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Key Health Data Launch 2008 - The Role of the CBSA

Key Health Data Launch 2008 - The Role of the CBSA. September 08. The CBSA . The West Midlands Commissioning Business Support Agency – a contract management unit set up by the 17 West Midlands PCTs. We provide: Information support and advice on contract payments to PCTs.

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Key Health Data Launch 2008 - The Role of the CBSA

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  1. Key Health Data Launch 2008 - The Role of the CBSA September 08

  2. The CBSA • The West Midlands Commissioning Business Support Agency – a contract management unit set up by the 17 West Midlands PCTs. • We provide: • Information support and advice on contract payments to PCTs. • Best practice guidance and benchmarking services. • Advice on contract management issues. • Secure access to up to date acute hospital data for Commissioners. • A single point of contact for Trusts – Their Account Manager – focused on a single Trust, on behalf of all Commissioners.

  3. The CBSA Relationship Manager Analyst Single Trust Focus Contract Manager On behalf of All PCTs

  4. Our data – a few principles • Timely: • Through the requirements of the national acute services contract, hospitals are required to supply fully coded data within 1 month of the month of discharge to be certain of payment for those patients. • High Quality: • As the regional contract management unit, we therefore work with the mostly timely datasets available, and are working continually with providers to improve timeliness and data quality, with significant financial incentives. Each data item is put through a validation process incorporating more than 20 quality checks. • Comprehensive: • A major development in information provision in the region, our data warehouse securely stores all admitted patient care, outpatient and A&E attendances for the last four years, for every patient registered with a West Midlands PCT GP– a considerable data source, and growing every month! • Comparable: • The most up to date comparable data source – records are extracted from the national SUS system as and when they are updated, and made available to users within days of extraction. Single formats and storage models allow effective comparison between Trusts and PCTs.

  5. Applying the data in practice • A network of 30 PCT based Managers and Analysts, actively working with data users and the Acute Hospitals to continuously improve data quality and timeliness. • IAN – An online data reporting tool available free to every PCT and GP practice in the West Midlands. • Risk Stratification – A major project in conjunction with BUPA Health Dialog and NHS West Midlands, developing methods for identifying patients at high risk of hospital admission (and plans for preventative intervention), using hospital data, but also primary care and pharmacy information. • A series of analytical reports produced, looking in depth at different aspects of hospital provision: • Complex Elderly Care • Non-PbR services – differential patterns of charging • Maternity Services • Emergency Admission rates for Ambulatory Care Sensitive Conditions (those for which early intervention in primary care can have a significant impact). • Audit Commission Coding Assurance Indicators.

  6. A sample coding analysis – Complex elderly patients Differences in coding with significant implications – as a consequence of the coding above, Sandwell PCT spends £8m per year more on complex elderly admissions than expected.

  7. Quality and Value for Money - Maternity Services • The Trusts with the highest cost per birth, didn’t necessarily provide the best quality.

  8. Quality Metrics • Originally developed in conjunction with Dr Foster and the West Midlands SHA, to provide a series of quality measures that were useful and statistically robust. • Aimed at helping commissioners place greater emphasis on quality in the services they purchase. • Six Metrics, all incorporated into the 2008/9 hospital contracts in the West Midlands, and monitored monthly: • Excess Bed Days • Ethnicity recording • Day case rates for certain procedures • Days in hospital before an elective procedure • Days in hospital before certain emergency procedures • Readmission rates

  9. Quality Metric Example - Time to Surgery Definition: The proportion of elective admissions operated on within two days for all procedures. Definition: Aggregate rate of emergency admission spells operated on within two days; standardised for the volume of procedures for a specific basket of procedures • Either – Elective patients being brought in early; or • Emergency patients not being operated on as quickly as their condition would require – often a key factor in the patient’s recovery.

  10. Time to Elective Surgery

  11. Time to Surgery – Emergency Procedures

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