Methods Stethoscope Indicator Metadata...Public Release Methods Analytics Methods Stethoscope Indicator Metadata Domain 1: Preventing people from dying prematurely Public Release Methods

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Methods Stethoscope Indicator Metadata

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Methods Stethoscope CCG Indicator Metadata Website version V1 11

version 1.11 | version date 22 June 2015| printed 22 Jun 2015 22:07

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Stethoscope CCG Indicator Metadata

Version Number 1.12

Version Date 22 June 2015

Publish Status Final

Authors Simon McInerney, Dylan Knight

Owner Methods Analytics

Approved By Simon Swift

Approved Date 22 June 2015

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Document control

Revision History

Date of this revision: 22 June 2015

Revision No

Revision Date Summary of Changes

1.6 13/05/14 Split SHMI Indicator into Poisson limits and IC OD limits

Inserted “Available Drills” and “Available Views” for subscriber view

Split “Reporting Schedule” into Subscriber and Public

Aligned indicator numbering scheme with Stethoscope

Correction to indicator C5.07: OPCS = R18

Updated PROMs indicators (C3.07 and C3.08) to primary procedures only

Updated indicator C1.03 from low risk HRGs to low risk CCS groups

1.7 28/05/14 Updated indicator A4.05 from 95th percentile to percentage under 18 weeks

Updated indicators C2.01 and C2.02 with HSCIC definition for ACSCs

1.8 12/01/15 Aligned mortality indicator C1.03 with CQC IMR definition

Updated emergency admissions to include ADMIMETH = 2A, 2B, 2C, 2D

1.9 16/01/15 Added new indicators C1.09, C3.13 and C1.14

1.10 09/06/15 Added new indicators 0145, 0146, 0147, 0148, 0149, 0150 and renamed C6.01 0415 and moved it to Domain 7

1.11 22/06/15 Updated indicator codes to numbers

0049 indicator name updated to ‘BADS Day Case Rate (including outpatient procedures)’

Added 0106, 01,07, 0108, 0109

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1.12 28/07/2015 Corrected 0046 to reflect use of Elective codes

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Contents

Acknowledgments .......................................................................................................... 7

Domain 1: Preventing people from dying prematurely ................................................... 8

Domain 2: Enhancing the quality of life for people with long term conditions .............. 17

Domain 3: Helping people recover from episodes of ill health or following injury ........ 26

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Domain 4: Ensuring that people have a positive experience of care ........................... 41

Domain 5: Treating and caring for people in a safe environment and protecting them from avoidable harm ....................................................................................... 46

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Domain 6: Organisational Context ............................................................................... 53

Domain 7: Market Share .............................................................................................. 60

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Methods Stethoscope CCG Indicator Metadata Website version V1 12 version 1.9 | version date 16 January 2015 | printed 28 Jul 2015 10:31

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Acknowledgments

In creating Stethoscope, Methods Insight Analytics have accessed a wide range of data sources, the majority of which are publically available. The organisations below represent the sources of data and methodologies used.

National HES data has been used for many of the indicators included in Stethoscope. Data for 2014/15 is provisional. Further information and detailed footnotes are available at www.hscic.gov.uk/hes. Stethoscope also uses published reports from the HSCIC which are available at www.hscic.gov.uk for the NHS to re-use. All data Copyright © 2015, Health and Social Care Information Centre

Stethoscope uses published reports from NHS England which are available at www.england.nhs.uk.

Stethoscope includes data from published DH information

Stethoscope uses methodology employed by HQIP

Workforce data from ESR which is available through iView has been usedin Stethoscope

SPC Methodology published by APHO (now a part of Public Health England) has been used to create some of the statistics.

Stethoscope uses the BADS directory of daycase surgery

Published infection control data available at www.hpa.org.uk has been used in stethoscope

Stethoscope uses published CQC patient survey data

Published national patient safety data from www.npsa.nhs.uk has been used.

Prescribing data from the NHS Business Services Authority has been used within Stethoscope

http://www.hscic.gov.uk/hes

http://www.hscic.gov.uk/

http://www.england.nhs.uk/

http://www.hpa.org.uk/

http://www.npsa.nhs.uk/

http://www.hscic.gov.uk/home

http://www.england.nhs.uk/

http://www.dh.gov.uk/en/index.htm

http://www.google.co.uk/url?sa=i&source=images&cd=&cad=rja&docid=nrB0kA2Vnt94aM&tbnid=DtHrRtPXj8i4iM:&ved=0CAgQjRwwAA&url=http://www.hqip.org.uk/hqip-summit-presentations-now-live/&ei=4jFMUruxHvCQ0QXQ8oHQDw&psig=AFQjCNGGIbtqNnZh72rVO148goi224B6uw&ust=1380811618609628

http://www.google.co.uk/url?sa=i&source=images&cd=&cad=rja&docid=CREAzsJ1p-1tRM&tbnid=kh5nVzYpWcGboM:&ved=0CAgQjRwwAA&url=http://www.ehi.co.uk/news/ehi/8052/electronic-staff-record-up-for-re-tender&ei=VzJMUpboD4XL0QX7_4DwBQ&psig=AFQjCNHVW-EGTmKt6vbmYRMMw9pnbI0T5w&ust=1380811735332839

http://www.google.co.uk/url?sa=i&source=images&cd=&cad=rja&docid=xMZnRaLW6k_qGM&tbnid=TdQMz-A7K7WLlM:&ved=0CAgQjRwwAA&url=https://www.eventbrite.co.uk/event/6974836925&ei=BzNMUrDvHaHG0AXoz4DYCg&psig=AFQjCNG4pc5XqyTgw0b7XsnlNJC0mDmylQ&ust=1380811911542006

http://www.google.co.uk/url?sa=i&source=images&cd=&cad=rja&docid=hWLkrd-OPN-DnM&tbnid=tG4MJQhQNsSH3M:&ved=0CAgQjRwwAA&url=http://www.rcseng.ac.uk/media/images/badsbluelogo/view&ei=KzNMUqDWPOam0AWOx4HwBQ&psig=AFQjCNEO4WyMlaL8qbGTaEjrvLPezaU6GA&ust=1380811948048524

http://www.google.co.uk/url?sa=i&source=images&cd=&cad=rja&docid=3L0qn9CyCZsuCM&tbnid=zbik6tMVHdCmlM:&ved=0CAgQjRwwAA&url=http://www.cambridge-water.co.uk/home/regulators&ei=ojNMUrqCOsWU0AX-qICQCg&psig=AFQjCNEwVjWx__eDvaFb58bZvDIpd1hHlA&ust=1380812067000610

http://www.google.co.uk/url?sa=i&source=images&cd=&cad=rja&docid=XanGHxBVdTX_1M&tbnid=iX9FsBX_8O8o3M:&ved=0CAgQjRwwAA&url=http://www.blueribboncare.org.uk/localoffice/chichester/&ei=0TNMUviZCezw0gWB84DACw&psig=AFQjCNFTxioTQduWsXOfunTgjIoUW-RqRw&ust=1380812113200171

http://www.google.co.uk/url?sa=i&source=images&cd=&cad=rja&docid=RWA53pfOFX__DM&tbnid=35K3JIv7xZUn2M:&ved=0CAgQjRwwAA&url=http://www.cimlondon.co.uk/newsletters/2008_9.htm&ei=_jNMUp2YHaXP0AXFqIDQBA&psig=AFQjCNF1oSkJT56uWWM69kviqivgmEwNqA&ust=1380812158519381

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Domain 1: Preventing people from dying prematurely

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0011: In-hospital mortality in low risk CCS groups (Standardised Mortality Ratio)

Indicator: In-hospital mortality in low risk diagnosis groups (Crude rate per 1,000 admissions)

Numerator: Count of denominator spells with method of discharge as death:

DISMETH = 4

Denominator: Count of Spells with a primary diagnosis associated with a low mortality diagnosis group where the mortality rate has been shown to be consistently below 0.5%. CCS group inclusions:

7, 10, 46, 47, 53, 57, 61, 64, 66, 67, 69, 72, 74, 75, 80, 84, 86, 87, 88, 89, 90,

91, 92, 93, 94, 95, 98, 102, 112, 119, 120, 124, 126, 136, 137, 138, 140, 141, 142,

143, 144, 147, 160, 162, 163, 164, 165, 166, 167, 168, 169, 170, 171, 172, 173, 174,

175, 176, 177, 178, 179, 180, 181, 182, 183, 184, 185, 186, 187, 188, 189, 190, 191,

192, 193, 194, 195, 196, 198, 200, 202, 203, 205, 206, 208, 209, 210, 211, 212, 225,

232, 234, 235, 236, 241, 242, 247, 251, 253, 254, 256, 257, 258

Exclusions:

Exclude spells where admission age is under 19: STARTAGE < 19

Exclude spells where DISDATE = NULL

Exclude spells with Primary diagnosis or Secondary diagnosis = R296 (‘Tendency to fall, not elsewhere classified’) in any position

Exclude spells where primary diagnosis is trauma, cancer, or immunocompromised states, see table below:

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Condition group Primary Diagnosis

Trauma S011, S020, S021, S022, S023, S024, S026, S027, S028, S029,

S030, S052, S053, S054, S055, S057, S058, S059, S060, S062,

S062, S064, S064, S065, S066, S068, S068, S070, S099, S120,

S121, S127, S128, S129, S131, S133, S141, S142, S143, S150,

S152, S153, S157, S158, S159, S179, S220, S222, S223, S224,

S225, S231, S241, S242, S250, S251, S252, S253, S254, S255,

S257, S258, S259, S268, S269, S270, S271, S272, S273, S274,

S278, S278, S279, S320, S321, S323, S324, S325, S328, S331,

S332, S341, S342, S343, S344, S350, S351, S352, S353, S354,

S355, S357, S358, S359, S360, S361, S362, S363, S364, S365,

S366, S368, S369, S370, S371, S372, S376, S378, S379, S380,

S381, S420, S421, S422, S423, S424, S430, S431, S432, S433,

S451, S452, S47, S520, S521, S522, S523, S524, S525, S526,

S528, S529, S531, S552, S570, S579, S580, S581, S620, S621,

S622, S623, S624, S628, S630, S631, S652, S655, S670, S678,

S710, S720, S721, S722, S723, S724, S729, S730, S750, S751,

S752, S772, S789, S810, S820, S821, S822, S824, S825, S826,

S828, S830, S831, S832, S833, S850, S851, S855, S858, S859,

S870, S878, S880, S881, S889, S913, S920, S921, S922, S923,

S929, S930, S931, S933, S951, S958, S959, S970, S971, S978,

S980, T012, T021, T024, T025, T039, T041, T042, T043, T049,

T052, T053, T055, T061, T080, T081, T092, T093, T094, T100,

T101, T114, T116, T120, T121, T131, T142, T143, T145, T147,

T148, T200, T201, T202, T203, T210, T211, T212, T213, T220,

T221, T222, T223, T230, T260, T261, T262, T264, T790, T791,

T792, T793, T794, T795, T796, T797, T798

Cancer B21, C, D46, D47, D48, D00-D09, M724, Z08, Z12, Z511, Z85

Immunocompromised States

B24, B59, D70, D71, D720, D800, D801, D802, D803, D804,

D805, D808, D814, D819, D820, D821, D830, D831, D838, D849,

D898, D899, E40, E41, E43, I120, I131, I132, K912, M359,

N18, T860, T861, T862, T864, T868, T869, Z452, Z491, Z940,

Z941, Z942, Z944, Z948, Z992

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Method: Deaths per 1,000 spells

Data Source: SUS

Funnel Plot Rule: Square Root Method

Availability: Public and subscription

Reporting Schedule (Public): RY Quarterly

Reporting Schedule (Subscriber): RY Monthly

Available Subscriber Drill-downs: GP, Trust, Specialty, Age Group, Sex, CCS Group, Weekend/Weekend, Pathway

Available Subscriber Views: Map

0012: In-hospital perinatal mortality, including still births (Crude rate per 1,000 births)

Indicator: Number of deaths within 7 days of birth / Total number of births

Numerator: Include all records from denominator and restrict to:

DISMETH = 5 or

DISMETH = 4 and ENDAGE = 7001, 7002

Denominator: All HES Inpatient records satisfying the following criteria:

HRG_3.5 = N01 – N05 or

SUS generated HRG = PB01Z, PB02Z, PB03Z

Method: Crude rate per 1,000 births

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Data Source: HES (Admited Patient Care)

Funnel Plot Rule: Poisson Distribution




Available Subscriber Drill-downs: GP, Trust, Weekend/Weekend


0264: Summary Hospital-level Mortality Indicator (HED - SHMI) (IC OD Control Limits)

Indicator: Observed elective & emergency mortality rate / Expected elective and emergency mortality rate

Method: Published method of calculation on IC website

www.hscic.gov.uk/SHMI

Data Source: HES (Admitted Patient Care) / ONS

Funnel Plot Rule: Over dispersion control limits




Available Subscriber Drill-downs: Specialty, Age Group, Sex, CCS Group, Weekend/Weekend, Pathway


http://www.hscic.gov.uk/SHMI

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0265: Summary Hospital-level Mortality Indicator (HED - SHMI) (Poisson Control Limits)


Method: Published method of calculation on IC website

www.hscic.gov.uk/SHMI

Data Source: HES (Admitted Patient Care) / ONS


Availability: Subscription only

Reporting Schedule (Public): N/A




0268: Hospital Standardised Mortality Ratio (HSMR)


Method: Published method of calculation by Dr Foster, data provided by UHB

http://drfosterintelligence.co.uk/wp-content/uploads/2011/10/HSMR-Toolkit-Version-6-October-2011.pdf

Data Source: HES (Admitted Patient Care)

http://www.hscic.gov.uk/SHMI

http://drfosterintelligence.co.uk/wp-content/uploads/2011/10/HSMR-Toolkit-Version-6-October-2011.pdf

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Reporting Schedule: RY Monthly






Available Subscriber Views: Map, VLAD

0013: In-hospital mortality rate for Cardiovascular / Respiratory / Liver disease in under 75 year olds (Crude rate per 1,000 admissions)

Indicator: Number of deaths in the <75 for Cardiovascular, Respiratory or Liver disease / Number of < 75 admissions


DISMETH = 4


STARTAGE <75 OR STARTAGE >7000

Cardiovascular Disease: ICD-10 Codes: DIAG1 = I00 - I99

Respiratory Disease: ICD-10 Codes: DIAG1 = J00 – J99

Liver Disease: ICD-10 Codes: DIAG1 = K70 – K77, B15 – B19, C22, T864

Exclude records where DISDATE = NULL

Method: Crude rate per 1,000 admissions

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Available Subscriber Drill-downs: GP, Trust


0014: Emergency admissions for alcohol related liver disease (Directly Standardised Rate per 100,000 population)

Indicator: Number of emergncy admissions for alcohol related conditions / CCG population

Numerator: All HES Inpatient records satisfying the following criteria:

ADMIMETH = 21, 22, 23, 24, 28, 2A, 2B, 2C, 2D

EPISTAT = 1, 3

SEX = 1, 2

EPIORDER = 1

ADMISOURCE is not 51, 52 or 53

CLASSPAT = 1

Alcohol related admissions: DIAG1 = K70

Denominator: CCG population based on patients registered with the constituent GP practices

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Method: Directly standardised rate by age and sex per 100,000 population – based on CCG level count of patients registered with the constituent GP Practices

Data Source: HES





Available Subscriber Drill-downs: GP, Trust, Specialty, Age Group, Sex, CCS Group, Weekend/Weekend, Pathway


0015: In-hospital mortality rate (Crude rate per 1,000 admissions)

Indicator: Number of discharges coded as deaths / Number of admissions


DISMETH = 4 or 5

Denominator: Include all records where:

Exclude records where DISMETH = NULL


CLASSPAT = 1 or 2

Method: Crude rate per 1,000 admissions

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Available Subscriber Drill-downs: Trust, GP, Specialty, Age Group, Sex, CCS Group, Weekday/Weekend, Pathway


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Domain 2: Enhancing the quality of life for people with long term conditions

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0024: Emergency admissions for acute Ambulatory Care Sensitive Conditions (Directly Standardised Rate per 100,000 population)

Indicator: Number of patients admited in an emergency for acute ambulatory care sensitive conditions / CCG population


EPIORDER = 1

STARTAGE BETWEEN 0 AND 120 OR STARTAGE >=7000

ADMIMETH = 21, 22, 23, 24, 28, 2A, 2B, 2C, 2D

EPISTAT = 1, 3

SEX = 1, 2

ADMISORC NOT IN (51,52,53)

EPITYPE = 1

CLASSPAT = 1

SPELDUR IS NOT NULL

Any acute ACS condition in the following list:

DIAG1 IN ('J10', 'J11', 'J13', 'J14', 'A36', 'A37', 'B05', 'B06', 'B26','J153',

'J154', 'J157', 'J159', 'J168', 'J181', 'J188', 'B161', 'B169', 'M014') AND DIAG2 -

DIAG14 <> 'D57'

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DIAG1 IN ('I240','I248','I249') AND OPERTN1 - OPERTN14 ('A', 'B', 'C', 'D', 'E', 'F',

'G', 'H', 'I', 'J', 'K', 'L', 'M', 'N', 'O', 'P', 'Q', 'R', 'S', 'T', 'V', 'W') AND

OPERTN1 - OPERTN14 NOT IN ('X0','X1','X2','X4','X5')

DIAG1 IN ('E86','K52','A04','A08','A09','A020','A059','A072')

DIAG1 IN ('N10','N11','N12','N136','N159','N390','N300','N308','N309')

DIAG1 IN ('K20', 'K21', 'K250', 'K251', 'K252', 'K254', 'K255', 'K256', 'K260',

'K261', 'K262', 'K264', 'K265', 'K266', 'K270', 'K271', 'K272', 'K274', 'K275',

'K276', 'K280', 'K281', 'K282', 'K284', 'K285', 'K286')

DIAG1 IN ('L03','L04','L88','L01','L02','L080','L088','L089','L980','I891') AND

OPERTN1 - OPERTN14 NOT IN ('A', 'B', 'C', 'D', 'E', 'F', 'G', 'H', 'I', 'J', 'K', 'L',

'M', 'N', 'O', 'P', 'Q', 'R', 'T', 'V', 'W', 'X0', 'X1', 'X2', 'X4', 'X5', 'S1', 'S2',

'S3', 'S41', 'S42', 'S43', 'S44', 'S45', 'S48', 'S49')

DIAG1 IN ('H66','H67','J02','J03','J06','J312','J040')

DIAG1 IN ('K02','K03','K04','K05','K06','K08','K12','K13','A690','K098','K099')

DIAG1 IN ('R56','O15','G253')






Reporting Schedule (Public): Quarterly

Reporting Schedule (Subscriber): Monthly

Available Subscriber Drill-downs: GP, Trust, Specialty, Age Group, Sex, Weekend/Weekend, ACS Condition

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0025: Emergency admissions for chonic Ambulatory Care Sensitive Conditions (Directly Standardised Rate per 100,000 population)

Indicator: Number of patients admited in an emergency for chonic ambulatory care sensitive conditions / CCG population


EPIORDER = '1'

STARTAGE BETWEEN 0 AND 120 OR STARTAGE >=7000

ADMIMETH = 21, 22, 23, 24, 28, 2A, 2B, 2C, 2D

EPISTAT = 1, 2

SEX = 1, 2

ADMISORC NOT IN (51,52,53)

EPITYPE = 1

CLASSPAT = 1

SPELDUR IS NOT NULL

Any chonic ACS condition in the following list:

DIAG1 IN ('B180','B181') AND DIAG2 - DIAG14 <> 'D57'

DIAG1 IN ('J45','J46')

DIAG1 IN ('I50','J81')

DIAG1 IN ('I110','I130') AND OPERTN1 - OPERTN14 NOT IN ('K0', 'K1', 'K2', 'K3', 'K4',

'K50', 'K52', 'K55', 'K56', 'K57', 'K60', 'K61', 'K66', 'K67', 'K68', 'K69', 'K71')

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DIAG1 IN ('E10','E11','E12','E13','E14')

DIAG1 IN ('J41','J42','J43','J44','J47')

DIAG1 = 'J20' AND DIAG2 – DIAG14 IN ('J41','J42','J43','J44','J47')

DIAG1 IN ('I20','I25') AND OPERTN1 NOT IN ('A', 'B', 'C', 'D', 'E', 'F', 'G', 'H',

'I', 'J', 'K', 'L', 'M', 'N', 'O', 'P', 'Q', 'R', 'S', 'T', 'V', 'W', 'X0', 'X1',

'X2', 'X4', 'X5')

DIAG1 IN ('D51','D52','D501','D508','D509')

DIAG1 IN ('I10','I119') AND OPERTN1 - OPERTN14 NOT IN ('K0', 'K1', 'K2', 'K3', 'K4',

'K50', 'K52', 'K55', 'K56', 'K57', 'K60', 'K61', 'K66', 'K67', 'K68', 'K69', 'K71')

DIAG1 IN ('G40','G41','F00','F01','F02','F03','I48')








Available Subscriber Drill-downs: GP, Trust, Specialty, Age Group, Sex, Weekend/Weekend, ACS Condition


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0026: Emergency admissions for patients age 65 and over with Dementia (Directly Standardised Rate per 100,000 population)

Indicator: Number of admissions for patients aged over 65 years old with any coding of Dementia in any secondary position / CCG population


STARTAGE >= 65 AND STARTAGE < 7000

ADMIMETH = 21, 22, 23, 24, 28, 2A, 2B, 2C, 2D

EPIORDER= 1

CLASSPAT = 1, 2

Exclude records where SPELLDUR is NULL

Dementia ICD-10 codes: F00, F01, F02, F03, F05, R54, G20, G30 present in DIAG2 – DIAG14

Denominator: CCG population based on patients aged over 65 years old registered with the constituent GP practices







Available Subscriber Drill-downs: GP, Trust, Specialty, Age Group, Sex, CCS Group, Weekend/Weekend


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0027: Emergency admissions for asthma, diabetes and epilepsy in under 19 year olds (Directly Standardised Rate per 100,000 population)

Indicator: Number of emergency admissions in under 19 year olds for asthma, diabetes and epilepsy / CCG population


STARTAGE <19 OR STARTAGE >7000

ADMIMETH = 21, 22, 23, 24, 28, 2A, 2B, 2C, 2D

EPIORDER = 1

Asthma ICD-10 codes DIAG1 = J45, J46

Diabetes ICD-10 codes DIAG1 = E10 – E14

Epilepsy ICD-10 codes DIAG1 = G40, G41

Denominator: CCG population based on patients aged under 19 years old registered with the constituent GP practices


Indicator Definition: HSCIC Indicator Portal:

https://indicators.ic.nhs.uk/download/Outcomes%20Framework/Specification/NHSOF_2.3.ii_I00671_S_V8.pdf






https://indicators.ic.nhs.uk/download/Outcomes%20Framework/Specification/NHSOF_2.3.ii_I00671_S_V8.pdf

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0028: Diabetes admissions with complications (Directly Standardised Rate per 100,000 population)

Indicator: Number of admissions with diabetes complications / CCG population


STARTAGE >17 AND STARTAGE <7000

ADMIMETH = 21, 22, 23, 24, 28, 2A, 2B, 2C, 2D

EPISTAT = 1, 3

SEX = 1, 2

CLASSPAT = 1

EPIORDER = 1

Diabetes Complications = E10.0 - E10.8, E11.0 - E11.8, E12.0 - E12.8, E13.0 - E13.8, E14.0 - E14.8



Data Source: HES



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Available Subscriber Drill-downs: GP, Trust, Specialty, Age Group, Sex, Weekend/Weekend


0029: Admissions for patients age 65 and over for or with a fall (Directly Standardised Rate per 100,000 population)

Indicator: Number of patients aged over 65 years old admitted with or for a fall / CCG Population


ADMIMETH = 21, 22, 23, 24, 28, 2A, 2B, 2C, 2D

SEX = 1, 2

CLASSPAT = 1

EPIORDER = 1

Fall ICD-10: W00 – W19 present in DIAG1 – DIAG14

Denominator: CCG population based on patients over 65 years old registered with the constituent GP practices


Data Source: HES



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Domain 3: Helping people recover from episodes of ill health or following injury

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0041: Emergency re-admissions: Percentage within 30 days of an elective admission

Indicator: Number of emergency re-admissions within 30 days of discharge / Number of discharges following an elective admission

Numerator: Count of re-admissions where PSEUDOHESID can be matched and when DISDATE of the discharge episode and ADMIDATE of the admission episode are within 30 days. Note: may include a small number of inter-provider transfers. Readmissions other than to the same trust are attributed to the discharging organisation (the trust that created the first spell in a series)

Admission episode inclusions:

ADMIMETH = 21, 22, 23, 24, 28, 2A, 2B, 2C, 2D

CLASSPAT = 1

EPIORDER = 1

Admission episode exclusions:

TRETSPEF = 700 - 715, 501, 560, 610

DIAG1 = O, C, D0, D1, D2, D3, D4, F, Z08, Z51.1, Z51.2, Z51.3, Z51.5

Denominator: Discharge episode inclusions:

ADMIMETH = 11, 12, 13

CLASSPAT = 1

Discharge episode exclusions:

DISMETH = 4,

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DISDATE = NULL

TRETSPEF = 700 - 715, 501, 560, 610


Method: Percentage








0042: Emergency re-admissions: Percentage within 2 days of an elective admission




ADMIMETH = 21, 22, 23, 24, 28, 2A, 2B, 2C, 2D

CLASSPAT = 1

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EPIORDER = 1


TRETSPEF = 700 - 715, 501, 560, 610



ADMIMETH = 11, 12, 13

CLASSPAT = 1


DISMETH = 4,

DISDATE = NULL

TRETSPEF = 700 - 715, 501, 560, 610


Method: Percentage








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0043: Emergency re-admissions: Percentage within 30 days of a non-elective admission




ADMIMETH = 21, 22, 23, 24, 28, 2A, 2B, 2C, 2D

CLASSPAT = 1

EPIORDER = 1


TRETSPEF = 700 - 715, 501, 560, 610



ADMIMETH = 21, 22, 23, 24, 28, 2A, 2B, 2C, 2D

CLASSPAT = 1


DISMETH = 4,

DISDATE = NULL

TRETSPEF = 700 - 715, 501, 560, 610

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Method: Percentage








0044: Emergency re-admissions: Percentage within 2 days of a non-elective admission




ADMIMETH = 21, 22, 23, 24, 28, 2A, 2B, 2C, 2D

CLASSPAT = 1

EPIORDER = 1


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TRETSPEF = 700 - 715, 501, 560, 610



ADMIMETH = 21, 22, 23, 24, 28, 2A, 2B, 2C, 2D

CLASSPAT = 1


DISMETH = 4,

DISDATE = NULL

TRETSPEF = 700 - 715, 501, 560, 610


Method: Percentage


Reporting Schedule: Monthly







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0045: Emergency admissions (Directly Standardised Rate per 100,000 population)

Indicator: Number of emergency admissions / CCG population


ADMIMETH = 21, 22, 23, 24, 28, 2A, 2B, 2C, 2D

EPIORDER = 1

SEX = 1, 2

CLASSPAT = 1, 2



Data Source: HES







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0046: Elective admissions (Directly Standardised Rate per 100,000 population)

Indicator: Number of emergency admissions / CCG population


ADMIMETH = 11, 12, 13

EPIORDER = 1

SEX = 1, 2

CLASSPAT = 1, 2



Data Source: HES







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0047: Patient Reported Outcome Measures for primary hip replacement (Adjusted average health gain)

Indicator: Case-mix adjusted average health gain for primary hip procedures using the Oxford Hip Score

Method: The Oxford hip score is a joint-specific outcome measure tools designed to assess symptoms and function in patients undergoing joint replacement surgery. The case-mix adjusted average health gain score is used, with 0 indicating the worst possible and 48 indicating the highest possible score.

Organisations with a questionnaire count of less than 30 have been highlighted in grey italics. No adjusted results have been calculated for these providers as the underlying statistical methods break down when counts are low.

Data Source: HSCIC

http://www.hscic.gov.uk/proms



Reporting Schedule (Public): Year to date quarterly (switch to next year in November/December update)

Reporting Schedule (Subscriber): Year to date quarterly (switch to next year in November/December update)

Available Subscriber Drill-downs: None


0048: Patient Reported Outcome Measures for primary knee replacement (Adjusted average health gain)

Indicator: Case-mix adjusted average health gain for primary knee procedures using the Oxford Knee Score – will then need to do case-mix adjustment


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Method: The Oxford knee score is a joint-specific outcome measure tools designed to assess symptoms and function in patients undergoing joint replacement surgery. The case-mix adjusted average health gain score is used, with 0 indicating the worst possible and 48 indicating the highest possible score.

Organisations with a questionnaire count of less than 30 have been highlighted in grey italics. No adjusted results have been calculated for these providers as the underlying statistical methods break down when counts are low.

Data Source: HSCIC




Reporting Schedule (Public): Year to date quarterly (switch to next year in November/December update)

Reporting Schedule (Subscriber): Year to date quarterly (switch to next year in November/December update)



0049: BADS Day Case Rate (including outpatient procedures)

Indicator: Number of procedures performed as a daycase / Number of procedures

Numerator: Number of BADS procedures given in denominator performed as a daycase:

CLASSPAT = 2 (day case)

Denominator: ADMIMETH = 11, 12, 13 (Elective admission)

OPCS codes from the BADs handbook 4th Edition


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Funnel Plot Rule: Poisson distribution




Available Subscriber Drill-downs: GP, Trust, Specialty, Age Group, Sex, CCS Group, Weekend/Weekend, BADS Procedure


0050: Fratured Neck of Femur: Percentage operated on within 48 hours

Indicator: Total number of #NOF patients operated on within 48 hours / Total number of #NOF patients operated on


Difference between ADMIDATE and procedure date (OPDTE_NN) < 2

Procedure date (OPDTE_NN) determined by first procedure field OPER_NN (0 < NN <= 5) where OPCS codes in denominator are present.


CLASSPAT = 1, 2

EPISTAT = 3


Primary Diagnosis ICD-10 codes = S72

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Operation codes are filtered at the 5th level - OPSC Codes = W461, W471, W472, W473, W474, W475, W476, W477, W478, W479, W480, W481, W371, W381, W391, W191, W241

Method: Percentage








0051: Outpatient first attendances following GP referral (Directly Standardised Rate per 100,000 population)

Indicator: Number of first out-patient attendances where the referal source is GP / CCG population

Numerator: All HES Outpatient records satisfying the following criteria:

REFSOURCE = 3

SEX = 1, 2

ATENTYPE = 1, 4, 7, 10, 21, 24, 27, 30

DNADATE = NULL


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Data Source: HES (OP)







0052: Proportion of first out-patient appointments which result in discarge

Indicator: Number of first out-patient attendances referred from a GP where the outcome is discharge / Number of first out-patient attendances referred from a GP


OUTCOME = 1


SEX = 1, 2

ATENTYPE = 1, 21

REFSOURCE = 3

Method: Percentage

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0269: A&E Attendances (Directly Standardised Rate per 100,000 population)

Indicator: Number of A&E Attendances / CCG population

Numerator: Count of all HES A&E attendances



Data Source: HES (A&E) and ONS





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0053: A&E Conversion Rate (Percentage admitted following an A&E attendance)

Indicator: Number of A&E Attendances / Number of A&E attendances who are admitted as an inpatient

Numerator: All records from the denominator where:

AEATTENDDISP = 01

Denominator: All HES A&E records satisfying the following criteria:

AEDEPTTYPE = 01

Method: Percentage

Data Source: HES (A&E)







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Domain 4: Ensuring that people have a positive experience of care

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0063: Proportion of people attending A&E who have more than 3 attendances in the last 12 months

Indicator: Number of A&E frequent flyers / Number of patients attending A&E

Numerator: Number of A&E frequent flyers defined by having more than 3 attendences in the rolling year

Denominator: Number of patients attending A&E

Method: Percentage






Available Subscriber Drill-downs: GP, Trust, Age Group, Sex


0064: Diagnostic waits: Percentage of patients waiting over 6 weeks

Indicator: Patients waiting 6 weeks or more for diagnostic tests from the date of request / Number of diagnostic tests

Method: Percentage

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Data Source: NHS England

http://www.england.nhs.uk/statistics/statistical-work-areas/diagnostics-waiting-times-and-activity/





Available Subscriber Drill-downs: Diagnostic Group


0065: Inpatient Referral to Treatment (RTT): Percentage of patients seen within 18 weeks

Indicator: Number of completed admitted pathways (with a known clock start) within 18 weeks / Total number of completed admitted pathways

Numerator: Total number of completed admitted pathways (with a known clock start) within 18 weeks

Denominator: Total number of completed admitted pathways (all)


http://www.england.nhs.uk/statistics/statistical-work-areas/rtt-waiting-times/




http://www.england.nhs.uk/statistics/statistical-work-areas/diagnostics-waiting-times-and-activity/

http://www.england.nhs.uk/statistics/statistical-work-areas/rtt-waiting-times/

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0066: Cancer waits: Percentage with first out-patient appointment within 14 days of GP referral

Numerator: Number of patients seeing a specialist within 14 days after being urgently referred with suspected cancer by their GP

Denominator: Total number of patients seeing a specialist after being urgently referred with suspected cancer by their GP

Method: Percentage


http://www.england.nhs.uk/statistics/statistical-work-areas/cancer-waiting-times/








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0067: Cancer waits: Percentage waiting less than 31 days from diagnosis to first treatment

Numerator: Number of patients starting their first definitive treatment within 31 days of receiving their diagnosis

Denominator: Total number of cancer patients starting their first definitive treatment

Method: Percentage









0068: Cancer waits: Percentage waiting less than 62 days from GP referral to first treatment

Numerator: Number of patients starting their first definitive treatment within 62 days of receiving their diagnosis

Denominator: Total number of cancer patients starting their first definitive treatment

Method: Percentage



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Domain 5: Treating and caring for people in a safe environment and protecting them from avoidable harm

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0080: MRSA bacteraemia (Rate per 1,000,000 population)

Numerator: Number of MRSA infections recorded


Method: Crude rate per 1,000,000 population

Data Source: HPA

http://www.hpa.org.uk/web/HPAweb&Page&HPAwebAutoListName/Page/1191942169773

Views requried Funnel plot, run chart, bar chart








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0081: Clostridium difficile infections (Rate per 100,000 population)

Numerator: Number of Cdiff infections recorded


Method: Crude rate per 100,000 population

Data Source: HPA







0082: MSSA bacteraemia (Rate per 100,000 population)

Numerator: Number of MSSA infections recorded


Method: Crude rate per 100,000 population

Data Source: HPA




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Views requried Funnel plot, run chart, bar chart







0083: Proportion of babies born with a low birth weight (< 2500g)

Indicator: Total number of births where birth weight is less than 2500g / Total number of births


BIRWEIT < 2500


BIRWEIT is not NULL

Method: Percentage

Data source: HES




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Available Subscriber Drill-downs: GP, Trust, Weekday/Weekend


0084: Proportion of births which are premature (< 37 weeks)

Indicator: Total number of births where gestation period is less than 37 weeks / Total number of births


GESTAT1 < 37


GESTAT1 is not NULL

Method: Percentage

Data source: HES







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0085: Proportion of births delivered by elective caesarian section

Indicator: Total number of births where deliver method was elective caesarian section / Total number of births


Elective C-Section: OPCS = R17


HRG_3.5 = N06 - N11 OR SUS generated HRG = NZ01A - NZ01H, NZ02A, NZ02B, NZ03C - NZ03E

Method: Percentage

Data source: HES







0086: Proportion of births delivered by non-elective caesarian section

Indicator: Total number of births where deliver method was non-elective caesarian section / Total number of births


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Non-elective C-Section: OPCS = R18


HRG_3.5 = N06 - N11 OR

SUS generated HRG = NZ01A - NZ01H, NZ02A, NZ02B, NZ03C - NZ03E

Method: Percentage

Data source: HES







0087: Admissions for self harm in under 16 year olds (Rate per 100,000 population)

Indicator: Number of admissions for unintentional and deliberate injuries in under 16 year olds / CCG population


EPISTAT = 1, 3

STARTAGE < 16 OR STARTAGE >= 7000

SEX = 1, 2

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EPIORDER = 1

EPITYPE = 1

ADMISOURCE is not 51, 52 or 53

CLASSPAT = 1

Unintentional and deliberate injuries: DIAG1 = X60 - X84

Denominator: CCG population based on patients under 16 years of age registered with the constituent GP practices


Data source: HES

Reporting Schedule: Quarterly





Available Subscriber Drill-downs: GP, Trust, Sex, Weekday/Weekend


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Domain 6: Organisational Context

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0102: All prescribing Net Ingredient Cost (NIC) per Astro PU (Age Sex Temporary Resident Originated Prescribing Unit)

Numerator: Total Net Ingredient Cost (NIC) for all prescribing

Denominator: Astro PU (Age Sex Temporary Resident Originated Prescribing Unit)

Method: NIC is the basic price of a drug, ie the price listed in Part II Clause 8 of the Drug Tariff (www.ppa.org.uk/ppa/edt_intro.htm)

ASTRO-PU stands for Age, Sex and Temporary Resident Originated Prescribing Units. This weighting is designed to weight individual practice populations for age, sex and temporary residents to allow for better comparison of prescribing patterns. These figures are based on the cost of prescribing across all therapeutic areas. (www.hscic.gov.uk/prescribing/measures)

Data source: NHS Business Services Authority

https://apps.nhsbsa.nhs.uk/infosystems/guestlogin.do?captchaText=hbpfx




Reporting Schedule (Subscriber): Quarterly



http://www.ppa.org.uk/ppa/edt_intro.htm

http://www.hscic.gov.uk/prescribing/measures


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0103: Number of antibacterial items per STAR-PU (Specific Therapeutic Group Age-sex Related Prescribing Unit)

Numerator: Total number of prescription items for antibacterial drugs

Denominator: STAR-PUs (Specific Therapeutic Group Age-sex Related Prescribing Units)

Method: There are differences in the age and sex of patients who are prescribed drugs in specific therapeutic groups, for instance dementia drugs will be represented in older age brackets. STAR-PUs (Specific Therapeutic Group Age-sex weightings Related Prescribing Units) allow you to make comparisons within a specific therapeutic group by taking into account the types of people who will be receiving that treatment. They have been developed along similar lines to the ASTRO-PU but based on costs within therapeutic groups. (www.hscic.gov.uk/prescribing/measures)









0104: Cephalosporins and quinolones prescribed as a percentage of selected antibacterial prescriptions

Numerator: Total number of prescription items for cephalosporins and quinolones

Denominator: Total number of prescription items for selected antibacterial drugs

http://www.hscic.gov.uk/prescribing/measures


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Method: Denominator includes:

o Penicillins (BNF code: 050101)

o Cephalosporins (BNF code: 0501021)

o Tetracyclines (BNF code: 050103)

o Macrolides (BNF code: 050105)

o Sulfonamides And Trimethoprim (BNF code: 050108)

o Metronidazole, Tinidazole & Ornidazole (BNF code: 050111)

o Quinolones (BNF code: 050112)

o Urinary-Tract Infections (BNF code: 050113)










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0105: Proportion of patients attending A&E with no recorded investigation or treatment

Indicator: Number of A&E attendences with no recorded investigation or treatment / Number of A&E attendences

Numerator: Number of A&E attendences where:

HRG = VB11Z, V08

Denominator: Total number of A&E attendences

Method: Rate per 1,000 admissions

Data source: HES





Available Subscriber Drill-downs: GP, Trust


0106: Elective admissions count

Numerator: Count of admissions coded with:

ADMIMETH = 11, 12, 13

EPIORDER = 1

Denominator: N/A

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Method: Count

Data Source: HES (APC)

Funnel Plot Rule: Poisson




Available Subscriber Drill-downs: Age Group, CCS Group, Day of Week, GP, GP Locality, ICD10 Chapter, Sex, Site, Specialty, Trust


0107: Emergency admission count

Numerator: Count of admissions coded with:

ADMIMETH = 21, 22, 23, 24, 28, 2A, 2B, 2C, 2D

EPIORDER = 1

Denominator: N/A

Method: Count

Data Source: HES (APC)




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Available Subscriber Drill-downs: Age Group, CCS Group, Day of Week, GP, GP Locality, ICD10 Chapter, Sex, Site, Specialty, Trust


0108: Outpatient appointment count

Numerator: All HES Outpatient records satisfying the following criteria:

DNADATE = NULL

Denominator: N/A

Method: Count






Available Subscriber Drill-downs: Age Group, Attended, Day of Week, GP, GP Locality, Sex, Site, Specialty, Trust


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0109: A&E and Urgent Care Centre attendance count

Numerator: Count of all A&E attendances

Denominator: N/A

Method: Count






Available Subscriber Drill-downs: Age Group, Day of Week, GP, GP Locality, Sex, Trust


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Domain 7: Market Share

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0415: Proportion of patients admitted to main provider

Indicator: Total number of admissions to main provider / Total number of admissions

Numerator: Main provider identified by the highest number of admissions for patients registered with the constituent GP practices


ADMIMETH = 11, 12, 13, 21, 22, 23, 24, 28, 2A, 2B, 2C, 2D

Method: Percentage

Data source: HES





Available Subscriber Drill-downs: GP, Specialty, Pathway


0145: Total PbR spend for inpatient activity (Pounds)

Indicator: Total PBR_FINAL_TARIFF for all discharged spells

Numerator: Sum of PBR_FINAL_TARIFF for discharged spells

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Denominator: N/A

Method: Count

Data Source: SUS PbR APC Spells

Funnel Plot Rule: N/A




Available Subscriber Drill-downs: Age Group, CCS Group, Day of Week, GP, GP Locality, ICD10 Chapter, Pathway, Sex, Specialty, Site, Trust


0146: Age\Sex standardised PbR spend for inpatient activity (Directly Standardised spend per population) (Pounds)

Indicator: Total PBR_FINAL_TARIFF for all discharged spells / CCG population

Numerator: Sum of PBR_FINAL_TARIFF for discharged s


Method: DSR

Data Source: SUS PbR APC Spells





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Available Subscriber Drill-downs: Age Group, CCS Group, Day of Week, GP, GP Locality, ICD10 Chapter, Pathway, Sex, Specialty, Site, Trust


0147: Total PbR spend for activity in A&E and Urgent Care Centres (Pounds)

Indicator: Total PBR_FINAL_TARIFF for all attendances

Numerator: Sum of PBR_FINAL_TARIFF for attendances

Denominator: N/A

Method: Count

Data Source: SUS PbR A&E





Available Subscriber Drill-downs: Age Group, Day of Week, GP, GP Locality, Sex, Site, Trust


0148: Age\Sex standardised PbR spend for activity in A&E and Urgent Care Centres (Directly Standardised spend per population) (Pounds)

Indicator: Total PBR_FINAL_TARIFF for all attendances / CCG population

Numerator: Sum of PBR_FINAL_TARIFF for attendances

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Method: DSR

Data Source: SUS PbR A&E





Available Subscriber Drill-downs: Age Group, Day of Week, GP, GP Locality, Sex, Site, Trust


0149: Total PbR spend for outpatient activity (Pounds)

Indicator: Total PBR_FINAL_TARIFF for all outpatient attendances

Numerator: Sum of PBR_FINAL_TARIFF for outpatient attendances

Denominator: N/A

Method: Count

Data Source: SUS PbR OP





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Available Subscriber Drill-downs: Age Group, Day of Week, GP, GP Locality, Sex, Specialty, Site, Trust


0150: Age\Sex standardised PbR spend for outpatient activity (Directly Standardised spend per population) (Pounds)

Indicator: Total PBR_FINAL_TARIFF for all outpatient attendances / CCG population

Numerator: Sum of PBR_FINAL_TARIFF for outpatient attendances


Method: DSR

Data Source: SUS PbR OP





Available Subscriber Drill-downs: Age Group, Day of Week, GP, GP Locality, Sex, Specialty, Site, Trust


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