
1.9%
PCT SALFORD
1.9%
PCT BLACKBURN WITH DARWEN CTP
PCT CENTRAL LANCASHIRE
2.5%
PCT CENTRAL & EASTERN CHESHIRE
3.0%
PCT WIRRAL
4.1%
PCT BURY
4.4%
4.9%
PCT TRAFFORD
5.0%
PCT STOCKPORT
PCT EAST LANCASHIRE TEACHING
5.6%
6.0%
PCT MANCHESTER
6.1%
PCT OLDHAM
6.2%
PCT LIVERPOOL
6.8%
PCT BOLTON
6.9%
PCT KNOWSLEY
7.8%
-8.0% -6.0% -4.0% -2.0%
0.0%
2.0%
4.0%
6.0%
PCT WARRINGTON
8.0% 10.0%
Work stream level
Medicines Management: (6)
PCTs (Nutritional Supplements) Year on Year Change (%) to Q4 11/12
Nutritional Supplements Growth (%) in Expenditure
1%
-14%
-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
-6%
-5%
-5%
-4%
-4%
-4%
-4%
-3%
0%
3%
4%
4%
5%
5%
5%
5%
Growth %
8%
11%
11%
12%
12%
14%
-20%
-15%
-10%
-5%
0%
5%
10%
15%
NORTH WEST
PCT BURY
PCT TAMESIDE & GLOSSOP
PCT BLACKBURN WITH DARWEN CTP
PCT CUMBRIA TEACHING
PCT WARRINGTON
PCT LIVERPOOL
PCT WIRRAL
PCT CENTRAL & EASTERN CHESHIRE
PCT KNOWSLEY
PCT MANCHESTER
PCT OLDHAM
PCT HEYWOOD, MIDDLETON & ROCHDALE
PCT NORTH LANCASHIRE TEACHING
PCT BOLTON
PCT STOCKPORT
PCT CENTRAL LANCASHIRE
PCT SEFTON
PCT ASHTON,LEIGH & WIGAN
PCT TRAFFORD
PCT SALFORD
PCT HALTON & ST.HELENS
PCT EAST LANCASHIRE TEACHING
PCT BLACKPOOL
PCT WESTERN CHESHIRE
20%
Work stream level
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 this
route
Period
Jan,Feb,March 2012
Actual savings
Potential additional
savings
Cheshire
Cumbria
Lancashire
Manchester
Merseyside
£
£
£
£
£
400,828
221,981
479,368
1,139,154
480,029
£
£
£
£
£
305,720
122,362
580,023
729,567
429,319
Total
£
2,721,361 £
2,166,991
Better Care Better Health Better Life
Work stream level
Informatics – Electronic prescription service
at 31st March 2012
rank /51 **
GP Practice
32
35
19
31
Better Care Better Health Better Life
↓ February 2012 RAG Status ↓
Cumbria 30
Lancashire
28
Manchester
27
Merseyside
Some clusters still not
engaging fully with
this initiative. Further
development work is
required to maintain
momentum
Cheshire
Cluster
u
37
18
26
PCT
Map
Ref
Central and Eastern Cheshire
Warrington
Western Cheshire
Wirral
Cumbria
Blackburn With Darwen
Blackpool
Central Lancashire
East Lancashire
North Lancashire
Ashton, Leigh & Wigan
Bolton
Bury
Heywood, Middleton & Rochdale
Manchester
Oldham
Salford
Stockport
Tameside & Glossop
Trafford
Halton & St Helens
Knowsley
Liverpool
Sefton
A
B
C
D
E
F
G
H
I
J
K
L
M
N
O
P
Q
R
S
T
U
V
W
X
u
Release1
BGL/TGL*
R2 BGL
/R1 TGL
** EPS R1
National PCT
Rank (/151)
91%
96%
98%
77%
93%
97%
100%
92%
85%
79%
94%
90%
100%
93%
100%
94%
96%
92%
95%
89%
81%
88%
96%
71%
0%
0%
3%
0%
5%
24%
0%
0%
2%
0%
0%
0%
21%
0%
1%
4%
6%
0%
9%
3%
0%
0%
0%
0%
51
137
58
112
87
56
41
105
121
122
55
91
1
37
90
48
36
107
50
117
86
65
68
123
Work stream level
Lancashire
Manchester
1%
17%
10%
Planning
53
385,625
6347
464503
1.37%



23
92%
28
167641
1945
206837
0.94%
22
172,206
0
Western Cheshire
C
40
261,783




34
85%
40
215,814
3438
260497
1.32%
7
25,395
17
4572
333008
1.37%
11
58,872
0
D
61
331,710
48
79%
62
269,940
E
86
513,923
55
64%
0
0
Blackburn With Darwen
F
29
168,874
16
55%
31
130,729
749
167308
# Practices Uploaded
#patient opt outs
Project Board Established
Project Manager In Post
Wirral
Cumbria

# Patient Records Created
74%

% Patient Opt Out
(of practices reporting)
39
208,801
Patients surveyed for opt out
470,829
25
# of PIP Letters Sent
(To Patients > 16yrs)
53
B
% of Potential total GP Practices
A
Warrington
SCR Clinical Lead In Place
Central and Eastern Cheshire
Business Case Developed
PCT Name
PCT Population
# Practices Where Patient PIP Letters Sent
(Public Information Programme)
Adoption
# of Practices
# Potential GP Practices
(EMIS LV, iSoft Synergy, InPS or TPP)
In progress / Not done
# Practices Entered into Provisional Business Go Live
Field
Awareness & Engagement
Map Ref
Cluster
Cheshire
20%
Cumbri
0%
a
Merseyside
Only 20 %
(152 out of
763) of
practices
have
uploaded
Summary
Care
Records.
An increase
from Dec
2011 (14.5 %
of practices)
% of patients with records created
Informatics – Summary Care Record
at 31st March 2012
0
0.00%
0
0.45%
27
0.00%
0
Blackpool
G
22
153,069
12
55%
0
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
n
N
n
n
North Lancashire
J
37
339,752
18
49%
39
293,437
1904
337424
0.56%
2
22,582
0
Ashton, Leigh & Wigan
K
66
320,418




57
86%
66
262,378
1949
320429
0.61%
31
146,202
0
Bolton
L
45
296,358




43
96%
44
237,759
3127
289864
1.08%
19
144,755
0
Bury
M
33
195,942




33
100%
32
159,073
1455
160359
0.91%
26
147,631
7
Heywood, Middleton & Rochdale
N
40
224,321




27
68%
5
0
Manchester
O
103
568,105




32
31%
103
450,633
2727
558490
0.49%
1
9,168
92
Oldham
P
49
240,857




25
51%
49
187,082
192
28294
0.68%
6
43,413
42
247488
0.00%
0
0.00%
10
0.00%
0
Salford
Q
56
250,190

40
71%
0
0
Stockport
R
52
299,487


17
33%
0
0
Tameside & Glossop
S
43
240,706


24
56%
0
0
0.00%
15
Trafford
T
40
234,400

25
63%
41
187,762
2887
233396
1.24%
0
Halton & St Helens
U
55
321,194
n
25
45%
55
261,045
2459
319591
0.77%
Knowsley
V
33
158,349




28
85%
31
0
780
158514
0.49%
Liverpool
W
97
492,835

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
1275
7,433,353
763
60%
988
4,541,802
5,714,837
0.76%
N/West Total
Better Care Better Health Better Life
43,415
0
27
152
127,968
898,192
0
270
Work stream level
Demand & Threshold Management :
Increased number of patients dying at home
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.
Better Care Better Health Better Life
Confidential North West SHA
Cluster Q4 Self Assessment of QIPP Programme Milestones
Cumbria
Cluster QIPP Update
Q4 Self Assessment
SHA Triangulation
% Complete
120%
R
100%
80%
60%
40%
20%
0%
A/R
QIPP Milestone Programmes
Cluster Self Assessment Exceptions
Urgent Care
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
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.
SHA Triangulation
May 2012
A/R
Long Term Conditions
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)
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.
Cumbria PCT
A/R
Watching brief:
Outpatients and electives,
recognise improvements made on finance and
sickness absence.
Better Care Better Health Better Life
Non-Elective G&A Admissions
175942
154618
156315
166508
184539
172544
Previous Year
All Elective G&A Admissions
145585
135757
138643
38954
36787
Planned Activity
Elective Daycase G&A Admissions
Elective Ordinary G&A Admissions
458996
463901
600000
470385
502033
503335
516036
400000
37299
204247
NHS North West
Activity Monitoring
All first G&A outpatient attendances
207226
197851
500000
All referrals for first G&A outpatient
appointment
Other referrals for first G&A outpatient
appointment
297786
305484
308810
The 4th quarter saw some
reductions in a trend of 300000
rises across a number of
200000
areas.
But, growth continued for; 100000
other referrals (7.5%),
0
All referrals (1.7%)
elective day cases (7%)
all electives (4.7%)
GP referrals for first G&A outpatient
appointment
Cluster level
Activity - Cumbria March 2012
Actual Activity
Cluster Level - Cumbria
Workforce – March 2012
Cumbria
CUMBRIA PARTNERSHIP NHS TRUST
CUMBRIA PCT
NORTH CUMBRIA ACUTE HOSPITALS NHS TRUST
RAG
Dec 11
RAG
Mar 12