What is NHS SoTW doing? Predictive modelling 22 September 2009 Working together to make South of Tyne and Wear healthy for you Better health Using your

What is NHS SoTW doing?

Predictive modelling22 September 2009

Working together to make South of Tyne and Wear healthy for you

Better health

Using yourmoney wisely

Excellent patient experience

Vision

Where do we

want to be?Vision & future state

Where will we be

if we do nothing?Predictive model

What do we

need to do to

close the gap?Predictive model

OGIM planning

Predictive Modeling & StrategyWhere are we

now?JSNA etc

Our Vision


Better health



• Better health

• Excellent patient experience

• Using your money wisely

Trends in circulatory disease mortality under 75 years

70

90

110

130

150

170

190

210

230

1993-95 1994-96 1995-97 1996-98 1997-99 1998-00 1999-01 2000-02 2001-03 2002-04 2003-05

Dir

ec

tly

Sta

nd

ard

ise

d R

ate

pe

r 1

00

,00

0 p

op

ula

tio

n

North East Gateshead South Tyneside Sunderland ENGLAND

Trends in circulatory disease mortality under 75 years

70

90

110

130

150

170

190

210

230

1993-95 1994-96 1995-97 1996-98 1997-99 1998-00 1999-01 2000-02 2001-03 2002-04 2003-05

Dir

ec

tly

Sta

nd

ard

ise

d R

ate

pe

r 1

00

,00

0 p

op

ula

tio

n

North East Gateshead South Tyneside Sunderland ENGLAND

Better healthWhere are we now?

Dramatic reduction & narrowing of gap in South Tyneside and Sunderland but not in Gateshead. The gap is still high in all three

areas.

Circulatory disease mortality under 75 years

Better health - future state

PreventionTargets in

partner plans

Reduce inequalities

Reduce risk factors

Secondary prevention

Excellent patient experienceWhere are we now?

Emergency Hospital Admissions per 1000 Population

0

20

40

60

80

100

120

Gateshead South Tyneside Sunderland England Average

Em

erg

en

cy

Ad

ms

sio

ns

pe

r 1

00

0 P

op

ula

tio

n

Emergency Hospital Admissions per 1000 Population

0

20

40

60

80

100

120

Gateshead South Tyneside Sunderland England Average

Em

erg

en

cy

Ad

ms

sio

ns

pe

r 1

00

0 P

op

ula

tio

n

Emergency hospital admission per 1000 population

Excellent patient experience - future state

ChoiceCare close to home

Every contact a health

improvement contact

Public confidence

Self care, personal control

Safe, effective care

Whole systems care

Using your money wiselyWhere are we now?

Emergency admissions for ambulatory care sensitive conditions (usually treatable outside of hospital)

0

500

1000

1500

2000

2500

Gateshead South Tyneside Sunderland North East England

Ad

mis

sio

n r

ate

per

100

,000

po

pu

lati

on


0

500

1000

1500

2000

2500

Gateshead South Tyneside Sunderland North East England

Ad

mis

sio

n r

ate

per

100

,000

po

pu

lati

on


Wise use of money - future state

Value for money

No unnecessary

waits

Fit for purpose estate

Right care, right place, first time

Where will we be if we do nothing?

Forecast reductions in young but significant increases in the very elderly

Without change by 2016 we will need 500 more hospital beds for over 40,000 more admissions, costing £50m

South of Tyne and WearForecast Change in Population Compared to 2006

-25,000

-20,000

-15,000

-10,000

-5,000

0

5,000

10,000

15,000

20,000

25,000

30,000

0-14yrs 15-39yrs 40-64yrs 65-84yrs 85+yrs

2006-2016 2006-2026

-9% -11% -5%

-10%

-0%

-4%

10%

25%

35%78%

Obesity Smoking

Endoflife

Planned care

RehabilitationCVD risk

Urgent care

Alcohol

Mental health

Long term

conditions

Maternity Children

What are we going to do?12 strategic objectives

Obesity

Smoking

Alcohol CVD Risk

MSK Maternity

Urgent care

Children

Mental Health

LTC CVD

Rehab End of Life

Childhood obesity

We will ensure better health by minimising health risks and supporting the adoption of healthy lifestyles

Alcohol-related admission

Smoking in pregnancy

Outcomes How will we know if the things we do get us to where we

want to be?

Smoking in people with a chronic condition

Hypertension control for people with heart disease

We will ensure better health through access to treatments that minimise the impact of risks and improve survival

BreastfeedingAdmissions for conditions treatable outside hospital

We will improve patient experience and use money wisely

Breastfeeding

Modeling the Future – the ‘Bigger Picture’

BreastfeedingPredicted increase in elective demand over the next 10 years ( ≈ 20%)

NHS SoTW CommissioningAll Elective Admissions Modelling

0

20,000

40,000

60,000

80,000

100,000

120,000

140,000

2001/02 2002/03 2003/04 2004/05 2005/06 2006/07 2007/08 2008/09 2009/10 2010/11 2011/12 2012/13 2013/14 2014/15 2015/16 2016/17

Nu

mb

er

of

Ad

mis

sio

ns

Actual Forecast re population changes Forecast re population & other changes 95% CI

Breastfeeding


Predicted increase in non-elective demand over the next 10 years ( ≈ 20%)

NHS SoTW CommissioningAll Non-Elective Admissions Modelling

0

20,000

40,000

60,000

80,000

100,000

120,000

140,000

2001/02 2002/03 2003/04 2004/05 2005/06 2006/07 2007/08 2008/09 2009/10 2010/11 2011/12 2012/13 2013/14 2014/15 2015/16 2016/17

Nu

mb

er

of

ad

mis

sio

ns


Breastfeeding

Total cost of acute activity adjusted for impact of initiatives(2008/09 prices)

£330

£340

£350

£360

£370

£380

£390

2008/09 2009/10 2010/11 2011/12 2012/13

To

tal c

ost

(£m

illio

ns)

No impact Planned impact High impact

Acute costs are expected to rise - if successful more activity shifted to primary care


Healthcare Trends – The Emerging Story

Breastfeeding

Number of Consultations split by Age Cohort

0

1000

2000

3000

4000

5000

6000

7000

8000

0-4

5-9

10-1

4

15-1

9

20-2

4

25-2

9

30-3

4

35-3

9

40-4

4

45-4

9

50-5

4

55-5

9

60-6

4

65-6

9

70-7

4

75-7

9

80-8

585

+

Age Cohort

Nu

mb

er

of

Co

ns

ult

ati

on

s

Number of Consultations per 1,000 list sizesplit by Age Cohort

-

2,000

4,000

6,000

8,000

10,000

12,000

14,000

16,000

18,000

20,000

Age Cohort

Nu

mb

er o

f C

on

sult

atio

ns

per

1,

000

list

size

Increasing consultation demand with increasing age


BreastfeedingIncreasing demand for home visits and telephone contact with age

Number of Consultations by Age and Location

0

1,000

2,000

3,000

4,000

5,000

6,000

7,000

0-4

5-9

10

-14

15

-19

20

-24

25

-29

30

-34

35

-39

40

-44

45

-49

50

-54

55

-59

60

-64

65

-69

70

-74

75

-79

80

-84

85

+

Age

Nu

mb

er o

f C

on

sult

atio

ns

Home Visit Telephone Contact G.P.Surgery


Breastfeeding

Consultations by age and HCP

Population Changes

Breastfeeding

South of Tyne and WearForecast Change in Population Compared to 2006

-25,000

-20,000

-15,000

-10,000

-5,000

0

5,000

10,000

15,000

20,000

25,000

30,000

0-14yrs 15-39yrs 40-64yrs 65-84yrs 85+yrs

2006-2016 2006-2026

-9% -11% -5%

-10%

-0%

-4%

10%

25%

35%78%

ONS forecasts show a significant increase in the elderly over the next 10 and 20 years

Potential Impact on Consultations

Breastfeeding

Predicted % change in number of consultations from 2008 to 2018

0%

1%

2%

3%

4%

5%

6%

7%2

00

8/0

9

20

09

/10

20

10

/11

20

11

/12

20

12

/13

20

13

/14

20

14

/15

20

15

/16

20

16

/17

20

17

/18

Year

% C

ha

ng

e i

n N

um

be

r o

f C

on

su

lati

on

s

Driven by an increase in the elderly, consultations are expected to increase year on year

Potential Impact on Consultations

Breastfeeding

Predicted % change in number of consultations from 2008 to 2018 split by Age Group

-4%

-2%

0%

2%

4%

6%

8%

10%

12%

14%20

08/0

9

2009

/10

2010

/11

2011

/12

2012

/13

2013

/14

2014

/15

2015

/16

2016

/17

2017

/18

% C

han

ge

in N

um

ber

of

Co

nsu

ltat

ion

s

0-19 20-39 40-59 60+

The elderly population are dominating the potential increase in consultations

What picture is our work painting?

Breastfeeding

Increase in elderly

population

Year on year increase in consultations due to population alone

Significant impact on workload, in particular for healthcare professionals that work with the elderly

More home visits and telephone contacts required

Increase in activity from secondary to primary care

Evaluating year 1 of the bigger picture work

Breastfeeding

NHS SoTW CommissioningAll Elective Admissions Modelling

0

20,000

40,000

60,000

80,000

100,000

120,000

140,000

2001/02 2002/03 2003/04 2004/05 2005/06 2006/07 2007/08 2008/09 2009/10 2010/11 2011/12 2012/13 2013/14 2014/15 2015/16 2016/17

Nu

mb

er

of

Ad

mis

sio

ns


NHS SoTW CommissioningAll Non-Elective Admissions Modelling

0

20,000

40,000

60,000

80,000

100,000

120,000

140,000

2001/02 2002/03 2003/04 2004/05 2005/06 2006/07 2007/08 2008/09 2009/10 2010/11 2011/12 2012/13 2013/14 2014/15 2015/16 2016/17

Nu

mb

er

of

ad

mis

sio

ns


Specialty SunTPCT GPCT STPCTElective Total Non-Elective Total

In terms of prediction direction


In terms of prediction accuracy (± 10%)


In terms of prediction accuracy (± 5%)


Breastfeeding

Specialty SunTPCT GPCT STPCT

100 General Surgery 101 Urology 110 Trauma & Orthopaedics 120 ENT 130 Ophthalmology 140 Oral Surgery 145 Oral & Maxillo Facial Surgery

* 140 and 145 300 General Medicine 301 Gastroenterology 302 Endocrinology 303 Clinical Haematology 320 Cardiology 340 Thoracic Medicine 361 Nephrology 400 Neurology 410 Rheumatology 420 Paediatrics 430 Geriatric Medicine 502 Gynaecology 800 Clinical Oncology (Previously Radiotherapy) Other Gen Med and Sub Specialties (300,301,302,303,320,340,361,430)

Total

Ele

ctiv

e



* 140 and 145 180 Accident & Emergency 300 General Medicine 301 Gastroenterology 302 Endocrinology 303 Clinical Haematology 320 Cardiology 340 Thoracic Medicine 361 Nephrology 400 Neurology 410 Rheumatology 420 Paediatrics 430 Geriatric Medicine 502 Gynaecology 800 Clinical Oncology (Previously Radiotherapy) Other Gen Med and Sub Specialties (300,301,302,303,320,340,361,430)

Total

No

n-E

lect

ive

In terms of prediction direction


Breastfeeding

In terms of prediction accuracy (± 10%)Specialty SunTPCT GPCT STPCT


* 140 and 145 300 General Medicine 301 Gastroenterology 302 Endocrinology 303 Clinical Haematology 320 Cardiology 340 Thoracic Medicine 361 Nephrology 400 Neurology 410 Rheumatology 420 Paediatrics 430 Geriatric Medicine 502 Gynaecology 800 Clinical Oncology (Previously Radiotherapy) Other Gen Med and Sub Specialties (300,301,302,303,320,340,361,430)

Total

Ele

ctiv

e



* 140 and 145 180 Accident & Emergency 300 General Medicine 301 Gastroenterology 302 Endocrinology 303 Clinical Haematology 320 Cardiology 340 Thoracic Medicine 361 Nephrology 400 Neurology 410 Rheumatology 420 Paediatrics 430 Geriatric Medicine 502 Gynaecology 800 Clinical Oncology (Previously Radiotherapy) Other Gen Med and Sub Specialties (300,301,302,303,320,340,361,430)

Total

No

n-E

lect

ive

Future plans for predictive modelling work

Breastfeeding

• Extend bigger picture model

Extend by 1 year

Disease prevalence modelling

Incorporate Strategic Plan and QIPP plan initiatives

Workforce modelling

Combining primary care and secondary care

Mental health

Thank you

Contact details

[email protected] 5027172

[email protected] 5027170


Better health



mailto:[email protected]



Documents

What is NHS SoTW doing? Predictive modelling 22 September 2009 Working together to make South of Tyne and Wear healthy for you Better health Using your