QIPP Dashboard March 2012 position Healthier Horizons.

15
QIPP Dashboard March 2012 position Healthier Horizons

Transcript of QIPP Dashboard March 2012 position Healthier Horizons.

Page 1: QIPP Dashboard March 2012 position Healthier Horizons.

QIPP DashboardMarch 2012 position

Healthier Horizons

Page 2: QIPP Dashboard March 2012 position Healthier Horizons.

Work stream levelMedicines Management: Chart 1Benchmarked overall prescribing costs to March 2012

The overall costs for primary care prescribing are high in the NW compared to the England average, except for 3 PCTs.

KNOWSLEY

OLDHAM

HMR

HALTON & ST.HELENS

TAMESIDE & GLOSSOP

BwD

EAST LANCS

TRAFFORD

SEFTON

NORTH LANCS

CENTRAL LANCASHIRE

England average

WESTERN CHESHIRE

£0.00 £5.00 £10.00 £15.00 £20.00 £25.00 £30.00 £35.00 £40.00

£33.85£33.48

£32.09£31.95£31.74

£31.06£30.61£30.47

£29.78£29.31£29.21

£28.76£28.47

£28.01£27.20£27.11

£26.67£26.30£26.22£26.15£26.03

£25.22£24.47

£23.98£23.71

£23.21

Cost Per Astro PU (£)

Page 3: QIPP Dashboard March 2012 position Healthier Horizons.

Work stream levelMedicines Management: (2a)Performance on national QIPP indicators Q4

Prescriber Name ScoreACE inhibitor %

items

Low cost lipid modifying

drugsLow cost PPIs

% itemsHypoglycaemic

agentsNSAIDs

ADQ/STAR PU

NSAIDs: Ibuprofen & Naproxen %

Items

ASHTON,LEIGH & WIGAN 11 71.69 h 69.52 h 93.29 h 81.28 i 1.53 i 70.36 h

BLACKPOOL 30 76.19 h 79.81 h 97.60 h 85.45 h 1.26 i 70.08 h

BOLTON 11 66.45 h 73.92 h 95.05 h 80.75 i 1.14 i 69.08 h

BURY 23 68.95 h 76.58 h 97.07 h 80.92 h 1.15 i 70.65 h

CENTRAL & EASTERN CHESHIRE 28 73.23 i 76.74 h 95.88 h 85.62 h 0.92 i 69.55 h

CENTRAL LANCASHIRE 23 74.67 i 72.82 h 95.47 h 84.19 h 0.91 i 65.09 h

CUMBRIA TEACHING 31 72.37 h 78.31 h 98.24 h 87.88 i 1.05 i 47.39 h

EAST LANCASHIRE TEACHING 19 70.46 h 79.50 h 95.95 h 83.79 h 1.13 i 58.74 h

HALTON & ST.HELENS 14 71.64 h 70.26 h 96.19 h 85.01 i 1.34 i 65.02 h

HEYWOOD, MIDDLETON & ROCHDALE 11 67.81 h 73.77 h 96.39 h 79.35 i 1.91 h 56.76 h

KNOWSLEY 8 73.56 h 66.32 h 96.28 h 85.72 i 1.30 h 56.68 h

LIVERPOOL 12 75.24 h 66.65 h 95.73 h 82.56 i 1.21 i 67.08 h

MANCHESTER 18 71.74 h 71.38 h 96.95 h 81.44 h 1.25 h 64.45 h

NORTH LANCASHIRE TEACHING 24 69.86 h 75.84 h 96.15 h 82.67 h 1.08 i 66.27 h

OLDHAM 8 65.82 h 67.69 h 93.71 h 80.59 i 1.56 i 55.16 h

SALFORD 26 74.71 h 76.02 h 97.73 h 77.40 h 1.00 i 60.70 h

SEFTON 15 72.90 h 65.60 h 95.48 h 85.20 i 1.06 i 67.07 h

STOCKPORT 23 71.79 h 73.02 h 97.18 h 83.37 i 0.94 i 56.27 h

TAMESIDE & GLOSSOP 15 69.07 h 71.26 h 95.55 h 82.88 h 1.45 i 46.54 h

TRAFFORD 15 72.48 h 66.39 h 94.00 h 80.85 i 1.14 i 48.96 h

WARRINGTON 14 69.68 h 72.98 h 96.86 h 84.42 i 1.26 i 63.71 h

WESTERN CHESHIRE 23 71.24 h 75.23 h 96.11 h 83.46 h 0.97 i 70.34 h

WIRRAL 15 70.01 i 74.35 h 97.81 h 80.30 i 1.24 i 62.59 h

BLACKBURN WITH DARWEN CTP 23 71.56 h 81.77 i 96.99 h 80.57 i 1.46 i 68.18 h

Page 4: QIPP Dashboard March 2012 position Healthier Horizons.

Work stream levelMedicines Management: (2b)Performance on national QIPP indicators Q4

Prescriber Name Score

Antibacterial items/STAR

PU

Cephalosporins & quinolones

% items

Inhaled Corticosteroid

s NIC/ADQ

Alendronate as % of all

biphosphonates

Long/Intermediate

Insulin Analogues

Enteral Feeds (SIPS) Cost

Per PU

Hypnotics ADQ/STAR

PU

ASHTON,LEIGH & WIGAN 11 0.38 h 5.67 i £0.57 n 83.83 h 92.17 i £0.51 h 1.90 i

BLACKPOOL 30 0.37 h 4.04 i £0.66 n 85.44 h 75.01 h £0.39 h 0.95 i

BOLTON 11 0.38 h 8.13 i £0.56 h 77.07 h 86.70 h £0.45 h 1.42 i

BURY 23 0.36 h 5.67 i £0.53 h 84.04 n 80.58 h £0.28 i 1.45 i

CENTRAL & EASTERN CHESHIRE 28 0.35 h 5.50 i £0.51 h 85.50 i 90.73 i £0.33 i 1.04 i

CENTRAL LANCASHIRE 23 0.35 h 6.53 i £0.50 h 85.49 h 85.10 i £0.41 i 1.02 i

CUMBRIA TEACHING 31 0.35 h 5.76 i £0.50 h 85.68 i 85.89 i £0.20 i 1.21 i

EAST LANCASHIRE TEACHING 19 0.39 h 5.38 i £0.56 i 82.83 h 77.78 i £0.49 h 1.71 i

HALTON & ST.HELENS 14 0.40 h 8.41 h £0.65 h 83.97 h 82.00 h £0.52 h 1.60 i

HEYWOOD, MIDDLETON & ROCHDALE 11 0.42 i 6.24 i £0.55 h 83.62 h 85.72 i £0.50 i 1.69 i

KNOWSLEY 8 0.38 h 7.98 i £0.65 h 82.13 h 91.85 h £0.74 h 1.41 i

LIVERPOOL 12 0.35 h 8.30 i £0.60 i 79.32 h 92.54 h £0.81 i 1.32 i

MANCHESTER 18 0.35 h 4.17 i £0.56 i 84.45 h 92.59 i £0.43 i 1.66 i

NORTH LANCASHIRE TEACHING 24 0.33 h 6.19 i £0.60 h 83.64 h 83.22 i £0.35 i 1.21 i

OLDHAM 8 0.40 h 4.52 i £0.54 h 75.86 h 96.90 i £0.48 h 1.74 i

SALFORD 26 0.35 h 5.70 i £0.53 h 90.57 h 55.36 i £0.40 i 1.16 i

SEFTON 15 0.36 h 9.11 i £0.60 i 82.63 i 91.98 i £0.64 i 1.32 i

STOCKPORT 23 0.35 h 4.08 i £0.58 i 84.43 h 86.11 h £0.18 h 1.40 i

TAMESIDE & GLOSSOP 15 0.33 h 6.70 i £0.57 h 86.67 h 95.81 i £0.27 i 1.40 i

TRAFFORD 15 0.35 h 5.75 i £0.50 h 86.78 h 96.00 i £0.26 i 1.19 i

WARRINGTON 14 0.37 h 6.22 i £0.62 n 79.62 h 82.04 i £0.35 i 1.68 h

WESTERN CHESHIRE 23 0.35 h 6.83 i £0.51 h 85.78 h 91.49 i £0.39 h 1.10 i

WIRRAL 15 0.38 h 8.71 i £0.57 h 85.48 i 96.82 h £0.38 h 1.48 i

BLACKBURN WITH DARWEN CTP 23 0.38 h 5.37 i £0.53 h 87.53 h 83.15 i £0.32 i 1.70 i

Page 5: QIPP Dashboard March 2012 position Healthier Horizons.

Work stream level Medicines Management (3)PCT cost growth 11/12 (compared to 10/11)

The NW has good reduction in PCT ongoing cost growth, ranging from -5.98% in Bury to -0.46% in ALW.Increasing investment maintained in treatments for hypertension and vaccinations as part of the Quality improvements.

Page 6: QIPP Dashboard March 2012 position Healthier Horizons.

Work stream levelMedicines Management: (4)PCTs (Specials) Year on Year Change (% reduction) to Q4 11 /12

Special formulations highlighted as a key cost pressure in 09/10. PCTs have taken action to reduce costs.DH have introduced drug tariff prices from Nov 11 to mitigate the

ongoing risks.

Reduction in Expenditure %

PCT BLACKBURN WITH DARWEN CTP

PCT BURY

PCT HEYWOOD, MIDDLETON & ROCHDALE

PCT NORTH LANCASHIRE TEACHING

PCT EAST LANCASHIRE TEACHING

PCT MANCHESTER

PCT SALFORD

PCT CENTRAL & EASTERN CHESHIRE

PCT CENTRAL LANCASHIRE

PCT LIVERPOOL

PCT OLDHAM

PCT SEFTON

PCT HALTON & ST.HELENS

PCT STOCKPORT

PCT TAMESIDE & GLOSSOP

PCT ASHTON,LEIGH & WIGAN

PCT TRAFFORD

PCT KNOWSLEY

PCT BLACKPOOL

PCT CUMBRIA TEACHING

PCT WIRRAL

PCT BOLTON

PCT WESTERN CHESHIRE

PCT WARRINGTON

-70% -60% -50% -40% -30% -20% -10% 0%

-65%

-59%

-58%

-53%

-51%

-45%

-43%

-42%

-42%

-40%

-40%

-40%

-37%

-35%

-35%

-34%

-31%

-29%

-24%

-14%

-12%

-11%

-6%

-4%

-37%

Growth in Expenditure %

Growth %

Page 7: QIPP Dashboard March 2012 position Healthier Horizons.

Work stream levelMedicines Management: (5)PCTs (Antibacterial Drugs) Change (%) to Q4 11/12

The PCTs have been working to reduce the use of antibacterial drugs in primary care as part of initiatives to reduce C. Diff incidence –(1.2% down), BUT Q4 figures for most PCTs have risen

PCT WARRINGTON

PCT KNOWSLEY

PCT BOLTON

PCT LIVERPOOL

PCT OLDHAM

PCT MANCHESTER

PCT EAST LANCASHIRE TEACHING

PCT STOCKPORT

PCT TRAFFORD

PCT BURY

PCT WIRRAL

PCT CENTRAL & EASTERN CHESHIRE

PCT CENTRAL LANCASHIRE

PCT BLACKBURN WITH DARWEN CTP

PCT SALFORD

PCT HALTON & ST.HELENS

PCT SEFTON

PCT NORTH LANCASHIRE TEACHING

PCT WESTERN CHESHIRE

PCT ASHTON,LEIGH & WIGAN

PCT CUMBRIA TEACHING

PCT HEYWOOD, MIDDLETON & ROCHDALE

PCT BLACKPOOL

PCT TAMESIDE & GLOSSOP

NORTH WEST

-8.0% -6.0% -4.0% -2.0% 0.0% 2.0% 4.0% 6.0% 8.0% 10.0%

7.8%

6.9%

6.8%

6.2%

6.1%

6.0%

5.6%

5.0%

4.9%

4.4%

4.1%

3.0%

2.5%

1.9%

1.9%

1.7%

0.7%

0.6%

0.4%

-0.4%

-1.1%

-1.2%

-1.2%

-6.8%

2.8%

Anti Bacterial Drug Growth (%) Items

Page 8: QIPP Dashboard March 2012 position Healthier Horizons.

Work stream levelMedicines Management: (6)PCTs (Nutritional Supplements) Year on Year Change (%) to Q4 11/12

PCTs identified this as a cost pressure in 2010/11 and took measures to reduce expenditure in 2011/12. Outcome small growth of 1% across the NW at year end

PCT WESTERN CHESHIRE

PCT BLACKPOOL

PCT EAST LANCASHIRE TEACHING

PCT HALTON & ST.HELENS

PCT SALFORD

PCT TRAFFORD

PCT ASHTON,LEIGH & WIGAN

PCT SEFTON

PCT CENTRAL LANCASHIRE

PCT STOCKPORT

PCT BOLTON

PCT NORTH LANCASHIRE TEACHING

PCT HEYWOOD, MIDDLETON & ROCHDALE

PCT OLDHAM

PCT MANCHESTER

PCT KNOWSLEY

PCT CENTRAL & EASTERN CHESHIRE

PCT WIRRAL

PCT LIVERPOOL

PCT WARRINGTON

PCT CUMBRIA TEACHING

PCT BLACKBURN WITH DARWEN CTP

PCT TAMESIDE & GLOSSOP

PCT BURY

NORTH WEST

-20% -15% -10% -5% 0% 5% 10% 15% 20%

14%

12%

12%

11%

11%

8%

5%

5%

5%

5%

4%

4%

3%

0%

-3%

-4%

-4%

-4%

-4%

-5%

-5%

-6%

-12%

-14%

1%

Nutritional Supplements Growth (%) in Expenditure

Growth %

Page 9: QIPP Dashboard March 2012 position Healthier Horizons.

Work stream level

Better Care Better Health Better Life

Informatics – Choose & Book for 3 months ending at 31st March 2012

Whilst Choose & Book continues to perform well the opportunity remains to save a further £2m per quarter if at least 90% of referrals are conducted via thisroute

Period Jan,Feb,March 2012

Actual savingsPotential additional

savings

Cheshire 400,828£ 305,720£ Cumbria 221,981£ 122,362£ Lancashire 479,368£ 580,023£ Manchester 1,139,154£ 729,567£ Merseyside 480,029£ 429,319£

Total 2,721,361£ 2,166,991£

Page 10: QIPP Dashboard March 2012 position Healthier Horizons.

Work stream level

Better Care Better Health Better Life

Informatics – Electronic prescription service

at 31st March 2012

Some clusters still not engaging fully with this initiative. Further development work is required to maintain momentum

u u

Clu

ster

Release1BGL/TGL*

R2 BGL/R1 TGL

** EPS R1National PCT Rank (/151)

Central and Eastern Cheshire A 91% 0% 51Warrington B 96% 0% 137

Western Cheshire C 98% 3% 58Wirral D 77% 0% 112

Cumbria 30 32 Cumbria E 93% 5% 87Blackburn With Darwen F 97% 24% 56

Blackpool G 100% 0% 41Central Lancashire H 92% 0% 105

East Lancashire I 85% 2% 121North Lancashire J 79% 0% 122

Ashton, Leigh & Wigan K 94% 0% 55Bolton L 90% 0% 91Bury M 100% 21% 1

Heywood, Middleton & Rochdale N 93% 0% 37Manchester O 100% 1% 90

Oldham P 94% 4% 48Salford Q 96% 6% 36

Stockport R 92% 0% 107Tameside & Glossop S 95% 9% 50

Trafford T 89% 3% 117Halton & St Helens U 81% 0% 86

Knowsley V 88% 0% 65Liverpool W 96% 0% 68Sefton X 71% 0% 123

19 18

Merseyside

31 26

Cheshire

27

↓ F

ebru

ary

2012

RA

G S

tatu

s ↓

28

Lancashire

35 37Manchester

rank /

51 *

*

PCTMapRef

GP Practice

Page 11: QIPP Dashboard March 2012 position Healthier Horizons.

Work stream level

Better Care Better Health Better Life

Informatics – Summary Care Record

at 31st March 2012

Only 20 % (152 out of 763) of practices have uploaded Summary Care Records.An increase from Dec 2011 (14.5 % of practices)

Cluster

% of patients

with records created

PCT NameMap Ref

# of Practic

es

PCT Populatio

n

Awareness & EngagementPlanning Adoption

In progress / Not done

Project Manager In

Post

Business Case

Developed

Project Board

EstablishedSCR Clinical Lead In Place

# Potential GP Practices

(EMIS LV, iSoft Synergy, InPS

or TPP)

% of Potential total GP Practices

# Practices Where Patient PIP Letters

Sent(Public Information

Programme)# of PIP Letters Sent(To Patients > 16yrs)

#patient opt outs

Patients surveyed for

opt out

% Patient Opt Out

(of practices reporting)

# Practices Uploaded

# Patient Records Created

# Practices Entered into Provisional

Business Go Live Field

Cheshire

20%

Central and Eastern Cheshire A 53 470,829         39 74% 53 385,625 6347 464503 1.37%     0

Warrington B 25 208,801 ü ü ü ü 23 92% 28 167641 1945 206837 0.94% 22 172,206 0

Western Cheshire C 40 261,783 ü ü ü ü 34 85% 40 215,814 3438 260497 1.32% 7 25,395 17

Wirral D 61 331,710   ü     48 79% 62 269,940 4572 333008 1.37% 11 58,872 0

Cumbria

0% Cumbria E 86 513,923         55 64% 0 0     0.00%     0

Lancashire

1%

Blackburn With Darwen F 29 168,874         16 55% 31 130,729 749 167308 0.45%     27

Blackpool G 22 153,069 n N n n 12 55% 0 0     0.00%     0

Central Lancashire H 89 473,015         49 55% 89 385,063 2700 471573 0.57%     0

East Lancashire I 66 388,318         35 53% 67 314,274 2004 387985 0.52%     60

North Lancashire J 37 339,752         18 49% 39 293,437 1904 337424 0.56% 2 22,582 0

Manchester

17%

Ashton, Leigh & Wigan K 66 320,418 ü ü ü ü 57 86% 66 262,378 1949 320429 0.61% 31 146,202 0

Bolton L 45 296,358 ü ü ü ü 43 96% 44 237,759 3127 289864 1.08% 19 144,755 0

Bury M 33 195,942 ü ü ü ü 33 100% 32 159,073 1455 160359 0.91% 26 147,631 7

Heywood, Middleton & Rochdale N 40 224,321 ü ü ü ü 27 68% 5 0     0.00%     0

Manchester O 103 568,105 ü ü ü ü 32 31% 103 450,633 2727 558490 0.49% 1 9,168 92

Oldham P 49 240,857 ü ü ü ü 25 51% 49 187,082 192 28294 0.68% 6 43,413 42

Salford Q 56 250,190 ü       40 71% 0 0   247488 0.00%     0

Stockport R 52 299,487 ü   ü   17 33% 0 0     0.00%     10

Tameside & Glossop S 43 240,706 ü   ü   24 56% 0 0     0.00%     15

Trafford T 40 234,400 ü       25 63% 41 187,762 2887 233396 1.24%     0

Merseyside

10%

Halton & St Helens U 55 321,194       n 25 45% 55 261,045 2459 319591 0.77%     0

Knowsley V 33 158,349 ü ü ü ü 28 85% 31 0 780 158514 0.49% 27 127,968 0

Liverpool W 97 492,835 ü n n n 36 37% 98 401,489 4180 490081 0.85%     0

Sefton X 55 280,117   n n n 22 40% 55 232,058   279196 0.00%     0

   

    N/West Total   1275 7,433,353         763 60% 988 4,541,802 43,415 5,714,837 0.76% 152 898,192 270

Page 12: QIPP Dashboard March 2012 position Healthier Horizons.

Work stream levelDemand & Threshold Management :Increased number of patients dying at home

Better Care Better Health Better Life

Slight increase in the number of patients dying at home overall (0.35%) but not in Warrington, HMR, Stockport, Tameside & Glossop, Trafford, Blackburn with Darwen and Halton & St Helens.

Page 13: QIPP Dashboard March 2012 position Healthier Horizons.

Cluster Q4 Self Assessment of QIPP Programme Milestones

SHA TriangulationMay 2012

Cumbria PCT

A/R Watching brief: Outpatients and electives,recognise improvements made on finance and sickness absence.

Confidential North West SHA

CumbriaCluster QIPP Update

Q4 Self Assessment R

SHA Triangulation A/R

0%20%40%60%80%100%120%

% C

om

plet

e

QIPP Milestone Programmes

Cluster Self Assessment Exceptions

Activity for unscheduled care at month 10 is 7.8% above the contract plan (but about level with the outturn for 2010/11). Each of the six localities is focused on putting in place the local community based actions which are now required in these areas

Urgent Care

This section of the QIPP Programme is RAG rated Amber/red because the month 10 activity monitoring for the C2H condition groups reveals Cumbria to be 7.8% above plan for the C2H LTC condition groups ( but performance varies across the six localities)

Long Term Conditions

Planned Care

Activity at month 10 is now below the contract plan by 1.6% (but in value is up by 4%, £2.5m). NCUHT is below plan by 9% but UHMBFT is above plan by 8.3%. The Planned Care Turnaround workstream has a remit to confirm the operational plans to deliver the changes required in planned care and the delivery of the activity and financial targets over the next three years.

Transition Planning

A GP-led Clinical Commissioning Group has been operational since April 2011 and a Managing Director and the senior team have been appointed. Six Locality Directors have been appointed and the locality commissioning teams are in place. The QIPP plan brings together the commissioning intentions of all six localities and has been led by the Clinical Senate, which have also conducted the 2012/13 contracts negotiation. The CCG and Cluster jointly oversee operational delivery of the QIPP programme.

A/R

Page 14: QIPP Dashboard March 2012 position Healthier Horizons.

The 4th quarter saw some reductions in a trend of rises across a number of areas.But, growth continued for;other referrals (7.5%),All referrals (1.7%)elective day cases (7%)all electives (4.7%)

Cluster level

Better Care Better Health Better Life

Activity - Cumbria March 2012

GP

re

ferr

als

for

f...

Oth

er

refe

rra

ls fo

r...

All

refe

rra

ls fo

r f..

.

All

first

G&

A o

utp

a...

Ele

ctiv

e O

rdin

ar.

..

Ele

ctiv

e D

ayc

ase

...

All

Ele

ctiv

e G

&A

...

No

n-E

lect

ive

G&

A...

0

100000

200000

300000

400000

500000

600000

3088

10

2072

26

5160

36

4703

85

3729

9

1386

43 1759

42

1665

08

3054

84

1978

51

5033

35

4639

01

3678

7

1357

57 1725

44

1563

15

2977

86

2042

47

5020

33

4589

96

3895

4

1455

85 1845

39

1546

18

NHS North WestActivity Monitoring Planned Activity Previous Year Actual Activity

Page 15: QIPP Dashboard March 2012 position Healthier Horizons.

CumbriaCUMBRIA PARTNERSHIP NHS TRUSTCUMBRIA PCTNORTH CUMBRIA ACUTE HOSPITALS NHS TRUST

Cluster Level - CumbriaWorkforce – March 2012

RAGDec 11

RAG Mar 12