Clinical commissioning groups have set themselves ambitious targets to cut avoidable admissions and improve patient experience over the next five years, plans submitted to NHS England reveal.

Reduction of avoidable emergency admissions if targets are met

Reduction of avoidable emergency admissions if targets are met

Reduction of avoidable emergency admissions if targets are met

However, CCGs’ improvement “ambitions” against five key national quality indicators - set out in plans running from this year to April 2019 - would not significantly reduce health inequalities between the most and least deprived areas.

Analysis of planned performance across the indicators, which were set by NHS England, shows CCGs overall are aiming for steeper improvement than has been seen in recent years against all indicators, including the rate of avoidable admissions (see graph, above).

Their aims, if met, would result in reductions by 2018-19 of:

  • 8.3 per cent in negative responses to the hospital inpatient and 15 per cent in negative responses to the GP patient survey;
  • 12 per cent in the rate of emergency hospital admissions that are considered avoidable with good healthcare - equal to about 140,000 fewer each year; and
  • 11 per cent in the annual rate of “life years” lost due to deaths considered preventable by healthcare - about 134,000 life years per annum.

However, analysis shows that even if all CCGs met their goals, a large gap would remain between performance of CCGs with the most deprived populations and that of those with the least.

For life years lost due to healthcare amenable deaths, the average rate in the most deprived fifth of CCGs would still be 38 per cent higher in 2018 than that in the least. The gap in 2013 was 48 per cent.

For avoidable emergency admissions, the difference in the rate between the most and least deprived would be 52 per cent - a slight narrowing from 57 per cent in 2013.

The difference in the rate of negative experience of GP services would drop to 28 per cent, from 30 per cent currently.

NHS England’s patient experience director Neil Churchill spoke to HSJ about CCG intentions to boost patient experience. He said nearly half of inpatients reported at least one important element of their care was poor and improvement was needed to make services “consistently good”.

He said the health service could go “beyond incremental gains” in patient experience by making “transformational changes” to services, such as “building care around the needs” of people with long term conditions, and better supporting carers.

Mr Churchill called for CCGs to do more work on improving experience for vulnerable groups. In relation to the gap between less and more deprived areas, he said: “We have to improve experience for all, but improve most for those who are vulnerable… The gap should be narrowing.”

Bradford City CCG chief officer Helen Hirst said in cases where her CCG believed it could influence improvement, it had decided to “aim for better than average [because] that is what places with more deprivation need”.

However, it had considered “the extent to which we are in control”, and decided some outcomes indicators were not strongly affected by factors within the CCG’s responsibility.

NHS England published the data on its website last week.

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