Data briefing: Better Care, Better Value indicators

The NHS Institute for Innovation and Improvement recently published the Better Care, Better Value indicators for the second quarter of this financial year. They can be analysed to give some insight into what is happening across the country.

The first graph summarises the changes in the upper-quartile position and the averages in performance in the seven main clinical indicators. In five, performance improved from the first to the second quarter; in two (surgical thresholds and day-case rate) it declined. Natural and seasonal variation makes meaningful comparisons between only two quarters of data of limited use. However, there seem to be distinct trends in some areas.

More than 60 per cent of trusts improved their performance in average and upper-quartile pre-operative bed days. The NHS institute's improved guidance on this indicator is based on both elective patients admitted on the day or days before surgery and emergency patients waiting for surgery. Nearly 75 per cent of all trusts made improvements in length of stay between the first and second quarter.

The most striking changes are for the prescribing of lower-cost non-proprietary statins as a percentage of all statin prescribing in primary care trusts. Almost all PCTs improved their performance here, with only 13 from a total of 303 PCTs declining (the second-quarter indicators are published for the 'old' PCTs). This resulted in the upper-quartile level indicator increasing from 68.7 per cent to 70.4 per cent of low-cost statin prescribing and the average for all PCTs increasing from 60.7 per cent to 62.8 per cent for the period.

The second graph shows that most PCTs increased performance against this indicator by 1-5 per cent regardless of their level of low-cost statin prescribing at quarter 1. All this suggests that PCTs can effectively and quickly take action to influence prescribing even if they already have a relatively high level of performance.

However, performance across the country is variable. The third graph shows the proportion of PCTs in each strategic health authority performing at or above upper-quartile level for this indicator. Only two PCTs in NHS London are at or above upper-quartile, against 87 per cent in NHS North East. The productivity savings opportunity varies from over£25m for NHS North West to less than£150,000 for NHS North East. (It is also influenced by the size of population served.)

Mark Jennings leads the delivering quality and value priority programmes at the NHS Institute for Innovation and Improvement. He can be contacted at mark.jennings@institute.nhs.uk. Full figures on the indicators can be found at www.productivity.nhs.uk.