Strategic Plans

1. Strategic Plans

2. Analysis in Joint Commissioning Cycle Analysis key part of commissioning cycle. Analysis sets out thinking, reasoning, decisions for rest of plan. Without robust analysis rest of plan will be weak and lack credibility. Good information allows partnerships to analyse effectively and sets basis for rest of plan.

3. Patient level data linking Health and social care linked data at patient/client level has a number of benefits. Total resource across total population, segment of population, by deprivation category, high resource cohorts. Who uses joint services, does level of social care make a difference to hospital admissions? Follow cohort through time to see if change to service/care pathway is having desired effect.

4. Alcohol and Drug Define substance misuse cohort. Use data from criminal justice and ADP services to augment data Prevalence and population characteristics Size and distribution of spend. Comparative to non substance misuse population. Follow as service is redesigned.

5. Breakdown of costs Non-substance misuse: Substance misuse:

7. Anticipatory Care Plans Health resource of 120 patients given ACPs. 2009/10 – 2012/13 583 A and E attendances (£60,000) 1345 outpatient appointments (£170,000) 6743 days in hospital (£2m) 31,455 Dispensed items (£311,000) Follow this cohort and non ACP cohort to analysis impact of ACPs.

8. Health and Social Care by SIMD65+ cost per capita

9. Dementia Define dementia cohort - from GP LTC register. Prevalence and population characteristics What health and social resources do dementia patients use? Comparative to non dementia population Forecast future demand as a result of demographic pressure Assist with planning and evaluating services redesign

10. Cost Attributable to Dementia

11. NHS Board X– individual level analysis • Inpatient services at maximum capacity • Requirement to understand current utilisation of services. Who? how old? how often? how long? Why? • Exploratory work – acute and community activity (SMR01 and SMR01E linkage), length of stay analysis, admissions, allocated bed day analysis, available beds, forecasting. • Granular analysis - study cohort of long stay patients • 400 acute inpatients - linked to length of stay information (acute, community, outwith HB treatment, total bed days) • Categorised by partnership (CHP), age band, admission type • Linked to delayed discharge, SPARRA, other local information info not on SMRs • Benefits of linked individual level data - understanding full hospital pathway, delayed discharge prevention, informed decisions

12. Service Utilisation Analysis Results • Explorative analysis of acute bed days in 2011/12 by partnership indicates a potential saving of 40 acute beds if occupied bed days consistent for all residents. This is due to a marked divergence in acute length of stay between the two partnership groups. • A study cohort of long stay patient showed that Partnership A used 35% more bed days than partnership B with the associated number of stays only 2% higher. • Community Hospital stay linked to delayed discharge - 50% of study cohort with a stay in a community hospital were recorded as having a delayed discharge. Less than 1 % who only had an acute hospital stay resulted in a delay. • 60% of partnership A residents with a community element to their stay also had a delayed discharge episode, this compares to 30% for partnership B residents. • IRF mapping for 2010/11 shows partnership A 75+ per capita spend approximately 30% higher for emergency acute inpatients than partnership B.

13. For more information on Integrated Resource Framework (IRF) and patient/client level data linking contact: Andrew Leeandrew.lee6@nhs.net0131 275 7594. Ishbel Robertson ishbel.robertson@nhs.net 0141 282 2276. Christine McGregor Christine.McGregor@scotland.gsi.gov.uk0131 244 3394 or 07867 375242.