Knowledge Matters volume 8, issue 2

issuu.com/SECQO

twitter.com/SECSHAQO

www.QualityObservatory.nhs.uk http://www.networks.nhs.uk/nhs-networks/sec-qo

Volume 8 Issue 2 June 2014

Welcome to Knowledge Matters

Inside This Issue :

KSS AHSN ACS admissions 2 Cancer dashboard 9 News 14

Chi-square– what on earth?! 4 Getting web design right 10 Back page fun! 16

Working with the SCN 6 NHS Confed 2014 12

Better Care Fund 8 From the postbag 13

Another tip top, fun packed, super informative and all round marvellous edition of Knowledge Matters is

here sports fans, so if you’re still crying into your lager at England’s early exit from the World Cup soothe

yourself with the treats we have in store for you.

Simon and I were delighted with the recent publication of the Ambulatory Care Sensitive Admissions Data

report for the KSS AHSN recently; find out more about the report and its contents on pages 2 and 3.

If you’ve ever wondered what keeps Adam with his head down all day, read his fascinating review of what

analytics for the Strategic Clinical Networks looks like. Never a dull moment, as evidenced by Rebecca’s

coverage of the cancer dashboard which she’s developed for the SCN.

Aleks gives us a fascinating insight into those all important first steps in designing your website; trust me,

she speaks from experience! Check out page 10 for details….

Speaking of non-stop fun, the 2014 NHS Confederation

Conference has been and gone and we were pleased to have had

a great stand; Amit gives us the highlights on page 12.

There is also a review of the Better Care Fund and what it means

for analytics, not to mention some highlights from our postbag. It

looks like the QO is running right alongside this fantastic summer

of sport!

It only remains to say ‘come on Andy Grigor!’.

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[email protected] www.QualityObservatory.nhs.uk

The Quality Observatory has recently delivered an in-depth

analysis report and suite of tools for Kent, Surrey & Sussex

Academic Health Science Network on emergency admissions

for Ambulatory Care Sensitive (ACS) Conditions, prompted by

last year’s report by The Health Foundation and Nuffield Trust.

The results and publication were presented by the Quality

Observatory’s Kate Cheema at a recent KSS AHSN event.

Guy Boersma, Managing Director of Kent Surrey Sussex AHSN

said: “I am delighted to have commissioned and published this

analysis. The first step towards improvement is to understand

what you need to change; this report is a position statement on

ambulatory care sensitive admissions for the region and, as

with all the best analysis, will prompt you to ask more probing

questions and discuss further what action can be taken in your

locality. The analysis presented in this report, alongside the

associated analytical tool, provides authoritative, detailed information on emergency hospital admissions for

ambulatory care sensitive conditions. The report also highlights areas of good practice from which lessons

can be learned. I hope to see this spread across the region, shaping strong support and learning networks

between peers. I trust that this report will support the spread of existing best practice, and help

commissioners and providers to work better to deliver the transformation of health and care services that is

needed to ensure that people living in Kent and Medway, Surrey and Sussex receive consistently high

quality care when and where they need it.”

Ambulatory care sensitive admission rates are a commonly used indicator of system health and

sustainability through the identification of emergency admissions that are generally seen as avoidable.

Such admissions can also be used to identify and monitor efforts to decrease costs and increase

productivity. A deeper understanding of ACS

conditions across the region will be critical to

ensuring that local out-of-hours strategies and

QIPP plans can deliver sustainable change

across the Kent, Surrey and Sussex region.

The report showed that whilst rates of ACS

admissions in Kent, Surrey and Sussex are

relatively low, the overall rate is increasing

rather than decreasing, at a similar rate to that

of England, which increased by 48% over an

eleven year period. Less than half of this

increase is explained by population growth and demographic change. Of particular concern is the rapid

growth of ‘other and vaccine preventable’ ambulatory care sensitive admission rates as well as the steady

rise in acute ACS conditions. Interestingly, chronic ACS conditions show limited growth, in stark contrast to

the increasing demand in this area from an ageing population that is living longer.

KSS ACS Emergency Admissions Report Published By Simon Berry and Kate Cheema

3


Clear variations between areas are apparent at both a national and regional level. Most areas show increased

rates of ambulatory care sensitive admissions

over time, but there is variation evident in the

degree of change and the extent to which this is

evident in different ACS conditions. Levels of

deprivation, which are strongly linked to rates of

ACS admission, can explain some of this

variation but there are still significant differences

between areas even after deprivation is taken

into account. The impact of deprivation is lesser

in the Kent, Surrey and Sussex region than in

England as a whole. A number of scenarios were

applied to the data in an effort to provide a high level estimate of the scale of resource redistribution

opportunity from hospital to out of hospital settings. The high level estimates from these scenarios ranged

from £6.7m to £27.3m and showed that despite the relatively good

rates of ACS admission rates in the region, opportunities remain to

redistribute resources from hospital to out of hospital settings.

The report sets out some highlights from analysis of specific ACS

conditions. Pneumonia (shown on the left) is a significant driver of

growth and disproportionately affects older people. There is significant

variation in emergency hospital admission rates between clinical

commissioning group areas and the majority of emergency hospital

pneumonia admissions are shown to be primarily for pneumonia and

not pneumonia as a co-morbidity.

Urinary tract infection and pyelonephritis is the most common ACS

admission reason across the Kent, Surrey and Sussex

region. These admissions are not purely the domain of

older people but also have an impact on younger

females which may have implications for public health.

Epilepsy and convulsions is an ACS condition where

admissions are evident in all age groups but especially

younger children; it is highlighted as an example of

where a condition can disproportionately impact a

younger group, and highlights the fact that ACS

admissions are not just a concern for the older

population.

Copies of the report are available on http://issuu.com/secqo/docs

If you are interested in similar pieces of analysis in your area, please contact the Quality Observatory at:

[email protected]

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I recently had a question which took me straight back to my school days (and incidentally brought me out in a

cold sweat). It was ‘what on earth is a chi-square test and when should I use it?’. The first time I came across

the chi-square test was in biology lessons, associated with dim remembrances of marking grasshoppers with

tippex before recapture. Hard times for grasshoppers.

Whilst the concept was, quite literally, greek to me then, the chi-square test has served me well since. I will

attempt to explain here why we use it, when to use and how to interpret the results.

Let’s imagine we want to know whether there is a difference between men and women’s tastes in sci-fi, as

illustrated by whether they prefer Star Wars or Star Trek. First of all, have a think about your hypothesis, what

do you expect to see? In this instance let’s assume that our hypothesis states that there is no difference

between men and women when it comes to a love of Kirk or Han Solo.

Right, time to collect some data. You ask 100 men, and 100 women which of Star Trek and Star Wars they

prefer and the results are shown in the table to the left. So,

do these results suggest a difference between the

genders? Well first we need to decide which test we might

use to decide this. Chi-square is a test that we can use with

categorical data. This is data that is, as the name suggests,

put into categories rather than measured on a continuous

scale such as height and weight. As we have very simple

categorical data here (shown in a 2x2 contingency table)

the Chi-square test is a good one to use.

Clearly we have different numbers for men and women in each category of sci-fi, but are our results far enough

away from what we would expect to see if there was no difference at all, so far far away in fact that we could

call it significantly ‘different’?

Therefore we have to think about what we would expect to see if our ‘null hypothesis’ was true; thus we need to

calculate what numbers of Trekkies and Star Wars lovers we

would expect in each category if men and women’s sci-fi

tastes didn’t differ from each other. Unless you have a

specific theory to apply, in this case we might expect to see a

50/50 split in both genders and as we’ve got 100 men and

100 women in the sample (how convenient) we would

therefore expect to see 50 people in each cell of our 2x2

table, like that to the right.

So, we now want to calculate a statistic which compares our actual (or observed) and expected data to see

whether the reality is significantly different from our theory which is, remember, that there is no difference

between the two genders.

For the purists amongst you, the formula to be applied can be seen on the next page. Basically, the Chi-square

value is a single number that adds up all the differences between our actual data and the data expected if

there is no difference. If the actual data and expected data are identical, the Chi-square value is 0. Greater

Chi-square– what on earth is that?!

ACTUAL

Men 85 15

Women 64 36

EXPECTED

Men 50 50

Women 50 50

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differences between expected and actual data produce a larger Chi-

square value. The larger the Chi-square value, the greater the

probability that there really is a significant difference. That phrase

‘greater the probability’ is an important one because we aren’t talking

about absolutes here. A high Chi-square statistic value means that it

is very unlikely that the difference isn’t down to pure chance, but

there always remains a slight probability that it is. This probability

reduces as the Chi-square statistic gets higher.

To work out whether your Chi-square statistic is big enough, we need to look up the value in a table (you can

find these online, or usually your software package of choice will do the work for you!). The reference tables

will provide you with a ‘critical value’ for the Chi-square test for each level of significance. So, for example, if

you wanted to see if your statistic indicated a probable difference at the 99% level, you’d look up a critical value

for that level, which would be higher than that for the 95% level and so on. The higher the level, the smaller the

probability that any difference identified is down to chance alone.

If the Chi-square value is greater than or equal to the critical value then there is a significant difference

between the groups we are studying. That is, the difference between actual data and the expected data (that

assumes the groups aren’t different) is probably too great to be attributed to chance. So we conclude that our

sample supports the hypothesis of a difference, in this case that men and women have different sci-fi

preferences.

If the Chi-square value is less than the critical value then there is no significant difference. The amount of

difference between expected and actual data is likely just due to chance. Thus, we conclude that our sample

does not support the hypothesis of a difference.

In this example, the critical value at the 99% level is 6.6. The Chi-square value was 11.6 which is larger than

6.6. Thus, there is a significant difference in sci-fi preferences between men and women in our sample. We

conclude that based on this sample, men generally strongly prefer Star Trek (85% of men responded in this

category) whilst women were more equal in their preferences with a near 60/40 split. You can see this is the

original raw data.

Generally speaking, your chosen software package will give you a ‘p-value’; this is the probability that the Chi-

statistic is down to chance alone. If your ‘p-value’ is less than 0.05 then the Chi-square statistic is significant at

the 95% level, if it’s less than 0.01 then it’s significant at the 99% level and so on.

WARNING!! We have not proven anything!!! These first samples might be atypical. Repeated sampling

may show a significant difference, or eliminate the difference we thought we saw. Because of this uncertainty,

we can only say that the hypothesis was supported or not supported, not that we have incontrovertible proof.

If you want to test your knowledge try this little nugget (which hopefully helps point to more healthcare related

applications). Answers on a postcard to the usual address!

If you’d like to develop your statistical skills

further, drop us a line to see what the QO can

do for you at [email protected]

Survival figures for

RMS Titanic by gender

Died Survived

Men 680 168

Women 126 317

6


A few issues ago I mentioned the importance of Strategic Clinical Networks and their various

work streams. We at the Quality Observatory have been working closely with the South East Coast SCN on

a whole range of projects. Elsewhere in this issue Rebecca has already detailed some of the interesting

cancer work she has done, and here are a few more extracts from some of the other pathways that highlight

the current thinking coming from this highly pro-active and engaged SCN.

Paediatrics

There has been much talk in paediatric circles around activity in 6 high volume conditions – Abdominal Pain,

Asthma & Wheeze, Bronchiolitis, Fever & Minor Infections,

Gastroenteritis/Diarrhoea & Vomiting, and Head Injury.

These 6 plus Urinary Tract Infections (UTI) have been shown

to make up the bulk of activity for some of the younger age

groups. Some of these conditions may well be very serious,

however often they can be relatively minor, and therefore if

admitted unnecessarily can be a drain on secondary care

resources, and divert clinicians from where they are needed

more. To look at this in more detail we have produced a

dashboard and some maps showing admissions to

secondary care for the 6 conditions plus UTI for patients under 5, who had a zero length of stay; this being

the cohort that is most likely to have unnecessary

admissions. In conjunction with this we looked at A&E

data—looking at patients in the same age band who have

been to A&E but have been discharged without either

investigation or treatment. This provides a larger picture of

where, in the system, these things are happening. This is

the start of the work. Now that the SCN has this

information they need to examine it and discuss with local

clinical stakeholders how best to use the data in

implementing changes to pathways, so that these children

get the appropriate level of care, which is not at the

expense of children with greater need.

This is not the only piece of paediatric work that is going on. There is a strand that is looking at the

management of paediatric long-term conditions—asthma, diabetes and epilepsy. This work is looking at the

cost and management of these conditions in secondary care with specific thought about transitioning these

out into community settings and making sure that the best and most appropriate care for those with long-

term conditions is available in the paediatric setting, so that the continued management of the condition into

adulthood is not only appropriate but also resource effective.

Maternity

There are many ongoing discussions around the building about a new online and interactive maternity

Working with the Strategic Clinical Network

By Adam C. Cook

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dashboard. There have been many meetings now that have hammered out what metrics are to be used,

how they are to be used and how we need best to present them. Agreement is being reached on this, and

soon work will begin on that in earnest over the next few months. Watch this space—as this is a major piece

of work, and we will be coming back to detail it in future editions of Knowledge Matters.

Cardiovascular

There has been a lot of work going on around the Cardiovascular pathway. We have been working on the

heart attack pathway focussing upon STEMI

(ST segment elevation myocardial infarction)

and Non-STEMI conditions. Particular interest

here lies in the numbers of patients undergoing

these events and especially the subsequent management

of this. So we have been looking at readmissions within

30, 60 and 90 days, and also if patients were transferred from one trust to another, some local trusts being

specialised centres for STEMI. We looked at how quickly patients were transferred to a more appropriate

setting. Expansion upon this detail was added around pacemakers, ablations and other intrinsic parts of the

cardiovascular pathway.

Stroke

Stroke has always been a pathway that has had a lot

of focus upon it. This is unsurprising; it is a high

volume, high cost, with high mortality pathway.

Clinical improvements and recommendations are

numerous and varied and so the SCN are very

interested in looking at all the available data to see

where best practice is already happening, and where

it needs improvement. This means looking at data

across a number of sources. There are stroke

relevant indicators in QOF and obviously the secondary care inpatient data is of huge value. More detail

though is to be found in the Sentinel Stroke National Audit Programme (SSNAP) which has a huge range of

indicators. We’re currently working on building a dashboard based on this using selected KPIs. Elsewhere

on the stroke pathway we’ve looked at the influence of atrial fibrillation on stroke and how that has an impact

upon the incidence and management of Ischaemic activity.

There are many others areas of work that the SCN is covering—I’ve been working up some projections on

adult obesity recently, and there are projects around diabetes, renal disease and mental health in the

pipeline. As new thoughts and ideas and ways of viewing data come out of these, we will be sure to feed

back on this.

Ischaemic Stroke Activity - Percentage with Atrial Fribrillation

NHS Eastbourne Hailsham & Seaford CCG

Source: Secondary Uses Service (SUS)

0

5

10

15

20

25

30

35

40

0%

10%

20%

30%

40%

50%

60%

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11

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12

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13

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Admissions

Admissions with AF

0

200

400

600

800

1000

1200

1400

0%

10%

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30%

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60%

70%

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12

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12

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Bed days

Beddays with AF

0

1

2

3

4

5

6

7

0%

10%

20%

30%

40%

50%

60%

70%

80%

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100%

30-Day Readmissions

Readmissions with AFEastbourne, Hailsham, Seaford

0

2

4

6

8

10

12

0%

20%

40%

60%

80%

100%

120%In-hospital Deaths

Deaths with AF Eastbourne, Hailsham, Seaford KSS

£-

£20,000

£40,000

£60,000

£80,000

£100,000

£120,000

£140,000

£160,000

£180,000

0%

10%

20%

30%

40%

50%

60%

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80%PbR Tariff

Tariff with Af Eastbourne, Hailsham, Seaford KSS

8


Better Care Fund By Nikki Tizzard, Information Analyst

In June 2013 the government announced the £3.8 billion Better Care Fund, designed to integrate spending

between the NHS and council social care. The intention is to build on existing work being done by CCGs

and councils to significantly expand the care provided in community settings. It is hoped that the funding will

help drive better integrated care and support for the ageing

population, not only helping to manage existing pressures but

also improve long term sustainability. CCGs and councils

have been tasked with developing a joint plan for supporting

adult social care services, where there will also be a health

benefit. Taking into account existing commissioning plans,

they must agree where the funding will be best spent and what

outcomes are expected. The effective use of data from both

healthcare and local government is essential for establishing

baselines at the outset and evidencing achievement in the

future.

The QO have become involved as part of our ongoing support

to Surrey Heath CCG and have started working closely with Surrey County Council to build and implement

the required plans. A specific BCF Metrics Group has been formed with representatives from across the

county to focus on establishing and delivering measureable outcomes.

Several nationally agreed metrics have been identified which must be incorporated into the joint plan:

Permanent admissions of older people to residential and nursing care homes

Proportion of older people who were still at home 91 days after discharge from hospital into reablement/rehabilitation services

Delayed transfers of care from hospital

Avoidable emergency admissions

Patient/service user experience (a national measure specific to integrated care is currently being

developed, so for now this can be an existing metric or BCF groups can develop a new one).

An additional, locally chosen measure is included as well, perhaps an existing one from any of the

Outcomes Frameworks or another suitable metric that meets the given criteria. Data sharing across

organisations will be done via use of NHS numbers to allow safe sharing across systems.

There are obviously challenges, such as the availability and timeliness of data or dividing the county into

measurable geographic areas. BCF plans are submitted at a county-wide level, but data is also needed at a

lower level so CCGs can be clear on their commitments. This is an issue where geographical footprints of

county council districts and boroughs differ from those of the CCGs. Also, where a BCF metric is also

included in other workstreams, we have needed to avoid a situation where an organisation ends up with two

different targets for the same measure while still making sure the BCF target is appropriate.

A significant chunk of the BCF funding is directly linked to achievement of the desired outcomes, so all of

the organisations involved are keen to make sure joint plans are robust from the outset. This means joint

use of data and a collaborative approach towards determining where we are now, and jointly evidencing our

progress.

9


Strategic Clinical Network Cancer Dashboard By Rebecca Matthews, Information Analyst

The Quality Observatory have been working with the SEC Cancer Strategic Clinical Network to create a set

of dashboards around the cancer care pathway. The first dashboard, which focuses on measures around

cancer awareness and early diagnosis has been developed and sent out to CCGs and key groups for com-

ments.

The first view on the dashboard has a number

of CCG level measures. All of the indicators

are shown on one page with a drop down box

to select the CCG you are interested in. There

is a second drop-down box which allows you to

select a second CCG as a comparator, with the

England figure also being shown on all charts.

The measures on this page include 2 week

wait referrals, emergency admissions with can-

cer, conversion rate, routes to diagnosis data,

uptake for national screening programmes and

diagnostic imaging data. There is also a provider-

based chart which looks at the latest National

Cancer Patient Experience Survey data around

the number of times a patient had to see their GP

before being referred.

The second view of the dashboard is a subset of

the CCG measures, but drilling down to GP Prac-

tice level for those measures where data is availa-

ble. The practice level charts also include the rele-

vant CCG figure as an additional benchmark.

The final sheet of charts in the dashboard looks at

the measures relating to cancer from the CCG

Outcomes Indicator Set including mortality and

survival rates.

The dashboard is still draft and plans for future

development include the addition of staging data

once this is available, also a set of charts allowing the user to compare all the CCGs for a selected measure.

Please get in touch if you have any questions or comments! [email protected]

mailto:[email protected]

10


Getting web design right– things to consider!

By Aleksandra Bujnicka

Solution:

Complexity 2/5

When considering a new website, at some point of the process of getting one, most people find themselves talking to a firm or a person specialising in designing web pages… As getting the design of your website just right is important - this is the very conversation that is worth preparing for.

Just like building a new house, building a new website requires some careful thought, planning and designing. As it is your website, the role of designer is to implement your idea. For this reason, the aim of the conversation you are about to have, is to give the designer a sense of what you are really looking for in your website, what you want to accomplish with it and how you want to accomplish it.

So, what are the things to consider before you talk to your designer?

You need to contemplate your approach to all of the required components of your “online hub”. Build the function first and let the design follow.

First of all, it might be reasonable to establish a few essential objectives for the website. The key information would be:

what type of website it is going to be – showcase for your organisation, information page, blog,

shop etc.

who is the target audience – age, gender, socio-economic group

what’s the purpose of the site – to let others know what you do, to provide information, to get

someone to do something, to impress the visitor, to sell services or goods

what is the user experience that you want people to have – professional, trendy-hip, socially

engaged, animated etc.

Then, you need to consider your website or web page architecture:

Content Management System (CMS) – will your site need maintaining; who will manage and

maintain the site, and how; do you need CMS that is easy to use and keep up to date

data collection – do you need a database-driven website (important when planning to collect

information) or a “static” one – without database

site structure – try putting together a list of pages and sub-pages required for the website

“I’m really keen to get a website up to help support the new programme but really not sure where to start? Can you help me?”

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It is also necessary to reflect upon the style of the web page:

content design – are you able to

supply text and photos for the website - knowing in advance how much text there is going to be on each page will help to decide on the amount of visual content needed to get the balance right

use of colour – what colours do you like or would rather avoid; what colour scheme would you want for your website – dark, light, bright, colourful…

logo/branding – will the website need to complement the existing branding and comply with related

guidelines

page layout – do you have any preferences regarding where different elements on the page

should go

Finally, to round up the whole process you might like to present examples of your favourite or least favourite websites. Try to find 3 websites similar to yours in terms of content and think what you like or dislike about them, then find an additional 3 sites which you like or dislike in terms of design, the look or the feel of them… or maybe with certain elements or aspects of them that are to your liking.

To sum up, the simple rules that might be worth keeping in mind while planning your website, which might help to get it just right, if followed, could be:

focus on user needs,

focus on quality content,

make it easy to navigate,

put the focus only on the essential elements of your website and get rid of the unnecessary

keep it simple and elegant

If, at some point in the future, you find yourself keen and ready to start an adventure with your own webpage and don’t know where to begin, need someone to give you advice or a hand with it – you could try the benefits of having the Quality Observatory Development Team working for you – it might be just the one you needed.

Have fun! ;-)

12


The NHS Confederation Conference was an

opportunity to network with other Commissioning

Support Units, Commissioning Care Groups and other

NHS and non-NHS bodies and companies. There are

a vast number of opportunities available within the

new NHS structure and it is evident that individuals are

using innovative methods to solve problems within the

NHS whilst working together.

NHS Confederation Conference is branded as one of

the biggest NHS shows of the year and this was the

first for the new CEO of NHS England, Simon

Stevens. An inspiring speech was given about how we

need to sustain the care patients deserve over the

future years whilst battling the most sustained budget crunch since the Second World War. He indicated that

too much time has been spent on analysing the challenges and there needs to be more focus on getting on with

the job and developing the solutions for future healthcare.

Simon Stevens’ speech concentrated on the following 3 topics:

Improving the sophistication of commissioning a focus on outcomes for patients and taxpayers

Accelerating the design of care delivery with greater local flexibility to meet the social care needs for the

people we serve

Actively exploiting and embracing the fundamental transformations that are believed to sweep modern

medicine

The three topics are presented in more detail on: http://www.england.nhs.uk/2014/06/04/simon-stevens-speech

-confed/

NHS Confederation for the QO

Tim Kelsey, 2014: BIG DATA REVOLUTION “we should think of data, not as some dry technocratic scientific

clinical record base entity. We should think of data as a pooling of our collective wisdom and our collective

experience of health care.”

Tim Kelsey indicates that there are pockets of health care which we just do not have any data on. For example,

we are unaware of the number of patients that underwent chemotherapy and whether the chemotherapy had

any benefit to the patient. This is something we do not have data on. In addition there is very little information

about general practice, mental health services and there is next to nothing on social care.

This speech outlined the fundamentals of the importance of data as historically data has been used to judge

instead of improve. It is the power of data that will allow us to improve, grow and energise the NHS system.

What does this all mean for the QO team? It means data will no longer be treated as Kryptonite for trusts and

local health care bodies. It means that data will be used for what it was fundamentally designed for - to share

good practice and aid evidence-based working.

QO goes to Confed - Liverpool 2014 By Amit Chavda, Information Analyst

13


The virtual postbag is heaving with feedback after the last edition of Knowledge

Matters. We’d like to thank our readers and encourage you all to feed back your

comments and any ideas for future issues (and if you ever fancy contributing do drop

us a line!). Here are a selection of comments and thoughts:

Letters to the editor(s)

Have just been enjoying the latest edition of KM which was full of useful material as ever. I have a couple of

pieces of feedback for you.

The first relates to the article on rare events SPC. Right at the end, you mention Don Wheeler and his

views on rare events charts. I haven’t read the article you quote but Don’s view about specialist SPC charts

in general are that you should only use them if the assumptions used to create the control limits are valid for

your data. This is why he advocates using XmR charts because they make the least assumptions about the

data. I have successfully used XmR to plot both time between and cases between data.

The second relates to the super article on bar charts in Ask an Analyst. As well as the method described

(which works just fine), there is an alternative. Place the values of interest in a separate column (as de-

scribed) but replace them in the main column with a zero. Then use a stacked bar chart format (the only

time a stacked bar chart is useful in my view, but that’s quite another story) which avoids the need to fiddle

around with overlapping columns.

-Mike Davidge, Director, NHS Elect and Head of Improvement Methodology, 1000 Lives Improvement Ser-

vice (NHS Wales)

Thanks very much for your letter Mike; we’d be really keen to hear from anyone else who has used XmR

charts in this way. The assumptions and techniques behind many of the specialist SPC charts can some-

times prove hard to grasp so being able to use the XmR as an SPC ‘swiss army knife’ would be great!

I think the appropriate usage of stacked bar charts could be the subject of a whole future edition of

Knowledge Matters! - Ed.

Just wanted to say, I am very impressed with the

elearning you’ve put together (http://www.seqo.nhs.uk/

elearning/NHSST_Analytics/story.html), it is excellent

and I’m sure will be of help to a lot of people. Well

done!

- Jackie Smith, Informatics Development Manager, De-

veloping Informatics Skills and Capability (DISC),

HSCIC

Thanks very much for your kind words Jackie.

We’re currently working on a whole suite of e-

learning tools to help bring the fundamentals of

measurement for improvement to an easily ac-

cessible and, hopefully, fun platform! Watch this

space! - Ed

https://mail.wiltshire.nhs.uk/owa/redir.aspx?C=cfERJCVnSUi-3yDhB3cLx3eyTOAkZ9EIRA650eoAuGc3ryl6X7or1gmDFv555uxPYRV4eHpvPg0.&URL=http%3a%2f%2fwww.seqo.nhs.uk%2felearning%2fNHSST_Analytics%2fstory.html

https://mail.wiltshire.nhs.uk/owa/redir.aspx?C=cfERJCVnSUi-3yDhB3cLx3eyTOAkZ9EIRA650eoAuGc3ryl6X7or1gmDFv555uxPYRV4eHpvPg0.&URL=http%3a%2f%2fwww.seqo.nhs.uk%2felearning%2fNHSST_Analytics%2fstory.html

14


NEWS

Latest CCG outcomes indicators published

The latest Clinical Commissioning Group Out-comes Indicators were recently released by the Health & Social Care Information Centre. The indi-cators aim to provide information about the quality of health services commissioned and associated health outcomes. New indicators include:

One-year survival from all cancers

Breast feeding prevalence at 6-8 weeks

Access to psychological therapies services by people from black and minority ethnic groups

For more information see:

http://www.hscic.gov.uk/catalogue/PUB14298

Federation for the Health Informatics Profes-

sion

BCS The Chartered Institute for IT, the UK Coun-cil of Health Informatics Professionals (UKCHIP) and the Institute of Health Records and Information Management are working to create a new Federa-tion for the Health Informatics profession. Consul-tation on this proposal continues until October 2014. Three specific questions are being posed about the priorities for the Federation:

What is important to you?

Why is it important?

What are the best ways of involving you and

your professional colleagues to make sure we get this right?

For more information see: http://www.ukchip.org/?page_id=5404

Moving….

The QO is pleased to (very quietly on the back pages, because we’re not ones to tempt fate) an-nounce that we will shortly be on the move to our new premises– we’ll still be based in sunny Horley but our address and telephone numbers will change, hopefully by September. Make sure you keep in touch via e-mail and keep up with Knowledge Matters to see how the move is pro-gressing!

Sign up to Safety

Sign up to Safety is a new

national patient safety campaign that was announced in March by the Secretary of State for Health. It launched on 24 June 2014 with the mission to strengthen patient safety in the NHS and make it the safest healthcare system in the world.

The Secretary of State for Health set out the ambition of halving avoidable harm in the NHS over the next three years, and saving 6,000 lives as a result. This is supported by a campaign that aims to listen to patients, carers and staff, learn from what they say when things go wrong and take action to improve patient’s safety, helping to ensure patients get harm free care every time, everywhere.

The five Sign up to Safety pledges

1. Put safety first. Commit to reducing avoidable

harm in the NHS by half and make public the goals

and plans developed locally.

2. Continually learn. Make their organisations

more resilient to risks, by acting on the feedback

from patients and by constantly measuring and

monitoring how safe their services are.

3. Honesty. Be transparent with people about

their progress to tackle patient safety issues and

support staff to be candid with patients and their

families if something goes wrong.

4. Collaborate. Take a leading role in supporting

local collaborative learning, so that improvements

are made across all of the local services that

patients use.

5. Support. Help people understand why things

go wrong and how to put them right. Give staff the

time and support to improve and celebrate the

progress.

The QO will be making a pledge very soon, will

you?!

https://www.gov.uk/government/speeches/sign-up-to-safety-the-path-to-saving-6000-lives




15


Feedback sought on Code of Practice for

Confidential Information

The HSCIC is inviting feedback on its draft Code of Practice on Confidential Information2.

Under the Health and Social Care Act 2012, the HSCIC is required to publish a Code of Practice. Organisations that handle confidential information about the provision of health and adult social care in England are required to have regard to it, from GP practices and hospital trusts, to commissioners and research organisations.

The HSCIC released a Guide to Confidentiality in Health and Social Care in September 2013 which provided citizens and health and care staff with clear, accessible guidance on the handling of confidential information3.

The Code of Practice aims to complete the picture by providing good practice guidance to those responsible for setting and meeting organisational policies in this arena. It will help organisations to ensure that the right structures and procedures are in place to help all staff follow the confidentiality rules in the previously published guide.

The HSCIC is inviting a wide range of stakeholders to read the draft Code available at www.hscic.gov.uk/cop and provide their feedback by 18 August 2014.

Results of the feedback gathering will be published on our website and used to develop the final Code before its publication at the end of September 2014.

BCS ASSIST mentorship programme

Regular readers of Knowledge Matters will know how passionate we are here at the QO about professional development for folk in our line of work. In light of this, we are pleased to announce that BCS Assist (The Association for Informatics

Professionals in Health and Social Care) will be launching a mentoring programme. The key aims of this programme are to help and advise ASSIST members with their continued professional development by developing specific skills and knowledge that will enhance their professional and personal growth. Mentoring will:

Help develop the next generation in health

informatics

Facilitate growth by sharing resources and

networks

Focus on the individual’s development as a

whole

Focus on professional development that may

be outside an individual’s area of work/knowledge

Enhance the skill set and knowledge about a

specific issue

Facilitate the sharing of expertise with others.

Help the individual learn more about other

areas within health informatics.

Help the individual gain from the mentor’s

expertise

Help the individual develop a sharper focus on

what is needed to grow professionally within health informatics

Help the individual learn specific skills and

knowledge that are relevant to personal goals

ASSIST will aim to help members find a mentor/trusted advisor. 9 members of the National Council will be able to provide one on one mentoring for an hour each month. Our National Council mentors have a wealth of knowledge and experience to share with you. If you’re interested in getting mentored, please get in touch with the BCS

Secretary ([email protected]").

NEWS

http://www.hscic.gov.uk/cop



Knowledge matters is the newsletter of the NHS Quality Observatory, to discuss any items raised in this pub-lication, for further information or to be added to our distribution list, please contact us.

Hosted by: Central Southern Commissioning Support Unit

E-mail: [email protected]

To contact a team member: [email protected]

Au revoir!

As Adam’s poem may have sug-

gested, our long time team admin-

istrator Suzanne is leaving us for

a life of leisure and a well de-

served retirement. The whole

team, along with some old faces,

gathered to send Suzanne off in

style in the traditional way!

I know we all hate to say goodbye,

But sometimes we really must,

So we bid a fond adieu

To someone in whom we trust.

Suzanne has kept us running smoothly,

For more years than I can mention,

But now she is retiring,

I'll ask you to pay attention,

Because we come to praise her,

And to thank her for her work,

She's coped with all our craziness,

But never gone berserk.

She's sorted out our diaries,

Ensured we've been on time,

Made sure we've filled the forms out,

And kept us all in line

She's gone beyond the call of duty,

In screening out unwanted callers,

And when we buy up extra tech,

She's sorted out the orders.

Suzanne will now be leaving us,

For a life of leisure,

Extra time to spend with Fred,

I'm sure that she will treasure.

We all thank you Suzanne,

for being our administrator,

We will all miss you so,

You couldn't have been greater!

Simon says…….

“It requires a very unusual mind to undertake analysis of the obvious” - Alfred North Whitehead

SUZANNE – A farewell ode


Knowledge Matters volume 8, issue 2

Documents

Transcript of Knowledge Matters volume 8, issue 2