Diabetic Retinopathy Screening Service

National Management Groups Meeting

Perth Concert Hall - 9th Nov

Mike Black - DRS Collaborative Coordinator

KPIs – what they tell us and performance management

Q2 2011 KPI summary • Total Diabetic Population aged 12 and over on Soarian

(KPI 0) = 258,394 • Eligible population (KPI 0) = 223,555• Number of individuals attending screening at least once

(KPI 2 -Uptake rate) = 93,303

41.7%• Total number of the current eligible population

successfully screened (KPI 4) = 84,500

37.8%• Not screened or suspended = 139,000

62.2%• Referral to Ophthalmology = 2,994 - 3.3%

Q2 2011 KPI summary

223555

24910

14065 4136

Total Diabetic Population Q2 2011 = 258,394

Eligible Pop = 223,555

Temp Suspended = 24,910

Permanently Suspended = 14065

Temporarily Unavailable = 4,136

Q2 2011 KPI summary

37.8%

62.2%

Eligible population as at 30th Sept 2011 = 223,555

- Successfully Screened = 84,500

- Unscreened = 139,055

KPI 2 – Uptake rate - Number of individuals attending screening at least

once.

Ayrsh

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Forth

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0.00%

5.00%

10.00%

15.00%

20.00%

25.00%

30.00%

35.00%

40.00%

45.00%

50.00%

KPI 2 Percentage Q2 2011

40%

• Ayrshire & Arran 42.60% • Borders 44.40% • Dumfries and Galloway 46.40% • Fife 36.40% • Forth Valley 43.50% • Grampian 45.10% • Greater Glasgow 41.60% • Highland 39.50% • Lanarkshire 39.60% • Lothian 41.20% • Orkney 43.50% • Shetland 46.90% • Tayside 43.30% • Western Isles 42.70%         • National Average - 41.70%

• What’s the key to having a good uptake rate ?

• How about a good invitation rate

(Screening Invitation rate - KPI 1)

KPI 1 Screening Invitation rate

Ayrsh

ire &

Arra

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Borde

rs

Dumfri

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Forth

Vall

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0.00%

10.00%

20.00%

30.00%

40.00%

50.00%

60.00%

70.00%

KPI 1 Percentage Q1 2011

50%

• Ayrshire & Arran 58.00% • Borders 56.20% • Dumfries and Galloway 53.10%• Fife 45.20% • Forth Valley 46.20% • Grampian 58.30% • Greater Glasgow 51.50% • Highland 49.10% • Lanarkshire 44.60% • Lothian 48.20% • Orkney 50.30% • Shetland 0.20% • Tayside 50.10% • Western Isles 48.70%         • Total 50.50%

• KPI 1 derived from – Percentage (100*INV/EP-API)

• INV = patients invited at least once• EP = eligible population• API = patients attending without invitation

API

Patient Invited

Reference Date

Reporting Start Date

Reporting interval

time

10th Nov 2010

Patient Screened

INV = 1 API = 0

INV = 0 API = 1

• Conclusion to all this is that API rates are wrongly reported and used in KPI 1.

• Proposal is to use the following equation to show invitation rate – Percentage 100 *(API+ INV) / (EP)

This would result in the following changes to KPI 1 screening invitation rates

• Ayrshire & Arran 58.00% - 61.8%• Borders 56.20% - 60.1%• Dumfries and Galloway 53.10% - 56.8%• Fife 45.20% - 51.0%• Forth Valley 46.20% - 51.9% • Grampian 58.30% - 62.5%• Greater Glasgow 51.50% - 55.4%• Highland 49.10% - 53.5%• Lanarkshire 44.60% - 51.1%• Lothian 48.20% - 53.9%• Orkney 50.30% - 55.1%• Shetland 0.20% - 47.0%• Tayside 50.10% -56.6% • Western Isles 48.70% -  55.5%       • Total 50.50% - 55.1%

Invitation Profiles

• 100% / 12 months = 8.33% invitation rate per month (in an ideal world).

• Consider profiling your invitation rates on a monthly or even weekly basis.

• Your ‘Invitation Profile’ will depend on many factors related to your area.

April

May

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ne July

Augus

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Septem

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Octobe

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Novem

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Decem

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Janu

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Febru

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Mar

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2

4

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12

• Don’t forget that KPIs can also be used to enhance your invitation targeting by other categories.

• Ethnic Minorities

Percentage referable each ethnic group. Source: DRS collaborative, Scotland June 2010

0%1%2%3%4%5%6%7%8%9%

10%

Ethnic group

Pe

rce

nta

ge

re

fera

ble

• Or age group

Percentage referable each age groupSource: DRS collaborative, Scotland June 2010

0.0%

4.5%

8.2%

5.8%

4.2%3.3%

2.7% 2.7% 3.0% 3.4%

0%1%2%3%4%5%6%7%8%9%

10%

Age Group

Pe

rc

en

tag

e r

efe

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ble

• and deprivation quintile

Percentage referable by quintile of deprivation (Scottish

Index of Multiple Deprivation 2009). Source: DRS collaborative, Scotland June 2010

4.1% 3.9%3.1% 3.2% 3.4%

0%1%2%3%4%5%6%7%8%9%

10%

1 2 4 5 Scotland

Quintile of deprivation

Pe

rce

nta

ge

re

fera

ble

• To continue to increase performance of the DRS service we will use KPIs to target the use of –– SMS– Email– Voice messaging

• To summarise– KPIs are not perfect and require interpretation.– We can do more with them.– They are not being used regularly enough by

Managers.– They are good for reporting success.– They are also good for reporting failure !!! – Especially when your service is under pressure.– They will be important for any future business cases.

• Questions and comments ?