Here is my presentation for an exciting event at King's Fund 26 MARCH 2015 This is the published programme for the day Session one: Opening plenary 9.45am: Welcome and introduction Dr Johnny Marshall, ‎Director of Policy, NHS Confederation 9.55am: Transforming community health care services in London Caroline Alexander, Chief Nurse, NHS England, London Region 10.15am: Panel session: The challenges and opportunities for improving and developing community services Caroline Alexander, Chief Nurse, NHS England, London Region Matthew Winn, Chief Executive, Cambridge Community Services NHS Trust and Chair, NHS Confederation Community Health Services Forum Dr Crystal Oldman, Chief Executive, Queen's Nursing Institute further panelists to be confirmed 10.55am: Questions and discussion 11.10am: Refreshment break and networking Session two: What does good look like? 11.40am: Welcome and introduction Catherine Foot, Assistant Director of Policy, The King’s Fund 11.45am: Regulating community health services Ellen Armistead, Deputy Chief Inspector, Care Quality Commission 12.05pm: How and what should we measure to ensure quality? Christina Walters, Programme Director, Community Indicators Programme Andrew Barber, Technical Consultant, Community Indicators, Outcome Measures and Payment System Development Programme 12.25pm: Questions and discussion 12.40pm: Buffet lunch, networking and exhibition Session three: Good practice breakout sessions Sessions will run from 1.40-2.55pm and delegates will have the choice of: A: Quality assurance: how are you using data locally to measure for quality? 1.40pm: Welcome and introduction 1.45pm: The use of PROMs (Patient Reported Outcome Measures) in a community setting Iain Cockley-Adams, Service Improvement Manager, Gloucestershire Care Services NHS Trust 2.05pm: Over2You Quality Volunteers Ruby Smith, Head of Personalisation, South Yorkshire Housing Association 2.25pm: PROMS in Practice: The Collection Analysis and Reporting of quality of life indicator EQ5D in rehabilitation services in Cambridgeshire Community Services Andrew Bateman PhD, Physiotherapist and Service Manager, Oliver Zangwill Centre for Neuropsychological Rehabilitation, Cambridgeshire Community Services NHS Trust 2.45pm: Questions and discussion B: Working with patients and communities: what are you doing to involve patients and their families and carers and to make your services more person-centred? C: Partnerships and relationships with other parts of the system: how are you building effective local partnerships across health and social care? 2.55pm: Refreshment break and networking Session four: Good practice breakout sessions Sessions will run from 3.15-4.30pm and delegates will have the choice of: D: Supporting and encouraging team working: what are you doing to support team working? E: Working with patients and communities: what are you doing to involve patie

1. Euroqol EQ5D-5L
in community rehab services
Andrew Bateman, NeuroRehab Manager
Oliver Zangwill Centre, Ely UK
Acknowledgements
to Community Rehab Teams,
Data warehouse team, especially Ian Moyes
March 2015
Cambridgeshire Community Services NHS Trust: providing services across Cambridgeshire, Luton, Norfolk, Peterborough and Suffolk

2. Our objectives
• Quality: to be recognised as a provider of
safe and effective services that people
want to use
• Quality: to collaborate with organisations
to improve the care given to people who
use our services
• Sustainability: to be recognised as a
provider of safe and innovative services
that helps commissioners achieve their
outcomes
Cambridgeshire Community Services NHS Trust: providing services across Cambridgeshire, Luton, Norfolk, Peterborough and Suffolk

3. • We will only know if we are
effective and if we are improving
the care given to people if we ask
our service users about their
health and outcomes
• (process measures don’t tell us if
what we do is working)
Cambridgeshire Community Services NHS Trust: providing services across Cambridgeshire, Luton, Norfolk, Peterborough and Suffolk

4. We built a read-coded data capture tool into our Electronic Patient Record

5. Using the EQ-5D-5L Value Sets
• A list of 3127 values is available.
The values are set on a scale
where
• 1 = full health through to
• 0 = death (minus values are
states “worse than death” e.g.
coma or severe intractable pain)
So a Health State 11111 = 1 (Full
health) 55555 = -0.594 (State
worse than death)
• example: 2 3 4 2 1 = 0.516 (or,
roughly, as a percentage of full
health 51.6%)
11111 1.000
11112 0.879
11113 0.848
11114 0.635
11115 0.414
11121 0.837
11122 0.768
11123 0.750
11124 0.537
11125 0.316
11131 0.796
11132 0.740
11133 0.725
11134 0.512
11135 0.291
11141 0.584
11142 0.527
11143 0.513
etc
Slide from Chartered Society Physiotherapy

6. Nochange
Higherindexscores–
improvedselfrating
Increasedawareness
ordeterioration

7. Uses of the data
• 1) At the individual level
• 2) aggregated for a community team
• 3) aggregated across our trust
• 4) health economics

8. OZC “commissioned” © artwork by Lucy Driver
https://www.facebook.com/pages/Lucy-Driver-Illustration/295208450629274
“Using the questionnaire opened the door for me to have a
holistic conversation with my patient” (Community OT)

9. COUNTY WIDE TEAM PRIORITIES
Our patients (n=9148) report severe problems with
40% of our patients report severe/extreme
problems doing their usual activities
14%
20%
24%
8% - 680 people

10. Community Service Outcomes
Our patients (n=4300) report
improvements in all domains
% reporting NO/SLIGHT problems
We can report nearly double (32%->58%)
the number of people endorsing “no/slight
problems” doing their usual activities.
This is the aim of rehabilitation.
45 65
38 59
45 65
62 77
73 82
32 58
before after

12. Conclusions
• There is room for improvement
• We can look at variation across
Cambridgeshire between different services
• …and between different patient groups
• More work to do on data quality, links to
activity, and psychometric/econometric work

13. Thank you and questions
Keep the conversation going on twitter
@ozcboss
Resources at http://www.scoop.it/t/eq-5d
Cambridgeshire Community Services NHS Trust: providing services across Cambridgeshire, Luton, Norfolk, Peterborough and Suffolk