The NHS Institute for Innovation and Improvement has published the Q3 2006-07 Better Care, Better Value indicators. As the indicators have been published for the first time on the basis of the 152 new primary care trusts (previous quarters reported on the 303 PCTs that existed until Q2 end) the discontinuity in data at PCT level makes trend comparisons difficult to identify. However, stability in the acute sector allows us to gain some insight as to what is happening in our hospitals across the country.
The first chart shows that nationally, steady progress is being made in the three main clinical productivity indicators that are designed to help trusts make improvements in areas where the highest levels of resources are consumed - namely the use of hospital beds.
Consistent improvement is evident in these indicators over the three quarters for which they have been published to date (the decline in the pre-operative bed days and bed days saved values is an improvement as both indicators measure the potential for saving bed days). In particular the day-case rate improvement from under 70 per cent at Q1 to over 76 per cent at Q3 shows how trusts are starting to focus on using operational and clinical practice elsewhere.
This focus on fundamental operational performance improvement is displayed by the majority of trusts. The second chart shows nearly twice as many trusts improved their performance against the three main clinical productivity indicators from Q2 to Q3, compared with those where performance declined over this period. The improvements are fairly consistent, showing all strategic health authorities having at least half of their acute trusts improve their outcomes on the indicators.
This concentration on improving operational performance by acute trusts has provided opportunities for releasing resources to contribute to savings or for reinvestment. The third chart shows how productivity opportunity calculated on the basis of organisations achieving Q1 upper quartile performance has fallen by£76m since Q1. This is just over a 5 per cent reduction on the total opportunity identified at the inception of the indicators with 70 per cent attributed to length of stay reductions. -
Mark Jennings leads the delivering quality and value priority programmes at the NHS Institute for Innovation and Improvement. He can be contacted at firstname.lastname@example.org. The institute will publish indicators for Q4 2006-07 next month. For full figures on all Better Care, Better Value indicators for Q3, visit www.productivity.nhs.uk.