Strategic Plans

Analysis in Joint Commissioning Cycle

> Analysis key part of commissioning cycle.> Analysis sets out thinking, reasoning, decisions for rest

of plan.> Without robust analysis rest of plan will be weak and

lack credibility.> Good information allows partnerships to analyse

effectively and sets basis for rest of plan.

Patient level data linking

> Health and social care linked data at patient/client level has a number of benefits.

> Total resource across total population, segment of population, by deprivation category, high resource cohorts.

> Who uses joint services, does level of social care make a difference to hospital admissions?

> Follow cohort through time to see if change to service/care pathway is having desired effect.

Alcohol and Drug

> Define substance misuse cohort.− Use data from criminal justice and ADP services

to augment data− Prevalence and population characteristics

> Size and distribution of spend.> Comparative to non substance misuse population.> Follow as service is redesigned.

Breakdown of costs

Non-substance

misuse:

Substance

misuse:

Anticipatory Care Plans

> Health resource of 120 patients given ACPs.> 2009/10 – 2012/13

− 583 A and E attendances (£60,000)− 1345 outpatient appointments (£170,000)− 6743 days in hospital (£2m)− 31,455 Dispensed items (£311,000)

> Follow this cohort and non ACP cohort to analysis impact of ACPs.

Health and Social Care by SIMD 65+ cost per capita

Dementia

> Define dementia cohort - from GP LTC register.> Prevalence and population characteristics> What health and social resources do dementia patients

use?− Comparative to non dementia population

> Forecast future demand as a result of demographic pressure

> Assist with planning and evaluating services redesign

Cost Attributable to Dementia

NHS Board X– individual level analysis

> Inpatient services at maximum capacity

> Requirement to understand current utilisation of services. Who? how old? how often? how long? Why?

> Exploratory work – acute and community activity (SMR01 and SMR01E linkage), length of stay analysis, admissions, allocated bed day analysis, available beds, forecasting.

> Granular analysis - study cohort of long stay patients

− 400 acute inpatients - linked to length of stay information (acute, community, outwith HB treatment, total bed days)

− Categorised by partnership (CHP), age band, admission type− Linked to delayed discharge, SPARRA, other local information info not on SMRs

> Benefits of linked individual level data - understanding full hospital pathway, delayed discharge prevention, informed decisions

• Explorative analysis of acute bed days in 2011/12 by partnership indicates a potential saving of 40 acute beds if occupied bed days consistent for all residents. This is due to a marked divergence in acute length of stay between the two partnership groups.

• A study cohort of long stay patient showed that Partnership A used 35% more bed days than partnership B with the associated number of stays only 2% higher.

• Community Hospital stay linked to delayed discharge - 50% of study cohort with a stay in a community hospital were recorded as having a delayed discharge. Less than 1 % who only had an acute hospital stay resulted in a delay.

• 60% of partnership A residents with a community element to their stay also had a delayed discharge episode, this compares to 30% for partnership B residents.

• IRF mapping for 2010/11 shows partnership A 75+ per capita spend approximately 30% higher for emergency acute inpatients than partnership B.

Service UtilisationAnalysis Results

> For more information on Integrated Resource Framework (IRF) and patient/client level data linking contact:

> Andrew Lee andrew.lee6@nhs.net 0131 275 7594. > Ishbel Robertson ishbel.robertson@nhs.net 0141 282

2276.> Christine McGregor

Christine.McGregor@scotland.gsi.gov.uk 0131 244 3394 or 07867 375242.