Right Care Atlas of Variation in Healthcare - Children and Young People


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For the first time, variations across the breadth of child health services provided by NHS England are presented together to allow clinicians, commissioners and service users to identify priority areas for improving outcome, quality and productivity.

This presentation is by Dr Ronny Cheung, Atlas editor and Paediatric SpR St Thomas' Hospital, London

Published in: Health & Medicine, Education
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Right Care Atlas of Variation in Healthcare - Children and Young People

  1. 1. NHS Atlas of Variation in Healthcarefor Children and Young PeopleMarch 2012Dr Ronny CheungEditor, Child Health Atlas Copyright 2011 Right Care
  2. 2. Why variation matters • For Children & Families • Equity of access • Quality of care • Appropriateness of care • Improved outcomes • For the NHS • Inefficiency • Poor value from limited resources2
  3. 3. 3
  4. 4. Unwarranted variation “Variation that cannot be explained by patient illness or preference” Prof J Wennberg, Dartmouth Atlas of Variation4
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  7. 7. Categories Indicator Maps Resources 1. Expenditure on community child health Health promotion & 2-4: Immunisation rates Disease prevention 5: Breastfeeding Neonatal care 6. Perinatal mortality 7. Retinopathy of prematurity testing 8. Admission rates of full term infant 9. Readmissions of newborns Disorders of blood 10. Sickle Cell disease admissions Endocrine, metabolic and nutritional 11-12. Diabetes: HbA1c<10% & DKA rates Mental health 13. Inpatient admissions for mental health Learning Disability 14. Rates of children with SEN Neurological problems 15-16. Epilepsy: emergency admission & LOS Hearing 17. Newborn screening 18. Grommet insertion rates Respiratory 19. Asthma: emergency admissions 20-21. Bronchiolitis: admissions & LOS 22. Tonsillectomy rates Gastrointestinal 23. Endoscopy rates 24. Inflammatory bowel disease: admissions Genitourinary system 25. Orchidopexy performed by age 2yrs Emergency care 26. A&E attendance rates under 4yrs End-of-Life care 27. Deaths in hospital for children with life-limiting conditions7
  8. 8. Diabetes: Diabetic ketoacidosis rate Percentage of children 0-15yrs with previously diagnosed diabetes admitted to hospital for DKA 2009-2010 Threefold variation8
  9. 9. Epilepsy: Emergency admission rate for children with epilepsy per population aged 0-17yrs 2007/8-2009/10 Over fourfold variation9
  10. 10. Asthma: Emergency admission rate for children with asthma per population aged 0-17yrs 2007/8-2009/10 Nearly fivefold variation10
  11. 11. Perinatal mortality rate per all births 2007-9 Twofold variation11
  12. 12. Percentage of children with statement of special educational needs in primary school children in state-funded schools, by LA at Jan 2011 Sixfold variation12
  13. 13. Tackling variations • Key questions • Is the variation warranted or unwarranted? • If unwarranted, what are the causes? • What can we do to address the causes? • Key steps • Tackle high priority areas • Commissioning for value • System-based approach • Clinical leadership • Clinical networks13
  14. 14. About ChiMat ChiMat provides information and intelligence which will help you examine and address questions which the NHS Atlas of Variation in Healthcare for Children and Young People may raise for your local area. For example, ChiMat’s Disease Management Information Toolkit (DMIT) allows PCTs to compare their emergency admission rates, bed-days and lengths of stay with a range of different comparators for children with asthma, diabetes and epilepsy. It is designed to highlight variations at PCT level and allow benchmarking to inform the commissioning decision-making process for children’s services. Other useful tools include: ChiMat Data Atlas which brings together a range of data and statistics on child and maternal health into one easily accessible hub. Local Authority Child Health Profiles 2012 which provide a snapshot of child health and well-being for each local authority in England using key health indicators, which enables comparison locally, regionally and nationally14
  15. 15. Thank you Follow Right Care online: -Subscribe to get a weekly digest of our blog in your inbox -Receive Occasional eBulletins -Follow us on Twitter @qipprightcare www.rightcare.nhs.uk15