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PCTs working with foundation TrustsSUS Update
Stockport 19th February 2007
PbR in 07/08
Transition to an on-line service
• SUS PbR was designed as an on-line service• Initial user assurance has proved the basic
extracts• November 06 upgrade gave users extended
ability to choose from a wide range of fields for inclusion in extracts
• Early adopters work just commencing• Roll-out to all will take place in 07/08, but will be
subject to delivery of additional capacity planned for Q1 07/08
Issues
• Need to improve access to extracts
• Need for a wider range of extracts– All attributes– Episode view– Prime Recipient– Change view– Extended open spell
• These added at 2006-B but not QA’d
Provider
Sender
Commissioner
PCT of residence
Recipient
Episode Standard
Spell
Non-dominant Commissioner
Extended ExtractFlex
Freeze
Monthly
Current
Change
New & Revised Extracts
Constraints
• Very large number of extracts now available
• Need to prioritise QA process
PbR Reconciliation Processes
Background
• Moves to make SUS “authoritative”
• Need to improve payment processes
• Increasing scope of PbR (08/09 onward)
ReconciliationProcess
Local System
Managed Service Extracts
2006-BOn-line extracts
Provider
Managed Service Extracts
2006-BOn-line extracts
Commissioner
SEM SEM
Front end tool
Supporting data on PbR
18 week waits
Extract from brief to BT
What does the business need?
• Ability to identify risks to 18 weeks• Retrospective - Cause of 18 week problems
– Pinch points / capacity– Process problems
• Prospective – Warning of problems in the pipeline– Ability to identify actions to avoid breaches– …PTL = Priority Treatment List
• Ability to support Commissioners in delivering 18 weeks
Critical functionality- Linkage
• Ability to identify patient pathway• S6 maintains a pathway identifier
– Fundamental to SUS not just 18ww – e.g. future PbR
• Need to deal with transitional period – additional linkage will be required
• IG implications
Critical functionality
- Flexibility
• True BI reporting functionality• Flexible, easily used by non-specialists• Able to access appropriate comparator
for context• Drill down• Rapid response
(Draft) Functional Decomposition
Release 3R
18 Week waits
Processing
Derived Data
Linkage Algorithm
RetrospectiveReporting
MonitoringFuture Waits
(PTL)
ProspectiveReporting
Replace currentTactical Reporting
Comparators and Benchmarking
Data QualityReporting
MonitoringPast Waits
(RTT)
Drill down toidentify outliers
Activity byDimensions
Allocate to Patient Pathways
Maintain StandardPatient Pathways
Activity byDimensions
Drill down toidentify outliers
Comparators and Benchmarking
PTL
ChangesIn PTL
Release 3R
18 Week waits
Processing
Derived Data
Linkage Algorithm
RetrospectiveReporting
MonitoringFuture Waits
(PTL)
ProspectiveReporting
Replace currentTactical Reporting
Comparators and Benchmarking
Data QualityReporting
MonitoringPast Waits
(RTT)
Drill down toidentify outliers
Activity byDimensions
Allocate to Patient Pathways
Maintain StandardPatient Pathways
Activity byDimensions
Drill down toidentify outliers
Comparators and Benchmarking
PTL
ChangesIn PTL
SUS Practice Based Commissioning (PBC)
Update
Objectives
• To deploy a national, web-based, system for the provision of GP comparator and indicator information based on existing PbR data
• Accessible down to GP practice• Providing comparators of commissioning activity,
referral patterns and outcomes• Initially data refreshed quarterly
Timescales
• Release 1 scheduled for delivery in two drops• First, and main, release will be ready by end of
March and available to the Service on Monday 2 April
• ‘Top-up’ release will be made at the end of April• Functionality limited to what’s achievable in
these timescales, but additional requirements will be captured for later use
Method of Delivery
• Web-based access• Summary level information• Intuitive ‘dash board’ graphical style presentation• Built-in help and supporting information• First release accessed through separate web
portal• Initially 18 comparators provided
Functionality - Outpatients
1. OP first attendances for source of referral = GP per 1000 population for the six specialities identified for care outside hospital (ENT, trauma and orthopaedics, dermatology, urology, gynaecology and general surgery)
2. Cost for OP first attendances for source of referral = GP per 1000 population for the six specialities identified for care outside hospital (ENT, trauma and orthopaedics, dermatology, urology, gynaecology and general surgery)
3. Total outpatient attendances per 1000 population
4. Cost per 1000 population for Outpatients (at PBR tariff)
Functionality – Non Elective Admissions
5. Non-Elective admissions for 19 ambulatory care sensitive
6. Cost for Non-Elective admissions for 19 ambulatory care sensitive
7. Cost per 1000 population for Non-Elective admission (at PBR tariff)
8. Non-Elective Admissions per 1000 population
9. Four QOF area admissions per 1000 population (CHD, Asthma, COPD, diabetes), 3 of which are covered in 5 above.
10. Admissions for four QOF area per 1000 population (CHD, Asthma, COPD, diabetes)
Functionality – ElectiveAdmissions
11. Elective IP Admissions per 1000 population
12. Cost for Elective IP Admissions per 1000 population
13. Day case Admissions per 1000 population
14. Cost for day case Admissions per 1000 population
15. Total elective admissions per 1000 population
16. Cost per 1000 population for Elective admission (at PBR tariff)
17. Admissions for five procedures with evidence of overuse / 1000 population
18. Costs for five procedures with evidence of overuse / 1000 population
Testing and User Assurance
• Development done through iterative prototyping and review
• Key user experts and reviewers have been identified
• Workshops planned for end of Feb for initial view and assessment
• Testers will be able to access online remotely
Current Status
• Project is on track• Good progress being made• List of Release 1 comparators agreed (as shown
on the functionality slides)• Storyboard created• First version shortly ready for review
