Presented by Julian Denney, Assistant Chief Executive

1. Presented by Julian Denney, Assistant Chief Executive NHSI strategy : Driving innovation by example

2. Presentation Overview NHSI Overview Current Information based products - BCBV Strategy Going Forward

3. Our mission • The NHS Institute for Innovation and Improvement supports the NHS to transform healthcare for patients and the public by rapidly developing and spreading new ways of working, new technology and world class leadership.

4. The Case for Improvement • The NHS is improving; • Improved mortality from CHD and Cancer • Faster access to A&E, GP, Outpatients and Surgery • Improved patient satisfaction • It bears comparison with most other health care systems; • But it needs to improve a lot more because • There is wide variation in clinical practice • Evidence that care is not as safe as it could be • Costs of care are rising in a manner which is unsustainable • Patient experience is still not satisfactory

5. The NHS Institute: Scope Learning Leadership Development Priority programmes that help drive the NHS reform agenda Product and technological Innovation (NIC) Service Improvement

6. Our priorities • Safer Care • Delivering Quality and Value • Care Outside Hospital • No Delays • Building Capability for a self improving NHS • Learning • Leadership • Service Transformation • Exploiting Innovation - National Innovation Centre (NIC)

7. Presentation Overview NHSI Overview Current Information based products - BCBV Strategy Going Forward

8. The challenge facing the NHS is improving clinical and service quality while controlling costs…….. • NHS providers and commissioners operate in an environment where : • Frontline clinical services use 80% of NHS resources • Productivity & efficiency varies widely • A focus on access related targets has meant less concern about delivering VFM • Achieving financial balance is a challenge • A Payment by Results system that is beginning to highlight where costs exceed income • There is relatively poor benchmark information to help inform decision making To help the NHS meet this challenge : Clear benchmarks to guide performance analysis, comparison and best practice NHS Better Care, Better Value Indicators Sustainable solutions to improve performance of core clinical processes High Volume Care

9. The NHS Better Care, Better Value Indicators help the NHS know where to look……. Clear high level performance comparison Opportunity scaling …and what to focus on by using the Indicator Explorer….. Breakdown by specialty

10. NHS Indicators – Clinical AHT • Reduced variation in length of stay ( bed days saved) • Day case rate for Audit Commission basket for 25 procedures • Reduction in wasted bed days as a result of admission prior • to operation • Admission rates for selected procedures where thresholds for • surgery vary • Reduction of avoidable emergency admissions against • 19 recognised diagnoses • Referral rate standardised - first Outpatient appointment • Proportion of statin prescriptions that are low cost AHT AHT PCT PCT PCT PCT

11. Reduce wasted bed days

12. Procedure thresholds

13. Productivity Opportunity Indicator Changes between Q1 06/07 and Q1 07/08

14. Low cost statin Indicator Changes between Q1 06/07 and Q1 07/08

15. Low cost statin Indicator Changes by SHA between Q1 06/07 and Q1 07/08

16. Better Care, Better Value Indicators Feedback 87% PCT and Trust Board /clinical Directors awareness The “productivity opportunity” illustrated by the indicators, was seen as a key element in raising interest and incentivising organisations. PCTs had a lower level of knowledge about the BCBVIs. It was suggested that in PCTs, BCBVIs and other data could be promoted as a lever for change through commissioning.

17. T I M E T A B L E

18. Presentation Overview NHSI Overview Current Information based products - BCBV Strategy Going Forward

19. Our Strategy:Information Tools and Services • “Some is not a number, soon is not a time” (Institute for healthcare improvement: Don Berwick) • We see good quality information as absolutely critical part of improvement – we have done so since the NHSI Institute was founded and will continue to do so in the future. Therefore, where appropriate our products will have an information component. • However – we are an improvement and innovation organisation – not an information organisation . Our information strategy is derived from improvement and innovation imperatives rather than the other way round

20. Our Strategy:NHS Partners • DH are our sponsors , so our approach to information strategy is developed with them • We’re at the early stages of building a partnership with the NHS Information Centre. We see our role as complementary: we provide tools and techniques to interpret information produced by the NHSIC to support innovation and improvement in the NHS. • We have a partnership with Connecting for Health , with a senior manager seconded to them

21. Our Strategy:Private Sector Role • We are a commissioning organisation and will continue to be one • We value the pace, responsiveness and good market understanding that the private sector can bring • The private sector have given us expertise , innovation and customer impact • We would like to see a more plural market so that we get a wider range of credible tenders for our work in future