PCTs working with foundation Trusts SUS Update

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PCTs working with foundation TrustsSUS Update

• Stockport 19th February 2007

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PbR in 07/08
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Transition to an on-line service

• SUS PbR was designed as an on-line service
• Initial user assurance has proved the basic
  extracts
• November 06 upgrade gave users extended ability
  to choose from a wide range of fields for
  inclusion in extracts
• Early adopters work just commencing
• Roll-out to all will take place in 07/08, but
  will be subject to delivery of additional
  capacity planned for Q1 07/08

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Issues

• Need to improve access to extracts
• Need for a wider range of extracts
• All attributes
• Episode view
• Prime Recipient
• Change view
• Extended open spell
• These added at 2006-B but not QAd

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New Revised Extracts

• Commissioner extracts for responsible and
  resident population
• Episode v. Episode in spell view
• Derivations for extended open spells (will not be
  costed)

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New Revised Extracts
Commissioner PCT of residence Recipient
Provider Sender
Spell
Episode Standard
Flex Freeze Monthly Current Change
Non-dominant Commissioner
Extended Extract
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Constraints

• Very large number of extracts now available
• Need to prioritise QA process

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PbR Reconciliation Processes
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Background

• Moves to make SUS authoritative
• Need to improve payment processes
• Increasing scope of PbR (08/09 onward)

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ReconciliationProcess
SEM
SEM
Managed Service Extracts
2006-BOn-line extracts
Commissioner
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Reconciliationtechniques

• Best at record level
• Look first at subset
• Links by SPELL_ID and GENERATED_RECORD_ID within
  SUS
• Use CDS_UNIQUE_IDENTIFIER where possible to
  compare with local system

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Points to note

• Duplicates because of primary recipient change
  are evident by inconsistent PbR LOS
• Note difference between SEM and PbR
• SEM all episodes within dates
• PbR all episodes in Episodes with Discharge
  date falling in period

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Front end tool
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(No Transcript)
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Supporting data on PbR
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18 week waits

• Extract from brief to BT

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What does the business need?

• Ability to identify risks to 18 weeks
• Retrospective - Cause of 18 week problems
• Pinch points / capacity
• Process problems
• Prospective
• Warning of problems in the pipeline
• Ability to identify actions to avoid breaches
• PTL Priority Treatment List
• Ability to support Commissioners in delivering 18
  weeks

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Critical functionality- Linkage

• Ability to identify patient pathway
• S6 maintains a pathway identifier
• Fundamental to SUS not just 18ww e.g. future
  PbR
• Need to deal with transitional period
  additional linkage will be required
• IG implications

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Critical functionality - Flexibility

• True BI reporting functionality
• Flexible, easily used by non-specialists
• Able to access appropriate comparator for context
• Drill down
• Rapid response

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(Draft) Functional Decomposition
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SUS Practice Based Commissioning (PBC) Update
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Objectives

• To deploy a national, web-based, system for the
  provision of GP comparator and indicator
  information based on existing PbR data
• Accessible down to GP practice
• Providing comparators of commissioning activity,
  referral patterns and outcomes
• Initially data refreshed quarterly

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Timescales

• Release 1 scheduled for delivery in two drops
• First, and main, release will be ready by end of
  March and available to the Service on Monday 2
  April
• Top-up release will be made at the end of April
• Functionality limited to whats achievable in
  these timescales, but additional requirements
  will be captured for later use

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Method of Delivery

• Web-based access
• Summary level information
• Intuitive dash board graphical style
  presentation
• Built-in help and supporting information
• First release accessed through separate web
  portal
• Initially 18 comparators provided

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Functionality - Outpatients

• OP first attendances for source of referral GP
  per 1000 population for the six specialities
  identified for care outside hospital (ENT, trauma
  and orthopaedics, dermatology, urology,
  gynaecology and general surgery)
• Cost for OP first attendances for source of
  referral GP per 1000 population for the six
  specialities identified for care outside hospital
  (ENT, trauma and orthopaedics, dermatology,
  urology, gynaecology and general surgery)
• Total outpatient attendances per 1000 population
• Cost per 1000 population for Outpatients (at PBR
  tariff)

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Functionality Non Elective Admissions

• Non-Elective admissions for 19 ambulatory care
  sensitive
• Cost for Non-Elective admissions for 19
  ambulatory care sensitive
• Cost per 1000 population for Non-Elective
  admission (at PBR tariff)
• Non-Elective Admissions per 1000 population
• Four QOF area admissions per 1000 population
  (CHD, Asthma, COPD, diabetes), 3 of which are
  covered in 5 above.
• Admissions for four QOF area per 1000 population
  (CHD, Asthma, COPD, diabetes)

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Functionality ElectiveAdmissions

• Elective IP Admissions per 1000 population
• Cost for Elective IP Admissions per 1000
  population
• Day case Admissions per 1000 population
• Cost for day case Admissions per 1000 population
• Total elective admissions per 1000 population
• Cost per 1000 population for Elective admission
  (at PBR tariff)
• Admissions for five procedures with evidence of
  overuse / 1000 population
• Costs for five procedures with evidence of
  overuse / 1000 population

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Testing and User Assurance

• Development done through iterative prototyping
  and review
• Key user experts and reviewers have been
  identified
• Workshops planned for end of Feb for initial view
  and assessment
• Testers will be able to access online remotely

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Current Status

• Project is on track
• Good progress being made
• List of Release 1 comparators agreed (as shown on
  the functionality slides)
• Storyboard created
• First version shortly ready for review