November 2009 presentation ppt 2.94MB

2. Agenda for today

3. General Update � Netta Hollings and Nick Bridges Bulletin Payment by Results Contract Autism ICD-10 Changes Conference on 14th January IAPT Highlighting issues for MHMDS

4. Improving Access to Psychological Therapies (IAPT)

5. Improving Access to Psychological Therapies (IAPT) Data Set Change Notice (DSCN) under development. Planned dates Issue DSCN 31 March 2010 Mandated collection from 01 April 2011 Advanced notification published http://www.connectingforhealth.nhs.uk/dscn/dscn2009/advance/an0509.pdf

6. IAPT cont. Data set undergone definitional testing with providers data dictionary testing professional body review user consultation The views of contributing stakeholders have been considered in making the data set both useful and collectable

7. Data testing � Common themes � Clarification regarding misinterpretation of guidance Changes arose within human behavioural guidance � Data Dictionary definitions needed to be more explicit Each data item has subsequently undergone further review with the Data Dictionary team � Queries arose around outcomes tools and their usage Additional explanation given in human behavioural guidance and outcomes toolkit � Concern that therapist may not be suitably qualified to record diagnosis Further guidance has been developed. IAPT Expert Reference Group to investigate further � Request to supply a standard set of diagnosis codes Most appropriate ICD-10 codes for anxiety & depression have been selected

8. Consultation - examples of outputs Some data items assessed as clinically ambiguous or irrelevant reviewed by the IAPT Expert Reference Group employment status amended referred problem removed Some corrections to align data items with data dictionary Some of the comments asked for an expansion of functionality out of scope at this time

9. IAPT DSCN development Currently in process of developing draft submission to ISB Included in this will be appendices such as: Human behavioural and technical guidance Business requirements Information requirements Outcomes toolkit IAPT clinical record IAPT data standard Collection system options appraisal Outcomes of consultation Outcomes of MDS testing 2006-2008 Definitional testing outcomes Data set issues and action log Implementation plan Data quality and data system quality assurance self assessment

10. IAPT DSCN development cont. A very involved process A lot additional helpful documentation to assist and guide implementation in addition to the DSCN itself ISB site has an Excel file with links to submission documents http://www.isb.nhs.uk/isbsearch/isb-standards/health-and Draft approval is planned for January 2010 Note: This is draft, it may change prior to �full submission� when the final DSCN is issued

11. Highlighting Issues for MHMDS Scope Submissions Changes to dataset Future Intentions

12. Scope High Secure Primary Mental Health EIP Independent Sector

13. Submissions Shortening Timescales Proposed MHMDS submission dates, 2010-2011

14. Changes to dataset PbR for Mental Health Count Me In Refocusing the CPA CPA Abuse Questions Changes to Contacts (including duration and contact medium) for CPA 7 day follow up

15. Changes to dataset Outcome measures HoNOS HoNOS 65+ PHQ-9 EQ-5D Disaggregating the Reviews Table Referral Reviews CPA Reviews Employment Status Accommodation Status CPA Level Discharge

16. Changes to dataset Changes regarding staff Inpatients Mental Health Act Staff Team Reducing Number of tables (?)

17. Future Intentions ACRA Data Quality (especially for people on CPA plus diagnosis and HoNOS) Reducing the burden of data collection New Performance Indicators Audit Commission Benchmarking Club

18. Any questions?

19. MHMDS Update � Jo Simpson and Nick Bridges

23. Review outputs of assembly process:

24. Diagnostic report on IDB tables Diagnostic report: Features: Reports on pre-assembly source data in IDB Current uses - checks Links with MPI table Blank tables (eg MHAC, KWASS) Lack of synch between WARDSTAYS and IPEP Any others?

29. MHMDS Assembler investigation

30. MHMDS Assembler investigation Investigation into functionality of the assembler and usefulness of �diagnostic report.xls� and �report.txt� Opportunity to express views, issues, concerns on assembler and influence redesign of output reports So far consulted with three groups � London, Birmingham and Leeds Please let me know your thoughts Summary of initial findings�..

31. Assembler investigation - so far�. The assembler: Rules and validations Spell creation Table linkages and impact of not linking Reporting period versus use made of �all� data within IDB DNA�s and episode start dates Automatic closing of episodes Definitional issues

32. Assembler investigation - so far�. 2. Report.txt Usefulness of report Interpreting the report Too much repetition of the same error Need to aggregate as error counts ? 3. Diagnostic report.xls Overly long? Only use selected tables? Not using the report at all? Uncertainty as to how to interpret?

33. Future reporting outputs Undecided: Single report ? Pre and post assembly reports ? Decided: Greater description of errors More user friendly More useful in assessing data quality and assembler processing

34. Guidance � now and in future Use what already exists � offer lots of useful guidance and assistance Not yet decided what output of investigation will be - Amendment to existing publications and/or new publication ? A need to describe the step by step assembly process Please get involved�..

35. Contributing to the investigation Session this afternoon Data Quality Guild Discussion forums posted on eSpace Register. Get involved ! http://www.ic.nhs.uk/services/the-data-quality-programme/project-areas/data-quality-guild http://www.espace.connectingforhealth.nhs.uk/ Contact me directly

36. GuildSpace

37. Forums

38. Independent Sector collection of MHMDS

39. Independent Sector collection of MHMDS Standard contract The NHS standard contract covers agreement between PCT�s and providers for the delivery of NHS funded services �Level playing field� for all providers 2009/10 Interim standard contract 2010/11 standard contract operational Planned to be issued mid December following the release of the operating framework

40. Independent Sector collection of MHMDS Data collection and flow Proposed phased in collection � larger providers first From April 2012 all providers collecting and flowing data Discussion underway between some providers and CfH on establishing data flows � N3 must be used Discussions underway regarding some providers becoming N3 aggregators to support smaller providers Guidance developed to specifically support Independent sector � will be placed onto IC web site in near future

43. Indicators� Used by CQC for Periodic Review 2009-10 Completeness of the MHMDS Data quality of ethnic group Patterns of care for MHMDS Numerator (0809 definition) Count of records that fulfill the following criteria: Discharges (mental health) >0 CPA level (at end of reporting period) = 2 End date (mental health care spell) = blank or after the end of snapshot date Occupation (CPA care coordinator) = a valid occupation code Denominator Count of record that fulfill the following criteria: Discharges (mental health) >0 CPA level (at end of reporting period) = 2 End date (mental health care spell) = blank or after the end of snapshot date

57.

58.

60.

61.

62.

63. Afternoon Session Policy change, system change Netta Hollings

64. PSA16 � improving the collection of data on employment and accommodation in Mental Health Minimum Data Set Want to cover 3 things� 1. NIs 143-150 a.k.a. PSA 16 in central govt � socially excluded adults PSA: what it is, why it matters 2. Delivery issues on the ground � the challenges and how HRS helps to overcome them 3. Touch on role of 3rd sector organisations and resilience Key message is: Addressing multiple needs � Securing multiple benefits Want to cover 3 things� 1. NIs 143-150 a.k.a. PSA 16 in central govt � socially excluded adults PSA: what it is, why it matters 2. Delivery issues on the ground � the challenges and how HRS helps to overcome them 3. Touch on role of 3rd sector organisations and resilience Key message is: Addressing multiple needs � Securing multiple benefits

66. Public Service Agreements are the Government�s top delivery priorities - send national policy signal about what matters. 30 new PSAs announced in the Comprehensive Spending Review in October 2007. They are commitments to improve outcomes, e.g. Make communities safer; Promote better health and wellbeing for all. They are based on indicators with regular public reporting and scrutiny and responsibility usually cuts across a number of government departments. PSA 16 = target to improve outcomes for socially excluded adults. Goal is a home and a job - basic components of living - for adults particularly at risk of social exclusion. It is a challenging target - as I�ll go on to explain - and is a priority area for several different government organisations. This is not the sum total of policy interest on social exclusion. There are other PSAs: e.g..PSA 11 to narrow gap in educational achievement for children from low incomes and disadvantaged backgrounds; PSA 17 tackling poverty and promoting greater independence and well being in later life. Plus there is the broader set of programmes and work I mentioned earlier. How will an �adults facing social exclusion� PSA help? Encourage prevention and early intervention, by focusing on transition points when individuals can be helped to avoid long-term exclusion Promote joint working, by setting out a shared cross-Government commitment to tackling exclusion Focus resources, by sending a clear signal that helping these groups is a Government priority Incentivise and drive delivery, through a clear performance management framework for tackling social exclusion amongst adults and for monitoring and managing progress Contribute to the achievement of wider outcomes, for example community cohesion, worklessness, reoffending Save money as the future costs of exclusion are prevented Public Service Agreements are the Government�s top delivery priorities - send national policy signal about what matters. 30 new PSAs announced in the Comprehensive Spending Review in October 2007. They are commitments to improve outcomes, e.g. Make communities safer; Promote better health and wellbeing for all. They are based on indicators with regular public reporting and scrutiny and responsibility usually cuts across a number of government departments. PSA 16 = target to improve outcomes for socially excluded adults. Goal is a home and a job - basic components of living - for adults particularly at risk of social exclusion. It is a challenging target - as I�ll go on to explain - and is a priority area for several different government organisations. This is not the sum total of policy interest on social exclusion. There are other PSAs: e.g..PSA 11 to narrow gap in educational achievement for children from low incomes and disadvantaged backgrounds; PSA 17 tackling poverty and promoting greater independence and well being in later life. Plus there is the broader set of programmes and work I mentioned earlier. How will an �adults facing social exclusion� PSA help? Encourage prevention and early intervention, by focusing on transition points when individuals can be helped to avoid long-term exclusion Promote joint working, by setting out a shared cross-Government commitment to tackling exclusion Focus resources, by sending a clear signal that helping these groups is a Government priority Incentivise and drive delivery, through a clear performance management framework for tackling social exclusion amongst adults and for monitoring and managing progress Contribute to the achievement of wider outcomes, for example community cohesion, worklessness, reoffending Save money as the future costs of exclusion are prevented

67. LUNCH Afternoon session starts 13.45

68. Contact details I�d like to finish with a call to do what you can to help make progress on this � through your day job, through sharing your learning, and helping those of us in national government understand the issues better and help us act accordingly. I�ve also included a couple of websites to find out more about our work and add to the national on-line conversations. So I hope what I�ve said has helped to set out the context and will stimulate ideas and encourage work with socially excluded adults. Addressing multiple needs to secure multiple benefits � challenging but worth it. I�ve included a few questions to prompt discussion but first hand over to� I�d like to finish with a call to do what you can to help make progress on this � through your day job, through sharing your learning, and helping those of us in national government understand the issues better and help us act accordingly. I�ve also included a couple of websites to find out more about our work and add to the national on-line conversations. So I hope what I�ve said has helped to set out the context and will stimulate ideas and encourage work with socially excluded adults. Addressing multiple needs to secure multiple benefits � challenging but worth it. I�ve included a few questions to prompt discussion but first hand over to�

69. MENTAL HEALTH INFORMATION EVENT PSA 16 � IMPROVING DATA COLLECTION DH PERSPECTIVEDAVID DANIELDEPARTMENT OF HEALTHMental Health Division

70. What is collected? Two key items. Both apply to the following target group. Those aged 18 to 69 who are receiving secondary mental health services and who are on the Care Program Approach The employment status: Employed, unemployed, other inc. education or training (or otherwise economically inactive) The accommodation status: Settled or unsettled

71. We�ve covered the �what� and the �why�. Lets address the �How�! There are two key processes � a) counting and monitoring, and b) Improving Performance There is a two way interaction between a) and b) but I want to concentrate on a) here

72. Counting and monitoring Collection is normally at a CPA review. This should be at least once a year and given that most of these users will have severe/complex needs we might expect it to happen more frequently Clinical engagement matters. Not just down to you but you can help!

73. Pass on messages about why employment and accommodation are so important for mental health users. And that central government treats them as one of its top priorities. Does the Cabinet Office have any other PSA than the one on social exclusion?

74. We recognise that IT is a major issue. But the current evidence is that there is no �Silver bullet� or �White Knight� which will suddenly arrive. Most Trusts are NOT relying on CfH software. But two Trusts which use the same software whether CfH or not can have very different performances in terms of data completeness.

75. CONCLUDING MESSAGES Be focussed on encouraging recording and communicate the �Why� and the �How� Share and learn from your colleagues in other Trusts Aim to get really good data for Q4 2009-10 and the whole of 2010-11

76. END David.Daniel@dh.gsi.gov.uk Direct line: 020 7972 4242

77. What next.. Q & A session 13.45 Tea & coffee break Break out session � Implementing changes to datasets and validating data Summary and close

78. And finally�