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Transcript of NHS Confederation - Independent sector providers …/media/Confederation/File… · Web viewThe NHS...
Independent sector providers caring for NHS patientsComparative performance indicators
May 2015
Edition 16
New in this edition
Updated data this month Friends and family test results VTE RTT waiting times Diagnostic times Monthly volume numbers and share by specialty: inpatient and outpatient elective
NB, all the graphs and charts in this document are derived directly from data provided by independent sources including NHS England, the Health and Social Care Information Centre and the Care Quality Commission. The relevant source, including links wherever possible, is given by each visualisation.
If organisations wish to refer to specific visualisations contained within this data, we would recommend that the relevant source data, together with the relevant explanatory notes as published in this document, are included in any citations.
For more information about the data underlying the visualisations in this presentation, please contact [email protected]
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ContentsNew in this edition................................................................................................................................................................................................................................................. 2
Patient experience................................................................................................................................................................................................................................................. 6
Friends and family test performance..................................................................................................................................................................................................................... 7
Friends and family test – performance of all providers.........................................................................................................................................................................................8
Friends and family test – the top performers........................................................................................................................................................................................................ 9
Friends and family test response rates................................................................................................................................................................................................................ 10
Clinical quality..................................................................................................................................................................................................................................................... 11
CQC standards 2013–14...................................................................................................................................................................................................................................... 12
CQC compliance rates – hospital care standards................................................................................................................................................................................................. 13
CQC compliance rates – community healthcare standards.................................................................................................................................................................................14
CQC compliance rates – independent ambulances............................................................................................................................................................................................. 15
Patient outcomes and safety............................................................................................................................................................................................................................... 16
Patient Reported Outcome Measures (PROMs).................................................................................................................................................................................................. 18
PROMs – primary hip replacement.................................................................................................................................................................................................................. 19
PROMs – primary knee replacement.............................................................................................................................................................................................................. 24
PROMs – groin hernia...................................................................................................................................................................................................................................... 29
Rate of assessment for VTE (blood clots)............................................................................................................................................................................................................ 32
Infection control data.......................................................................................................................................................................................................................................... 33
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Efficiency indicators............................................................................................................................................................................................................................................. 34
Referral to treatment times................................................................................................................................................................................................................................. 35
Percentage of patients treated within 18 weeks................................................................................................................................................................................................. 36
Typical waiting times........................................................................................................................................................................................................................................... 37
Average waiting times by specialty...................................................................................................................................................................................................................... 38
Waiting times for 95% of patients....................................................................................................................................................................................................................... 39
Diagnostic waiting times...................................................................................................................................................................................................................................... 40
Numbers of patients treated............................................................................................................................................................................................................................... 42
Elective admissions and GP referrals (1).............................................................................................................................................................................................................. 44
Elective admissions and GP referrals (2).............................................................................................................................................................................................................. 45
Elective admissions and GP referrals (3).............................................................................................................................................................................................................. 46
Acute elective patients treated by independent sector and NHS organisations..................................................................................................................................................47
Monthly number of acute elective patients treated by the independent sector................................................................................................................................................48
Number of inpatients treated by the independent sector by specialty...............................................................................................................................................................49
Number of outpatients treated by the independent sector by specialty............................................................................................................................................................50
Share of inpatients treated by the independent sector by specialty...................................................................................................................................................................51
Proportion of NHS outpatients treated by the independent sector by specialty.................................................................................................................................................52
Diagnostic tests carried out by independent sector by modality........................................................................................................................................................................53
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Independent sector performance
The NHS Partners Network is the trade association representing the widest range of independent sector providers of NHS clinical services ranging through acute, diagnostic, primary and community care, as well as dental services. Our members are drawn from both the “for profit” and “not for profit” sectors and include large international hospital groups and small specialist providers. All are committed to working in partnership with the NHS and to the values set out in the NHS Constitution.
This document gives an overview of the performance of independent sector providers of care to NHS patients. It focuses on care sectors represented by NHSPN members and the indicators available cover five broad domains of quality:
Patient experience Clinical quality Patient outcomes and safety Efficiency indicators The contribution of the sector shown by numbers of patients treated
All the visualisations shown in this document are based on publicly available data published by organisations such as NHS England, Public Health England, the Health and Social Care Information Centre and the Care Quality Commission.
Not all data collected for traditional NHS organisations and independent sector providers can be compared easily. Historic differences in the way NHS and independent sector providers have been regulated have often required independent providers to collect different information from their NHS counterparts. As the range of information is increasingly harmonised, we hope to be able to produce more comparative information published by third parties such as the organisations listed above.
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Patient experience
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Friends and family test performanceThe Government’s preferred measure of patient satisfaction, the Friends and Family Test (FFT), applies equally to traditional NHS and the independent sector. Collected monthly since April 2013, around 99% of patients would be ‘extremely likely’ or ‘likely’ to recommend independent providers compared with a national average of around 94%. At present, acute inpatient care is the only area where the FFT is collected by both independent and NHS providers however NHS England is in the process of rolling out the FFT across all NHS care.
Apr-14 May-14 Jun-14 Jul-14 Aug-14 Sep-14 Oct-14 Nov-14 Dec-14 Jan-15 Feb-15 Mar-15 Average0.0%
10.0%
20.0%
30.0%
40.0%
50.0%
60.0%
70.0%
80.0%
90.0%
100.0%
Friends and Family Test scores (inpatients)
Percentage of inpatients who would recommend their provider during the past 12 months. Source: NHS England. Green bars: independent providers and blue bars: Av of all providers to NHS patients
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Friends and family test – performance of all providersIndependent providers cluster at the ‘high end’ of performance. The graph below shows the performance of all providers that collect the FFT for inpatient acute care and which produce a minimum response rate of 20% amounting to at least 20 patients per month. Green bars represent independent organisations and blue bars show NHS hospitals.
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%Friends and Family score by site (inpatients) – March 2015
Blue columns are NHS organisations, green columns are independent providers. Only sites with a response rate of 20% or above, that produced 20 or more responses and with actual response data are shown. Source: NHS Eng
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Friends and family test – the top performersThe graph below shows all those hospitals that scored a 100% recommendation rate (extremely likely and likely to recommend) as measured by patients in their response to the FFT for acute inpatient care. Within this group, organisations are ordered on the basis of those with the highest proportion of patients ‘extremely likely’ to recommend their providers (highest on left, lowest on right). NB some providers with an overall percentage recommendation rate below 100% may have achieved higher rates of patients ‘extremely likely’ to recommend them than those shown on this graph.
BMI -
The
Som
erfiel
d Hosp
ital -
NT4
38
Fulw
ood Hal
l Hosp
ital -
NVC07
Orth
opaedic
s an
d Spin
e Sp
ecia
list H
ospita
l
BMI -
The
Highfiel
d Hosp
ital -
NT4
20
Sunder
land E
ye In
firmar
y - R
LNGM
The
Berks
hire In
depen
dent H
ospita
l - N
VC02
The
Spen
cer W
ing
(Ram
sgat
e Road
) - N
N801
Spire
Suss
ex H
ospita
l - N
T309
Nuffi
eld H
ealth
, Brig
hton H
ospita
l - N
T205
BMI -
Gorin
g Hal
l Hosp
ital -
NT4
17
The
Horder
Cen
tre -
St Jo
hns Road
Notti
ngham
Woodth
orpe
Hospita
l - N
VC40
Fairfi
eld H
ospita
l - N
VG01
Kidder
min
ster
Hosp
ital -
RW
P31Circ
le R
eadin
g
Benen
den H
ospita
l - N
WF0
1
Moorfi
elds
Eye
Hospita
l (City
Road
) - R
P601
BMI -
The
Droitw
ich S
pa Hosp
ital -
NT4
12
Spire
Met
hley
Park
Hospita
l - N
T350
BMI -
Thre
e Sh
ires
Hospita
l - N
T441
Spire
Lee
ds Hosp
ital -
NT3
32
South
Wes
t London E
lecti
ve O
rthopae
dic C
entre
- RVRTC
Sprin
gfiel
d Hosp
ital -
NVC18
Spire
Ches
hire H
ospita
l - N
T324
Spire
Har
penden
Hosp
ital -
NT3
16
BMI T
he Cav
ell H
ospita
l - N
T451
Nuffi
eld H
ealth
, Der
by Hosp
ital -
NT2
13
Spire
Norw
ich H
ospita
l - N
T318
Birmin
gham
Wom
en's
Hosp
ital -
RLU
01
Spire
Cla
re P
ark
Hospita
l - N
T345
Birmin
gham
Mid
land E
ye C
entre
(Bm
ec) -
RXK03
Spire
Bush
ey H
ospita
l - N
T315
Berw
ick
Infirm
ary
- RTF
DH0%20%40%60%80%
100%
Friends and Family score by site (inpatients) – March 2015_x000d_Organisations with overall 100% recommendation rate,
ranked by % extremely likely to recommend
Blue columns represent NHS orgs and green columns show independent providers. Shows only sites with response rate of 20% or above, with 20 or more responses and a 100% recommendation rate. Ranking by
percentage of patients 'extremely likely' to recommend.
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Friends and family test response ratesResponse rates to the FFT are used by the CQC to measure NHS Trusts’ reporting culture. On average independent providers manage response rates of over 45% compared with an England average of 37%.
Apr-14
May-14
Jun-14Jul-1
4
Aug-14
Sep-14
Oct-14
Nov-14
Dec-14
Jan-15
Feb-15
Mar-15
Averag
e0.0%
10.0%
20.0%
30.0%
40.0%
50.0%
60.0%
Friends and Family Test response rates (inpatients)
Friends and Family Test inpatient response rates for the past 12 months. Green bars show independent providers and blue bars represents average for all organisations treating NHS patients. Source: NHS England
The data that underpins all the FFT graphs above is available at: http://www.england.nhs.uk/statistics/statistical-work-areas/friends-and-family-test/friends-and-family-test-data/
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Clinical quality
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CQC standards 2013–14The CQC is currently introducing a new approach to regulating independent and NHS organisations. This will go live across all areas of care from April 2015. We hope that this will allow a fair and appropriate comparison between all providers of health and social care.
The existing regime is based on compliance with a set of standards defined by the CQC. The CQC has assessed all providers against these outcome measures for the past three years. In general the IS complies with more outcome measures than its NHS peers. The graphs that follow show the rate at which independent and NHS organisations comply with CQC standards. We have shown all relevant standards for the care areas covered by NHS Partners Network members, i.e.:
hospital care standards community healthcare standards independent ambulances (the CQC does not hold comparable State of Care category data for NHS ambulance services)
The graphs that follow are compiled from information provided by the CQC in response to a Freedom of Information request. It provides more detail compliance rates for comparable categories of independent and NHS organisations than was provided in figure 1.2 in the CQC’s latest annual State of Care report.
Source: http://www.cqc.org.uk/content/state-care-2013-14 and the CQC via a Freedom of Information request.
NB when interpreting the graphs below, higher compliance is better. Also, breaches are classed either as minor, moderate or major. It is therefore better if the proportion of breaches classed as minor is higher, as this means a lower proportion of all breaches were moderate and major breaches.
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CQC compliance rates – hospital care standards
Respect & involvem
ent
Care & welfare
Nutritional needs
Safeguarding
Cleanliness and infection contro
l
Medicines managem
ent
Safety a
nd suitability of prem
isesSta
ffing
Supporting worke
rs
Monitoring service quality Complain
ts
0.0%10.0%20.0%30.0%40.0%50.0%60.0%70.0%80.0%90.0%
100.0%
Hospital compliance rates
Percentage of inspections that were compliant with CQC essential standards in 2013-14. Source: CQC. Blue bars show NHS organisations and green bars indicate independent providers.
Respect & involvem
ent
Care & welfar
e
Nutritional needs
Safeguarding
Cleanliness and infecti
on control
Medicines m
anagement
Safety a
nd suitability of prem
isesSta
ffing
Supporting worke
rs
Monitoring service quality Complain
ts
0.0%10.0%20.0%30.0%40.0%50.0%60.0%70.0%80.0%90.0%
100.0%
Hospital care – proportion of breaches classed as minor
Percentage of inspections that were compliant with CQC essential standards in 2013-14. Source: CQC. Blue bars show NHS organisations and green bars indicate independent providers.
NB the total number of moderate and major breaches for independent providers relating to medicines management and safety and suitability of premises is significantly lower than that for NHS organisations. The reason the graphs show a higher apparent proportion for NHS organisations is related to the fact that there are a considerably greater proportion of overall breaches by NHS organisations for these standards compared with their independent sector counterparts.
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CQC compliance rates – community healthcare standards
Respect & involvement
Care & welfa
re
Nutritional n
eeds
Safeguarding
Cleanliness and infection control
Medicines management
Safety a
nd suitability
of premises
Staffing
Supporting workers
Monitoring service q
uality Complaints
0.0%10.0%20.0%30.0%40.0%50.0%60.0%70.0%80.0%90.0%
100.0%
Community healthcare compliance rates
Percentage of inspections that were compliant with CQC essential standards in 2013-14. Source: CQC. Blue bars show NHS organisations and green bars indicate independent providers.
Respect & involvem
entCare & welfare
Nutritional n
eeds
Safeguarding
Cleanliness a
nd infection control
Medicines m
anagement
Safety a
nd suitability
of premises
Staffing
Supporting workers
Monitoring service quality Complaints
0.0%10.0%20.0%30.0%40.0%50.0%60.0%70.0%80.0%90.0%
100.0%
Community healthcare – proportion of breaches classed as minor
Percentage of inspections that were compliant with CQC essential standards in 2013-14. Source: CQC. Blue bars show NHS organisations and green bars indicate independent providers.
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CQC compliance rates – independent ambulancesNB, information for independent ambulances is shown below. The CQC does not hold comparable State of Care category data for NHS ambulance services. Because the actual number of breaches is very low, we have not produced a graph of the proportion of minor breaches as this would not be statistically meaningful.
Respect
& involvement
Care & welfa
re
Nutritional n
eeds
Safegu
arding
Cleanliness
and infec
tion contro
l
Medicines m
anagement
Safety
and suitab
ility o
f premises
Staffing
Supporting worke
rs
Monitorin
g servic
e qualit
yComplain
ts
0.0%10.0%20.0%30.0%40.0%50.0%60.0%70.0%80.0%90.0%
100.0%
Independent ambulance compliance rates
Percentage of inspections that were compliant with CQC essential standards in 2013-14. Source: CQC. Green bars indicate independent providers. No data is available for NHS Ambulance Trusts.
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Patient outcomes and safety
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Patient outcomes and safety
Indicators that relate to outcomes and safety for which it is reasonable to make comparisons between independent sector organisations and their NHS counterparts include:
Patient Reported Outcome Measures (PROMs); and Rate of assessment for VTE (blood clots)
Infection control information is also an important indicator. Because Public Health England analyses information collected for the independent sector and the NHS organisations on a different basis, its view is that like-for-like comparison should not be made. For completeness, we have published rates for independent sector providers in the pages that follow. These show that independent providers have very low rates of healthcare-acquired infections.
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Patient Reported Outcome Measures (PROMs)Patient Reported Outcome Measures (PROMs) are collected by the Health and Social Care Information Centre for a range of elective procedures: hip and knee replacements, groin hernias and varicose vein treatment.
The Health and Social Care Information Centre (HSCIC) publishes casemix-adjusted health gain by provider each quarter. The graphs that follow are based on the most recently available 12-month period (April 2013 to March 2014, provisional data – released Feb 2015).
PROMs data is not published for all organisations that submit completed PROMs questionnaires. The HSCIC collects data from every organisation that offers these types of surgery as it is a national requirement that all organisations should offer PROMs questionnaires to patients eligible to participate. However, it is voluntary for patients to complete these forms and the HSCIC only publishes adjusted data for organisations that have a representative number of completed records.
The pages that follow use funnel plot data from http://www.hscic.gov.uk/catalogue/PUB16477 for two different types of PROMs scores for primary knee and hip replacements. These graphs show adjusted health gain. The original source files provided by the HSCIC should be used to identify positive and negative statistical outliers.
The Oxford Scores focus on joint function and pain and include questions about patients’ mobility and factors such as ability to navigate stairs and use transport specifically affected by the hip or knee. More information about these measures is available at http://www.isis-innovation.com/outcomes/orthopaedic/. The EQ-5DTM score, developed by the EuroQol Group, is a standardised instrument for use as a measure of health outcome and has a broader base than the Oxford scores. Its questions relate to mobility, self-care, usual life activities, pain/discomfort and anxiety/depression. More information about the EQ-5D is available at http://www.euroqol.org. The Health and Social Care Information Centre also provides an informative guide to PROMs methodology used by the Centre, available at http://www.hscic.gov.uk/article/3843/Background-information-about-PROMs.
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PROMs – primary hip replacement
The tables below show average adjusted health gain on PROMs reported by the Health and Social Care Information for independent providers compared to the national average.
Independent providers England average20.800
21.000
21.200
21.400
21.600
21.800
22.000
22.200
22.400
Oxford hip score – average health gain
Average adjusted health gain on PROMs reported by the Health and Social Care Information Cen-tre. Green line shows patient-weighted average for independent providers for which HSCIC pub-
lishes a value. Blue line shows England average.
Independent providers England average0.420
0.425
0.430
0.435
0.440
0.445
0.450
0.455
0.460
0.465
Hip replacement EQ 5D – average health gain
Average adjusted health gain on PROMs reported by the Health and Social Care Information Cen-tre. Green line shows patient-weighted average for independent providers for which HSCIC pub-
lishes a value. Blue line shows England average.
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0
5
10
15
20
25
PROMs adjusted average health gain primary hip replace-ment_x000d_Oxford Hip Score Apr 2013 to Mar 2014
Graph shows average adjusted health gain on Patient Reported Outcome Measures (PROMs) reported by the Health and Social Care Information Centre.
Green lines relate to independent providers and blue bars treated by NHS organisationsPage 20 of 53
BMI - TH
REE SH
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ITAL
BMI - TH
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ITAL
SPRIN
GFIELD
HOSPITA
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NUFFIELD
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AMBRIDGE HOSP
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TON M
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ETER N
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05
10152025
PROMs adjusted average health gain primary hip replacement_x000d_Oxford Hip Score Apr 2013 to Mar 2014 (top 50
providers)
Graph shows average adjusted health gain on Patient Reported Outcome Measures (PROMs) reported by the Health and Social Care Information Centre.
Green lines relate to independent providers and blue bars treated by NHS organisationsPage 21 of 53
00.05
0.10.15
0.20.25
0.30.35
0.40.45
0.50.55
0.6
PROMs adjusted average health gain – primary hip re-placement_x000d_EQ-5D Score Apr 2013 to Mar 2014
Graph shows average adjusted health gain on Patient Reported Outcome Measures (PROMs) reported by the Health and Social Care Information Centre.
Green lines relate to independent providers and blue bars treated by NHS organisations
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BMI - TH
E PARK HOSP
ITAL
NUFFIELD
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, CAMBRIDGE H
OSPITA
L
BMI - TH
REE SH
IRES HOSP
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SPIRE C
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ARK HOSP
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SPRIN
GFIELD
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OSPITA
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NUFFIELD
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BMI - TH
E CHILT
ERN HOSP
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AMBRIDGE LEA
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KING'S
COLLEGE H
OSPITA
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OUNDATION TR
UST
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OYAL O
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ALL HOSP
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GE HEA
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NORTHAMPTO
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RUST
00.15
0.30.45
0.6
PROMs adjusted average health gain – primary hip replace-ment_x000d_EQ-5D Score Apr 2013 to Mar 2014 top 50
providers
Graph shows average adjusted health gain on Patient Reported Outcome Measures (PROMs) reported by the Health and Social Care Information Centre.
Green lines relate to independent providers and blue bars treated by NHS organisations
Page 23 of 53
PROMs – primary knee replacement
The tables below show average adjusted health gain on PROMs reported by the Health and Social Care Information for independent providers compared to the national average.
Independent providers England average15.90016.00016.10016.20016.30016.40016.50016.60016.70016.80016.900
Oxford knee score – average health gain
Average adjusted health gain on PROMs reported by the Health and Social Care Information Cen-tre. Green line shows patient-weighted average for independent providers for which HSCIC pub-
lishes a value. Blue line shows England average.
Independent providers England average0.318
0.320
0.322
0.324
0.326
0.328
0.330
0.332
Knee replacement EQ5D – average health gain
Average adjusted health gain on PROMs reported by the Health and Social Care Information Cen-tre. Green line shows patient-weighted average for independent providers for which HSCIC pub-
lishes a value. Blue line shows England average.
Page 24 of 53
02468
101214161820
PROMs adjusted average health gain – primary knee re-placement_x000d_Oxford Knee Score Apr 2013 to Mar 2014
Graph shows average adjusted health gain on Patient Reported Outcome Measures (PROMs) reported by the Health and Social Care Information Centre.
Green lines relate to independent providers and blue bars treated by NHS organisationsPage 25 of 53
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IPSWICH HOSP
ITAL N
HS TRUST
BMI WOODLA
NDS HOSP
ITAL
SPRIN
GFIELD
HOSPITA
L
DARTFORD AND GRAVESH
AM NHS T
RUST
EUXTO
N HALL
HOSPITA
L
NORTHER
N DEVON HEA
LTHCARE N
HS TRUST
SPIRE E
LLAND HOSP
ITAL
FITZW
ILLIAM HOSP
ITAL
NUFFIELD
HEALTH
, TEES
HOSPITA
L
SPIRE P
ORTSMOUTH
HOSPITA
L
BMI - TH
E PARK HOSP
ITAL
THE R
OTHER
HAM NHS F
OUNDATION TR
UST
ISLE O
F WIGHT N
HS TRUST
EMER
SONS G
REEN N
HS TREA
TMEN
T CEN
TRE
0
6
12
18
PROMs adjusted average – health gain primary knee replacement_x000d_Oxford Knee Score Apr 2013 to Mar 2014 (top 50
providers)
Graph shows average adjusted health gain on Patient Reported Outcome Measures (PROMs) reported by the Health and Social Care Information Centre.
Green lines relate to independent providers and blue bars treated by NHS organisationsPage 26 of 53
0
0.05
0.1
0.15
0.2
0.25
0.3
0.35
0.4
0.45
PROMs adjusted average health gain – primary knee replacement_x000d_EQ-5D Score Apr 2013 to Mar 2014
Graph shows average adjusted health gain on Patient Reported Outcome Measures (PROMs) reported by the Health and Social Care Information Centre.
Green lines relate to independent providers and blue bars treated by NHS organisationsPage 27 of 53
BMI THE L
ANCASTER HOSP
ITAL
NUFFIELD
HEALTH
, CAMBRIDGE H
OSPITA
L
NORTHAMPTO
N GENER
AL HOSP
ITAL N
HS TRUST
SPIRE S
USSEX HOSP
ITAL
BENEN
DEN HOSP
ITAL
WINFIE
LD HOSP
ITAL
WIRRAL UNIVER
SITY T
EACHIN
G HOSPITA
L NHS F
OUNDATION TR
UST
FULW
OOD HALL HOSP
ITAL
SPIRE C
AMBRIDGE LEA
HOSPITA
L
DUCHY HOSP
ITAL
NORTHER
N DEVON HEA
LTHCARE N
HS TRUST
NUFFIELD
HEALTH
, DER
BY HOSP
ITAL
SPIRE C
HESHIRE H
OSPITA
L
WOODLAND HOSP
ITAL
NEW HALL
HOSPITA
L
COUNTESS O
F CHEST
ER HOSP
ITAL N
HS FOUNDATIO
N TRUST
FITZW
ILLIAM HOSP
ITAL
BMI - TH
E RIDGEW
AY HOSP
ITAL
EUXTO
N HALL HOSP
ITAL
SHEP
TON M
ALLET N
HS TREA
TMEN
T CEN
TRE
NUFFIELD
HEALTH
, WOLV
ERHAMPTO
N HOSPITA
L
BMI - TH
REE SH
IRES HOSP
ITAL
SPIRE L
EICEST
ER HOSP
ITAL
NORTH TE
ES AND HARTLE
POOL NHS F
OUNDATION TR
UST
NOTTINGHAM W
OODTHORPE H
OSPITA
L
NUFFIELD
HEALTH
, PLYM
OUTH HOSP
ITAL
BMI ST E
DMUNDS HOSP
ITAL
ISLE O
F WIGHT N
HS TRUST
ROYAL S
URREY COUNTY
HOSPITA
L NHS F
OUNDATION TR
UST
SPIRE P
ORTSMOUTH
HOSPITAL
NUFFIELD
HEALTH
, LEIC
ESTER
HOSPITA
L
BMI WOODLA
NDS HOSP
ITAL
SPIRE A
LEXANDRA HOSP
ITAL
SPRIN
GFIELD
HOSPITA
L
STOCKPORT N
HS FOUNDATIO
N TRUST
BMI - TH
E PARK HOSP
ITAL
AIREDALE
NHS FOUNDATIO
N TRUST
EMER
SONS G
REEN N
HS TREA
TMEN
T CEN
TRE
OAKLANDS H
OSPITA
L
SPIRE H
ULL AND EA
ST RIDIN
G HOSPITA
L
EAST
CHESHIRE N
HS TRUST
EAST
LANCASH
IRE HOSP
ITALS
NHS TRUST
ST HUGH'S
HOSPITA
L
THE R
OTHER
HAM NHS F
OUNDATION TR
UST
IPSWICH HOSP
ITAL NHS T
RUST
SPIRE H
ARPENDEN HOSP
ITAL
BMI - TH
E ALEX
ANDRA HOSPITA
L
BMI GISB
URNE PARK HOSP
ITAL
THE H
ORDER CEN
TRE -
ST JO
HNS ROAD
PINEH
ILL HOSP
ITAL
00.10.20.30.4
PROMs adjusted average – health gain primary knee replace-ment_x000d_EQ-5D Score Apr 2013 to Mar 2014 (top 50
providers)
Graph shows average adjusted health gain on Patient Reported Outcome Measures (PROMs) reported by the Health and Social Care Information Centre.
Green lines relate to independent providers and blue bars treated by NHS organisationsPage 28 of 53
PROMs – groin hernia
The tables below show average adjusted health gain on PROMs reported by the Health and Social Care Information for independent providers compared to the national average.
Independent providers England average0.083
0.084
0.085
0.086
0.087
0.088
0.089
Groin hernia EQ5D – average health gain
Average adjusted health gain on PROMs reported by the Health and Social Care Information Cen-tre. Green line shows patient-weighted average for independent providers for which HSCIC pub-
lishes a value. Blue line shows England average.
Page 29 of 53
0
0.02
0.04
0.06
0.08
0.1
0.12
0.14
0.16
PROMs adjusted average health gain – groin hernia_x000d_EQ-5D Score Apr 2013 to Mar 2014
Graph shows average adjusted health gain on Patient Reported Outcome Measures (PROMs) reported by the Health and Social Care Information Centre.
Green lines relate to independent providers and blue bars treated by NHS organisationsPage 30 of 53
BMI - TH
E FOSC
OTE HOSP
ITAL
WYE VALLE
Y NHS T
RUST
ROYAL L
IVERPOOL A
ND BROADGREEN UNIVER
SITY H
OSPITA
LS NHS T
RUST
SPIRE S
OUTH BANK HOSP
ITAL
OAKS HOSP
ITAL
SPIRE D
UNEDIN
HOSPITA
L
ROYAL D
EVON AND EX
ETER N
HS FOUNDATIO
N TRUST
ROYAL B
ERKSH
IRE NHS F
OUNDATION TR
UST
SALIS
BURY NHS F
OUNDATION TR
UST
SPIRE H
ULL AND EA
ST RIDIN
G HOSPITA
L
CAMBRIDGE UNIVER
SITY H
OSPITA
LS NHS F
OUNDATION TR
UST
BMI GISB
URNE PARK HOSP
ITAL
RIVERS H
OSPITA
L
THE B
ERKSH
IRE INDEP
ENDEN
T HOSP
ITAL
CIRCLE BATH
HOSPITA
L
BARNSLEY H
OSPITA
L NHS F
OUNDATION TR
UST
BMI - TH
E HARBOUR HOSP
ITAL
NORTH CUMBRIA UNIVER
SITY H
OSPITA
LS NHS T
RUST
SPIRE M
ETHLEY
PARK HOSPITA
L
ROYAL U
NITED HOSP
ITALS
BATH N
HS FOUNDATIO
N TRUST
PENNIN
E ACUTE
HOSPITA
LS NHS T
RUST
COBALT HOSPITA
L
WALSALL
HEALTH
CARE NHS T
RUST
NORTHER
N DEVON HEA
LTHCARE N
HS TRUST
TAUNTO
N AND SOMER
SET N
HS FOUNDATIO
N TRUST
00.040.080.120.16
PROMs adjusted average – groin hernia_x000d_EQ-5D Score Apr 2013 to Mar 2014 (top 50 providers)
Graph shows average adjusted health gain on Patient Reported Outcome Measures (PROMs) reported by the Health and Social Care Information Centre.
Green lines relate to independent providers and blue bars treated by NHS organisationsPage 31 of 53
Rate of assessment for VTE (blood clots)All providers of acute adult inpatient care are required to provide information on the percentage of admitted patients who are risk-assessed for venous thromboembolism (blood clots). The graph below shows data for the past year. The average rate for independent providers is 98.7% compared with a national average of 96.1%.
Mar-2014
Apr-2014
May-2014
Jun-2014
Jul-2014
Aug-2014
Sep-2014
Oct-2014
Nov-2014
Dec-2014
Jan-2015
Feb-2015
Average
90.0%91.0%92.0%93.0%94.0%95.0%96.0%97.0%98.0%99.0%
100.0%
Percentage of admitted patients risk-assessed for VTE_x000d_ Mar 14 to Feb 15
Percentage of admitted patients risk-assessed for Venous Thromboembolism (VTE) by NHS (blue bars) and independent sector providers (green bars). Source: NHS England
Source: http://www.england.nhs.uk/statistics/statistical-work-areas/vte
Page 32 of 53
Infection control dataInfection control information that allows direct comparisons between the NHS and independent sector is not available. In 2009, the Health Protection Agency, now part of Public Health England, which has responsibility for collecting infection-control data, published its rationale for this approach here. This is summarised on page 1 of the commentary linked below.
Despite this lack of comparative information, Public Health England data makes it clear that there are very low healthcare acquired infection rates in the independent sector.
During the twelve months between Apr 2013 and March 2014, the total number of reported infections across the entire independent estate (NHS-funded and privately funded care) was just:
No of cases
Rate per 100,000
MRSA bacteraemia 11 0.48C difficile infection 71 3.12MSSA bacteraemia 32 1.40E. coli bacteraemia 147 6.45
The number of modified bed-days published by Public Health England for this twelve-month period was 2,277,796.
Source: Public Health England (https://www.gov.uk/government/statistics/mrsa-mssa-and-e-coli-bacteraemia-and-clostridium-difficile-infection-annual-data-for-independent-sector-healthcare-organisations)
Page 33 of 53
Efficiency indicators
Page 34 of 53
Referral to treatment times
Referral to treatment times show that patients are treated earlier by independent sector providers compared with those treated by NHS organisations. Waiting times are an important indicator of organisational efficiency and for patients deciding where to choose treatment.
Mean* and median waiting times are generally shorter across most specialties for both inpatients and outpatients treated by independent providers compared with their NHS peers.
Charts have been updated this month to cover waiting times during February 2015. During that month: Outpatients treated by independent providers had on average (mean) waited for 5.2 weeks, i.e. 12 fewer days than the English average outpatient waiting time Inpatients treated by independent providers waited an average (mean) of 9.9 weeks: 5.7 fewer days than the English average inpatient waiting time 95% of outpatients treated by independent sector organisations were treated within 12 weeks, compared with an English average of 17 weeks to treat the same
proportion of outpatients 95% of inpatients treated by independent sector organisations were treated within 16.4 weeks, with NHS organisations taking 24.4 weeks to treat the same
proportion of outpatients – over six weeks above the 18-week commitment.
http://www.england.nhs.uk/statistics/statistical-work-areas/rtt-waiting-times/
* NB Means have been inferred from data published by NHS England. This data shows numbers of patients waiting between 1 and 2 weeks, 2 and 3 weeks, etc. up to 52+ weeks for RTT times and 13+ weeks for diagnostic waiting times. Mean values have been calculated on the assumption that patients who have been waiting between 1 and 2 weeks have waited an average of 1.5 weeks etc. Also, for those patients waiting longer than 52 weeks (RTT) or 13 weeks (diagnostics), we have used values of 52.5 (RTT) and 13.5 weeks (diagnostics) which is likely to be an underestimate. As we are looking at national trends rather than specific provider-level performance we have counted all patients when calculating means rather than excluding organisations with low volumes.
Page 35 of 53
Percentage of patients treated within 18 weeks
The graphs below show the proportion of patients seen within the 18-week referral to treatment commitment enshrined within the NHS constitution.
Apr 14 May 14 Jun 14 Jul 14 Aug 14 Sep 14 Oct 14 Nov 14 Dec 14 Jan 15 Feb 15 Mar 15 Average0.0%
10.0%20.0%30.0%40.0%50.0%60.0%70.0%80.0%90.0%
100.0%
Inpatients seen within 18 weeksRTT for completed admitted patient pathways: percentage of patients
treated within 18 weeks
Source: NHS England, Monthly Referral to Treatment (RTT) waiting times for completed admitted pathways (on an ad-justed basis). Blue bars represent national average performance and green bars show figures for independent providers.
Apr 14 May 14 Jun 14 Jul 14 Aug 14 Sep 14 Oct 14 Nov 14 Dec 14 Jan 15 Feb 15 Mar 15 Average0.0%
10.0%
20.0%
30.0%
40.0%
50.0%
60.0%
70.0%
80.0%
90.0%
100.0%
Outpatients seen within 18 weeksRTT for completed non-admitted patient pathways: percentage of
patients treated within 18 weeks
Source: NHS England, Monthly RTT waiting times for completed non-admitted pathways. Includes outpatientsand patients whose waiting times were stopped without treatment. Blue bars show national average and green bars show independent providers.
Page 36 of 53
Typical waiting times
Median waiting times illustrate the typical experience of most patients when waiting for care.
Apr 14 May 14 Jun 14 Jul 14 Aug 14 Sep 14 Oct 14 Nov 14 Dec 14 Jan 15 Feb 15 Mar 15 Average0.001.002.003.004.005.006.007.008.009.00
10.00
Typical inpatient waiting timesMonthly RTT for completed admitted patient pathways – average
median waiting time in weeks
Source: NHS England, Monthly Referral to Treatment (RTT) waiting times for completed admitted pathways (on an ad-justed basis). Blue bars represent national average performance and green bars show figures for independent providers.
Apr 14 May 14 Jun 14 Jul 14 Aug 14 Sep 14 Oct 14 Nov 14 Dec 14 Jan 15 Feb 15 Mar 15 Average0.00
1.00
2.00
3.00
4.00
5.00
6.00
Typical outpatient waiting timesMonthly outpatient RTT waiting times – average median waiting time
in weeks
Source: NHS England, Monthly RTT waiting times for completed non-admitted pathways. Includes outpatientsand patients whose waiting times were stopped without treatment. Blue bars show national average and green bars show independent providers.
Page 37 of 53
Average waiting times by specialty
The graphs below show a weighted average of inpatient and outpatient waiting times by specialty.
General Surgery Urology
Trauma & OrthopaedicsENT
OphthalmologyOral Surgery
Neurosurgery
Plastic Surgery
Gastroenterology
Dermatology
Rheumatology
Gynaecology Other
0.00
2.00
4.00
6.00
8.00
10.00
12.00
14.00Inpatient waiting times March 2015
Weighted average of admitted patient waiting times (weeks). Green bars show patients treated by independent sector organisations. Blue bars England average. All specialities shown where volumes >= 100 patients. Data source: NHS Eng
General Surgery Urology
Trauma & OrthopaedicsENT
OphthalmologyOral Surgery
Neurosurgery
Plastic Surgery
Gastroenterology
Dermatology
Thoracic MedicineNeurology
Rheumatology
Gynaecology Other
0.001.002.003.004.005.006.007.008.009.00
10.00
Outpatient waiting times March 2015
Weighted average of non-admitted patient waiting times (weeks). Green bars show patients treated by independent sector organisations. Blue bars England average. All specialities shown where volumes >= 100 patients. Data source: NHS
Eng
Page 38 of 53
Waiting times for 95% of patients
It is likely that there will be a small number of patients for whom treatment takes a significantly longer than expected amount of time. The graphs below show the maximum waiting time for 95% of patients, i.e. the longest period that most patients can reasonably expect to have to wait.
Apr 14 May 14 Jun 14 Jul 14 Aug 14 Sep 14 Oct 14 Nov 14 Dec 14 Jan 15 Feb 15 Mar 15 Average0.0
5.0
10.0
15.0
20.0
25.0
Waiting times for 95% of inpatientsMonthly RTT for completed admitted patient pathways – 95th
percentile waiting time (in weeks)
Source: NHS England, Monthly Referral to Treatment (RTT) waiting times for completed admitted pathways (on an ad-justed basis). Blue bars represent national average performance and green bars show figures for independent providers..
Apr 14 May 14 Jun 14 Jul 14 Aug 14 Sep 14 Oct 14 Nov 14 Dec 14 Jan 15 Feb 15 Mar 15 Average0.0
2.0
4.0
6.0
8.0
10.0
12.0
14.0
16.0
18.0
Waiting times for 95% of outpatientsMonthly outpatient RTT waiting times – 95th percentile waiting time
(in weeks)
Source: NHS England, Monthly RTT waiting times for completed non-admitted pathways. Includes outpatientsand patients whose waiting times were stopped without treatment. Blue bars show national average and green bars show independent providers.
Page 39 of 53
Diagnostic waiting times
The graph below shows mean waiting times for diagnostic tests by modality. MRI scans and non-obstetric-ultrasound are the most frequently provided diagnostic tests by independent organisations.
AUDIOLOGY_ASSESSMENTS
COLONOSCOPY CT
CYSTOSCOPY
DEXA_SCAN
ECHOCARDIOGRAPHY
ELECTROPHYSIOLOGY
FLEXI_SIGMOIDOSCOPY
GASTROSCOPY MRI
NON_OBSTETRIC_ULTRASOUND
PERIPHERAL_NEUROPHYS
0.00
0.50
1.00
1.50
2.00
2.50
3.00
Average waiting time for diagnostic tests by type and sector in March 2015
Chart shows mean time (weeks) spent waiting by patients for diagnostic tests for each type where vol of proceduces >= 100. Blue bars show national average waiting times. Green bars show mean waiting times
for independent providers. Source: NHS England
Source: http://www.england.nhs.uk/statistics/statistical-work-areas/diagnostics-waiting-times-and-activity NB see note in section on referral to treatment times about the calculation of mean waiting time values
Page 40 of 53
Cancelled elective operationsOperations that are cancelled on the day of surgery for non-clinical reasons are disruptive and distressing for patients. Cancellations are also a good indicator of an organisation’s system-wide efficiency.
NHS England does not publish the total number of elective operations alongside its cancellations data so it is not possible to make a precise calculation of comparative cancellation rates, however, the data published at www.england.nhs.uk/statistics/statistical-work-areas/cancelled-elective-operations reveals that NHS patients treated by independent sector providers experience far fewer cancellations on the day than those treated by traditional NHS organisations.
The data shows that less than 0.5% of non-clinical cancellations occur at independent providers. Also, of that small number of patients who do experience a cancellation at an independent provider, hardly any wait longer than a further 28 days for their treatment (just four patients in total in the whole of the last 12 months). Cancelled Operations (elective only)
Period NHS provider non-clinical cancellations (percentage of all cancellations)
Independent provider non-clinical cancellations (percentage of all cancellations)
Percentage of all patients still waiting for treatment after 28 days following last minute elective cancellation (NHS organisations)
Percentage of all patients still waiting for treatment after 28 days following last minute elective cancellation (Independent providers)
Quarter 1, 2014-15 (April to June 2014) 99.20% 0.80% 99.88% 0.12%Quarter 2, 2014-15 (July to September 2014) 99.66% 0.34% 99.85% 0.15%Quarter 3, 2014-15 (October to December 2014) 99.76% 0.24% 100.00% 0.00%Quarter 4, 2014-15 (January to March 2015) 99.57% 0.43% 99.94% 0.06%Average 99.55% 0.45% 99.92% 0.08%
Page 41 of 53
Numbers of patients treated
Page 42 of 53
Numbers of patients treated by independent providersElective care is critically dependent on independent sector provision.
Around 20% of all elective gastroenterology procedures and hip and knee replacements are now carried out by the independent sector. In some areas of the country this figure is far higher.
As well as NHS patients, many independent sector providers also treat large numbers of privately-funded patients as well.
The graphs in the section that follows show a steady increase in the number and proportion of procedures carried out by independent providers since 2011 when easily comparable statistics were first published. However, the overall number of NHS patients treated by independent organisations remains a small fraction of total NHS volumes.
Page 43 of 53
Elective admissions and GP referrals (1)
Analysis of quarterly hospital activity data (http://www.england.nhs.uk/statistics/statistical-work-areas/hospital-activity/quarterly-hospital-activity/) shows that the number of patients treated by the independent sector is steadily growing.
Apr to Jun 11
Jul to Sep
11
Oct to Dec 1
1
Jan to Mar 1
2
Apr to Jun 12
Jul to Sep
12
Oct to Dec 1
2
Jan to Mar 1
3
Apr to Jun 13
Jul to Sep
13
Oct to Dec 1
3
Jan to Mar 1
4
Apr to Jun 14
Jul to Sep
14
Oct to Dec 1
4
0,000
20,000
40,000
60,000
80,000
100,000
120,000
Independent sector quarterly elective admissions
Quarterly admissions to independent sector providers: NHS elective activity. Source: NHS England Apr to Jun 11
Jul to Sep
11
Oct to Dec 11
Jan to Mar 1
2
Apr to Jun 12
Jul to Sep
12
Oct to Dec 12
Jan to Mar 1
3
Apr to Jun 13
Jul to Sep
13
Oct to Dec 13
Jan to Mar 1
4
Apr to Jun 14
Jul to Sep
14
Oct to Dec 14
0,000
20,000
40,000
60,000
80,000
100,000
120,000
140,000
160,000
180,000
200,000
GP referrals for independent sector outpatients appointments
Quarterly GP referrals for independent sector outpatients appointments. Source: NHS England
Page 44 of 53
Elective admissions and GP referrals (2)
Despite the growth in independent sector provision, it is clear that traditional NHS providers still dominate overall provision for NHS patients.
Apr to Jun 11
Jul to Sep
11
Oct to Dec 1
1
Jan to Mar 1
2
Apr to Jun 12
Jul to Sep
12
Oct to Dec 1
2
Jan to Mar 1
3
Apr to Jun 13
Jul to Sep
13
Oct to Dec 1
3
Jan to Mar 1
4
Apr to Jun 14
Jul to Sep
14
Oct to Dec 1
4
0,000
200,000
400,000
600,000
800,000
1,000,000
1,200,000
1,400,000
Quarterly independent sector and NHS admissions
Quarterly elective admissions to independent sector providers (green bars) and NHS organisations (blue bars). Source: NHS England
Apr to Jun 11
Jul to Sep
11
Oct to Dec 1
1
Jan to Mar 1
2
Apr to Jun 12
Jul to Sep
12
Oct to Dec 1
2
Jan to Mar 1
3
Apr to Jun 13
Jul to Sep
13
Oct to Dec 1
3
Jan to Mar 1
4
Apr to Jun 14
Jul to Sep 14
Oct to Dec 1
4
0,000
500,000
1,000,000
1,500,000
2,000,000
2,500,000
3,000,000
3,500,000
Total GP referrals for outpatients appointments
Quarterly GP referrals for outpatients appointments. Independent sector providers (green bars) and NHS organisations (blue bars). Source: NHS England
Page 45 of 53
Elective admissions and GP referrals (3)
The overall percentage of patients treated by the independent sector has grown in accordance with the increasing number of patients choosing independent providers.
Apr to Jun 11
Jul to Sep
11
Oct to Dec 1
1
Jan to Mar 12
Apr to Jun 12
Jul to Sep
12
Oct to Dec 1
2
Jan to Mar 1
3
Apr to Jun 13
Jul to Sep
13
Oct to Dec 1
3
Jan to Mar 1
4
Apr to Jun 14
Jul to Sep
14
Oct to Dec 1
4
0.00%
1.00%
2.00%
3.00%
4.00%
5.00%
6.00%
7.00%
8.00%
9.00%
Elective admissions to independent sector providers as a proportion of all NHS patients
Quarterly admissions to independent sector providers as a proportion of all NHS elective activity. Source: NHS England
Apr to Jun 11
Jul to Sep
11
Oct to Dec 1
1
Jan to Mar 1
2
Apr to Jun 12
Jul to Sep
12
Oct to Dec 12
Jan to Mar 1
3
Apr to Jun 13
Jul to Sep
13
Oct to Dec 1
3
Jan to Mar 14
Apr to Jun 14
Jul to Sep
14
Oct to Dec 1
4
0.00%
1.00%
2.00%
3.00%
4.00%
5.00%
6.00%
Percentage GP referrals for independent sector outpatients ap-pointments
Quarterly GP referrals independent sector outpatients appointments as a proportion of all NHS elective activity. Source: NHS England
Page 46 of 53
Acute elective patients treated by independent sector and NHS organisations
For most specialties, independent sector provision represents a small proportion of overall care. However, in some specialties, notably trauma & orthopaedics and ophthalmology, the proportion of care provided by independent organisations has reach significant levels.
General Surgery Urology
Trauma & OrthopaedicsENT
OphthalmologyOral Surgery
Neurosurgery
Plastic Surgery
GastroenterologyDermatology
RheumatologyGynaecology
0
10,000
20,000
30,000
40,000
50,000
60,000
Inpatients treated by independent providers and NHS organisations during March 2015
Total number of admitted pathways. Blue columns represent patients treated by NHS organisations and green columns show those treated by independent providers. Source: NHS England
General Surgery Urology
Trauma & OrthopaedicsENT
OphthalmologyOral Surgery
Neurosurgery
Plastic Surgery
GastroenterologyDermatology
Thoracic MedicineNeurology
RheumatologyGynaecology
0
10,000
20,000
30,000
40,000
50,000
60,000
70,000
80,000
90,000
Outpatients treated by independent providers and NHS organisations during March 2015
Total number of non-admitted pathways. Blue columns represent patients treated by NHS organisations and green columns show those treated by independent providers. Source: NHS England
Page 47 of 53
Monthly number of acute elective patients treated by the independent sector
Apr-11Jun-11
Aug-11Oct-1
1Dec-1
1Feb
-12Apr-12
Jun-12Aug-12
Oct-12Dec-1
2Feb
-13Apr-13
Jun-13Aug-13
Oct-13Dec-1
3Feb
-14Apr-14
Jun-14Aug-14
Oct-14Dec-1
4Feb
-15
0
5,000
10,000
15,000
20,000
25,000
30,000
35,000
Total inpatient acute elective patients (all specialties) treated by independent providers since April 2011
Number of admitted adjusted patients pathways completed each month. Source: NHS England (www.england.nhs.uk/statistics/statistical-work-areas/rtt-waiting-times
Apr-11Jun-11
Aug-11Oct-1
1Dec-1
1Feb
-12Apr-12
Jun-12Aug-12
Oct-12Dec-1
2Feb
-13Apr-13
Jun-13Aug-13
Oct-13Dec-1
3Feb
-14Apr-14
Jun-14Aug-14
Oct-14Dec-1
4Feb
-15
05,000
10,00015,00020,00025,00030,00035,00040,00045,000
Total outpatient acute elective patients (all specialties) treated by independent providers since April 2011
Non-admitted patients pathways completed each month. Source: NHS England (www.england.nhs.uk/statistics/statistical-work-areas/rtt-waiting-times
Page 48 of 53
Number of inpatients treated by the independent sector by specialty
Apr-11
Jul-1
1
Oct-11
Jan-1
2
Apr-12
Jul-1
2
Oct-12
Jan-1
3
Apr-13
Jul-1
3
Oct-13
Jan-1
4
Apr-14
Jul-1
4
Oct-14
Jan-1
50
5,000
10,000
15,000
20,000
25,000
30,000
35,000
Number of NHS inpatients treated by independent providers by specialty Apr 11 to Mar 15
OtherGynaecologyGeriatric MedicineRheumatologyNeurologyThoracic MedicineDermatologyCardiologyGastroenterologyGeneral MedicineCardiothoracic SurgeryPlastic SurgeryNeurosurgeryOral SurgeryOphthalmologyENTTrauma & Or-thopaedicsUrologyGeneral Surgery
Admitted adjusted patients pathways completed each month. Source: NHS England (www.eng-land.nhs.uk/statistics/statistical-work-areas/rtt-waiting-times
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Number of outpatients treated by the independent sector by specialty
Apr-11
Jul-1
1
Oct-11
Jan-1
2
Apr-12
Jul-1
2
Oct-12
Jan-1
3
Apr-13
Jul-1
3
Oct-13
Jan-1
4
Apr-14
Jul-1
4
Oct-14
Jan-1
50
5,00010,00015,00020,00025,00030,00035,00040,00045,000
Number of NHS outpatients treated by independent providers by specialty Apr 11 to Mar 15
OtherGynaecologyGeriatric MedicineRheumatologyNeurologyThoracic MedicineDermatologyCardiologyGastroenterologyGeneral MedicineCardiothoracic SurgeryPlastic SurgeryNeurosurgeryOral SurgeryOphthalmologyENTTrauma & Or-thopaedicsUrologyGeneral Surgery
Non-admitted patients pathways completed each month. Source: NHS England (www.england.nhs.uk/statistics/statistical-work-areas/rtt-waiting-times
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Share of NHS inpatients treated by the independent sector by specialty
Apr-11
Jul-1
1
Oct-11
Jan-1
2
Apr-12
Jul-1
2
Oct-12
Jan-1
3
Apr-13
Jul-1
3
Oct-13
Jan-1
4
Apr-14
Jul-1
4
Oct-14
Jan-1
50.00%
5.00%
10.00%
15.00%
20.00%
25.00%Share of all NHS inpatients treated by independent providers by
specialty Apr 11 to Mar 15TotalGeneral SurgeryUrologyTrauma & Or-thopaedicsENTOphthalmologyOral SurgeryNeurosurgeryPlastic SurgeryCardiothoracic SurgeryGeneral MedicineGastroen-terologyCardiologyDermatologyThoracic MedicineNeurologyRheumatologyGeriatric MedicineGynaecologyOther
Share of all NHS admitted adjusted patients pathways completed each month treated by independent providers.
Source: NHS England (www.england.nhs.uk/statistics/statistical-work-areas/rtt-waiting-times)
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Proportion of NHS outpatients treated by the independent sector by specialty
Apr-11
Jul-1
1
Oct-11
Jan-1
2
Apr-12
Jul-1
2
Oct-12
Jan-1
3
Apr-13
Jul-1
3
Oct-13
Jan-1
4
Apr-14
Jul-1
4
Oct-14
Jan-1
50.00%
2.00%
4.00%
6.00%
8.00%
10.00%
12.00%
14.00%
16.00%Share of all NHS outpatients treated by independent providers by
specialty Apr 11 to Mar 15TotalGeneral SurgeryUrologyTrauma & Or-thopaedicsENTOphthalmologyOral SurgeryNeurosurgeryPlastic SurgeryCardiothoracic SurgeryGeneral MedicineGastroen-terologyCardiologyDermatologyThoracic MedicineNeurologyRheumatologyGeriatric MedicineGynaecologyOther
Share of all NHS non-admitted patients pathways completed each month treated by independent providers.
Source: NHS England (www.england.nhs.uk/statistics/statistical-work-areas/rtt-waiting-times)
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Diagnostic tests carried out by independent sector by modality
The pie chart below shows the range of diagnostic tests provided by independent sector organisations.
Independent sector workload (all tests carried out by independent providers for which waiting times are collected) during March 2015
AUDIOLOGY_ASSESSMENTSCOLONOSCOPYCTCYSTOSCOPYDEXA_SCANECHOCARDIOGRAPHYELECTROPHYSIOLOGYFLEXI_SIGMOIDOSCOPYGASTROSCOPYMRINON_OBSTETRIC_ULTRASOUNDPERIPHERAL_NEUROPHYS
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