GP No Follow-up Rate - West Midlands

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. You can change region, or view national data.

Potential savings 2008/09

Potential savings that could be gained by reducing the number of first outpatient attendances that do not have any follow-up appointments or admissions.

PCT name Sum of Potential Saving (£)
South Staffordshire
469,902
Wolverhampton City
456,096
Shropshire County
366,547
Coventry
321,208
Warwickshire
310,923
Worcestershire
298,081
Birmingham East and North
266,497
Heart Of Birmingham
260,523
Sandwell
221,411
Stoke On Trent
216,204
Telford and Wrekin
201,806
Herefordshire
199,629
South Birmingham
190,350
Dudley
169,793
North Staffordshire
167,001
Walsall
133,501
Solihull Care Trust
131,509
National average: 285,551

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Methodology

Description
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.
Definition
The percentage of first outpatient attendances where there was not an outpatient follow up attendance to any specialty within 1 year or an admission to any specialty within 6 months. Savings are based on meeting National performance.
Rationale
This indicator reviews the number of outpatient attendances that could be assessed in primary care, rather than in hospital.
Direction
A high rate indicates that the PCT has more first attendances with no follow-ups than the national average. This means that there is greater potential for savings.
Calculation of Potential
Potential savings are calculated by multiplying the number of excess first attendances with no follow-ups (based on a GP practice's observed first attendances with no follow-ups minus expected first attendances with no follow-ups where the GP practice has a higher rate than the national average) by the average PbR tariff for that particular specialty.
Technical definition

The percentage of first outpatient attendances with no follow-ups is calculated as the number of first outpatient attendances that did not have an outpatient follow-up attendance to any specialty within 1 year or an admission to any specialty within 6 months of the original outpatient attendance, divided by the total number of outpatient first attendances. Rates are calculated for each GP practice and outpatient specialty.

The potential savings are based on comparing the observed number of outpatient attendances with no follow-ups to an expected number. The number of expected first attendances with no follow-ups is based National benchmarks which are adjusted for outpatient specialty and year.

The expected number of first attendances with no follow-ups is calculated as the national rate multiplied by the total number of first attendances for each GP practice by specialty. The difference between this expected number and the actual number of first outpatient attendances with no follow-ups gives an excess amount of first outpatient attendances with no follow-up. This excess amount is multiplied by the average PbR tariff to produce a potential saving.

It should be noted that although results are calculated at GP practice and specialty level, for presentation purposes, they have been aggregated into two results tables: one showing the results by PCT and specialty, the other by GP practice only. It is therefore not possible to derive the expected number of outpatient attendances with no follow-ups, the excess amount, and the potential savings directly from the two tables.

In line with HES protocol, single-handed GP Practices have not been identified in the GP practice results table. Cases where the GP practice was unknown, non-applicable (e.g. MoD, prison, dentist), or a single-handed practice have been aggregated under the category 'Null/Unknown/Other'.

Inclusions - Only where the referral source is a General Medical Practitioner for the original first outpatient attendance.

Exclusions - The following specialties were excluded from the analysis of the first outpatient attendance : Paediatric Medical Oncology (260), Medical Oncology (370), Gynaecological Oncology (503), Clinical Oncology (800).

Basis
Primary Care Trust
Data source & Time frame
SUS - 1st Outpatient Appointment in Financial Year 2008/09

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