HULL CCG BUSINESS INTELLIGENCE FRAMEWORK

Transcription

1 HULL CCG BUSINESS INTELLIGENCE FRAMEWORK 1. INTRODUCTION As NHS Hull CCG is now a statutory organisation it needs to have robust business intelligence (BI) arrangements in relation to both its statutory responsibility as a commissioner and as a membership organisation. The CCG will be held accountable by the Area Team of NHS England for delivery of key national requirements and it will need to demonstrate that its commissioning decisions are making a difference. In addition, it will need to ensure its members are receiving timely information to support decision making and facilitate clinical involvement and leadership. A BI framework is important as it not only enables the CCG to receive up to date performance on the national and local indicators but also ensures there is clear reporting mechanism in place with clear accountability and ownership between groups and individuals. This BI framework identifies leads for each of the indicators covering both the national and local requirements. The lead is responsible for the performance either through their role as a programme area lead or contract lead. They will be responsible for managing any underperformance either through development and monitoring of recovery plans and/or implementation of contractual arrangements. The framework also clarifies the relationship between the forums within the CCG. This enables the CCG to focus on not only reporting and monitoring but the active management of performance, through internal and external assurances on delivery and improvement. The BI framework identifies two sources for assurance: programme areas and contractual management boards. For any underperformance assurances will be provided to the Quality and Performance Committee on improvements. The Quality and Performance Committee will in turn provide assurances to the Governing Body that they are satisfied with the systems in place to improve performance. Establishing these arrangements within the BI framework should ensure the Governing Body when presented with a performance issue has a clear reason for underperformance, along with a robust recovery plan that has assurances that the plan will be delivered and that improvements in performance will be made. 2. NATIONAL REPORTING REQUIREMENTS The CCG will be held accountable by NHS England for the delivery of key national requirements and the various national frameworks that are relevant to the CCG are described below: NHS Outcomes Framework The NHS Outcomes Framework sets out the outcomes and corresponding indicators that will be used to hold the NHS England to account for improvements in health outcomes, as part of the government s mandate. Hull CCG Business Intelligence Framework 1

2 Indicators in the NHS Outcomes Framework are grouped around five domains, which set out the high-level national outcomes that the NHS should be aiming to improve. For each domain, there are a small number of overarching indicators followed by a number of improvement areas. They focus on improving health and reducing health inequalities: Preventing people from dying prematurely; Enhancing quality of life for people with long-term conditions; Helping people to recover from episodes of ill health or following injury; Ensuring that people have a positive experience of care; and Treating and caring for people in a safe environment and protecting them from avoidable harm. The five domains were derived from the three part definition of quality first set out by Lord Darzi as part of the NHS Next Stage Review. In addition, the Secretary of State, NHS England and Clinical Commissioning Groups have a duty, for the first time, to have regard to the need to reduce inequalities between the people of England. The NHS Outcomes Framework sits alongside similar frameworks for public health and adult social care. CCG Indicator set The CCG indicator set (CCG IS) includes NHS outcome indicators that can be measured at CCG level and additional indicators developed by NICE and the Health and Social Care Information centre. The aim of CCG IS is to support CCG and Health and Well-being Board (HWB) partners improve health outcomes by providing comparative information on the quality of health services commissioned by CCG and the associated health outcomes. It is intended to support CCGs in determining local priorities and levels of ambition with HWB. The NCB will monitor the CCG on the CCG IS although it will not set thresholds or levels of ambition for CCGs, although the Everyone Counts planning guidance states that CCG plans should be built on the assumption that no indicator contained within the national NHS outcomes framework or CCG outcomes indicator set deteriorates. Therefore, it is important to monitor the CCG IS in year to ensure no indicators are deteriorating and if required implement recovery plans. Many of the indicators have not been reported by the CCG or previous PCT and some are still in development. Work is ongoing to baseline indicators and compare with peers to identity where the CCG is an outliner. In addition, for those indicators that can be measured in year these will need to be reported on quarterly to the Quality and Performance Committee (In full) and Governing Body by exception. All the CCG IS have been aligned to one of the programme areas and/ or one or more providers. For each indicator there is also a CCG lead identified as shown in appendix 2. Where a CCG IS is aligned to a programme area these will form part of the programme area report. NHS Mandate and Constitutional requirements Hull CCG Business Intelligence Framework 2

3 The NHS mandate confirmed the commitment to the NHS constitutional requirements and as a result CCGs were required to self-certify that plans ensured that the performance standards in the NHS Constitution will be delivered throughout 2013/14. The existing commitments include: 18 week Referral to treatment Cancer waits for 2 weeks, 1 month and 2 months Ambulance response times A&E four hour wait Cancelled operations offered a new appointment within 28 days and; Care Programme Approach (CPA) for mental health patients. The Everyone Counts planning guidance included further commitments in relation to the constitutional indicators including: Zero tolerance to 52 week waits All handovers between an ambulance and an A&E department to take place within 15 minutes and crews ready to accept new calls within further 15 minutes Implementation of contractual fine for all delays over 30 minutes for both of the above situations and a further fine for delays of over an hour for both situations No patient to tolerate an urgent operation being cancelled for the second time Zero tolerance to MRSA No waits from decision to admit to admission (trolley waits) over 12 hours The NHS mandate also includes the commitment for the full roll out of the Improved Access to Psychological Therapies (IAPT) programme by 2014/15 with the expectation that 15% of eligible patients will receive IAPT services with a 50% recovery rate. Everyone Counts planning for patients 2013/14 requirements As part of the The everyone counts planning for patients 2013/14 CCG can now receive a Quality Premium. This will be paid to the CCG in 2014/15 based on 2013/14 performance for achieving improved or high standards of quality in the following four measures: 1. Potential years of life lost from causes considered amenable to healthcare 2. Avoidable emergency admissions 3. Friends and family test 4. Incidence of C. Difficile (include a zero tolerance for MRSA) In addition, the CCG is expected to deliver on three locally selected indicators and a locally set ambitious dementia diagnosis target. 3. CCG RELATIONSHIPS As covered above It is important to clarify the reporting arrangements between the various groups within the CCG and externally. The diagram below illustrates these relationships and how assurances are reported. At the core of the diagram is the Quality and Performance Committee, which will receive reports, recovery plans and/or assurances from the contact Hull CCG Business Intelligence Framework 3

4 management boards (CMB) and the transformational programme areas. It will also triangulate BI with Quality and Safety and Patient Engagement reporting which are detailed below. In Appendix 1 and 2 all National requirements have been aligned to either a programme area and/or contract. This ensures each is reviewed and discussed prior to it being presented to the Quality and Performance Committee. If an indicator s performance is dependent on a provider and this is detailed within the relevant contract, this is classified as a contractual indicator and will not be required to be reported on by one of the transformational programmes. The transformational programme areas will only focus on indicators that they have a level of direct control over. The Quality and Performance Committee will need to have an overview of all key performance indicators to assure itself and the Governing Body that the CCG is meeting its statutory responsibilities. In addition, the Quality and Performance Committee will be required to challenge any underperformance and scrutinise recovery plans for improvement and once satisfied, provide assurances to the governing body that improvements in performance will be made. The mechanism for how Peer groups will feed into the framework and how and who they assure is still being developed. 4. PROPOSED REPORTING ARRANGEMENTS Hull CCG Business Intelligence Framework 4

5 Group Governing Body Quality & Performance Senior Leadership Team Programme areas HWB To facilitate the relationships described above and decision making within the organisation a suite of BI reports are required. A report is required for each of the CCG groups described in the diagram of varying detail, content and style of presentation. NHS constitution requirement By exception Quality premium (4 indicators) (Graph) 3 local priority indicators. (Graph) Dementia and IAPT. (Graph) Yes Yes Yes Sections CCG Indicators By exception Programme area key outcome measures By Exception Programme productivity measures Yes Yes Yes Yes Yes Yes No Yes Yes Yes Yes No Proxy measures Yes if aligned to area Yes- if aligned to area No Yes Yes Yes By exception Yes if aligned to area By exception By Exception Yes No No Yes Finance (Graph). Peer Groups No No No Integrated Audit and Governance Committee Exception Exception Exception Exception Exception Exception No Exception Public Yes Yes Yes Yes No No Yes Yes Yes No No For example the governing body report will be made up of sections covering: NHS constitution requirements (by exception), Quality premium, local priorities, dementia/ IAPT, CCG IS (by exception), key outcome measures (by exception). Practice and Peer Groups It is proposed that in the short term the current practice level report continues with a CCG commitment to review during 2013/14 through consultation with practices and peer groups. Transformational programme areas Each of the four programme areas will receive a BI report that will contain any CCG IS, NHS constitutional and NHS Mandate requirements that they have an impact on. In addition, each programme area will need to pick 2-5 key outcome measures which will be used to demonstrate overall performance of the programme to the Quality and Performance Committee and Governing Body. The reports will contain a number process measures to be used by the programme board to monitor and assure of the progress and impact of delivery plans. Each programme area has identified the measures it will use and these are demonstrated in appendix 3 to 7. Quality and Performance to Governing Body The Quality and Performance Committee will receive reports covering all the constitution and mandate commitments, indicators linked to the Quality Premium, CCG IS and the key outcome measures from each of the programme areas. In addition, it will receive any associated recovery plans and assurances. Hull CCG Business Intelligence Framework 5

6 Governing Body The Governing Body will receive reports covering all the constitution and mandate commitments, indicators linked to the Quality Premium, CCG IS by exception and key outcome measures for the programme areas by exception. Rather than receiving detailed recovery plans it will receive narrative for each of the underperforming indicators. The narrative will cover reasons for underperformance, actions to improve performance and expected timescales when performance is expected to improve by. Integrated Audit and Governance Committee The Integrated Audit and Integrated Governance Committee will receive reports covering by exception the constitutional, CCG indicators set and Key outcome measures (as detailed above) on a timeframe to be agreed. 5. ROLE OF THE HULL CCG BI TEAM The CCG has an internal Business Intelligence team within the Resources Directorate. The BI team is responsible for the development and implementation of this BI framework and will be responsible for ensuring the BI framework is delivering all the responsibilities. This will include ensuring the quality of BI reports produced by the CSU, the co-ordination of recovery plans and the quality of narratives. In addition, members of the Hull CCG BI team are aligned to the programme areas and healthcare contracts. 6. ROLE OF THE CSU BI TEAM The implementation and ongoing servicing of the BI framework is dependent on a fully staffed embedded BI team which will be in place from April The embedded team will be responsible for developing the reports, baselining the indicators and then ensuring all reports are fully populated to agreed timescales. A development plan is in place for the development of the various sections and reports. 7.EXTERNAL REPORTING To meet NHS constitutional requirements the national reporting requirements need to be published on the website and be publically available. The NHS constitutional indicators, CCG outcome measures, and national reporting requirements will be published monthly on the Hull CCG website. It will be the responsibility of the CSU BI team to ensure that the internet and intranet have up to date BI reports. 8. ALIGNMENT TO THE CCG BAF AND RISK REGISTER Hull CCG Business Intelligence Framework 6

7 Ultimately the BI framework will be aligned to the CCG BAF and risk register. This is currently being scoped and is captured in the development plan (appendix 9). 9. QUALITY AND SAFETY FRAMEWORK Patient Experience Alongside this BI framework the CCG has in place a Quality and Safety Framework and Patient Experience framework. Each will report to the Quality and Performance Committee to give a balanced picture of the local health community. There are overlaps and in relation to the BI framework as there are some indicators included in this framework that appear in the other two frameworks as listed below. The performance of these indicators will be reported through the BI framework with qualitative information associated with the indicators included within the quality and safety report and patient experience report. BI link to Quality and Safety Mixed Sexed Accommodation breaches C4.4 Friends and Family test C5.1 Patient safety incident reporting C5.2 Incidence of hospital-related venous thromboembolism (VTE) C5.3 Incidence of healthcare associated infection MRSA C5.4 Incidence of healthcare associated infection C.Difficile BI link to Patient Experience C3.3a Total health gain as assessed by patients for elective procedures Hip C3.3b Total health gain as assessed by patients for elective procedures - Knee replacement C3.3c Total health gain as assessed by patients for elective procedures - Groin hernia C3.3d Total health gain as assessed by patients for elective procedures Varicose veins C4.1 Patient experience of primary care - GP out-of-hours services C4.2 Patient experience of hospital care C4.4 Friends and Family test C4.4 Patient experience of outpatient services C4.5 Responsiveness to in-patients personal needs C4.6 Patient experience of A&E services C4.7 Women s experience of maternity services C4.8 Patient experience of community mental health services 10. FINANCE AND CONTRACTING UPDATE A further section will focus on the financial reporting for the CCG, the measures are listed in appendix 8, as well as a contract update. The contract update which will be mostly narrative will cover the following points for the main providers Financial position Activity position Hull CCG Business Intelligence Framework 7

8 CQUIN proportion of total indicator delivering. Outstanding issues. Hull CCG Business Intelligence Framework 8

9 Waiting times Emergency department Ambulance response times Appendix 1 - Constitutional indicators and Everyone counts additional planning requirements Indicator RTT waiting times - 90% of admitted patients to start treatment within a max of 18 weeks from referral (to include number of specialty level breaches) RTT waiting times - 95% of non-admitted patients to start treatment within a max of 18 weeks from referral (to include the number of speciality level breaches) RTT - 92% of patients on an incomplete non-emergency pathway (yet to start treatment) should have been waiting no more than 18 weeks from referral Zero tolerance for all patients for any referral to treatment waits of more than 52 weeks. Patients waiting for a diagnostic test should have been waiting no more than 6 weeks from referral 99% Contract HEYHT, CHCP & Other acute and community providers HEYHT, CHCP & Other acute and community providers HEYHT, CHCP & Other acute and community providers HEYHT, CHCP & Other acute and community providers HEYHT, CHCP & Other acute and community providers Transformational programme area 95% of patients should be admitted, transferred or discharged within 4 hours of their arrival at an A&E department? HEYHT & CHCP Unplanned care No waits from decision to admit to admission (trolley waits) over 12 hours HEYHT & CHCP All handovers between an ambulance and an A&E department to take place within 15 minutes and crews ready to accept new calls within further 15 minutes 75% Cat A calls resulting in an emergency response arrive within 8 minutes (met for red 1 and red 2 calls separately) 95% cat A calls resulting in an ambulance arriving at the scene within 19 minutes YAS & HEYHT YAS YAS CCG responsible Owner Hull CCG Business Intelligence Framework 9

10 Cancer waiting times Dignity Cancelled operations. Mental Health Hospital infections 93% max 2 week wait for first appointment for patients referred urgently with suspected cancer by a GP HEYHT 93% max 2 week wait for first appointment for patients referred urgently with breast symptoms (where cancer was not initially suspected) HEYHT 96% max one month (31-day) wait from diagnosis to FDT for all cancers HEYHT 94% max 31 day wait for subsequent treatment where that treatment is surgery HEYHT 98% 31 day wait for subsequent treatment where that treatment is an anti-cancer drug regime HEYHT 94% max 31 day wait for subsequent treatment where that treatment is a course of radiotherapy HEYHT 85% max 2 month (62-day)wait from urgent GP referral for FDT for cancer HEYHT 95% max 62 day wait from referral from an NHS Screening service for FDT for all cancers HEYHT Max 62 day wait for FDT following a consultant's decision to upgrade the priority of the patient (all cancers) - no operational standard. HEYHT Mixed sexed breaches All patients who have operations cancelled, on or after the day of admission (including the day of surgery), for non-clinical reasons to be offered another binding date within 28 days, or the patients treatment to be funded at the time and hospital of the patients choice. No patient to tolerate an urgent operation being cancelled for the second time Care Programme Approach (CPA): 95% of the proportion of people under adult mental health specialities of CPA who were followed up within 7 days of discharge from psychiatric in-patient care during the period HEYHT & other acute providers HEYHT & other acute providers HEYHT & other acute providers Humber FT Quality and safety IAPT Humber FT & AQPs Mental Health C. Difficile infections HEYHT Quality and safety Director of Quality and Clinical Governance Zero tolerance on MRSA breaches HEYHT Quality and safety Director of Quality and Clinical Governance Hull CCG Business Intelligence Framework 10

11 Appendix 2 CCG indicator set Domain Indicator Contract Frequency Programme area CCG responsible Owner Preventing people from dying prematurely C1.1 Potential Years of Life Lost (PYLL) from causes considered amenable to health care Adults and Children and YP (OF A1i and ii) Annual (ONS) HWB Director of Commissioning & Partnerships C1.2 Under 75 mortality rate from cardiovascular disease Annual (PCMD)l HWB Director of Commissioning & Partnerships C1.3 Cardiac rehabilitation completion CHCP Quarterly Planned Care C1.4 Myocardial infarction, stroke, stage 5 kidney disease in people in diabetes SSNAP Primary Care Senior Commissioning (Primary Care) C1.5 Mortality within 30 days of hospital admission for stroke HEYHT Monthly Unplanned ) (SUS) care/ Primary care C1.6 Under 75 mortality rate from respiratory disease Annual HWB Director of Commissioning & Partnerships C1.7 Under 75 mortality rate from liver disease Annual HWB Director of Commissioning & Partnerships C1.8 Emergency admissions for alcohol related liver disease Monthly (SUS) Primary Care Senior Commissioning (Primary Care) C1.9 Under 75 mortality rate from cancer Annual HWB Director of Commissioning & Partnerships C1.10a Under 75 mortality from cancer - 1 year survival from all cancers Annual HWB Director of Commissioning & Partnerships C1.10b Under 75 mortality from cancer - 5 year survival from all cancers Annual HWB Director of Commissioning & Partnerships C1.11a Under 75 mortality from cancer - 1 year survival from breast, lung and colorectal cancer Annual HWB Director of Commissioning & Partnerships C1.11b Under 75 mortality from cancer - 5 year survival from breast, lung and colorectal cancer Annual HWB Director of Commissioning & Partnerships C1.12 People with severe mental illness who have received a list of physical checks Humber Monthly (Practice Partnerships Senior Commissioning Partnerships Lists) C1.13 Antenatal assessment <13 weeks HEYHT Quarterly (UNIFY) Partnerships Senior Commissioning Partnerships C1.14 Maternal smoking at delivery HEYHT Quarterly Partnerships Senior Commissioning Hull CCG Business Intelligence Framework 11

12 Domain Indicator Contract Frequency Programme area CCG responsible Owner Enhancing quality of life for people with long term conditions (OMNIBUS) Partnerships C1.15 Breastfeeding prevalence at 6-8 weeks Quarterly (UNIFY) Partnerships Senior Commissioning Partnerships C2.1 Health related quality of life for people with long-term conditions Annual Primary Care Senior Commissioning (Primary Care) C2.2 Proportion of people feeling supported to manage their Annual Primary Care Senior Commissioning condition (Primary Care) C2.3 People with COPD and Medical Research Council CHCP Annual Primary Care Senior Commissioning dyspnoea scale 3 referred to a pulmonary rehabilitation (GPES) (Primary Care) programme C2.4 People with diabetes who have received nine care Annual Primary Care Senior Commissioning processes Quarterly? (Primary Care) C2.5 People with diabetes diagnosed less than one year HEYHT? Annual/ Primary Care Senior Commissioning referred to structured education Quarterly (Primary Care) C2.6 Unplanned hospitalisation for chronic ambulatory care Monthly Unplanned Senior Commissioning sensitive conditions (adults) C2.7 Unplanned hospitalisation for asthma, diabetes and epilepsy in under 19s C2.8 Complication associated with diabetes including emergency admissions for diabetic ketoacidosis and lower limb amputation (SUS) Monthly (SUS) Annual (National Diabetes audit) Care Unplanned Care/ Partnerships/ Primary Care (Unplanned Care) Senior Commissioning (Primary Care) Primary Care Senior Commissioning (Primary Care) C2.9 Access to community mental health services by people from BME groups Humber Quarterly Partnerships Senior Commissioning Partnerships C2.10 Access to psychological therapy services by people from BME groups Humber Quarterly Partnerships Senior Commissioning Partnerships C2.11 and C2.12 Recovery following talking therapies Humber Quarterly Partnerships Senior Commissioning Partnerships C2.13 Estimated diagnosis rate for people with dementia Humber Monthly Primary Care & Partnerships Senior Commissioning Partnerships & CSU C2.14 People with dementia prescribed anti-psychotic medication Annual (Dementia Partnerships and Primary Lead Senior Commissioning Partnerships Hull CCG Business Intelligence Framework 12

13 Domain Indicator Contract Frequency Programme area CCG responsible Owner Helping people to recover from episodes of ill health or following injury Ensuring that people have a C3.1 Emergency admissions for acute conditions that should not usually require hospital admission C3.2 Emergency readmissions within 30 days of discharge from hospital C3.3a Total health gain as assessed by patients for elective procedures - Hip C3.3b Total health gain as assessed by patients for elective procedures - Knee replacement C3.3c Total health gain as assessed by patients for elective procedures - Groin hernia C3.3d Total health gain as assessed by patients fro elective procedures Varicose veins C3.4 Emergency admissions for children with lower respiratory tract infections (LRTI) C3.5 People who have had a stroke who are admitted to an acute stroke unit within four hours of arrival to hospital C3.6 People who have had a stroke who receive thrombolysis following an acute stroke C3.7 People who have had a stroke who are discharged from hospital with a joint health and social care plan C3.8 People who have had a stroke who receive a follow up assessment between 4-8 months after initial admission C4.1 Patient experience of primary care - GP out-of-hours services HEYHT all acute providers HEYHT all acute providers HEYHT all acute providers HEYHT all acute providers HEYHT all acute providers C4.2 Patient experience of hospital care HEYHT all acute audit) Monthly (SUS) Monthly (SUS) Quarterly (PROMS) Quarterly (PROMS) Quarterly (PROMS) Quarterly (PROMS) Care Unplanned Care & Primary care Unplanned Care and Primary care Senior Commissioning (Primary Care) Senior Commissioning Unplanned Care Monthly Partnerships & Planned Care Senior Commissioning Partnerships HEYHT Quarterly? SSNAP HEYHT Quarterly SSNAP HEYHT/ Quarterly Partnerships BI Humber SSNAP Humber Quarterly SSNAP Quarterly Primary Care Senior Commissioning (GP Patient Query (Primary Care) Survey) unplanned care Annual Hull CCG Business Intelligence Framework 13

14 Domain Indicator Contract Frequency Programme area CCG responsible Owner positive experience of care Treating and caring for people in a safe environment and protecting them from avoidable harm providers C4.4 Friends and Family test HEYHT all acute providers Quarterly (UNIFY) C4.4 Patient experience of outpatient services HEYHT Annual Quality and Safety C4.5 Responsiveness to in-patients personal needs HEYHT Annual C4.6 Patient experience of A&E services HEYHT Annual C4.7 Women s experience of maternity services HEYHT Annual C4.8 Patient experience of community mental health services Humber Annual C5.1 Patient safety incident reporting All providers Monthly NRLS? Quality and Safety C5.2 Incidence of hospital-related venous thromboembolism HEYHT Monthly Quality and (VTE) Safety C5.3 Incidence of healthcare associated infection MRSA HEYHT Monthly Quality and Safety C5.4 Incidence of healthcare associated infection C.Difficile HEYHT Monthly Quality and Safety Quality Facilitator Director of Quality and Clinical Governance Director of Quality and Clinical Governance Hull CCG Business Intelligence Framework 14

15 APPENDIX 3 UNPLANNED CARE FRAMEWORK Key Outcome Measures Source Freq Target Attendance at AE (type 1 and 2) TBC TBC TBC Attendance at MIU (numbers) TBC TBC TBC Non elective admission over 65 SUS M Note a Non elective admissions from care homes SUS M Note a Delayed transfer of care TBC TBC TBC Excess bed days TBC TBC TBC C2.6 Unplanned hospitalisation for chronic ambulatory care sensitive conditions (adults) SUS M TBC NHS Constitutional Indicators Source Freq Target 95% of patients should be admitted, transferred or discharged within 4 hours of their arrival at an A&E department? Unify D 95% CCG Indicator Set Source Freq Target C1.5 Mortality within 30 days of hospital admission for stroke *** SUS M Note c C2.6 Unplanned hospitalisation for chronic ambulatory care sensitive conditions (adults) C2.7 Unplanned hospitalisation for asthma, diabetes and epilepsy in under 19s *&*** C3.1 Emergency admissions for acute conditions that should not usually require hospital admission *** SUS M TBC SUS M Note c SUS M Note c C3.2 Emergency readmissions within 30 days of discharge from hospital *** SUS M Note c Process measures Source Freq Target Primary care activity in AE. TBC M TBC Reduced length of stay for patients admitted with a mild to moderate stroke. TBC M TBC Fractured neck of femur (previous VS3) (HRG) SUS M TBC Total number of non-elective admissions (HRG) SUS M TBC Total number of non- elective admissions for over 65s (HRG) SUS M TBC Total number of non- elective admissions for over 65s (excluding LTC) SUS M TBC (HRG) Total number of non-elective admissions from care homes SUS M TBC Care Home Emergency Non-elective spells by Length of Stay SUS M TBC Care Home Emergency PbR Excess Bed days SUS M TBC Care Home Accident and Emergency Attendances by Time Status (HRG) SUS M TBC Care Home Emergency Non-Elective Spells Top 10 Primary Diagnosis SUS M TBC (HRG) Total number of non-elective admissions with COPD (HRG) SUS M TBC Total number of non-elective admissions with CHD-(HRG) SUS M TBC All LTC Only Excess Bed Days - SUS M TBC Total number of emergency re-admissions for CHD patients (HRG) SUS M TBC Total number of emergency re-admissions for COPD patients (HRG) SUS M TBC Delayed Transfers of Care Numerator (acute 8119) TBC TBC TBC NB unplanned care board (Hull and East Riding Headline measures) and programme report all key outcome measures Hull CCG Business Intelligence Framework 15

16 APPENDIX 4 PARTNERSHIPS FRAMEWORK Key Outcome Measure Source Freq Target Children experience of healthcare (composite measure from service TBC TBC TBC specifications) Query CQUIN IN DEVELOPMENT C1.13 Antenatal assessment <13 weeks Unify 2 Q TBC C4.7 Women s experience of maternity services CQC A TBC Number of non-elective emergency admissions for those aged under 19s SUS Q TBC (HRG) Reduction in assisted deliveries (births by intervention i.e. C-section, forceps and ventouse) TBC Q TBC CCG Indicator Set Source Freq Target C1.1 Potential Years of Life Lost (PYLL) from causes considered amenable ONS A Note c to health care Children and YP (OF A1i) C1.13 Antenatal assessment <13 weeks Unify 2 Q TBC C1.14 Maternal smoking at delivery + Unify 2 Q TBC C1.15 Breastfeeding prevalence at 6-8 weeks + OMNIBUS Q TBC C2.7 Unplanned hospitalisation for asthma, diabetes and epilepsy in under 19s **** SUS M TBC C3.4 Emergency admissions for children with lower respiratory tract infections (LRTI) ** C3.7 People who have had a stroke who are discharged from hospital with a joint health and social care plan. (UNIFY) Q TBC SUS M TBC C4.7 Women s experience of maternity services CQC A TBC Process measures Source Freq Target Infant mortality ONS A TBC Maternal mortality ONS A TBC Children experience of healthcare (composite measure from service TBC TBC TBC specifications) Query CQUIN IN DEVELOPMENT Low birth weight babies 10% of live births at term >38 weeks with LBW Provider Q TBC <2500g + VSC29 Unintentional and deliberate injuries to SUS M TBC children aged under 18 + Immunisation rates (all) + PC M TBC Number of non elective emergency admissions for those aged under 19s (HRG) Number of non elective emergency admissions for those aged under 19s (excluding LTC) (HRG) Number of non- elective emergency admissions for those aged under 19s (for LTC) (HRG) Number of and percentage BMI over 30 at 12 weeks and 6 days of maternity Proportion of women with a BMI recorded over 30 referred to healthy lifestyle midwife. SUS Q TBC SUS Q TBC SUS Q TBC Provider Q TBC Provider Q TBC Proportion of women booked at 12 weeks 6 days with a BMI recorded Provider Q TBC Number of pregnant women accessing stop smoking services Provider Q TBC Number of pregnant women stopped smoking at 4 week follow up. Provider Q TBC Hull CCG Business Intelligence Framework 16

17 Number of pregnant women accessing peer support/ Doula support services Provider Q TBC Percentage of neo natal babies having breast milk or donor milk Provider Q TBC Percentage of neo- natal babies having breast milk at discharge Provider Q TBC Number of mothers accessing birth preparation and parent education. Provider Q TBC Reception year obesity levels PH A TBC Year 6 obesity levels PH A TBC Number of children receiving a wheel chair on day of assessment Provider Q TBC Hull CCG Business Intelligence Framework 17

18 APPENDIX 5 MENTAL HEALTH Key Outcome Measure Source Freq Target CAHMS user and carers satisfaction to be developed within the Provider Q TBC contract* 15% of eligible patients receive IAPT services Data set Q 13% C2.13 Estimated diagnosis rate for people with dementia Register Q 46% Early diagnosis to be developed. Using 9 I statements National TBC TBC TBC dementia strategy. Friends and family approach to inpatient services (to be developed 13/14 and implemented 14/15 with all services). TBC TBC TBC NHS Constitutional Indicators Source Freq Target IAPT proportion of eligible patients receiving IAPT services Data set Q 13% IAPT recovery rate Data set Q 50% CCG Indicator Set Source Freq Target C1.12 People with severe mental illness who have received a list of GPES A Note c physical checks C2.9 Access to community mental health services by people from BME Data set Q Note c groups C2.10 Access to psychological therapy services by people from BME Data set Q Note c groups C2.11 and C2.12 Recovery following talking therapies all ages and over Data set Q Note c 65 C2.13 Estimated diagnosis rate for people with dementia *** Registers Q 46% C2.14 People with dementia prescribed anti-psychotic medication *** Dementia audit A Note c Process measures Source Freq Target Number of people accessing MH services Provider Q TBC Number of people accessing LD services Provider Q TBC Number of people accessing services out of area Provider Q TBC Hull CCG Business Intelligence Framework 18

19 APPENDIX 6 PRIMARY CARE Key Outcome Measures Source Freq Target People supported by telehealth to manage a Long Term Condition (#) CHCP M 550 by 31/03/ by 31/03/2015 People taking up a Personal Health Budget (#) CHCP M 100 per year in 2013/14 People with multiple Long Term Conditions comprehensively reviewed (#) Practices M 1,000 in 2013/13 2,000 in 2014/15 Reduction in non-elective admissions from care homes (#) SUS M Reduction of 220 per year by 2014/15 CCG Indicator Set Source Freq Target C1.4 Myocardial infarction, stroke, stage 5 kidney disease in people in SUS M Note c diabetes C1.5 Mortality within 30 days of hospital admission for stroke **** SUS M Note c C1.8 Emergency admissions for alcohol related liver disease SUS M Note c C2.1 Health related quality of life for people with long-term conditions TBC A Note c C2.2 Proportion of people feeling supported to manage their condition TBC A Note c C2.3 People with COPD and Medical Research Council dyspnoea scale GPES Note c 3 referred to a pulmonary rehabilitation programme C2.4 People with diabetes who have received nine care processes NDA A Note c C2.5 People with diabetes diagnosed less than one year referred to structured education C2.7 Unplanned hospitalisation for asthma, diabetes and epilepsy in under 19s *&**** C2.8 Complication associated with diabetes including emergency admissions for diabetic ketoacidosis and lower limb amputation NDA A Note c SUS M Note c NDA A Note c C2.13 Estimated diagnosis rate for people with dementia ***** QMAS M 46% C2.14 People with dementia prescribed anti-psychotic medication ***** Dementia A Note c audit C3.1 Emergency admissions for acute conditions that should not usually SUS M TBC require hospital admission **** C3.2 Emergency readmissions within 30 days of discharge from hospital SUS M TBC **** C4.1 Patient experience of primary care - GP out-of-hours services GP survey Q TBC Hull CCG Business Intelligence Framework 19

20 Process measures Source Freq Target Non elective admission for under 19 for asthma SUS TBC TBC % of people with a long-term condition who are "supported by people TBC TBC TBC providing health and social care services to manage their condition" Number of people diagnosed CHD, Heart Failure, AF, Stroke/ TIA, Practice Q TBC Hypertension, Asthma, COPD, Diabetes Mellitus, Dementia, Epilepsy. lists Number of NT-proBNP test administrated TBC TBC TBC Number of patients who participate in a cardiac rehabilitation programme TBC TBC TBC meeting NICE requirements duplicated by Cxxx Number of patients completing pulmonary rehabilitation duplicated by TBC TBC TBC Cxxx Risk stratification usage in primary care (to developed) TBC TBC TBC MDT usage (to be developed) TBC TBC TBC % eligible people who have been offered an NHS Health Check TBC TBC TBC TBC TBC TBC Hull CCG Business Intelligence Framework 20

21 APPENDIX 7 PLANNED CARE Key Outcome Measure Source Freq Target E consultation (to be developed) TBC TBC TBC Advice and guidance -choose and book- (to be developed) TBC TBC TBC CCG Indicator Set Source Freq Target C1.3 Cardiac rehabilitation completion National? Note c audit C3.4 Emergency admissions for children and lower respiratory tract infections (LRTI) * SUS M Note c Process measures Source Freq Target E consultation (to be developed) TBC TBC TBC Advice and guidance -choose and book- (to be developed) TBC TBC TBC Procedures of limited clinical value based on Capita work (to be TBC TBC TBC developed) Direct GP access to CT and Urology diagnostics (to be developed) TBC TBC Ophthalmology 1 st Appointment reduction SUS M 288 Ophthalmology Follow up activity reduction SUS M 672 Ophthalmology RRT Waiting times (to be base lined) Unify M TBC ENT 1 st Appointment reduction SUS M 160 ENT Follow up activity reduction SUS M 192 ENT RRT Waiting times (to be base lined) Unify M TBC Dermatology 1 st Appointment reduction SUS M 140 Dermatology Follow up activity reduction SUS M 230 Dermatology RRT Waiting times (to be base lined) Unify M TBC Plastics 1 st Appointment reduction SUS M 84 Plastics Follow up activity reduction SUS M 193 Plastics RRT Waiting times (to be base lined) Unify M TBC Rheumatology 1 st Appointment reduction SUS M 56 Rheumatology Follow up activity reduction SUS M 230 Rheumatology RRT Waiting times (to be base lined) Unify M TBC Urology 1 st Appointment reduction SUS M 100 Urology Follow up activity reduction SUS M 158 Hull CCG Business Intelligence Framework 21

22 Urology RRT Waiting times (to be base lined) Unify M TBC Neurology 1 st Appointment reduction SUS M 100 Neurology Follow up activity reduction SUS M 125 Neurology RRT Waiting times (to be base lined) Unify M TBC Diabetic Medicine 1 st Appointment reduction SUS M 26 Diabetic Medicine Follow up activity reduction SUS M 137 Diabetic Medicine RRT Waiting times (to be base lined) Unify M TBC Note a target as of unify submission for activity lines Note b no target just a comparison with the YTD last year Note c no deterioration * links to Partnership Programme area ** links to Planned Care Programme area *** links to Primary Care Programme area **** links to Unplanned Care Programme area ***** links to Mental Health Programme areas + links to public health Hull CCG Business Intelligence Framework 22

23 APPENDIX 8 FINANCIAL REPORTING Key Outcome Measure Source Freq Target Forecast out turn DS M As plan Running costs DS M 25 ph Cash Limit DS M As plan Run rate DS M As plan BPP DS M 95% Investment plan performance DS M As plan Finance risk (narrative) DS/ ES M Hull CCG Business Intelligence Framework 23

24 Task APPENDIX 9 DEVELOPMENT PLAN Develop CAMHS carers and user satisfaction indicator along with setting trajectory Develop early dementia diagnosis indicator - along with setting trajectory Develop reporting arrangement for LD E consultation (to be developed) Advice and guidance -choose and book- (to be developed) Procedures of limited clinical value based on Capita work Planned care baseline RTT waiting times for Ophthalmology, ENT, Dermatology, Plastic, Rheumatology, Urology, Neurology, Diabetic Medicine Direct access to CT diagnostics Responsible Officer Keith Baulcombe and Joy Dodson Keith Baulcombe and Joy Dodson Keith Baulcombe and Bernie Dawson Karen Bilany and Senior BI lead Karen Bilany and Senior BI lead Karen Bilany and Senior BI lead CSU BI team Date for completion TBC CSU BI team and TBC James Dawson Children experience of healthcare (composite measure from Bernie Dawson TBC service specifications) Query CQUIN IN DEVELOPMENT and Joy Dodson Risk stratification usage in primary care (to developed) Phil Davis and BI TBC lead MDT usage (to be developed) Phil Davis and BI TBC lead Review practice level report Hull CCG BI June 2013 Procedure for publishing report sections in the Hull CCG BI Lead April 2013 website Alignment to the CAF/ BAF Mike Napier and April 2013 BI lead Design Contracting update BI lead TBC Clarify roles and responsibilities between the Hull CGC BI and embedded CSU team. John Fitzsimmons and Joy Dodson TBC TBC TBC TBC TBC TBC TBC Hull CCG Business Intelligence Framework 24