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Maternity, Friends and Family Test, Public Health Intelligence, new data
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issuu.com/SECQO
twitter.com/SECSHAQO
www.QualityObservatory.nhs.uk http://www.networks.nhs.uk/nhs-networks/sec-qo
Volume 10 Issue 2 March 2016
Welcome all to another seasonal issue of Knowledge Matters. Easter is a time of rebirth and growth (and also chocolate), and this is no less true for the Quality Observatory. Some of you know that Kate Cheema, one of our long standing stalwarts of team QO, is moving onwards and upwards to new challenges, and as a result the team are taking the opportunity to shuffle around some workloads and give some people new growth opportunities.
Talking of growth we’re keeping ourselves busy at the QO—we’ve been recommissioned by NHS England to carry on with the Friends and Family Test dataset, and our Maternity Dashboard has had a lot of interest, especially in the wake of the recently published National Maternity Review. You can read about all of this inside this issue.
Other delights in this issue include a review of the Public Health Intelligence training provided by Public Health England, that some of the team went on. Nikki has been working closely with some of the Vanguard CCGs which has informed her article on collecting new
data for measurement.
Hope you enjoy this issue of Knowledge Matters. If there’s a burning topic you want to raise, or a piece of work that you want to show off then please let us know and you could contribute to future issues.
Have a relaxing (and chocolate filled) Easter holiday, and we’ll be
with you again in the summer.
Welcome to Knowledge Matters
Inside This Issue :
The South East Maternity Dash-
board
2 Friends and Family Test Contract 8 Public Health Intelligence
Training
11
Collecting New Data for Measure-
ment
6 Patient Insight & Feedback Con-
ference
10 News and updates 12
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info@qualityobservatory.nhs.uk www.QualityObservatory.nhs.uk
Long term readers may well remember the Maternity dashboard that we used to produce when we
were part of the old Strategic Health Authority, it was a big, clunky and colourful beast. It was useful,
but was limited, and severely in need of an overhaul.
The South East Strategic Clinical Network (SCN) thought so too, and have decided to revitalise the old
dashboard and re-build it with a greater focus on outcomes and how it can be used to show the kind of
activity that can be influenced by maternity professionals at a local level.
For many months the SCN went through a process of working through ideas with clinicians and other
senior staff across the Kent, Surrey & Sussex patch deciding what metric were needed, how they’re
going to be collected and how they are to be presented.
One of the disadvantages of the old collection methodology was that it put the entire onus on the trusts to collect the information every month. Whilst it is true that much of this information was being
collected anyway, getting from whatever system it was in then importing it into the dashboard was a labour intensive pro-cess, and not everyone was able to pro-vide everything every month. It was posit-ed that actually much data could be ob-tained by one person doing everything from a central repository of data. Rather helpfully the Royal College of Obstetri-cians and Gynaecologists (RCOG) have come up with a range of maternity indica-tors that they have extracted from HES. https://www.rcog.org.uk/en/guidelines-research-services/audit-quality-improvement/clinical-indicators-project/
The South East Maternity Dashboard
By Adam C. Cook, Specialist Analyst
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info@qualityobservatory.nhs.uk www.QualityObservatory.nhs.uk
We have taken these as the core indicators for our new dashboard, and RCOG have supplied their
methodology so that we could recreate their work. This means that not only can we update the majori-
ty of the data monthly, but it only takes one person to do it, and every organisation can be updated. It
also means that we can also use the national data as a
comparator.
The other advantage that the RCOG indicators have is
that they have a standard nationally agreed definition,
and therefore data is replicable and comparable be-
tween organisations. We recognise that local organisa-
tions may operate to slightly different definitions on
some indicators – however it was decided that coming
to a consensus around some of these may well be diffi-
cult and time-consuming, so skipping that step and us-
ing nationally agreed data has enabled to project to
move on at a quicker pace. A detailed definition page is
included in the website.
The issue with HES data for maternity is that many
people feel that is doesn’t accurately reflect
the data that is held within local maternity
systems. This is obviously an issue that
needs to be addressed if maternity profes-
sionals feel that they need to be able to trust
the system To this end we have built in a ca-
pability whereby they can add in their own
data for all metrics and this will generate
comparator charts between their data and
the centrally extracted data. This will provide
hard evidence of what differences there are
and what steps need to be taken to address these issues, so that data quality is something that can be
relied upon.
Having a separate data collection is also useful because there are a number of indicators that cannot
be reproduced by centrally collated information systems, and we have to be reliant upon the trusts to
provide this data. We felt that this was important as it gives a more rounded picture of what’s going on
at the trust. Currently this data is submitted direct to the QO on a spreadsheet and we upload this to
the site.
The site is split into different sections. The homepage provides and introduction to the project and has
a maps showing the locations of maternity units across South East Coast – these have clickable icons
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info@qualityobservatory.nhs.uk www.QualityObservatory.nhs.uk
which will provide summary statistics in a pop-out box.
There are two aspects to the site a public facing
part with data that is in the public domain, and a
site that only people who have registered with a
valid NHS e-mail address can see.
The National Maternity review, which has recently
been published (more details in the news pages of
this newsletter) had an emphasis on mothers being
able to access useful information to help decide
where they are going to give birth, or to reassure
them of the quality of care at their local trusts.
The first bit of the public data comes from the pop-
out box accessed from the front page map. This
shows data for the most recent 12 months for the chosen trust and displays an infographic of how
women may expect to deliver should they go to that trust. From this page more a detailed service
overview can be accessed in depth with further infographic. This includes things like induction, as-
sisted labour, Friends and Family test and complaints. Detailed definitions of clinical terms are
linked to from NHS Choices, so that the public can understand the nuances of the terminology.
This data is also available to NHS personnel, however when they login the main dashboard page
becomes visible.
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info@qualityobservatory.nhs.uk www.QualityObservatory.nhs.uk
The main view of this shows all the indicators with a run chart and funnel plot for each one. Trusts
can be selected from a drop down menu at the top of the page.
The HES data is shown by
default on the line chart, but
other lines can be added.
This includes the National
average, the Kent Surrey
and Sussex average and
the equivalent data from the
trusts own maternity sys-
tems. One of the ad-
vantages in this is that trusts
can compare their own data
against HES and use it to
check data quality. This
could be used as the first step on the road to get greater alignment between HES maternity data and
local maternity system data.
Users can see the individual charts in greater detail by clicking on them. This will show a larger view
of the chart, along with three others that are related to that measure. This is to ensure that people
looking at the data are not just looking at activity in isolation, but are thinking of the bigger picture.
Improvement in one area may have a corresponding worsening in another area, so it is always im-
portant to look at these
things together. This view is
available for both run charts
and funnel plots.
Elsewhere on the site there
is section for help and sup-
port. This includes things like
how to interpret the funnel
plots, bug fixes, and user fo-
rums so that experiences
can be shared easily.
If you are interested in hear-
ing more about the maternity
dashboard please contact Adam Cook
adam.cook@qualityobservatory.nhs.uk or you can take a look at public facing side yourself by going to: http://maternitydashboard.secscn.nhs.uk/
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info@qualityobservatory.nhs.uk www.QualityObservatory.nhs.uk
Collecting New Data for Measurement: a few basic rules and suggestions By Nikki Lawford, Specialist Analyst
Although it can sometimes feel as though we are awash with data in the NHS, there will always be
occasions when you need to measure something new, possibly activity or cost related or maybe a
qualitative area such as patient experience. Whether you are an analyst, part of a service re-design team,
a project manager or just someone trying to evidence how effective your work is, there are a few things to
bear in mind before you get started.
Focus your data needs
• Think carefully at the outset what you need to know and the message or story you hope to convey at the
end. Careful thought at this stage can save a lot of frustration and additional time later on!
• Consider the eventual reporting of your data and who the audience will be. For example, are you just
hoping to broadly demonstrate that you have achieved what you set out to do, or will you want to
provide regular feedback along the way to various stakeholders, staff or maybe patients?
• Wherever possible, try to collect exactly and only the data you will need. You need to be sure that all
the essential elements have been covered, however your data is much more likely to be consistent and
accurate, the less you try to collect.
What exactly do you need and not need to know?!
A ‘right first time’ approach
• Identify clearly who should, and should not, be
included in your data collection - think about age groups,
diagnoses, providers, type of patient contact, day/time of
activity etc.
• Although it may change over time, there is likely to be
a core set of metrics that will be needed in order to
demonstrate success. Think about short, medium and long term aims.
• How often will data be collected and reported?
• Who will record your data? Will it be best recorded by front line staff at the point of contact with the
patient, or would it be better to assign someone to collect the information later on? Get agreement early
on from those who will undertake the data collection.
• Once data has been collected ‘on the ground’, agree what will happen to it next - will it be sent on to a
manager, administrator or Business Intelligence contact? If so, how and how often?
• Ensure the complete process is in place prior to starting data collection, otherwise information could get
lost!
Simple categories
• Narrow these down to the really important ones and use ‘other’ for the rest
• Don’t try and capture data for every disease/condition/diagnosis individually - just
the ones where your project aims to show improvement
• For example, if your workstream is focused on respiratory diseases but not
particularly on pneumonia, maybe just give options for Asthma, COPD and Other
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info@qualityobservatory.nhs.uk www.QualityObservatory.nhs.uk
Simple responses
• Try to keep possible answers to yes/no, a rating of 1-5 etc.
• This limits potential differing interpretations of responses and ultimately increases
the likelihood of getting meaningful analysis from your data
• Simplicity is particularly important if you are collecting patient experience data, or
if it will be collected manually and entered electronically later on
• Devise a separate way to handle any comments or anomalies
Test your new data collection procedure!
• Wherever possible, involve a staff member who might typically be asked to
record the information and test it on someone who might be asked to respond
• Make sure everyone involved fully understands what is required
• Check that the broader data collection process works efficiently - in other
words, that all your data ends up where it ultimately needs to be
• Ask a friendly local analyst to check that they can produce something
meaningful from the test data
• And then check it will definitely answer the question you are trying to answer!
Information Governance
Before launching your new data collection process, be sure that it passes all necessary IG scrutiny! You may
need to undertake a Privacy Impact Assessment in advance, or new data sharing agreements may be
needed before data can be shared across organisations.
A note about proxy measures
It may be that you are unable to collect exactly the data needed to tell the story you wish to. If so, consider
using a proxy measure. In other words.... when you can’t measure exactly what you need, measure what
you can. For example, instead of reporting on a specific group of patients, maybe you could use available
data for a pre-defined age group and/or geographical area, with a specified set of co-morbidities, and so on.
It may not give you absolute certainty of the outcome of your project but it might give a reasonable degree of
confidence that you achieved your aims and also evidence any wider ‘knock-on’ effects. It may also be
helpful to use a proxy measure until you have enough of your new data, just to show you are on the right
track.
In summary
• Aim to get it right first time as much as you can
• Keep it focused
• Keep it simple
• Check IG requirements
• Test the process, and.....
... check you are definitely measuring what you need! Re-visit your original aims and double-check. And, if
you can’t measure what you need, measure what you can.
If you would like any further information please do get in touch at info@qualityobservatory.nhs.uk
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info@qualityobservatory.nhs.uk www.QualityObservatory.nhs.uk
The Quality Observatory are delighted to have retained our contract with NHS England for our work around the Friends and Family Test, following a frantic festive season of filling in tender documents and an interview for Rebecca and Kate in Leeds in January. What do we do? Our work falls into 2 main areas: firstly we manage the data processing for all of the collections, dealing with any issues uploading the returns, chasing up missing returns, validating the data and checking out any oddities in the data with providers and finally producing the outputs that get pub-lished on the NHS England website and the data that gets sent to other people for their use e.g NHS Choices.
Secondly we also run the national FFT help desk, dealing with any questions around anything to do with FFT so if you have an FTT related query and email england.friendsandfamilytest@nhs.net or call 0113 824 9494 you'll be speaking to one of our lovely FFT team.
Who are the FFT team? There are 5 of us in the Quality Observatory's FFT team: Rebecca (me) I nominally manage the team but everyone else knows far more about FFT than me! Feel free to contact me though for any FFT related issues or questions or if you want to learn more about what we do: Rebecca.matthews@qualityobservatory.nhs.uk Dani, Becki, Liam and Trishna are the experts in all things FFT related and know all of the many guidance documents inside out. So if you have an FFT question, do contact us on the details above!
Friends and Family Test Contract
By Rebecca Matthews, Specialist Analyst
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info@quailtyobservatory.nhs.uk www.QualityObservatory.nhs.uk
Rebecca and Kiran spent a day in Leeds on 17th March exhibiting
at the Patient Insight and Feedback Conference. The conference
was aimed at NHS staff leading patient insight and experience
work in both provider and commissioning services and provided an opportunity to look at what has
been learned so far from the Friends and Family Test and other sources of patient insight. Speak-
ers at the event included Anu Singh, Director of Patient and Public Participation and Dan Wellings,
Head of Insight and Feedback at NHS England and also included a session with four patient panel
members.
The winners of the FFT awards were also announced at the conference - the full list of winners is available here: https://www.england.nhs.uk/2016/03/fft-awards-patient-feedback/
The Quality Observatory were one of
12 exhibitors at the conference and
we took the opportunity to demo our
Insights platform and Friends and
Family Test Analysis website, as well as running an FFT data drop-in surgery throughout the day,
giving advice on how (and how not) to use your FFT data. We also had time for a quick photo with
Monkey from Monkey Wellbeing!
Patient Insight and Feedback conference
‘It is a capital mistake to theorize before one has data. Insensi-bly one begins to twist facts to suit theories, instead of theories to suit facts.’- Sherlock Holmes
As with so many things, Sherlock understands what the QO is all about; evidence based decision making, based on reliable, and incidentally beautiful, data. It’s a message I’m going to be taking out even wider in my new role as Head of Transfor-mation Analytics for South, Central and West CSU. It’s going to be wrench leaving the QO not least because the very lovely people in it, past and present, have all helped me learn so much. I’ll still be based at QO Towers though, so at least I’ll still get to see everyone’s smiling faces occasionally! The new role will be a challenge, not least with the current expectation of the NHS delivering huge savings, but there is no question that my time at the QO will have given me the very best possi-ble preparation for it. I look forward to being merely a contrib-utor to Knowledge Matters and seeing the QO team continue to go from strength to strength.
Goobye from Kate...
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info@qualityobservatory.nhs.uk www.QualityObservatory.nhs.uk
Public Health Intelligence Training by Becki Ehren
A couple of us at the Quality Observatory were invited to attend a pilot course put on by Public Health
England to provide training on public health intelligence. The course ran over 5 days, each covering a
different topic ranging from the background of public health and the role of PHE, Epidemiology, health
inequalities, health patterns and displaying the information (to name a few).
The training provided a great insight into where
the information comes from, how it is analysed
and what it is used for. One of my particular
favourite parts was the section on Epidemiology
and how Field Epidemiologists are vital in helping
counties and organisations to minimise the
negative impact on people’s lives during an event.
This part of the course also covered how it is so
important to consider the wording and imagery
that is used when data is published because
everyone interprets things differently. For
instance, the media will often use the term
‘epidemic’ to get a better reaction and to create better headlines, however this is the same as referring to
something as a cluster or an outbreak, which I think we can agree doesn’t sound half as dramatic as an
epidemic! The course also covered how it is really important to remember that how you use infographics
is very important due to the sensitivity of some subjects, and also to remember that whilst we may view
an image one way, a member of the public who does not have an analytical background may see it
completely differently.
It was great to meet people who work in various
roles that use public health data – some of who
worked in completely different backgrounds, so I
found it really useful to hear their view on some of
the data that is published. Attendees varied from
analysts, council workers, NHS staff, insurance
advisers and many others. Some of the training
that we covered involved looking at different types
of graphs and thinking about how even the
smallest change such as the colour of a line can
have a huge impact on how the target audience
receives the information.
One of the most useful tools that we were shown is
‘Fingertips’ by PHE. It’s great for looking through specific data in order to compare local areas against the
England average. You can change the way the data is displayed through various charts and graphs, and
the tool allows you to select additional comparatives to look deeper into the data. If you are interested,
the link to the site is http://fingertips.phe.org.uk/
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info@qualityobservatory.nhs.uk www.QualityObservatory.nhs.uk
CAS
The Central Alerting System (CAS) is a web-based cascading system for issuing patient safety alerts, important public health messages and other safety critical information and guidance to the NHS and others, including independent providers of health and social care.
Alerts currently available include safety alerts, CMO messages, drug alerts, missing patient alerts and medical device alerts.
We currently provide the service for the South and South West regions, with Devon and Cornwall being our most served areas. Alerts are sent to a number of service providers including GP practices, pharmacies, dental practices, substance abuse clinics and more.
Further information can be found here:
https://www.cas.dh.gov.uk/Home.aspx
CAMHS Modelling Tool
The CAMHS Strategic Modelling Tool has been created to help plan and improve the commissioning and delivery of Children and Adolescent Mental Health Services.
The scope for the model is across health, education, third sector and local authority services.
The tool is designed to enable a ‘whole system’ view of CAMHS in an area, regardless of the commissioning / funding route and the setting and provider of the service. Providers can enter a variety of figures into the tool and be provided with information such as how to optimise patient appointments based on waiting time, staffing cost estimates, yearly commission activity estimates and more.
Further information can be found here - http://www.scwcsu.nhs.uk/about-camhs
National Maternity Review
This review by Baroness Julia Cumberlege was releasesd in February of 2016. It says that:
”Maternity services in England must become safer, more personalised, kinder, professional and more family-friendly. “
Hopefully the South East Maternity dashboard goes some way to helping these ideals become reality. To read more about the report go to: https://www.england.nhs.uk/2016/02/maternity-review-2/ Or you can download it from: https://www.england.nhs.uk/wp-content/uploads/2016/02/national-maternity-review-report.pdf
Birthdays Showing the kind of remarkable efficiency for which the QO is known Aleksandra and Charlene had their birthday on the same day in February. Here there are enjoying traditional QO Birthday goodies!
QO Latest Projects NEWS
Knowledge matters is the newsletter of the NHS Quality Observatory. To discuss any items raised in this publication, for further information or to be added to our distribution list, please contact us.
Hosted by: South Central and West Commissioning Support Unit
E-mail: info@qualityobservatory.nhs.uk
To contact a team member: firstname.surname@qualityobservatory.nhs.uk
We're here to say goodbye to Kate, and wish her well in her endeavour,
We'll miss her when she is gone, and collectively be less clever.
She's Wrestled with performance, and sent returns away,
And she's made up targets for C-Diff and MRSA.
She's been the leading light of the Safety Ther-mometer,
The spreadsheets and the website they just could not beat her.
Her advice has been relied upon in matters quite statistical,
Always true, and thoughtful, and never egotistical.
Thanks to Kate for her good humour and her sense of fun,
And her sense of perspective in getting the job done.
We'll see her round the office, she's not going far away,
So will still enjoy her company, just not every day.
Good luck to her in your her job, we know that she'll be great,
We send her off with all our love, goodbye, and good luck to Kate.
In above grid-shading puzzle, each square is ei-ther black or white. One of the black squares has already been filled. Each row or column is labelled with a string of numbers. The numbers indicate the length of all consecutive runs of black squares, and are displayed in the order that the runs appear in that line. For example, a label "1 2 3" indi-cates sets of one, two and three black squares, each of which will have at least one white square separating them. The final image, when scanned will reveal a hid-den message. Good luck!
An Easter
Puzzle
For Kate
Recommended