Archive

Potentially overused elective treatments July 2011

There have been numerous reports, papers and articles published discussing the commissioning of or reduction in commissioning of treatments of 'low clinical value' or 'low priority' as well as the definitions of such lists; for example, Save to invest - Commissioning for equity (London Health Observatory, 2007); Reducing spending on low clinical value treatments (Audit Commission, 2011). A common theme of these reports is the variation in the application of these lists across the country. This month's Performance Healthcheck provides an example analysis of 10 elective treatments that sometimes feature on these lists and the variations that appear across PCTs and nationally over time.

Patient Safety Indicators - Accidental Puncture Or Laceration May 2011

The enhanced version of Dr Foster Intelligence's Real Time Monitoring (RTM) tool now features additional Patient Safety Indicators (PSIs) and service line indicators from the 2010 Hospital Guide. These indicators enable the monitoring and identifying of potential instances of patient harm. The new PSIs were developed by the Agency for Healthcare Research and Quality (AHRQ) in the United States and translated by the Dr Foster Unit at Imperial College London and in conversation with other leading indicator developments units. The methodologies for these indicators were also made available pre-Hospital Guide publication for comment and consultation, in partnership with HSJ last summer. The results of two of the indicators, Decubitus Ulcer and Accidental Puncture or Laceration are showcased in this month's Performance Healthcheck.

Alcohol attributable admissions February 2011
Recent analysis by Alcohol Concern (Making alcohol a health priority - Opportunities to reduce alcohol harm and rising costs, 2011) reported that the 'number of hospital admissions due to alcohol misuse was 1.1 million in 2009/10, a 100% increase since 2002/03. If the rise continues unchecked, by the end of the current Parliament a staggering 1.5 million people will be admitted to hospital every year' This indicator provides a summary view of the number of admissions attributable to alcohol for each PCT by sex.
Winter pressures January 2011
This indicator reviews outpatient attendance, cancellation and DNA (did not attend) rates with a view to discussing the impact of the winter season. The monthly trend analysis shows the seasonal variation in attendance rates and the winter of 2009 shows an increase in DNAs and cancellations.
GP no follow-up rate November 2010
This indicator provides an indication of the potential savings to be gained by reducing the number of first outpatient attendances that do not have any follow-up appointments or admissions within a given timeframe. The concept behind this is to not only review the appropriateness of some GP referrals but also to assess whether savings can be made to the health economy by caring for patients in primary care rather than in hospital.
Emergency admissions by PCT October 2010
The introduction of a marginal tariff is likely to affect the level of emergency admissions. It is hoped that capping 2010-2011 income at the level of admissions for 2008-09 and only paying 30% of tariff for activity thereafter will reduce admissions. While they are reducing their liability in respect of the trusts, PCTs should be actively managing demand locally.
Emergency admissions by Acute Trust October 2010
The introduction of a marginal tariff is likely to affect the level of emergency admissions. It is hoped that capping 2010-2011 income at the level of admissions for 2008-09 and only paying 30% of tariff for activity thereafter will reduce admissions. This policy will clearly directly affect trusts' income and thus they need to engage upstream with PCTs to reduce local demand.

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