Transcript Spend & Outcome Tool (SPOT) for Local Government

Using the commissioning for value
packs and resources to improve
population health
What will this session cover?
• Explore the opportunities to use Commissioning
for Value to improve population health
• Using examples from the CfV packs discuss
how to identify and make the most of these
opportunities
• Discuss the issues/barriers
• Discuss further support needs
Population health workshop
Who is in the room?
• Welcome and introductions
• Where do you work?
• What is your role?
• Experience of using commissioning for value
packs?
Population health workshop
Population health workshop
The packs available so far…
• October 2013 Insight packs produced for every CCG.
Looked at the top 10 highest spending programmes and
identified opportunities for improving spend, quality and
outcomes
• June 2014 Focus pack on CVD. Identified opportunities
for improvement across the cardiovascular pathway
• November 2014 Pathways on a page. Focus on 13
programmes and sub-programmes drawn from the
highest spending programmes
http://www.england.nhs.uk/resources/resources-forccgs/comm-for-value/
Population health workshop
Population health workshop
Population health workshop
Tips on where to start
•
The pathways on a page take the average of the 10 similar CCGs as the
benchmark - improvement to the middle line is effectively seen as aspiring
to be average.
•
Discuss the blue and see what other intelligence might be available to
explore further. Focus on the red and test out – but don’t ignore green (see
above)
•
Look for themes across pathways – for example management in primary
care, non-elective spend etc
•
Who in the similar 10 CCGs are doing better – is it worth a chat with them
around their pathway?
•
Primary care indicators include excepted patients in the denominator – so a
population view
Population health workshop
Population health workshop
Using the packs to investigate further
Using Haringey CCG as an example
From the integrated care packs:
• 2% of the most complex patients account for 17.6% of the spend
• Haringey spend 2.7% more on patients with circulation as a main condition
than similar CCGs
• Circulation, GI and Cancer are the main conditions which account for the
highest number of complex patients
• The pack show opportunities for prevention
Population health workshop
Population health workshop
Population health workshop
Population health workshop
Investigating further - the pathways on a page
packs
For Haringey the heart and stroke pathways show potential
opportunities to
• Reduce unmet need
• Improve management in primary care
• Reduce high non-elective spend
COPD, Asthma and Diabetes pathways on a page tell a
similar story
Population health workshop
Population health workshop
Population health workshop
Population health workshop
Exploring even further…
The NCVIN focus packs show potential opportunities for
Haringey to
• Reduce unmet need
• Improve management in primary care
• Improve management in secondary care
Population health workshop
Population health workshop
Population health workshop
Exploring further
• Opportunity to obtain data by practice for all the
indicators in the NCVIN focus packs
• Adding additional data
• The link to inequalities
• LHO segment tool
http://www.lho.org.uk/LHO_Topics/Analytic_Tool
s/Segment/TheSegmentTool.aspx
Population health workshop
Scarf chart showing the breakdown of the life expectancy gap between Kirklees as a whole and
England as a whole, by broad cause of death, 2010-2012
100%
Circulatory, 26.9%
Circulatory, 44.8%
80%
Respiratory, 18.4%
60%
Cancer, 8.7%
Digestive, 5.0%
Respiratory, 3.3%
40%
Mental and behavioural, 10.3%
External causes, 1.2%
Digestive, 6.4%
Other, 35.4%
Mental and behavioural, 8.6%
Other, 24.7%
20%
<28 days, 2.7%
<28 days, 3.5%
0%
Male
Circulatory diseases includes coronary heart disease and stroke.
Digestive diseases includes alcohol-related conditions such as chronic liver disease and cirrhosis.
External causes include deaths from injury, poisoning and suicide.
Female
Life expectancy years gained or lost if Kirklees as a whole had the same mortality rates as England as a
whole, by broad cause of death, 2010-2012
Male
Female
Circulatory
Other
0.49
Other
0.40
Circulatory
0.27
0.30
Cancer
0.09
Respiratory
Mental and behavioural
0.09
Mental and behavioural
Digestive
0.07
Digestive
0.06
Respiratory
0.04
Deaths under 28 days
0.03
Deaths under 28 days
0.04
External causes
0.01
External causes
Cancer
-0.12
-0.5
0
0.5
1
Life expectancy years gained/lost
1.5
2
0.21
0.12
-0.12
-0.5
0
0.5
1
Life expectancy years gained/lost
1.5
2
DRAFT
Local Data: Smoking prevalence
Low % smokers
High% smokers referred
Low % smokers
Low% smokers referred
High % smokers
High% smokers referred
High % smokers
Low % smokers referred
Practices within the dotted line do not have statistically
different level of smoking prevalence and % of smoking
referrals to the CCG as a whole
Practices which have a high % of smokers
and low percentage of smokers referred:
Local Data
Smoking prevalence versus % smoking referrals
DRAFT
Local Data: Obesity prevalence
High weight
management referrals
Low obesity prevalence
Low weight
management referrals
High weight
management referrals
High obesity prevalence
Low weight
management referrals
Practices within the dotted line do not have statistically
different level of smoking prevalence and % of smoking
referrals to the CCG as a whole
Practices which have high % obesity and
low % of weight management referrals :
(For a full list of all practice's see appendix
5)
Local Data
Obesity prevalence versus % weight management
referrals
Low obesity prevalence
High obesity prevalence
Opportunities for using local data
•
The most recent intelligence from providers
•
Contract monitoring data
•
Local prescribing data
•
Joint Strategic Needs Assessment (JSNA)
•
Preventative activity commissioned by local authorities
•
Data on inequalities
•
Local community data
•
Adult and children’s social care data
Population health workshop
Population health workshop
The five stages of grief
Adapted from Elisabeth Kübler-Ross 5 stage model
(Though more modern grief theories such as that of John Bowlby described as ‘ebb and flow of
processes such as shock and numbness, yearning and searching, disorganization and despair,
and reorganization’ have some attraction)
DENIAL
The data is
wrong
ANGER
It does not
apply to me
BARGAINING
DEPRESSION
RESOLUTION
I will get the
correct data
There is
nothing I
can do
about it
Acceptance
and action
Source: East Midlands Quality Observatory
Produced by
PHE Knowledge & Intelligence Team – Northern and Yorkshire
And finally…
• Summing up
• Further questions?
[email protected]
Population health workshop