The NHS Information Centre has a wide range of products and services designed to support commissioners.
World class commissioning is information hungry. To make the best possible decisions, local commissioners need national, comparative information to plan strategically, procure effectively and monitor and evaluate services.
The NHS Information Centre's range of products and services supports commissioners to do each of these tasks. Here are three of its latest services:
NHS Comparators enables commissioners to investigate aspects of local activity, costs and outcomes. It is a national resource for England, providing information for GP practices, primary care trusts, strategic health authorities and public health observatories, among others.
"NHS Comparators is a strong product that builds on the Secondary Uses Service data and is getting very good reviews," says Phil Collins, the SUS's lead on its development.
NHS Comparators is built around deriving practice indicators and activity from SUS. "It is costed data through the payment by results tariff, together with quality and outcomes framework information and GP practice demographic population profile data," continues Mr Collins.
"We put it into a range of comparators, over 140 at present, profiling comparative performance at aggregate level by GP practice, PCT level or above. It looks at a whole range of factors: in-patient, outpatient and disease-specific."
NHS Comparators is free to use, with a current and fast-growing 5,300 users.
It was initially designed to meet the Department of Health's need to give practices and PCTs better comparative information on their activities so they could understand local commissioning, activities and focus. Currently, there is just one user account for each GP practice, and only 2,000 practices using the service which is a relatively low take-up, but The NHS IC focus is on increasing awareness of the product. Of the current 5,000 users, over 2,000 are in GP practices, 2,000 are in PCTs and about 600 in SHAs.
NHS Comparators has broadened and already introduced elements such as prescribing and provider comparators. Mr Collins notes that "if a GP practice is significantly different from the average, there can be locally-known, clinically valid reasons. When they're out of line and didn't know they were, it gets interesting and that is certainly where users are finding the most value."
He adds that The NHS IC have put a lot of work into making NHS Comparators highly user-friendly. "We knew we couldn't train users individually, so the design is very clear and intuitive," he says.
"There are lots of interpretation, definitions and help in the system. It's designed to be picked up and used by novices, and it will continue to develop as data continues to come in. Its style of access presents information back in a comprehensible and digestible manner - it's a big step to make this type of information easily available and understandable."
The NHS IC's medical director Dr Mark Davies agrees that NHS Comparators is a good example of how vital information is to PBC. "There is a credibility gap in the minds of many clinicians that information can be a tool to drive improvements in service quality," he says.
"A key role for The NHS IC is to help close that gap and show good examples of where information has been used to effectively feed back to individual services, highlighting their performance against markers and national standards.
"That just gets the debate going - it doesn't provide the answers. But it gets people to ask the next level of detailed questions, and leads to services improving over time. In my GP practice, we compared our referral rates for different conditions and found wide variation - but that enabled a set of conversations to make us reflect on our own clinical practice as a group, and consequently the variation reduced over time."
SUS referral to treatment reporting application for 18 weeks
The 18-week referral-to-treatment target is one of the main policy imperatives for the NHS in England. By December 2008, no one should have to wait more than 18 weeks for non-emergency treatment from the time that they are referred, to the start of their treatment, unless it is clinically appropriate to delay treatment or patients choose to wait longer Naturally, will be necessary to have a system to assess and compare national performance across multiple providers and SUS is being developed to do this.
Stephanie Reid, The NHS IC's business lead for the SUS RTT reporting application for 18 weeks, points out that while the secondary uses service (SUS - see page xx) will become the standard repository for activity reporting and payments, from April 2009 it can also help organisations to monitor sustained delivery of national priorities such as the 18-week target in the meantime. She says: "The '3R' release of SUS is geared around initial reporting of 18 weeks.
In the past, the NHS tended to monitor outpatient and inpatient elements - and diagnostics - separately. Ms Reid observes: "Everyone understands and agrees the need for changing measurement to capture RTT times, but this has meant some major and significant changes in the ways we capture, collect and report data."
In order to report on referral to treatment times, SUS will require data to be submitted in Commissioning Data Set version 6 (CDSv6) formats which has introduced specific new items needed to monitor 18 weeks accurately such as RTT Start, RTT Stop and RTT Status. Ms Reid is aware that until NHS organisations are sending RTT data items to SUS, there will be limited use for the reports.
"To get ready for 18 weeks, lots of preparation is needed in an organisation's processes - engaging and consulting with staff so they understand the 18-week 'rules', system implementations, new data item capture, and submission of data via the new CDSv6."
iView Workforce is an important method by which Electronic Staff Record Data Warehouse data is made available to the NHS for workforce planning. iView Workforce builds on ESR data with other data and increases its accessibility. Registered users can use the service to make selections, view comparisons, create tables and generate graphs and extract data from national workforce data.
iview was developed by The NHS IC in conjunction with key partners, including the Department of Health, NHS trusts and strategic health authorities.
It currently includes: workforce numbers, agency spend, workforce earnings, workforce census and labour productivity.
Access to iView is through a user name and password which is available through The NHS IC's contact centre. To become a registered user of iView, users will need to be approved by the authenticated user within their trust.
The majority of NHS trusts are expected to be signed up to iView Workforce by this month (OCTOBER). Presentations have been given to strategic health authorities on its use.
NHS COMPARATORS IMPROVING ASTHMA CARE
Dr Ian Greaves' Staffordshire practice developed a new strategic partnership with their local acute trust after using NHS Comparators revealed the practice referred many more asthma sufferers than average for hospital admittance.
"The NHS Comparators site enabled us to map and plan how we could change from a hospital-based to a community-based service," says Dr Greaves.
Instead of many patients having to go to hospital for urgent care, the services are now coming to them. "We felt the high number of admissions could be avoided if urgent care services were better," said Dr Greaves. "So we agreed with the trust to bring those services here to the practice."
Since January 2008, junior doctors and doctors of registrar level have been based at the practice from 6:30 pm to 10:30pm every evening, including weekends and bank holidays. They see urgent cases, including asthmatics, as well as hospital outpatient follow-ups.
"Any new patient we refer will be seen by the doctors that evening, so we can therefore easily meet the 18 weeks target," says Dr Greaves.
"The patient is presented to the consultant by the junior doctor, who gets apprentice-type training. We are using the doctors who have failed to get onto specialist training posts and therefore they will have a better CV for when they reapply next year."
OTHER PRODUCTS FROM THE NHS IC
The NHS Information Centre's work is sufficiently diverse to make the task of summarising all its product range challenging. By visiting The NHS Information Centre's website - www.ic.nhs.uk - you can find out more details about:
Health poverty index - The health poverty index can show the factors that influence health inequalities in a local area. www.hpi.org.uk
Neighbour Statistics Service - This helps trusts narrow the gap between neighbourhood deprivation levels. www.ic.nhs.uk/statistics-and-data-collections/population-and-geography/neighbourhood-statistics
National child measurement programme - This is one of the biggest studies of its kind in the world and measure the weight of children in reception class and year six and can be used to support local public health initiatives. www.icweb.nhs.uk/ncmp/
National clinical audits support programme - This gives clinicians reliable information to help them review their own performance and identify areas for improvement. www.ic.nhs.uk/statistics-and-data-collections/audits-and-performance/national-clinical-audits
Hospital episode statistics - HES contains records of all patients admitted to NHS hospitals in England and helps organisations identify national trends. www.hesonline.nhs.uk
Health Survey for England - This gives an annual snap-shot of the nation's health. www.ic.nhs.uk/statistics-and-data-collections/health-and-lifestyles-related-surveys/health-survey-for-england
The Compendium of Clinical and Health Indicators - This enables users to find out how their area is performing against 250 indicators of public health. www.nchod.nhs.uk
Digital mapping data - This service enables users to identify health inequalities, record changes to patient catchment areas, carry out epidemiological analysis and target services to clinical hotspots. www.ic.nhs.uk/statistics-and-data-collections/population-and-geography/nhs-mapping-pilot
The Quality and Outcomes Framework database enables users to compare GP practices against each other and national averages www.ic.nhs.uk/pubs/qof0607
The NHS Information Centre has produced a pull-out poster with this supplement that details resources available to support each stage of the commissioning cycle.