QIPP National Urgent Care Clinical Dashboard

“From the outset it has been clear that the dashboard is a powerful tool to help

clinicians understandthe quality and effectiveness of their care, providing an invaluable tool to integrate and proactively manage care across our

local health economy”

Dr Anne Talbot, GP & Associate Medical Director, NHS Bolton

• Provides “real-time” information from local Acute Trust on A&E attendances, admissions and discharges combined with “real-time” information from Out of Hours and the Walk in Centre to each GP Practice.

• Displayed in a graphical, user-friendly way to help Practices to more pro-actively manage and co-ordinate patient’s healthcare, especially for the most vulnerable patients and those with long-term conditions.

• Doesn’t contain any more information than the Practice already receives, but presents the information in a timely way, displaying all of information together to present a more complete picture.

NHS Bolton Urgent Care Dashboard

A&E AttendancesPatient Attendance DatePatientA 01/02/2009PatientF 01/02/2009

PatientJ 02/02/2009PatientM 03/02/2009PatientJ 04/02/2009

PatientK 03/02/2009

AdmissionsPatient Admission DatePatientA 01/02/2009

PatientH 04/02/2009PatientK 08/02/2009

DischargesPatient Discharge DatePatientA 08/02/2009PatientK 08/02/2009

Walk in CentrePatient Attendance DatePatientM 01/02/2009PatientF 01/02/2009PatientJ 02/02/2009PatientM 03/02/2009PatientJ 04/02/2009

PatientK 08/02/2009

PatientK 03/02/2009

Out Of HoursPatient Contact DatePatientT 01/02/2009PatientY 01/02/2009PatientJ 02/02/2009

PatientM 03/02/2009PatientJ 04/02/2009

PatientK 02/02/2009

Practice Disease RegisterPatient RegisterPatientT Diabetes

PatientS CHD

PatientK COPD

Current Position

Information From Acute Trust

Information From Practice

Information received separately from multiple sources

within different time frames – making

identifying patterns difficult

Integration of information from multiple source systems

Patient Attendance DatePatientA 01/02/2009PatientF 01/02/2009

PatientJ 02/02/2009PatientM 03/02/2009PatientJ 04/02/2009

Patient Admission DatePatientA 01/02/2009

PatientH 04/02/2009

Patient Discharge DatePatientA 08/02/2009

Patient Attendance DatePatientM 01/02/2009PatientF 01/02/2009PatientJ 02/02/2009PatientM 03/02/2009PatientJ 04/02/2009

Patient Contact DatePatientT 01/02/2009PatientY 01/02/2009PatientJ 02/02/2009

PatientM 03/02/2009PatientJ 04/02/2009

Practice Disease RegisterPatient RegisterPatientT Diabetes

PatientS CHD

PatientK

Clinical Dashboard:Patient Drilldown - PatientK

Service Attendance Date Register?

PatientK

PatientK PatientK

PatientK

PatientK

PatientK

08/02/2009 03/02/2009

02/02/2009

08/02/2009

08/02/2009

03/02/2009

WiC

OOH

Discharge

Admission

A&EA&E

Admission

A&E

Discharge

OOH

WiC

COPD

COPD

COPD

COPD

COPD

COPD

COPD

Information From Acute Trust

Information From Practice

Integration of information: simple working example

Dashboard interface

Enables GPs, nurses and active case managers to monitor their own patients' recent attendances at A&E and out-of-hours services, and to highlight which of these patients are on disease registers.

1st stage patient level drill down

GPs, nurses and active case managers are able to access individual patient information including the care setting the patient presented at, frequency of contact and whether the patients is on a disease registers.

This information can highlight issues with the local delivery of care for specific types of disease management, providing pointers about where to focus local improvement efforts most effectively

2nd stage patient level drill down

Enables GPs, nurses and active case managers to see a more granular level of patient information including the symptoms the patient presented with and the outcomes.

Such information can greatly assist pro-active clinical intervention for patients with multiple presentations to unscheduled care settings. In particular, this level of information can help GPs and other healthcare staff to identify those patients in need of detailed Primary Care assessments, to then review existing management plans, and to establish new levels of care or assistance where this is needed.

Identifying patients regularly accessing unscheduled care services

This report shows urgent contacts, sorted in order by highest number of contacts. This enables practices to identify and focus on those patients that are regularly accessing unscheduled services.

Quality Benefits• Improved awareness about practice patients attending unscheduled care

services, enabled GPs and Practice Healthcare staff to proactively and better manage vulnerable patients and those ‘just below the clinical radar’

• The dashboard was used as an enabler and integrated alongside related initiatives to better channelling patient pathways and improving patient experience

Efficiency Benefits • Within the first pilot practices in Bolton, one practice reduced their A&E

attendance by 16.8%, compared to an increase of 3.85% in their peer practices. A second practice reduced their non-elective admissions in targeted areas of asthma, COPD, diabetes, falls and heart failure by 20.69%.

• Use of the dashboard combined with wider ‘joined-up’ initiatives and excellent clinical engagement across the PCT helped led to significant reductions in A&E attendances and non-elective admissions.

Benefits and levels of use

The Urgent Care Dashboard is now part of the QIPP Urgent Care workstream led by Sir John Oldham.

QIPP National Urgent Care Clinical Dashboard

High level aim - to make the Urgent Care Clinical dashboard (based on the NHS Bolton dashboard) available to all PCTs /GP Consortia across England over the next 2 years, starting with 12 locally led pioneer sites.

NHS Stoke on Trent and NHS North Staffordshire

NHS Devon

NHS TeesNE Lincolnshire Care Trust Plus / NHS North Lincolnshire / North Lincolnshire & Goole Hospitals NHS Foundation Trust

NHS Northamptonshire

NHS Cambridgeshire

NHS Oxfordshire

Central London Healthcare Pathfinder GP Consortium Newham Health Partnership / Newham Commissioning Group

South Cheshire and Vale Royal GP Commissioning Consortiums NHS Central Lancashire

NHS Brighton and Hove

QIPP Urgent Care dashboard - Pioneer Sites

Wider objectives• Inform the strategy and approach to the wider ‘local’

take-up of the Urgent Care dashboard• Development of Local SHA/PCT Cluster/GP Consortia

capability to become self-sufficient in supporting local deployment

• To create a toolkit to support wider take-up of the Urgent Care dashboard including Standards, Logical architecture, data feeds library, detailed design documentation, project management artifacts and updates to metrics repository

QIPP National Urgent Care Clinical Dashboard

Further information & contact

Resources NHS Networks - http://www.networks.nhs.uk/nhs-networks/qipp-urgent-care-gp-dashboard

Further informationBackground Information http://www.dh.gov.uk/en/Publicationsandstatistics/Bulletins/Medicaldirectorsbulletin/DH_122289DH QIPPhttp://www.dh.gov.uk/en/Healthcare/Qualityandproductivity/QIPP/index.htmNHS Institute for Innovation and Improvement http://www.institute.nhs.uk/cost_and_quality/qipp/cost_and_quality_homepage.htmlNHS Evidence http://www.evidence.nhs.uk/qualityandproductivityDetails relating to National Pilot (including case studies and toolkit) http://www.cfh.nhs.uk/clindash

Contacts Team Mailbox – clinical.dashboard@nhs.net